MEDICA_®

Patient Choice Insights^SM by Medica

Patient Choice Insights features a unique open access “tiered” network in which health care providers compete for patients based on value. Each year providers in the network — including primary care physicians, specialists and hospitals — are analyzed on cost, efficiency and quality measures and then ranked into three tiers. The lower the tier, the better they have performed on the measures. Members are free to access any provider in the network — in any tier. No referrals. Those who obtain services from network providers that are in a lower tier are rewarded through greater overall value and lower copayments and/or coinsurance.

Plan Highlights

You choose:

• Which physician, specialist or hospital is right for you from our vast network of physician locations and in-network hospitals
• When to see a specialist — no referrals needed

You get:

• The highest level of coverage when you go to a provider in a lower number tier
• Coverage for preventive care, mental health care, prescription drugs and emergency care
• In-network coverage at the tier 2 level if you receive care from any of more than 400,000 UnitedHealthcare Options PPO providers when you travel
• Our extensive information and tools, via our online member service center
• Customer Service by telephone, toll-free
• Access to registered nurses, 24 hours a day, to answer your medical questions
• Depending on the programs your employer offers, you may have access to Medica programs that can help you establish healthy habits, identify and manage your health risks, and make your health care the best it can be

Network Information

Each year providers in the Patient Choice network may be reassigned to a new tier. New tier assignments become effective January 1st. Because a provider's tier can affect members out-of-pocket costs, it is important to verify a provider's tier assignment prior to receiving services.


Find a Doctor

Search our Find a Doctor database to find a provider, or find out the tier assignment of your current provider.


Resources

• Patient Choice Insights by Medica Hospital Guide and Facility Pricing Catalog: View actual cost information for services delivered at hospitals and other health care facilities in the metro area.
  
  
• Patient Choice Insights by Medica for Members

Pharmacy

Search the Medica list of preferred drugs (formulary) to find out if your prescriptions are included or to look for generic alternatives to your existing prescriptions.

Customer Service
Questions? Please contact your human resources representative, or Medica customer service at 952-945-8000 or 1-800-952-3455.


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