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My Coverage

For Medica MinnesotaCare (MNCare) Members

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Looking for a quick overview of your plan benefits?

Here’s a summary of your plan benefits.

  • Gym membership at 800+ locations in Minnesota (16,000 nationwide)
  • Large network of doctors, clinics, hospitals, and other health care providers
  • Access to primary or specialty care without a referral
  • $0 rides for children and pregnant women to medical, dental, mental health, and substance use disorder visits

For a complete record of your plan benefits and any plan notices, see your plan documents.

Plan Features

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Mental Health and Substance Use Disorder Care

Get information and support on many mental health and wellness issues ranging from relationships and parenting to stress and depression. Visit the Live and Work Well website to get helpful tips, use online tools, search for mental health clinicians, view your behavioral/ mental health claims and more. 


Visit Live and Work Well

 


Self Care by AbleTo mobile app for on-demand help with stress, anxiety and depression that uses clinically validated techniques such as cognitive behavioral therapy (CBT). The app provides coping tools, daily mood tracking, guided journeys and weekly progress check-ins to stay engaged and manage symptoms.

Download from the Apple App Store or Google Play.

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Dental

Your plan includes dental coverage, which is managed by Delta Dental® of Minnesota. Delta Dental can help you:

  • Find a dentist
  • Understand your dental benefits
  • With dental claims
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Eyewear

Your plan covers a new pair of eyeglasses when medically necessary from Medica eyewear vendor Eye-Kraft®. Please see the eye care section of your Member Handbook for more information. Choose your eyewear from the catalog below.


Eyewear frame catalog (PDF)

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Language Resources

Medica will contact an interpreter to provide help over the phone. Medica will also provide interpreters for your medical, dental, pharmacy, and mental health and substance use disorder appointments at no cost to you. To request an interpreter, call Medica Member Services.

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$0 fitness program with gym membership

Members 18 and older are eligible for our fitness program through One Pass™ for a $0 annual fee.

Includes:

  • Gym membership at 16,000 locations nationwide with access to exercise equipment, group exercise classes and other gym amenities
  • More than 20,000 on-demand and live-streaming fitness classes
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$0 ride for children and pregnant women

Pregnant women and children can get ride from Medica Provide-a-Ride℠ to and from health care appointments - including medical, dental, mental health, and substance use disorder visits.

Call us at least five days before your appointment, and we'll be happy to provide a cab or bus ride to your appointment.

1-800-373-8335 (toll-free) TTY: 711

Understanding Your Premium 

People 21 and older who are not pregnant will pay a monthly premium and copays for covered health care benefits. Monthly premiums are determined by your income. Medica does not collect your premium. You pay your premium directly to MNCare.

Understanding Your Copays

A copay is an amount that you pay your provider when you receive care. Copay amounts are listed below.

You pay your copay directly to your provider. Many providers have you pay your copay when you arrive for your appointment. If you get non-emergency care at a hospital emergency room, they may bill you later.

If you can't pay your copay, the provider must still give you care. This is true even if you haven't paid your copay to that provider in the past or if you have other debts to that provider. The provider may still bill you for the unpaid copays.

Copay Amounts

Services

Visits for a health problem with care provided by a network care provider*

Common examples of these visits include:

  • Sore throat
  • Diabetes checkup
  • High fever
  • Sore back
  • Other illnesses or injuries

Copay

$30.00

Mental health services

Common examples of these visits include:

N/A

Copay

$0.00

Eyeglasses

Common examples of these visits include:

N/A

Copay

$25.00

Non-preventive dental

Common examples of these visits include:

N/A

Copay

$15.00

Procedures to diagnose a health problem

Common examples of these visits include:

  • Colonscopy
  • Endoscopy
  • Arthroscopy

Copay

$45.00

Emergency room

Common examples of these visits include:

N/A

Copay

$100.00

Inpatient hospital stay

Common examples of these visits include:

N/A

Copay

$250.00

*Network care providers for this type of visit include physicians, physician assistants, advanced practice nurses, certified professional midwifes, chiropractors, acupuncturists, podiatrists, audiologists, or eye doctors.

Copay Exceptions

In certain situations, you won't have to pay copays for medical services that are covered by MinnesotaCare. This applies if you:

  • Are an American Indian who receives or has received services from an Indian Health Care Provider or through IHS CHS referral from an IHS facility
  • Are pregnant (if you become pregnant, tell your county worker right away)
  • Are under age 21
  • Are receiving hospice care
  • Have been living in a nursing home, hospital or other long-term care facility for more than 30 days

Contact Us

8 a.m. – 6 p.m., CT, Monday – Friday

Mailing address:
Medica P.O. Box 9310
Minneapolis, MN 55440


American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For elders age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral.

Last updated: December 2022