Benefits and Coverage

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Medica Choice Care (MA)

Plan Benefits

Your plan:

  • Has no monthly fee, but you may pay a copay when you receive some health care services; see below for more information
  • Doesn't require referral. Choose your own doctor from our large network of health care providers. 
  • Covers preventive care and prescription drugs

Copays

A copay is an amount that you pay your provider when you receive care. Copay amounts are listed below. Some members have reduced or no copays, depending on their situation. View copay exceptions »

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.

Services  Copay Amount
 Visits for a health problem (for example, a sore throat, diabetes checkup, high fever, sore back, etc.) provided by a physician, physician assistant, advanced practice nurse, certified professional midwife, chiropractor, acupuncturist, podiatrist, audiologist or eye doctor  $3.00
Mental Health Services  $0.00
Procedures to diagnose a health problem (for example, colonoscopy, endoscopy, arthroscopy) $3.00 
Urgent care services received in an emergency room   $3.50
Non-emergency or non-urgent care received in a hospital emergency room Services are
not covered 

Plan Features

My Health Rewards Program

My Health Rewards by MedicaSM is a personalized program that can help you understand your health and learn how to improve it. As you make healthy decisions, you earn gift cards. 

Learn more »

Transportation

If you don’t have access to a car, our transportation program can help. Our Provide-A-RideSM service will give you a ride to and from medical, dental, mental health and substance abuse appointments. 

Call us two to five days before your appointment and we’ll be happy to assist you with getting a cab or bus ride to your appointment. 

952-992-2292 or toll free: 1-800-601-1805
(TTY users: 1- 800-855-2880)
8 a.m. – 5 p.m., Monday – Thursday
7:30 – 8 a.m., 9 a.m. – 5 p.m., Friday
Closed daily from noon to 12:30 p.m.

Language Resources

Medica has dedicated language lines to assist with questions, scheduling transportation to an appointment or scheduling an interpreter. 

  • Hmong: 952-992-2296 
  • Russian: 952-992-2294 
  • Somali: 952-992-2260 
  • Spanish: 952-992-2297 
  • Vietnamese: 952-992-2295 

For any other language, Medica will contact an interpreter to provide assistance. 

Interpreter Services 

Interpreters are available to go with you to medical, dental, mental health or substance abuse appointments at no cost to you. To request an interpreter, call Medica Customer Service at 952-992-2322, toll-free 1-800-373-8335 or one of the dedicated language lines. 

Sign Language Interpreters 

Sign language interpreters are available to go with you to health care appointments. To request a sign language interpreter, call Medica Customer Service. TTY users, call the National Relay Center at 1-800-855-2880 and ask them to dial 1-800-373-8335.

Social Services

Medica can help connect you and your family with resources in your community, including: 

  • Housing information
  • Financial assistance 
  • Food, clothing, and baby and household items

For information about these resources, call one of our social services coordinators at: 

952-992-3535 or toll free: 1-800-373-8335 (press option 4)
TTY users: 1-800-855-2880
Monday – Friday, 8 a.m.- 4:30 p.m. 
(closed 12 -12:30 p.m.)

Dental Services

Your plan includes dental coverage, which is managed by Delta Dental of Minnesota. 

Find a dentist in your network »

Or, you can get help by calling Delta Dental Customer Service. They can help you:

  • Find a dentist and schedule an appointment
  • Arrange transportation
  • Arrange interpreter services 
  • Schedule follow-up appointments

They can also explain your dental benefits and answer questions about your claims.

Delta Dental:  651-406-5919
Toll free: 1-800-459-8574 
TTY users: 1-800-855-2880
Monday - Friday, 8 a.m.-5 p.m. 

Eyewear

Your plan covers a new pair of eyeglasses every two years. Please see the eye care section of your Evidence of Coverage for more detailed information. Choose your eyeglass frames from the catalogs below.

Download complete eyewear frame catalog »

Order a print copy »

Download eyewear frame catalog by category:

Member Rights and Responsibilities

As a member, you have certain rights and responsibilities, which the laws of your state outline.

View your rights and responsibilities »

How to Get the Care You Need

This guide explains some of your health care options and has important information about your rights and responsibilities as a Medica member. It also tells where you can find more information if you need it. Please take a few minutes to review this guide. You may not need all of this information today, but it may be helpful in the future.

View the How to Get the Care You Need  booklet »



American Indians can continue or begin 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 enrollees age 65 years and older this includes Elderly Waiver 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 Medica primary care provider prior to the referral.