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2019 MEDICA PLAN DETAILS

Medica Prime Solution® (Cost)

NORTH DAKOTA & SOUTH DAKOTA

Medica Prime Solution® has three plan options available. Plan features include:

  • Large network of doctors, clinics and hospitals
  • Travel and "snowbird" coverage
  • Optional Part D drug coverage with access to 67,000 pharmacies nationwide

Prime Solution is available to residents of most North Dakota and all South Dakota counties.
View enrollment area

 

Medical + Part D Coverage

Monthly Premium
Premier with Rx: $229.50

    Key Features
  • $0 copays for most medical services
  • $0 for primary care visits and $0 for specialist visits
  • Maximum medical out-of-pocket limit of $3,000
  • Worldwide emergency care
  • Dental coverage
  • Annual benefit allowance for prescription eyewear and for hearing aids
  • 5 tier formulary with more than 3,200 drugs
    • $2 copays for Tier 1 drugs and $8 copays for Tier 2 drugs with a $270 deductible

Request a Prime Solution kit

Monthly Premium
Core with Rx: $115.70

    Key Features
  • Low copays for most medical services
  • $10 for primary care visits and $20 for specialist visits
  • Maximum medical out-of-pocket limit of $4,000
  • Worldwide emergency care
  • Dental coverage
  • Annual benefit allowance for prescription eyewear and for hearing aids
    • 5 tier formulary with more than 3,200 drugs
      • $2 copays for Tier 1 drugs and $6 copays for Tier 2 drugs with a $325 deductible

Request a Prime Solution kit

Monthly Premium
Thrift with Rx: $80.90

    Key Features
  • Coinsurance for most medical services with a $50 annual deductible
  • 20% for primary care visits and specialist visits
  • Maximum medical out-of-pocket limit of $6,700
  • 5 tier formulary with more than 3,200 drugs
    • "With Rx" includes $2 copays for  Tier 1 drugs and $6 copays for Tier 2 drugs with a $305 deductible

Request a Prime Solution kit

Need help paying for Part D drug coverage?
You may be able to get extra help paying for your prescription drug premiums and costs. See our Low-Income Subsidy (LIS) Summary Table for potential rates.
View LIS monthly premiums

Medical-only Coverage

Monthly Premium
Premier: $189.00

    Key Features
  • $0 copays for most medical services
  • $0 for primary care visits and $0 for specialist visits
  • Maximum medical out-of-pocket limit of $3,000
  • Worldwide emergency care
  • Dental coverage
  • Annual benefit allowance for prescription eyewear and for hearing aids

Request a Prime Solution kit

Monthly Premium
Core: $79.00

    Key Features
  • Low copays for most medical services 
  • $10 for primary care visits and $20 for specialist visits
  • Maximum medical out-of-pocket limit of $4,000
  • Worldwide emergency care
  • Dental coverage
  • Annual benefit allowance for prescription eyewear and for hearing aids

Request a Prime Solution kit

Monthly Premium
Thrift: $49.00

    Key Features
  • Coinsurance for most medical services with a $50 annual deductible
  • 20% for primary care visits and specialist visits
  • Maximum medical out-of-pocket limit of $6,700

Request a Prime Solution kit

2019 Prime Solution Plan Resources

Find Your Doctor

Check to see if your doctor, clinic, hospital or other medical provider is included in the plan network.

Search for a doctor or care provider

Find Your Drugs

Check to see if your drugs are covered by the plan formulary, what you would pay and which pharmacies are in our network.

View drug formulary
View drug costs
Find a network pharmacy

2019 Prime Solution Plan Documents

View the list of plan documents

Extras to Make Your Plan Even Better

A great Medicare plan is only one piece of the puzzle when it comes to maintaining your health. So we provide you with the extra resources you need to stay healthy each and every day.

Free Fitness Program Membership

Most of Medica's plans include a SilverSneakers® membership. This program gives members access to over 14,000 fitness locations nationwide. Enroll at multiple locations any time. For a complete list of locations and options, visit SilverSneakers.com

HealthAdvocate Personal Support Service

HealthAdvocate℠ has your back if you have questions about your Medica plan coverage or need help navigating the medical system. Our trained Personal Health Advocates can help you tackle health-related questions — from finding the right doctor to resolving claims questions.

NurseLine – Available 24/7

You and your family have a place to turn for trusted advice and information when you need it most. NurseLine™ has highly-trained nurses available to help answer your questions about symptoms, medications and health conditions, and offer self-care tips for non-urgent concerns.

Need Help?

1-877-704-7864 
(TTY: 711)
Get More Info

Are You Covered?

Every plan is different, find the right plan for you. Quickly search our resources to see if a plan includes your doctor and drugs. 

Select a plan
Ready to Enroll?

Ready to Enroll?

Help Me Choose

Choosing your Medicare plan is an important decision. We make it easy by giving you the information and options you need to make the right choice for you.

Medica Has the Plan for You

Help me choose

Ready to Enroll

Now that you have evaluated your options and selected a Medicare plan, it is fast and easy to enroll. You can enroll online or call Medica to enroll over the phone. If you prefer a paper application, just give us a call.

How to Enroll

Enroll online  |  Contact a Medica consultant

 

Medica is a Cost plan with a Medicare contract. Enrollment in Medica depends on contract renewal.

This information is not a complete description of benefits. Call Medica at 1-877-704-7864 (TTY: 711) for more information.

 

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Last Updated: October 2018