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News Release

With $25 Cap on Insulin Prescriptions, Medica Introduces Group Health Coverage to Nebraska

OMAHA, NE—Medica is expanding its health coverage offerings to support employers throughout the state of Nebraska and three border counties in Iowa. By bringing group coverage to Nebraska, Medica now offers health insurance in three distinct markets: individual coverage under the Affordable Care Act (ACA), Medicare and employer-sponsored group coverage.

Medica group coverage is available across Nebraska and three Iowa counties (Harrison, Mills and Pottawattamie) beginning January 1, 2021. The health insurer has offered individual coverage in those areas since 2016. It began offering Medicare coverage in Nebraska in 2019.

Insulin $25 Cap Meets Key Need

A key benefit of Medica's group plans is a $25 cap on member costs for a one-month supply of insulin. Starting in 2021, Medica's individual plan members in Nebraska with ACA coverage also will pay no more than $25 for a one-month supply of insulin.

Medica is making this essential benefit available at a low cost to ensure diabetics have access to insulin, which has been increasing in price at an unsustainable rate. Addressing the issue, Nebraska lawmakers last year introduced bills that would cap insulin at $100 per prescription.

"Medica is delighted to add group customers to our mix of business in Nebraska," said Patrick Bourne, Medica's market leader for Nebraska. "We are especially pleased that we can offer an important benefit like the $25 cap that address pressing needs facing Nebraskans. Medica values the trust placed in us by our customers. We will strive to provide access to the care they need through our benefit designs and the provider partnerships we develop."

Medica Provider Networks in Nebraska

Medica group products feature a variety of provider network options.

It has created an open access network with established health systems and providers throughout the state of Nebraska to ensure high quality, efficient care is delivered to its members. The network also includes a large national network.

In many larger Nebraska cities, including Omaha, Lincoln, Grand Island and Kearney, Medica has created in partnership with CHI Health & Accountable Care Organization (ACO) product for its group members. The organizations have been in a similar partnership for ACA members since 2018 and Medicare members since 2019. Medica currently has about 47,000 members in the ACO products with CHI Health.