Orlando Harmon
Medica offers a range of health insurance plans that provide discounted fees from doctors, clinics, hospitals, pharmacies, and other providers within your chosen network. These include Medicare plans for low-income residents of Minnesota, such as MinnesotaCare, which offers additional benefits like discounted gym memberships and healthy food savings at participating grocery stores. The Health+ by Medica card can be used for eligible eyewear and dental services, as well as over-the-counter purchases at participating retailers like Walmart, Walgreens, and CVS Pharmacy. Understanding your health plan's coverage and benefits is essential, as some services may be excluded, and costs vary based on the chosen plan.
| Characteristics | Values |
|---|---|
| Health Insurance Type | Medicare, Medicare Advantage, Medicaid |
| Discounts | Discounted fees from doctors, clinics, and hospitals in your plan's network |
| Card | Health+ by Medica card |
| Card Usage | Eligible eyewear or dental services |
| Reimbursement | Paper reimbursement form to recover expenses under your card benefits |
| Card Balance | OTC allowances are loaded at the beginning of January and July and balances don't roll over |
| Card Usage Locations | Walmart, Walgreens, CVS Pharmacy, Dollar General stores, and more |
| Plan Costs | Monthly premium, deductible, co-insurance, copay |
| Plan Benefits | $0 gym membership, Healthy Savings program, Provide-A-Dentist program, Ovia Health apps, NurseLine |
| Plan Networks | Doctors, clinics, hospitals, pharmacies, and other providers |
| Plan Types | Individual and family health plans |
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What You'll Learn
Discounted dental services
Dental coverage is not considered an essential health benefit for adults, and health plans are not required to offer dental coverage for adults. However, dental coverage is an essential health benefit for children, meaning that dental coverage must be available for those under 18, either as part of a health plan or as a separate dental plan.
There are two categories of Marketplace dental plans: high and low. If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit. You can also choose a health plan without dental benefits and get a separate dental plan, but you cannot buy a Marketplace dental plan unless you are also buying a health plan.
Medicare generally does not cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures and implants. However, there are some exceptions where Medicare may cover dental services. For example, dental services that are inextricably linked to certain Medicare-covered services, such as dental or oral exams as part of a comprehensive workup before Medicare-covered services like organ transplants or chemotherapy. Inpatient or outpatient dental services may also be covered if they are directly related to certain covered medical treatments, such as treating a mouth infection before cancer treatment. Medicare may also cover services to stabilise or immobilise teeth related to reducing a jaw fracture and dental splints used as part of covered treatments for conditions like dislocated jaw joints.
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Discounted eyewear
When it comes to eyewear, there are a few options for discounts with Medica health insurance. Firstly, it's important to distinguish between medical insurance and vision insurance. Medical insurance typically covers unexpected costs for eye injuries or diseases, while vision insurance covers routine vision needs such as eye exams, prescription glasses, and contacts.
Medica health insurance offers coverage for a new pair of eyeglasses when medically necessary through their eyewear vendor Eye-Kraft®. It is recommended to check the Member Handbook for more details on this coverage. Additionally, members have access to the Self Care by AbleTo mobile app, which provides tools and resources for managing mental health and wellness, including stress, anxiety, and depression.
Vision insurance policies often provide discounts or allowances for the cost of frames and lenses for various vision corrections. Some plans may also offer upgrades for enhanced lenses with features like anti-reflective coating, blue light blocking, or photochromic lenses. Contact lenses may also be included in the coverage, with some plans offering discounts on purchases or subscriptions.
It's worth noting that some retailers, such as Target Optical, offer savings on eyewear when using specific vision insurance plans. However, these discounts may not be valid in certain states or in conjunction with insurance benefits. It is always advisable to check with the retailer and insurance provider to understand the specific discounts and limitations offered.
Flexible spending accounts (FSAs) and health savings accounts (HSAs) are additional options provided by some employers. These accounts allow individuals to set aside pre-tax money for healthcare expenses not typically covered by insurance, including optometry visits, eye exams, glasses, and contact lenses.
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Gym membership deals
If you're looking for gym membership deals through your health insurance, there are a few options to consider. Firstly, it's important to note that gym memberships may be included as extra coverage in certain plans, such as Medicare Advantage Plans, other Medicare health plans, or Medicare Supplement Insurance (Medigap) plans. Therefore, reviewing the specifics of your insurance plan is a good starting point.
For those with insurance through Blue Cross Blue Shield, blue365deals.com offers discounted gym memberships at various locations, including the YMCA. Similarly, if your state offers Medicaid managed care, it's worth exploring the additional benefits provided by each managed care company, as they may include gym membership discounts or other wellness incentives.
For Minnesota residents, Medica MinnesotaCare is a health insurance plan designed for individuals with low incomes who need financial assistance. This plan includes a $0 gym membership fee, providing access to over 16,000 locations nationwide, including premium fitness partners like Life Time and YMCA. Members 18 and older are also eligible for the One Pass™ fitness program at no additional cost.
Additionally, some insurance companies offer programs or partnerships that provide discounted gym memberships. For example, Active & Fit Direct offers access to various gyms for a monthly fee, although recent changes limit users to a single gym location. Kaiser members have mentioned Active & Fit as an option, but it may only be included in specific plans. UHC OnePass is another program that allows members to access any gym for a slightly higher price than a single gym membership.
It's always a good idea to contact your insurance provider directly to understand the specific discounts and programs available to you, as these may vary based on your location and plan type.
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Healthy food discounts
Medica offers a Healthy Savings Program that provides members with exclusive savings on healthier food brands and health-related items at participating stores. The program is available on the Healthy Savings website and mobile app. Once you activate your Healthy Savings card, you can start saving on healthy food items. Weekly savings are pre-loaded onto your card, and you can choose to receive these savings via email or by checking the website or mobile app.
To redeem your benefits, simply present your Healthy Savings card or display the mobile app barcode to the cashier at checkout. The savings are instant and can be combined with in-store specials or coupons. The Healthy Savings program makes it easier to find healthier foods by promoting only foods that rank in the healthiest half of the items in a typical grocery store. These ratings are determined using the Guiding Stars nutrition guidance system, which measures the nutrient density of each item.
In addition to the Healthy Savings Program, Medica also offers savings on fitness items like pickleball equipment and health club memberships. With Medica, you can save money on nutritious foods, preventive care, and more. The company aims to help you manage your health and well-being with comprehensive solutions.
It is important to note that the Healthy Savings Program is only available to eligible sponsored members. The program provides access to savings on specific healthier food brands, and some users have noted that the discounts may not apply to budget-friendly or generic options. However, the program still offers significant savings of up to $50 each week, and in some cases, you may receive fresh produce discounts through Produce Perks.
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Tribal and Indian Health Services
If eligible, you pay no premiums or out-of-pocket costs for services provided by the Indian Health Service, Tribal programs, or urban Indian programs (known as I/T/Us). This includes services provided through the Purchased or Referred Care (PRC) program. Enrolling in a Marketplace plan, Medicaid, or CHIP can provide better access to services that I/T/Us may not offer. When you receive services from an I/T/U, they can bill your insurance program, which benefits the Tribal community by allowing them to provide more services to others.
Additionally, special cost and eligibility rules apply to Medicaid and CHIP, making it easier to qualify for these programs. Cost-sharing reductions, often referred to as "extra savings," are available in the Health Insurance Marketplace. If you meet the income requirements, you can enrol in a "zero-cost sharing" plan, which eliminates out-of-pocket expenses.
For more information on Tribal and Urban Indian Health Centers, you can refer to the Office of Direct Service and Contracting Tribes (ihs.gov) or the Office of Urban Indian Health Programs | Indian Health Service (IHS).
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Frequently asked questions
Your Medica health insurance is applicable at doctors', clinics', and hospitals' offices, as well as pharmacies, and other providers.
You can get discounted fees from doctors, clinics, and hospitals that are in your plan's network.
Cosmetic procedures, teeth whitening, orthodonture treatments, and refractive eye surgery are not included in your Medica health plan.
Yes, depending on your plan, you may have access to discounted gym memberships, discounts on healthy foods at participating grocery stores, and comprehensive dental care. Additionally, American Indians can use tribal and Indian Health Services (IHS) clinics without prior approval.
