Medica Insurance Company

Select by Medica Gold Share ($0 Virtual Care)

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Major Dental Care

Links

Plan Overview

Combined Medical and Drug Deductible	Individual: $1,000 Family: $3,000 Per Person: $1,000
Combined Medical and Drug Out of Pocket Maximum	Individual: $8,500 Family: $17,000 Per Person: $8,500

Office Visit

Primary Doctor	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Specialist	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Prescription Drug Information

Preferred Brand Drugs	CoPay: $80.00 CoInsurance: Not Applicable Covered: Covered Benefit Explanation: Prescription insulin will not exceed $25 per prescription unit
Non Preferred Brand Drugs	CoPay: Not Applicable CoInsurance: 50.00% Coinsurance after deductible Covered: Covered
Generic Drugs	CoPay: $5.00 CoInsurance: Not Applicable Covered: Covered
Specialty Drugs	CoPay: $550.00 CoInsurance: Not Applicable Covered: Covered

Inpatient Coverage

Hospital Services	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Inpatient Services	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Emergency and Urgent Care

Emergency Room	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Urgent Care Facility	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Maternity

Labor and Delivery Hospital Stay	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered
Pre and Postnatal Office Visit	CoPay: Not Applicable CoInsurance: 35.00% Coinsurance after deductible Covered: Covered

Vision

Routine Eye Exams For Children

CoPay: Not Applicable
CoInsurance: 35.00% Coinsurance after deductible
Covered: Covered

Major Dental Care

Routine Dental Checkups for Children	Covered: Not Covered
Routine Dental Checkups for Adults	Covered: Not Covered
Basic Dental Care - Adult	Covered: Not Covered
Basic Dental Care - Child	Covered: Not Covered
Major Dental Care - Adult	Covered: Not Covered
Major Dental Care - Child	Covered: Not Covered

Related Articles

You may be interested in these relevant articles from across the HealthMarkets.com network.

You have health insurance, but what about vision and dental insurance?

It’s important to have insurance for health, dental, and vision. But does one plan…Read More

Read More

Children's vision: How do I know if my child needs glasses?

While vision issues tend to be obvious in adults — you have trouble seeing…Read More

Read More

Heat Stroke And Heat Exhaustion: Hot-Weather Tips to Stay Safe

Warm-summer days, lots of sun, and outdoor activities can be fun. But when the…Read More

Read More