Essentia Choice Care with Medica

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Essentia Choice Care with Medica

Accountable Care Organization network

Essentia Choice Care with Medica provides a unique, high-quality health care experience at a lower cost. Our friendly and professional staff deliver care in more than 50 communities in northern Minnesota, eastern North Dakota and northwestern Wisconsin. Our philosophy is to be "Here with you" to help you get the care you need, when you need it, close to home.

If you’re away from home and get sick or hurt, we’ve got you covered! When you travel outside the Medica service area (Minnesota, North Dakota, South Dakota and western Wisconsin) you can get network coverage by visiting a provider in the Travel Program Network. This nationwide network is one of the largest in the country. If you have children attending college outside the service area, they can use this network, too.

Plan Highlights

  • Direct access to specialists. See any primary or specialty care provider in the Essentia Choice Care network without a referral.
  • Same-day access to a care team member. Get answers to questions and help with your health care needs in the same day, including e-visits.
  • Single phone number. This one-stop approach makes it easy to ask questions about your health plan benefits, billing, care and coverage and more.
  • MyHealth online patient portal. A secure online tool for communicating with your provider, accessing your health information and more.
  • Patient assistant. Welcomes members and provides extra help when needed.
  • 20% discount on products and services at Essentia Health Skin Renewal Centers in Duluth and Fargo.

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You can compare this plan side-by-side with up to two other plans to see the differences between their benefits.

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Benefit Summary for Essentia Choice Care with Medica

Network Information
Network Type Accountable Care Organization network
Network Area Northern Minnesota, eastern North Dakota and northwestern Wisconsin
Special Features Direct access to specialists; same-day access to care team; single phone number resource; online patient portal; discounts on skin products and services.
Referrals Needed No referrals needed if you see an Essentia Choice Care with Medica network provider.

How it works

Essentia Choice Care is an accountable care organization (ACO). In an ACO, groups of doctors, nurses and other health care providers work together with your health plan to provide coordinated care. You don’t need a referral when you see a provider in the Essentia Choice Care network.

» Find a physician or facility in the Essentia Choice Care network.
» See a map of provider locations in the Essentia Choice Care network.

Sample Certificate of Coverage

You can view a sample 2017 coverage document (called a Certificate of Coverage), which shows examples of what an Essentia Choice Care with Medica plan may cover for fully insured members. To view this sample, choose the state your employer is based in, then choose “Small groups” if your company has 50 or fewer employees, or “Large groups” if your employer has 51 or more employees.

MN: 
Small groups (2018 sample certificate coming soon)
Large groups (2018 sample certificate coming soon)

ND:
• Small groups (2018 sample certificate coming soon)
Large groups (2018 sample certificate coming soon)

WI:
Large groups (2018 sample certificate coming soon)

NOTE: This is not your actual certificate of coverage. This is only an example of what services may be covered. For information about specific benefits or levels of coverage (such as copay, coinsurance or deductible amounts), please contact your employer.

Information Sharing

One of the unique features of an ACO plan is how Medica works with your provider to coordinate your health care. By sharing member information with each other, Medica and your ACO can help you get the care you need and deliver programs and services to help you get and stay healthy. If you or your dependents don’t want Medica and the ACO to share your information with each other:

» Complete this form
» Or call Customer Service at 952-945-8000 or 800-952-3455

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