Medica Individual Product Portfolio FAQ

Medica Individual Product Portfolio with Access to Mayo Frequently Asked QuestionsWhat’s new about this relationship?Medica’s popular portfolio of health plans sold directly to consumers will now offer in-network access to Mayo Clinic, in addition to the in-network access already availablethrough Mayo Clinic Health System, for enrollees living in 22 counties in southernMinnesota.Also, Medica and Mayo Clinic have entered into a financial agreement where Medicawill reimburse Mayo Clinic based on how well it manages the population’s health in the22 county region.How does this benefit the community?Medica’s individual and family plans (Medica Solo, Medica Encore and MedicaSymphony) are the fastest growing in the state, with over half of all enrollment (in thissegment) coming to Medica since 2009. Providing in-network access to Mayo Clinic andMayo Clinic Health System, at competitive rates, provides greater choice and access tohigh quality health care in the communities that Mayo serves.What are the 22 counties?Blue Earth, Brown, Cottonwood, Dodge, Faribault, Fillmore, Freeborn, Goodhue,Houston, Jackson, Le Sueur, Martin, Mower, Nicollet, Olmsted, Redwood, Rice, Steele,Wabasha, Waseca, Watonwan, WinonaWill this area be expanded?Mayo and Medica are committed to discussions of expansion into other parts ofMinnesota, as well as into western Wisconsin. The initial roll-out is focused on theMinnesota counties where Mayo Clinic Health System is a primary care provider.What are the details of the financial relationship?The details are proprietary. Medica and Mayo have made a commitment to ensuringaccess to quality care and health improvement, while simultaneously managing costs.How is this product portfolio different from others available in the market on adirect to consumer basis?Medica’s individual and family products offer the most value – competitive rates pairedwith leading benefit designs that have been copied by competitors – and now have theadded bonus of offering direct access to Mayo Clinic at an in-network benefit level (thehighest level of coverage).1|P age June 13, 2012

Why is access to Mayo Clinic and Mayo Clinic Health System so important?It brings to southern Minnesota healthy competition based on quality and outcomes, aswell as total cost. Access to Mayo Clinic and Mayo Clinic Health System offers membersthe choice of the entire spectrum of care from an acknowledged high quality medicalprovider.Is Medica and Mayo Clinic and Mayo Clinic Health System creating a “narrownetwork” or single provider network?No. This agreement adds the Mayo Clinic as an in-network provider to Medica membersin 22 southern Minnesota counties. Those members can access the Mayo Clinic andMayo Clinic Health System as well as many other in-network providers in Medica’ssouthern Minnesota service area.If a Medica member sees a specialist at the Mayo Clinic but receives primary carefrom a provider not part of the Mayo Clinic Health System, how will that care becoordinated?Mayo Clinic specialists routinely see patients who receive their primary care fromproviders throughout the state (and world). There is a system in place that ensures all careis coordinated regardless of the referring physician.This agreement between Medica and Mayo Clinic provides in-network access to MayoClinic for Medica members in the 22 southern Minnesota counties. This step representsan evolution in the relationship between the two organizations, which will be looking foropportunities to expand the agreement beyond the 22 original counties.Won’t patients who are not part of Mayo Health Care System and receive specialtycare from Mayo Clinic have an impact on the organizations’ ability to ensurequality care, improve health and manage costs?That scenario is accounted for in our financial agreement. The details of thosearrangements are proprietary.Will members be paying more for access to Mayo Clinic services through thisinsurance plan?Mayo Clinic and Mayo Clinic Health System are included in the network for Medica’smembers in southern members. There are no additional costs involved in accessing eitherMayo Clinic or Mayo Clinic Health System. The premium rate for these Medicamembers is generally is less than rates charged by competing plans that do not includeMayo Clinic and Mayo Clinic Health System in their network, or have Mayo Clinic at ahigher “tier,” which means more out-of-pocket costs for the consumer.Isn’t it difficult to change health insurance coverage and providers?2|P age June 13, 2012

Not when working with Medica and Mayo. Medica’s direct-to-consumer products arehealth history underwritten, and a percentage of individuals are charged more or declinedcoverage. However, the vast majority of applicants are approved at the standard rate andthe approval decision generally takes less than a week.If someone doesn’t get sick very often and doesn’t see a doctor on a regular basis,why should they switch from their current health insurance coverage?We all need medical attention at some point in our lives, and when that time comes, it’simportant to have convenient, high quality options available. Mayo Clinic and MayoClinic Health System provide right care, in the right place, at the right time leads to highquality, better outcomes and overall lower costs over the long term. Also, shoppingaround for different insurance can often mean finding a lower price for comparable oreven increased coverage.Will medical records transfer with the new insurance plan?Current patients of Mayo do not need to transfer their records. Mayo is committed toproviding a quality experience for all of its patients and has a thorough new patientonboarding process that takes into account medical histories and records.Do consumers have to wait for a certain time of the year in order to switch healthinsurance coverage?No. Prior to health care reform becoming fully implemented effective January 2014,consumers can change plans at any time.How does a consumer go about switching to a new Medica health insurance planwith access to Mayo Clinic and Mayo Clinic Health System?Contact their Medica broker, call Medica at 1-800-670-5935, or go online to medica.comand click on “Individual and Family Plans.”3|P age June 13, 2012

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Medica Individual Product Portfolio FAQ

by Post-Bulletin Co. on Jun 14, 2012

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Medica Individual Product Portfolio FAQ Document Transcript