ACA Providers: Anthem, UHC…and Medica?

In My Humble Opinion
1

I’m shopping healthcare.gov for a plan for my wife. She’s had Anthem BCBS, but they’re feuding with a major local hospital group and won’t be covering her primary care doc. Who she loves. (We live in St. Louis.)

So I’m looking at the other providers. I’m familiar with United Healthcare (my Medicare Advantage company), a huge company, lots of fraud lawsuits, but usable. However there are several providers that are much cheaper.

Oscar is largely owned by the Kushners, so I’d rather not.
There’s a Missouri-based company owned by Centene (a very big company, but not like UHC). It has also had many law suits — lying about their network size, and cheating sub contractors.

And then there’s Medica. Their website says they’re Minnesota-based, and it traces their history of mergers, acquisitions, growth. But I can find almost no info outside their website. Nothing on Wikipedia.

Anyone know anything about Medica?

2

Can’t find very much. They’re a not-for-profit regional, based in Minnesota. They offer plans in all of the major segments (group/employer, Medicare, ACA), and mostly in the Midwest.

I work in the industry (my client is a big health insurer in the Southeast), and I’ve not heard of them before, but that’s probably because they don’t compete in my client’s region.

3

Call your primary care doc or most-frequently visited specialist and ask them what they think of whoever you choose. The plans’ coverage details are all pretty similar at any given tier, so what matters to you is how easily your practice gets paid, and what that indicates about whether the plan is just there to take your money or will actually provide actual, you know, coverage.

4

Is being a non-profit considered a good thing, generally?

5

A little bit; profits go back into operations, and (potentially) lowering rates, rather than to investors.

6

Medica was started with the 70s / 80s fad of HMOs. They were eventually bought out by United so United could get around the Minnesota law that for-profit insurance companies were not allowed to offer HMOs.

7

Thanks LivingGhost371. I’d seen an indecipherable graphic hinting at a UHC—Medica relationship.

8

There are a lot of companies with “United” in their name. Even just in the medical industry. It’s nice to be more specific when naming names.

9

This is mildly off-topic, but now I’m thinking about what advantages having a non-profit branch might offer a for-profit corporation.
—Provide cushy ceremonial jobs (board of directors and more) to the for-profit executives.
—Keep competitors from getting a foothold in key markets
—??