MEDICA Vs. Blue Cross Blue Shield: Choosing The Right Health Insurance

Finding the right health insurance can be confusing when faced with all the plan options from providers like MEDICA and Blue Cross Blue Shield. How do you know which company and policy will meet your needs and budget?

This comprehensive guide compares MEDICA and Blue Cross Blue Shield based on cost, plan types, network coverage, customer service, and more. Read on to learn the key differences between these two insurance giants so you can make an informed decision when choosing health insurance.

A Brief Comparison Table

AspectsMEDICABlue Cross Blue Shield
AvailabilityRegional – Midwest, West, SouthwestNational in all 50 states
Plan TypesPPOs, HMOs, POS, HDHPs, HSAsFull range of plan types
Network SizePreferred One network focused in core statesBlueCard PPO national network
CostLower deductibles typicallyPremiums vary more widely
Benefits$0 virtual visits, wellness incentives100% preventive care, gym discounts
Customer ServiceHighly rated, more personalizedMixed reviews, longer wait times

Introducing MEDICA and Blue Cross Blue Shield

First, let’s get to know the basic background behind each insurance company.

MEDICA Health Insurance
MEDICA Health Insurance

MEDICA is a regional health insurance provider based in the Minneapolis, MN area. They offer individual health plans, MEDICAre, and group policies for employers. MEDICA is only available in select states like Minnesota, Wisconsin, the Dakotas, and some western states.

Blue Cross Blue Shield (BCBS) is one of the largest health insurance providers nationwide. Their 36 companies provide coverage through employer plans, individual policies, MEDICAre Advantage, and MEDICAid in every state. BCBS insures over 106 million members.

Key Differences Between MEDICA And Blue Cross Blue Shield

Both companies offer access to extensive provider networks and a variety of plan types. Next, let’s dive into details of what each insurer provides.

  • Plan Types and Network Coverage

MEDICA and BCBS offer all the standard health insurance options from HMO to PPOs and HDHPs. How does coverage compare?

MEDICA provides all the typical plan types including PPOs, HMOs, POS plans, HDHPs, and HSAs eligible plans. TheirPreferred One PPO network offers the broadest coverage within their service states. MEDICAre Advantage plans are also available from MEDICA.

Blue Cross Blue Shield also provides the full spectrum of plan types. Their BlueCard PPO network includes over 90% of doctors and hospitals nationwide. BCBS MEDICAre Advantage plans are also robust. So outside MEDICA states, BCBS likely offers wider coverage.

For network breadth, BCBS is hard to beat given their national scale. But in its core midwestern states, MEDICA provides comparable coverage through their partner providers. Both enable access to top-rated facilities and doctors.

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  • Cost and Premiums

When weighing insurance options, premium costs are a major factor. How do MEDICA and BCBS compare?

MEDICA premiums are affordable relative to competitor plans in their states. For example, Average monthly premiums for a family of 4 range $900-$1500 for a gold plan or $700-$1200 for silver. Deductibles run $1700-$5000 depending on the plan selected.

BCBS Health Insurance
BCBS Health Insurance

BCBS premium costs can vary more widely given their national presence across higher- and lower-cost states. A gold family plan averages $800-$2000 in monthly premiums, while silver averages $500-$1800. Deductibles also range from $2000 on the low end to $8000 for high-deductible options.

In general, MEDICA tends to offer lower deductibles for more coverage upfront. BCBS plans have greater variability in cost nationwide. Comparing policies head to head within your state gives the best cost comparison.

For those who qualify, both MEDICA and BCBS offer discounted rates based on income and family size. This can significantly reduce monthly premium costs for eligible policyholders.

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  • Plan Offerings and Benefits

Beyond costs, the details of each plan’s structure and benefits should align with your lifestyle. How do offerings compare between providers?

MEDICA offers robust plan designs including:

  1. $0 virtual visits and low office visit copays
  2. $0 preventive care coverage
  3. Wellness incentives and health account options
  4. Competitive prescription coverage
  5. Optional dental and vision benefits

Watch this review video:

Blue Cross Blue Shield key benefits include:

  1. National network with providers in every state
  2. Preventive care covered at 100%
  3. Range of prescription drug coverage tiers
  4. Discounts for gym memberships
  5. Extensive selections of dental insurance

When it comes to plan benefits, both MEDICA and BCBS offer comparable coverage for essential health services. The main differences come down to regional availability and detailed structure of copays and coinsurance levels.

  • Customer Service Reputation

Choosing an insurer with strong customer service can save headaches if any issues arise. How do MEDICA and BCBS support stack up?

MEDICA customers give high marks for friendly service and fast claims processing. Their online portal makes it easy to estimate costs, review coverage and deductible status, and manage policies. Phone support has limited hours but provides personalized help navigating plans.

BCBS earns strong ratings for customer service but faces longer wait times due to high call volumes. Their app and online portal enable self-service for ID cards, cost estimators, and coverage info. Support agents assist with claims, payments, and health program questions.

Overall, both brands receive positive feedback, with MEDICA edging out BCBS for more personalized support thanks to their smaller size. But both offer comprehensive online self-service options to manage your policy.

Also Read: Comparison Between HealthTap And SteadyMD Virtual Care Service.

Frequently Asked Questions (FAQs)

How do you find the explanation of benefits?

Log into your insurance account portal online and look for a section called “Claims” or “Explanation of Benefits”. This details services billed, amount paid by insurance, and your responsibility. Explanations usually post after provider visits.

What to do with explanation of benefits?

Review EOBs to understand what you may owe for services or confirm care is covered as expected. Follow up on any claims not processed or denied. Pay member responsibilities as indicated. Document EOBs for your records in case of questions later.

Where is MEDICA 2023?

MEDICA offers health insurance plans in select states across different regions:
Midwest: Minnesota, Wisconsin, North Dakota, South Dakota, West: Arizona, California, Nevada, Oregon, Washington, Southwest: New Mexico, Texas, Expansion in additional states is possible for 2023 and beyond.

How long has MEDICA been around?

MEDICA has offered health coverage since the 1970s. Originally part of other insurers, MEDICA became its own standalone nonprofit insurance company in 1993 headquartered in Minnesota. They have continued serving states across the Midwest, West, and Southwest for over 25 years.

Choosing the Best Coverage for You

Comparing top insurers like MEDICA and Blue Cross Blue Shield is the first step to getting quality affordable health insurance tailored to your needs. Keep these key policy features in mind as you evaluate different plan options. And consult a licensed agent if you need help navigating the specifics for your situation. With the right knowledge, you can secure coverage that provides peace of mind and financial protection.

Also Read: Comparison Between Healthgrades And Zocdoc.

Final Thought

When deciding between MEDICA and Blue Cross Blue Shield, keep these key selection criteria in mind:

  • Location – BCBS has national reach, while MEDICA operates regionally
  • Cost – Compare plans head-to-head in your state for the best value
  • Network – Both provide access to top doctors and hospitals
  • Benefits – Focus on copays, deductibles, and prescription coverage
  • Customer service – Research reviews and support channels
  • Provider search – Confirm your doctors are in-network

For the widest selection of plans, go with BCBS. But in regional markets like the Midwest, MEDICA policies offer affordable options. Weigh premiums, deductibles, and out-of-pocket costs against your expected healthcare needs.

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