Minnesota Health Insurance,Minnesota Small Business Health Insurance,HSA Quotes

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Prime Solution - 2008 Monthly Rate Annual Rate

Value - Includes some copayments for services
 
Summary of Benefits

MN/ND/SD/WI Application
 
$35.00 $420.00
Basic - Includes some copayments for services Summary of Benefits (MN only)

Summary of Benefits (ND / SD) 

MN/ND/SD/WI Application 

WI Addendum
   $62.00 $744.00
Enhanced - No copayments for doctor office visits, routine exams, and many other preventive services Summary of Benefits (MN only)

Summary of Benefits (ND / SD) 

MN/ND/SD/WI Application

WI Addendum
$112.00 $1,344.00
SilverSneakers® Fitness Program   N/A N/A
Snowbirds/Travelers Coverage   N/A N/A
 
Optional Riders - 2008 Monthly Rate Annual Rate
Medica Part D - Modified Standard RX Part D Rider Application $26.70 $320.40
Medica Part D Rider - Enhanced RX Part D Rider Application $38.90 $466.80
Wisconsin Rider (WI only) WI Rider $20.50 $246.00
Senior Dental Rider (MN only) Senior Dental Rider Application $38.00 $456.00

Need Extra Help with Medicare Part D? 
You may be able to get extra help to pay for your prescription drug premiums and costs. See our Medica Prime Solution Summary Table for potential rates. To learn more, contact:
  • 1-800-MEDICARE (1-800-633-4227) 24 hours a day, seven days a week. TTY/TDD users should call 1-877-486-2048;
  • The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m, Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
  • Your State Medicaid Office

How to Enroll:
Complete the Medica Prime Solution Application Form and any chosen Rider application. Attached above and mail or fax to Medica. How to Contact Us. Please review the summary of benefits before enrolling. Call 1-877-800-7340 for assistance.

For a complete copy of your medical policy, including coverage terms, exclusions, contract termination, members' rights and responsibilities, and other information, please refer to the  - 2008 Evidence of Coverage - coming soon!

CMS File #H2409, H2410, H2450, H2458, H7526_1427 (10/2007)

 

 
 
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