Medica Applause Silver Share

Medica Insurance Company · 2027 plan year

Silver

Ind. deductible: $150
Family deductible: $300
Ind. OOP max: $2,400
Family OOP max: $4,800

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Standard Silver On Exchange Plan Zero Cost Sharing Plan Variation

More Medica Insurance Company plans in MN

Medica Applause Silver HSA Medica Applause Bronze HSA

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$5.00

Specialist

Benefit	In-network
Specialist Visit	$45.00

Hospital

Benefit	In-network
Emergency Room Services	10.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	10.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	10.00% Coinsurance after deductible
Urgent Care Centers or Facilities	10.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	$5.00
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	$125.00
Specialty Drugs	60.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	10.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$5.00

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	10.00% Coinsurance after deductible
Accidental Dental	10.00% Coinsurance after deductible
Allergy Testing	10.00% Coinsurance after deductible
Chemotherapy	$45.00
Chiropractic Care	$5.00
Delivery and All Inpatient Services for Maternity Care	10.00% Coinsurance after deductible
Diabetes Education	No charge
Dialysis	10.00% Coinsurance after deductible
Durable Medical Equipment	10.00% Coinsurance after deductible
Emergency Transportation/Ambulance	10.00% Coinsurance after deductible
Eye Glasses for Children	10.00% Coinsurance after deductible
Gender Affirming Care	10.00% Coinsurance after deductible
Habilitation Services	10.00% Coinsurance after deductible
Hearing Aids	10.00% Coinsurance after deductible
Home Health Care Services	10.00% Coinsurance after deductible
Hospice Services	10.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	10.00% Coinsurance after deductible
Infusion Therapy	10.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	10.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	10.00% Coinsurance after deductible
Nutritional Counseling	10.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	$5.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	10.00% Coinsurance after deductible
Outpatient Rehabilitation Services	10.00% Coinsurance after deductible
Prenatal and Postnatal Care	10.00% Coinsurance after deductible
Prosthetic Devices	10.00% Coinsurance after deductible
Radiation	10.00% Coinsurance after deductible
Reconstructive Surgery	10.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	10.00% Coinsurance after deductible
Rehabilitative Speech Therapy	10.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	10.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	10.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$5.00
Transplant	10.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	10.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	10.00% Coinsurance after deductible

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