Medica Individual Choice Gold Share

Medica · 2027 plan year

Gold

Ind. deductible: $2,600
Family deductible: $5,200
Ind. OOP max: $6,000
Family OOP max: $12,000

Compare with other Gold plans in ND

Side by side: deductibles, out-of-pocket limits and copays.

BlueDirect Gold 90 HSA Eligible $2600 DeductibleBlue Cross Blue Shield of North Dakota · Deductible $2,600 · Out-of-pocket max $4,300
Sanford Individual TRUE Standardized $2,500Sanford Health Plan · Deductible $2,500 · Out-of-pocket max $8,600
BlueValue Gold $30 PCP CopayBlue Cross Blue Shield of North Dakota · Deductible $2,500 · Out-of-pocket max $8,600

Compare 4 plans Browse all Gold plans in ND

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Gold Off Exchange Plan Zero Cost Sharing Plan Variation

More Medica plans in ND

Medica Individual Choice Bronze Share Medica Individual Choice Silver Share Medica Individual Choice Gold HSA Medica Individual Choice Silver HSA

Monthly premiums by age

Rating Area 3 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$526	$526
21	$688	$729
30	$780	$827
40	$879	$931
50	$1,228	$1,302
60	$1,866	$1,978
64 and over	$2,063	$2,186

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	$35.00

Specialist

Benefit	In-network
Specialist Visit	$100.00

Hospital

Benefit	In-network
Emergency Room Services	20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	20.00% Coinsurance after deductible
Urgent Care Centers or Facilities	20.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	$20.00
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	$80.00
Specialty Drugs	60.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$35.00

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	20.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	20.00% Coinsurance after deductible
Bariatric Surgery	20.00% Coinsurance after deductible
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	Not covered
Chemotherapy	$100.00
Chiropractic Care	$35.00
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	20.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
Diabetes Education	No charge
Dialysis	20.00% Coinsurance after deductible
Durable Medical Equipment	20.00% Coinsurance after deductible
Emergency Transportation/Ambulance	20.00% Coinsurance after deductible
Eye Glasses for Children	20.00% Coinsurance after deductible
Habilitation Services	20.00% Coinsurance after deductible
Hearing Aids	20.00% Coinsurance after deductible
Home Health Care Services	20.00% Coinsurance after deductible
Hospice Services	20.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	20.00% Coinsurance after deductible
Infertility Treatment	Not covered
Infusion Therapy	20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	20.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	Not covered
Nutritional Counseling	20.00% Coinsurance after deductible
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	$35.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	20.00% Coinsurance after deductible
Outpatient Rehabilitation Services	20.00% Coinsurance after deductible
Prenatal and Postnatal Care	20.00% Coinsurance after deductible
Private-Duty Nursing	Not covered
Prosthetic Devices	20.00% Coinsurance after deductible
Radiation	20.00% Coinsurance after deductible
Reconstructive Surgery	20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	20.00% Coinsurance after deductible
Rehabilitative Speech Therapy	20.00% Coinsurance after deductible
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	Not covered
Routine Eye Exam for Children	$35.00
Routine Foot Care	Not covered
Skilled Nursing Facility	20.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	20.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$35.00
Transplant	20.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	20.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	20.00% Coinsurance after deductible