Reviews

This profile includes reviews for Medica's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Medica

  401 Carlson Pkwy Minnetonka, MN 55305-5359

• 

  Medica

  PO Box 9310 Minneapolis, MN 55440-9310

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  Medica

  120 Cheshire Lane #100 Minnetonka, MN 55305

Review Details

• Review fromStacy S

  Date: 02/12/2025

  1 star

  Stacy S

  Date: 02/12/2025

  I spoke with a representative named ******* in Minnesota who was incredibly hostile and rude for no reason. If this is the behavior MEDICA endorses, I would stay far away.

  Medica

  Date: 02/13/2025

  We have been unable to locate a member with this name. 

• Review fromScott b

  Date: 01/25/2025

  1 star

  Scott b

  Date: 01/25/2025

  Absolutely the worst health insurance company. They say their goal is to get back to me in one business day- more like week. Pre approves tests but then finds ways to deny charges. Paid 6000 is out of pocket max now the want 700 more which was pre approved by them! I would never had the echo done without insurance preapproval! Had to pay a doctor twice because of their incompetence. Medica said oh the hospital will pay me back. Been 9 months and still nothing back. The WORST company!!

  Medica

  Date: 01/28/2025

  Our goal is to respond to emails received from members within one business day. However, there are times when the volume of correspondence received does not allow us to meet this goal. We apologize for any delay in receiving a response to an email.
  
  The review of the members account finds that the services were prior authorized and approved. However, the review of the procedure code attached to the denied charge finds that it does not match any procedure code that was pre-approved. As a result, the charge in question denied. The charge in question cannot be paid with the authorization on file.
  
  We do not have access to member accounts with providers and do not know when a member may have a credit on their account with a provider. Each provider determines how they handle member accounts. ********************** does not tell providers how to manage their accounts. If a member has a credit on their account with a provider, it is up to the provider to determine how that credit is handled. The member will need to contact the provider directly to determine if they have a credit and if so, how that credit can be returned to the member.

• Review fromMina B

  Date: 01/14/2025

  1 star

  Mina B

  Date: 01/14/2025

  Medica incorrectly charged our credit card for coverage for the month of November, 2024 in the amount of $1099. That coverage was cancelled on 10/31/2024. However, they did not refund that payment until January 9, 2025 after numerous requests and inquiries since November 1, 2024 when Medicare coverage began. Our numerous requests were unheeded until 1/9/2025. Requests to speak to a supervisor were accepted but never fulfilled from late December through today. The feedback was that it's ******************************'s fault and Medica set passively by and refused to help resolve this issue. Never was resolution expedited; no time frame was committed to, and no real help was offered. If you can choose another company, I suggest you do so.

  Medica

  Date: 01/15/2025

  We have been unable to locate a member with the information provided.

• Review fromMATTHEW S

  Date: 01/09/2025

  1 star

  MATTHEW S

  Date: 01/09/2025

  My wife accidentally threw away a 90-day supply of sertraline. Medica would not cover a replacement, and I was left to either pay $400 out of pocket or go off the meds cold turkey. To the shock of my doctor and my pharmacy, Medica did nothing to help me. No override, nothing. I was told by Medica that I had already received 2 overrides within the past year and couldn't have another one for 180 days. There's a big problem with that statement ... I have only been insured with them for 6 months, and I didn't know what an override was until they told me I wasn't eligible. I filed a grievance and never received a response. I called to follow up on the grievance and was disconnected 3 times after being placed on hold for 30 mins each time. After almost 2 hours I spoke with someone who just repeated the same c*** I filed the grievance about. THEY DO NOT CARE ABOUT YOUR HEALTH! ONLY PROFITS! If I could give them 0 stars, I would.

  Medica

  Date: 01/10/2025

  Our review found that the plan paid and covered a 90-day supply of the medication in question in the last week of December 2024. The member then attempted to refill the same medication for another 90-day supply just a few days later and the request was correctly denied. The plan document specifically excludes coverage for the replacement of a drug due to loss, damage, or theft.
  
  A complaint regarding this issue was recently assigned to a Medica Consumer Appeals Advisor and the member will receive a response to his complaint shortly. The request was received via the member portal and unfortunately,the plan receives a large number of inquiries at the start of a new year, and it does take longer than usual for them to be assigned for review and response.When the member contacted member service the complaint had not yet been assigned and the representatives were not aware that complaint had been received but was not yet assigned.
  
  We apologize for any delay in responding to the members concerns.

• Review fromRobbie M

  Date: 01/07/2025

  1 star
  They are the worst. Takes forever to get help. They don't make the changes requested. You need to physically fax or mail forms in to make changes. They can't find me a lot of the times when I call for help. I blew my knee and the max out of pocked was HUGE, 15k more than my deductable! It's honestly criminal. What a bad company.

• Review fromSara S

  Date: 01/06/2025

  1 star
  Have been trying to reach someone in customer service for over a week. I wait on hold for hours, no one ever answers. I've been trying to register for an online account, I keep getting an error of a mismatch. And when I call I can't get anyone to help me, I've yet to speak with an actual person. I have Medica to manage my medicare advantage. And it's been a bad experience only a week into the plan. On top of this, they want a paper check or money order for premiums (which should be deducted from my social security). No one has checks anymore. And the process for a money order and mailing just isn't realistic in 2025. I will be dropping them during next open enrollment.

• Review fromJamie S

  Date: 08/01/2024

  1 star
  I have been having problems with medica since having active coverage in January. No provider that I have visited has been able to verify that my coverage is active. My employer states they can't do anything about it. I have called them every single month since January as well for bills that I keep getting. The one that I have gotten have been outrageous despite having the best insurance that was provided through my employer. I have two kids, I'm pregnant and a spouse. We just moved out of state, but I'm still supposed to be covered out of network. They also have claims that still haven't been processed from March of 2024. It is now August, and I've receiving $1500 bills from a provider that has done nothing but ultrasounds. I met with a doctor one time. The rest of the time has been with a nurse. I also received an EOB where they only paid $99 for a service that was about $1000 which I also believe was over coded. No one can ever give me a reason why I'm consistently having issue while having this insurance company.

• Review fromMorgan S

  Date: 07/12/2024

  1 star
  I wish I could give negative stars. Their process for reviewing claims is atrocious. Nearly every claim ever submitted to Medica has been denied for various reasons and I have had to request they review each claim again. I just learned this week they ended up denying all claims from January 2024-March 2024 after they were already approved and paid out to my providers and stated I did not have coverage. What the heck was I paying a premium for??? Amounts owed with my providers is a mess because my claims are constantly in a state of being re-processed. We will never use Medica again.

• Review fromDaisy R

  Date: 03/13/2024

  1 star
  We're new to Minnesota, and my partner's employer recently switched from UnitedHealthcare to Medica. Medica is a "non-profit". What on earth does that mean? Established in 1975, Medica is the product of a merger between two physician-founded HMOs in Hennepin County, and its parent company is a non-profit, tax exempt holding company called, Medica Holding Company, and Medica calls itself a non-profit HMO? Honestly, nothing is clear, except for the following:Medica fails to pay for benefits, as approved and promised; the in-network coverage is totally impossible to understand; Medica arbitrarily pays for standard coverage, usually not in full, and we just don't know what we're going to get; and, finally, for some reason it feels like we're always satisfying a deductible--but we can't figure out what it is! I am still trying to get my head around every bill and statement Medica has sent us. We're compliant--we stay in network. But, of course, we can never be sure with Medica, even though we live in Minnesota and Medica was established locally for residents. Lastly, we are, obviously, seeing Minnesota providers. So, right here is the heart of the matter: what are we doing wrong to not get benefits paid and why can't we get simple answers?In a nutshell, ever since we started using Medica we have been spiraling into medical debt and EVERY SINGLE doctor visit we have made has been followed by an invoice from the provider. At this point, I can't bear to fight this by calling Medica. I have read too many complaints on this BBB web site, Wallet Hub, ****** Consumer and others that Medica is unresponsive and gives people the runaround, and I just don't know if I have the will, much less the time, to call Medica with what is now a stack of bills that have not been covered by Medica. What we ARE doing is telling my partner's employer that we are seeking our own insurance and getting AWAY from Medica as fast as we can.

• Review fromBrian H

  Date: 02/29/2024

  1 star

  Brian H

  Date: 02/29/2024

  Agreed. Medica has terrible customer service and poor prescription coverage.

  Medica

  Date: 03/01/2024

  Thank you for your feedback. Medica provides coverage of medications in accordance with the United ***************** Services Task Force. A review of your account shows no communication between you and Medica member service. We understand each members situation is unique and should you have any questions regarding your Medica prescription coverage you can contact Medica member service at the phone number located on the back of your ID card or online at medicamember.com.