Medica Q&A

SSM Health has formed a new strategic partnership with Medica – an independent, non-profit health plan headquartered in Minnetonka, Minn. Medica and SSM Health are two well-known Midwest health organizations who share a vision of bringing innovative high-quality health care solutions to both providers and members.

Under this arrangement, the two companies will maintain their respective health plan brands and products. For SSM Health, this includes Prevea360 Health Plan. The partnership is expected to be finalized later this year.

Information on this page will be updated to reflect incoming questions from providers and new information as it is available.

Will there be a new name created under this partnership? (9/13/21)

At this time, there are no plans to change organization names.

Will the new partners consolidate at a single office? (9/13/21)

We do not foresee changes in business locations, and plan to maintain a local health care presence in our provider network service areas.

What is Medica? (9/13/21)

Medica is a non-profit health plan headquartered in Minnesota. The company serves midwestern communities by providing health care coverage and related services in the employer, individual, Medicaid and Medicare markets. It operates in Minnesota, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin.

Is Medica part of United Health Care? (9/13/21)

No. United Health Care does not own Medica. There is a Medica Healthcare that offers Medicare Advantage plans in Florida and is part of United Health Care, but that entity is a completely separate entity from Medica and is not part of this strategic relationship.

My organization has a contract with Medica. Will that contract be affected by this partnership? (9/13/21)

The health plan’s partnership with Medica does not stipulate changes to existing contracts at this time. We encourage providers to reach out to Medica through their usual channels with any questions about their Medica contracts.

Are provider contracts with Prevea360 Health Plan affected by this partnership? (9/13/21)

No. There are no changes to provider contracts, reimbursement terms, or your key contacts.

Are Prevea360 Health Plan provider networks affected by this partnership? (9/13/21)

No. There are no changes to our provider networks or to Network Management’s policies regarding provider participation in the network.

Are my Prevea360 Health Plan patients affected by this partnership? (9/13/21)

No. Existing member benefits and products for your Prevea360 Health Plan patients will remain in place.

Does this partnership change how I currently conduct business with the Health Plan? (9/13/21)

No. There are no changes to current operational or medical management processes such as prior authorization requirements, claim submission, or medical policies as a result of this change.

How will updated information on this partnership be made available? (9/13/21)

The health plan will send an email to those providers who have opted in for electronic communications when updates are published on this web page. The “Opt In” option is available in the Provider Portal during the registration process and also can be selected after registration through Account Settings.

Who can I contact if I have further questions? (9/13/21)

Providers with questions may contact their Provider Network Consultant. To find your assigned Provider Network Consultant, go to prevea360.com/Providers and scroll to the bottom of the web page.