Medica Q&A

With SSM Health’s 2021 agreement with Medica – an independent, non-profit health plan headquartered in Minnetonka, Minnesota, WellFirst Health, a SSM Health-created health plan in Illinois, Missouri, Wisconsin, and Oklahoma, was brought into the Medica family. To unify product offerings and streamline resources, the WellFirst Health brand was discontinued and rebranded as “Medica.” As Medica, we continue to provide high quality support for providers and members in their communities amid an ever-evolving health care environment. See our Q&As below to learn more about this partnership.

To unify product offerings and streamline resources, the WellFirst Health brand was discontinued and rebranded as “Medica.” This name change includes the benefit plan for SSM Health employees.

Note: The Medica (formerly WellFirst Health) brand and products are different than the Medica brand and products that our partner Medica, headquartered in Minnesota, offers. Medica (formerly WellFirst Health) is sometimes referred to as Medica Central Health Plan to distinguish it from other Medica products. Access online information and resources for Medica Central from our landing page. While we make progress aligning business platforms and policies with our partner Medica, providers should continue referring to MO-Central.Medica.com and Central.Medica.com for information.

We do not foresee changes in business locations.

We encourage providers to reach out to Medica through their usual channels with any questions about their Medica contracts.

Yes, for some benefit plans. We’ve moved our 2024 Individual + Family Business (IFB)/Affordable Care Act (ACA) plans (both Marketplace and direct) to new business platforms under payer ID 41822. We’re partnering with Medica in Minnesota to align best practices and share technology.

The following business platforms and systems are for benefit plans under the payer ID 41822:

Availity Essentials Provider Portal
Availity Electronic Data Interchange (EDI) Gateway
InstaMed payment services (remittance advice, Explanations of Payments, electronic funds transfer [EFT], and paper checks)
New Provider Service phone number featuring expanded hours, and 24/7 self-service through the Interactive Voice Response (IVR) system

Currently, the above platforms only apply to 2024 IFB/ACA plans under payer ID 41822 (except for InstaMed which also applies to payer ID 39113). Business platforms for other products remain the same until further notice.

We’ll announce dates to move additional benefit plans to business platforms under payer ID 41822 in the future.

Continue to use the MO-Central.Medica.com and Central.Medica.com websites for online information.* See the following resources under the “Our Medica partnership” section of the Provider communications web page:

Medica (formerly WellFirst Health) Provider Quick Reference by Payer ID – Identifies resources and processes with the addition of payer ID 41822.
Medica’s Just in Time for Providers – Latest information on preparation and processes as we transition to business platforms under payer ID 41822.
Provider Communications – a list of communications about our partnership with Medica.

*As we align business platforms and policies with our partner Medica in Minnesota, Medica Central providers should continue referring to MO-Central.Medica.com and Central.Medica.com for information.

Refer to this FAQ web page for updates. Also, go to our Provider News and Provider communications web pages to see articles and communications regarding our partnership with Medica.

To unify product offerings and streamline resources, the WellFirst Health brand was discontinued and rebranded as “Medica.” The SSM Health Employee Health Plan, previously administrated by and branded as WellFirst Health, is branded as Medica. This is a name change only and there is no change to the provider network.

No, there is no change to the patients you can serve. You can deliver care to patients enrolled in benefit plans covered under your provider contract with us.

If you have questions, contact the Provider Network Consultant team at ProviderRelations@Medica.com.

Medica Q&A

Will there be a new name created under this partnership? (June 2024)

Will the new partners consolidate at a single office? (March 2023)

My organization has a contract with Medica. Is that contract affected by this partnership? (June 2024)

Does this partnership change how I currently conduct business with the Health Plan? (June 2024)

What are the new business platforms? (June 2024)

Will other benefit plans move to the new business platforms? (June 2024)

Where can I find more information about the new business platforms?(June 2024)

How is updated information on this partnership made available? (June 2024)

Does this partnership change any products? (June 2024)

Does this partnership change the members I can serve? (June 2024)

Who can I contact if I have more questions? (June 2024)