Reputation grade
C
Peer-relative, A–F
Insurer profile · Medica · NAIC + CMS
Medica Health Plans
Medica Health Plans's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- C
- Reputation grade
- 0.78
- Complaint index
- 23.5%
- Claims denied
- 3
- States active
The verdict
Medica Health Plans earns a C reputation grade - a record near the industry median, according to the NAIC's published complaint index, its ratio runs 0.78, below the 1.0 market average, and according to CMS Transparency in Coverage filings, 23.5% of its marketplace claims were denied across 1 state.
- C
- reputation grade
- 0.78
- NAIC complaint index
- 23.5%
- claims denied (CMS)
NAIC complaint index
0.78
1.0 = market average; lower is better
Claim denial rate
23.5%
CMS, 1 states
Graded on 3 of 3 measures: NAIC complaints, claim denials, prior authorisation.
How we calculated this grade →Where Medica Health Plans sits on complaints
- Best in data 0
Lowest complaint index in PlainInsurer's dataset: 0.23
0 complaint index
- Market avg 1
Market average complaint index = 1.0 (NAIC benchmark)
1 complaint index
- Medica Health Plans 1
Medica Health Plans: complaint index 0.78
1 complaint index
- Worst in data
Highest complaint index in PlainInsurer's dataset: 3.87
4 complaint index
What this shows Medica Health Plans's complaint index of 0.78 is 22% below the 1.0 market average for a carrier of its size.
Medica Health Plans vs. the full rated-insurer dataset
78% Among the most affordable more affordable than 65% of 72 rated insurers
Each bar is a band; taller bars hold more rated insurers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source NAIC published complaint index (2024) · 2024
Scale vs. complaint-adjusted score
Complaint record by line of business
| Line | Est. complaints | Complaint index | States active |
|---|---|---|---|
| Health Insurance (Individual) | ~310 | 0.78 | 3 |
Health insurance market share
National ranking by direct written premiums, NAIC 2024
Market share
0.38%
Direct written premiums
$6,362.5M
What the data shows for Medica Health Plans
According to PlainInsurer's dataset, Medica Health Plans has a lower (better) NAIC complaint index than 65% of the 72 rated insurers it tracks and ranks #5 of 18 carriers by complaint ratio in Health Insurance (Individual).
Medica Health Plans, part of Medica, carries a C reputation grade in PlainInsurer's dataset, with a composite score of 63.2 (higher means more consumer friction relative to size). Its NAIC complaint index of 0.78 sits below the 1.0 market average, meaning policyholders escalate fewer disputes to regulators than is typical for a carrier of its premium volume.
On the claims side, CMS Transparency-in-Coverage filings show Medica Health Plans denied 23.5% of marketplace claims across 1 reporting state - an elevated rate that warrants checking the plan's appeal-success record before enrolling. The carrier reports activity across 1 line of business.
See where Medica Health Plans sits against every reporting carrier in the claim-denial rate ranking.
Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2026), cms.gov.
Aggregates only, not advice. Full terms on the disclaimer.
Other C-graded carriers in PlainInsurer's dataset include Liberty Mutual and Aetna (CVS Health), and the closest overall composite score to Medica Health Plans's 63.2 belongs to Blue Cross and Blue Shield of NC (63.2), each rescaled across the measures that carrier reports.
Other C-graded insurers
Carriers with the same peer-relative reputation grade
| Insurer | Grade |
|---|---|
| Liberty Mutual | C |
| Aetna (CVS Health) | C |
| Allstate Property | C |
| AIG Homeowners | C |
| Allstate Insurance | C |
Closest composite score to Medica Health Plans
Carriers with the nearest overall composite score (63.2)
| Insurer | Composite score |
|---|---|
| Blue Cross and Blue Shield of NC | 63.2 |
| Florida Blue (BCBS FL) | 63.5 |
| Travelers Property | 63.6 |
| Unum Life | 62.8 |
| Oscar Insurance Company of Florida | 63.8 |
Questions about Medica Health Plans
What does Medica Health Plans's grade mean?
Medica Health Plans received a grade of C, indicating a record near the industry median.
How many complaints does Medica Health Plans have?
PlainInsurer estimates Medica Health Plans's complaint volume at roughly 310 across 3 states, derived from its published NAIC complaint index and market footprint (NAIC does not release exact per-company complaint counts via public bulk data).
How do I file a complaint against Medica Health Plans?
File against Medica Health Plans through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Medica Health Plans a good insurance company?
PlainInsurer's C grade for Medica Health Plans reflects a record near the industry median relative to peers on published complaint and denial data.
What types of insurance does Medica Health Plans offer?
Based on NAIC filing data, Medica Health Plans reports activity in 1 line of business: Health Insurance (Individual). Availability varies by state.
Verify Medica Health Plans
Medica Health Plans is filed with the NAIC under company number 95832. Search that number directly in the NAIC's own public consumer-information tool to cross-check this page against the primary source.
Verify on NAIC Consumer Information SourceSource: NAIC published complaint index + CMS Transparency in Coverage PY2026 Complaint index, reputation grade and per-state claim denial rates for Medica Health Plans · 2024
Share, download, and related pages for Medica Health Plans
Download the data behind this page
The full PlainInsurer extract, covering every insurer including Medica Health Plans, is available as CSV and JSON. Underlying federal data is public domain; see our methodology for the compilation and grading method.
Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2026. Not affiliated with NAIC or CMS.
Every figure on PlainInsurer comes directly from NAIC MCAS and CMS Transparency in Coverage data; no editor types in numbers. See our editorial standards or methodology, or report an error. Data current as of 2026-08-11. Grades measure only the published complaint/denial data; we don't recommend any insurer or policy.