Reputation grade
D
Peer-relative, A–F
Insurer profile · NAIC + CMS
Medica Insurance Company
Medica Insurance Company's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- D
- Reputation grade
- 22.0%
- Claims denied
- 5
- States (CMS data)
The verdict
Medica Insurance Company earns a D reputation grade — a worse-than-average record versus peers, CMS records show 22.0% of its marketplace claims denied across 5 states.
- D
- reputation grade
- 22.0%
- claims denied (CMS)
Grades are peer-relative within PlainInsurer's dataset. A high complaint ratio is not proof of wrongdoing — larger insurers draw more complaints by volume, which the index normalises.
NAIC complaint data Grade D CMS denial data · 5 states 0 states
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
22.0%
CMS, 5 states
Reputation grade D (composite score 36.2) — A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.
Medica Insurance Company — claim denial rate by state
Marketplace claims denied, by state (states with ≥100 claims on file)
- OK
OK: 26.8% denied (108,741 of 405,031 claims)
26.8 % of claims denied
- KS
KS: 25.1% denied (18,708 of 74,488 claims)
25.1 % of claims denied
- MO
MO: 23.8% denied (106,035 of 446,137 claims)
23.8 % of claims denied
- IA
IA: 23.1% denied (150,867 of 652,278 claims)
23.1 % of claims denied
- NE
NE: 19.6% denied (296,611 of 1,512,224 claims)
19.6 % of claims denied
What this shows Denial rates vary by state plan and network. Across 5 reporting states, Medica Insurance Company denied 22.0% of marketplace claims on average.
What the data shows for Medica Insurance Company
Medica Insurance Company carries a D reputation grade in PlainInsurer's dataset, with a composite score of 36.2 (higher means more consumer friction relative to size). It does not yet carry enough NAIC complaint history for a normalized complaint index.
On the claims side, CMS Transparency-in-Coverage filings show Medica Insurance Company denied 22.0% of marketplace claims across 5 reporting states — an elevated rate that warrants checking the plan's appeal-success record before enrolling.
The practical implication: complaint and denial data give a comparative view of how Medica Insurance Company treats policyholders relative to peers, but they cannot predict your individual claim experience. Compare the grade against named alternatives in your state, and weigh price, coverage terms and state licensing before any purchase. Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2025), cms.gov.
Use this data wisely. Complaint and denial figures reflect regulatory filings, not individual claim outcomes. A high complaint ratio is not proof of illegal behaviour. This page is informational and is not financial, legal, or insurance advice — verify coverage decisions with your insurer or a licensed agent.
Frequently asked questions
What does Medica Insurance Company's grade mean?
Medica Insurance Company received a grade of D, indicating a worse-than-average record versus peers. PlainInsurer grades insurers on a curve relative to the ~200 carriers in our dataset, using the NAIC complaint index (normalized by premium volume), CMS claim denial rates, and Medicare Advantage prior-authorization data where available.
How many complaints does Medica Insurance Company have?
Medica Insurance Company has 0 confirmed complaints on record across 0 states, based on published NAIC complaint data. Raw counts favour smaller insurers — PlainInsurer uses the complaint index (complaints relative to premium volume, where 1.0 is the market average) to compare carriers fairly.
How do I file a complaint against Medica Insurance Company?
Contact your state's Department of Insurance — every state has an insurance commissioner's office that accepts consumer complaints online, by phone, or by mail. The NAIC also runs a central complaint portal at naic.org. Document your policy number, claim number, dates, and the specific issue before filing.
Is Medica Insurance Company a good insurance company?
It depends on your coverage needs, state, and budget. PlainInsurer's D grade reflects a worse-than-average record versus peers relative to peers. Always compare quotes from multiple carriers and check complaint data for your specific state and line of coverage.
What types of insurance does Medica Insurance Company offer?
Detailed line-of-business data isn't currently available for Medica Insurance Company. The carrier is licensed in 0 states.
What to do with this
How to act on Medica Insurance Company's complaint and denial record.
- Compare this carrier side-by-side with another before you buy. Compare insurers
- See how every insurer in your state ranks on complaints and denials. Browse by state
- Denied a claim? Learn the internal and external appeal process. Appeal a denial
Complaint ratios normalise by premium volume so larger carriers are not penalised for writing more policies.
Source: NAIC published complaint index + CMS Transparency in Coverage PY2025 Complaint index, reputation grade and per-state claim denial rates for Medica Insurance Company · 2024 NAIC complaint index aggregates state-DOI consumer complaints, normalized against premium volume (1.0 = market average). Denial rates from CMS Transparency in Coverage PY2025. Reputation grade is PlainInsurer's peer-relative methodology applied to this public data.
Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2025. Not affiliated with NAIC or CMS. Read our methodology.