Medica

Medical Insurance

Website: https://www.medica.com/

Contact: Member Services

Phone Number: (952) 945-8000

It is important that you understand your coverage and know how to find providers that are in your network to ensure you get the best care possible and avoid unnecessary expenses. The tools and resources on this page will help you gain a better understanding of your medical benefit and what services you have available to you.

For personalized benefits information, claims information, and more, log into your MyMedica account.

Tools Offered to You Through Medica

Medica offers these tools to help save your time, money and stress. You can also use some to maintain your health.

Care Management

If you have diabetes, cardiac issues or asthma, please reach out to Medica’s Adult Case Management. There is both online education to support goal setting, tracking, education, and self-management as well as telephone-based nurse support. For more information, call Member Support at (800) 952-3455.

Adult Case Management Programs

Adult Case Management Programs

Case managers work with members and caregivers to ensure access to services to allow members to remain in their home for as long as possible.

Benefit Appeals

Benefit Appeals

Learn about the process to appeal a denied insurance claim.

Healthy Pregnancy Program

Healthy Pregnancy Program

Medica’s healthy pregnancy program helps you and your baby achieve optmial health throughout a pregnancy and the first six weeks after delivery.

Pediatric Case Management Programs

Pediatric Case Management Programs

Pediatric case managers are registered nurses responsible for case management of infants or children with special needs.

Transplant Case Mangement

Transplant Case Management

Note: All transplant services, except for corneas, require prior authorization.

Case managers work to make sure that things go smoothly before, during and after an organ transplant.

Health Tools

Mental and Behavioral Healthcare

Mental and Behavioral Healthcare

Find articles, self-care tools, caring providers, and more mental health and substance use disorder resources.

Preventive Care

Preventive Care

Read what services are covered under preventive care. Preventive care services are normally 100% covered by insurance.

Health Information

Health Information

Find information on health conditions, wellness issues, and more in easy-to-read language on MedlinePlus.

My Health Rewards

My Health Rewards

This program helps members build daily healthy habits and get rewarded for doing so.

Quit Smoking and Earn Rewards

Quit Smoking and Earn Rewards

Earn points as you advance through your program to quit smoking.

Lasik Eye Surgery Discounts

Lasik Eye Surgery Discounts

QualSight prices start at less than $995 per eye and are all-inclusive.

Phone Support

Member Services

(800) 952-3455

For questions about coverage, claims or account balances, finding a doctor in your network or health plan services.

CallLink Nurse Line

(800) 962-9497

When you need help making smart decisions about your health, call this toll-free number to speak with an experienced registered nurse, 24/7, 365 days a year.

Personal Health Advocate

(866) 668-6548

Your Personal Health Advocate will help you address your healthcare concerns and will do the legwork to get you to the right providers and the right answers, including resolving healthcare claim issues, finding the right provider/facility, scheduling appointments, help to transfer medical records and more.

Behavioral Health

(800) 848-8327

Find a mental health provider who practices at all levels of counseling and treatment.

Pharmacist Help Desk

(800)364-6331

Pharmacy policies and procedures