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Access Your Plan Materials and Member Forms
All plan materials are member forms are available on our website. Need a hard copy? Many of your materials can be downloaded at the links below and printed wherever it's convenient for you.
Information About Your Coverage
These documents tell you what services are covered under your plan, what you need to do to get covered services, and your rights and responsibilities.
Member Forms
Claims
Use these forms to tell us about other insurance you have or to request reimbursement of health care expenses.
Financial Accounts
Find forms for your flexible spending account, health reimbursement account or health savings account on MyMedica.com.
MyMedica.com log in
Continuity of Care
Use this form to request continuity of care with a specific physician.
Continuity of Care Form (DOC)
Coordination of Benefits
Use this form to let us know if you're insured by more than one health plan.
Replacement ID Card
Use this online form to order a replacement ID card. We will send it to the address we have on file for you.
Order ID Card form
Primary Care Clinic Change
Use this online form to change your primary care clinic. Medica Elect and Medica Essential members only.
Primary Care Clinic Change Request form
Plan Materials by Mail
If you are unable to print the above documents yourself, you may order them to be sent by mail. Please allow 10 business days for processing.
Order Plan Materials by Mail form