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For Medica Individual & Family Plans Members
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Plan Materials
Select the materials you want sent to you via mail.
Which year's materials would you like to order?
2021
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.
"How to Get the Care You Need" booklet
Medica Privacy Notice
Policy of Coverage
Summary of Benefits and Coverage (SBC)
Plan Forms
Use the following forms to change your personal information or to request reimbursement of health care expenses.
Personal information change form
Eyewear claim form
Medical claim form
Pharmacy claim form
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