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My Prescriptions

For Medica Medicare Advantage Solution H3632-001 (PPO) Members

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Prescription Support

$0 Premium DiscountExtra Help with Paying for Your Prescription (Low-Income Subsidy)

You can find out if you qualify for extra help paying for your prescription drug premiums and costs by contacting any of the following organizations. By clicking on your state Medicaid office below, you will be taken to their website for contact information.

Organization Contact Information Hours
Medicare 1-800-MEDICARE

TTY: 1-877-486-2048
24 hours a day,
seven days a week
Social Security Administration


TTY: 1-800-325-0778

7 a.m. – 7 p.m.
Monday – Friday,
State Medicaid Office


Hours vary by state
Best Available Evidence Policy

If you believe you are eligible for the Low-Income Subsidy, but your current information does not reflect that eligibility, you can correct your status on the Centers for Medicare and Medicaid (CMS) website.

About best available evidence on


change planGive Your Medications a Check-up

If you qualify, our Medication Therapy Management program provides one-on-one consultation with a pharmacist to manage your medications. To learn more about this program, call us.

Medication Therapy Management Program

Pharmacy Documents and Prescription Claim Forms

DocumentPharmacy Documents

To see the coverage details for your Part D coverage level, choose your plan below.

DocumentPrescription Claim Forms

Need to receive reimbursement for covered Part D prescription medications and vaccinations not submitted to your Part D coverage? Use the claim instructions and form below to get your prescription processed under your Part D coverage.

Last Updated: December 2020


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