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Member Rights and Responsibilities

For Medica Medicare Members

As a Medicare member of our plan, you have the right to:

  1. Be treated with dignity and respect at all times.
  2. Not be discriminated against based on race, ethnicity, national origin, disability, religion, gender or age.
  3. Protect the privacy of your personal health information.
  4. Be provided information in a way that works for you (e.g., Braille, large print).
  5. Receive timely access to network providers and prescription drugs, including emergency care services, 24 hours a day, seven days a week.
  6. Get information about the plan, its network of providers and your covered services.
  7. Know all your treatment options and participate fully in discussions and decisions about your health care.
  8. Refuse any treatment recommended to you by any provider.
  9. File a complaint, ask for a coverage decision, or ask us to reconsider decisions we have made.
  10. Get help if you believe you are being treated unfairly or your rights have not been respected.


As a Medicare member of our plan, you have the responsibility to:

  1. Help your doctors and other providers help you by giving them the necessary information, asking questions and following through on your care.
  2. Practice self-care by knowing how to recognize common health problems and what to do when they occur.
  3. Practice preventive care by having the appropriate texts and immunizations and engaging in healthy lifestyle choices (e.g., exercise, diet). 
  4. Tell your doctor and other health care providers that you are enrolled in our plan.
  5. Get familiar with your covered services and the rules you must follow to get these covered services. 
  6. Tell us if you have any other insurance coverage or prescription drug coverage in addition to our plan.
  7. Tell us if you move. If you move outside the plan’s service area, you cannot remain a member of our plan.

See your Evidence of Coverage document for more information about your rights and responsibilities, or call Medica Customer Service.

Medica DUAL Solution and AccessAbility Solution Enhanced are health plans that contract with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in Medica DUAL Solution and AccessAbility Solution Enhanced depends on contract renewal.

American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For elders age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in the tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral.

This information is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information call Medica Member Services or read your Member Handbook/Evidence of Coverage for more information.

Last Updated: December 2020


Date: 5/28/2023 4:26:58 AM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB01