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Health Improvement Programs

Medica offers several health improvement programs to help members manage and improve their health, focusing primarily on members who have chronic health conditions or behavioral issues. These clinical programs are designed to provide education and resources that help support members' ability to better manage their health.

To find out if Medica members are eligible for any of the programs listed below, direct them to the member section on medica.com.

Questions? For further information about these services and how to use them email us or call 1-866-905-7430.

 

Member Programs

Behavioral Health

We offer an integrated medical-behavioral program that supports members with depression, anxiety, stress, and other mood disorders. 

The liveandworkwell website offers many member resources including mental health tips, a clinician search, claim management and more.

liveandworkwell.com

Case Management

Medica Case Managers are available to support members living with serious or complex health conditions. Case Managers partner with members and their providers to help manage their conditions with the goal of influencing illness trajectory, promoting adherence to the prescribed plan of care, and improving health outcomes. Case Managers create a personalized care plan based on the member’s health goals and provide ongoing management and support as they work toward their goals.

Condition Management

Medica provides support to members with targeted chronic conditions such as asthma, diabetes, or heart disease. Members may receive telephonic or online support through our no cost condition management services. A registered nurse is available to work with the member to complete an assessment, develop personal health goals and to provide support and follow up. Members are identified to participate in the voluntary program using a variety of sources such as claims data and referrals from other resources including providers.

Pregnancy

Medica provides support to members who are pregnant. For all members, we offer online resources, a list of recommended services, and detailed benefit information to support a healthy pregnancy. For members identified as needing a little extra support during their pregnancy they have access to our Pregnancy Program. In this program, members work one on one with a nurse to receive additional support customized to their unique needs. Learn about Medica’s resources for members who are pregnant.

Healthy Pregnancy resources for Commercial (group plan) members
Healthy Pregnancy resources for Minnesota Health Care Program members
Notify Medica of low birth weights (PDF)

Tobacco Cessation Program

Medica offers members enrolled in Minnesota Health Care Programs access to our telephonic tobacco cessation program. The program provides ongoing coaching from specialty trained health coaches to help members who are ready to quit using tobacco. Qualifying, enrolled participants also have the option to receive nicotine replacement therapy (patch, gum, and lozenge) at no extra cost. Members choose the level of support they want to make the program work for them.

Alternative tobacco cessation support is in place for members enrolled in other health plans. Learn more about how Medica supports members who are ready to quit tobacco.

Tobacco cessation support

Transplant Program

Medica’s guidelines for organ and bone marrow/stem cell transplants are designed to help members get the care needed in the most effective setting, with the best possible outcome. We require prior authorization for all transplant services, including pre-transplant evaluations. Specialized Registered Nurses review information about facilities ranked as Centers of Excellence for transplant procedures with all members seeking an organ or bone marrow/stem cell transplant.

Case Managers guide each member through the evaluation and listing process, helping them maintain transplant readiness while awaiting organ transplant, and continue to provide ongoing management and support post-transplant. Transplant case managers complete both utilization management and case management functions to provide a seamless relationship and key point of contact with Medica.

To request these services call 1-866-905-7430

Transplant prior authorization and notification form (PDF)

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