A formulary is a list of drugs a health plan makes available to its members. Medica offers comprehensive formularies to help our members maximize their prescription drug benefit.

For more information on prescription drug benefits or to view a plan formulary, please select one of the options below.

Prescription drug benefits and plan formularies

Formulary Search

Are you looking for recent formulary changes?

We periodically update and make formulary changes.  When changes are made, they will be posted on medica.com.

View recent formulary changes.

Medication Request Forms

Medicare Part D Form for Appeal of Prescription Drug Denial
Medicare Part D Formulary and Prior Authorization Form
Medicare Part D Formulary and Prior Authorization Form - Online Submission

Are you looking for a Pharmacy near you?

Use our Pharmacy Directory to find convenient pharmacies in the Medica network. Medica contracts with over 56,000 pharmacies nationwide that equal or exceed CMS requirements.  Medica covers drugs from an out-of-network pharmacy only under special circumstances including illness while traveling outside of the plan’s service area where there is no network pharmacy. You may incur additional costs for drugs received at an out-of-network pharmacy. Search Pharmacy Directory.

Are you interested in Mail Order Prescriptions?

Print the forms below and follow the directions to have your prescriptions filled by mail.

• View BioScrip Mail Order Form.
• View Walgreens Mail Order Form.

Do you need extra help with Medicare Part D?

Find out if you qualify for extra help to pay for your prescription drug premiums and costs by contacting:

• 1-800-MEDICARE (1-800-633-4227) 24 hours a day, seven days a week. TTY/TDD users should call 1-877-486-2048;
• The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m, Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
• Your State Medicaid Office

Do you have a problem or complaint about your Part D coverage?

• View Medica Part D Problem and Complaint Resources.
• View Part D Transition of Care Policy.

Do you want to talk to Customer Service about your Part D pharmacy coverage?  

Call Medica Center for Healthy Aging  952-992-2345 or 1-800-906-5432. TTY users may call the National Relay Service at 1-800-234-8819 and ask to be transferred to 1-800-906-5432. Hours of operation are 8 a.m. - 8 p.m. (Central Time), seven days a week. Please note that access to a representative may be limited evenings and weekends during certain times of the year.

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Pending CMS approval
Last Updated: October 2011