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Non-Discrimination Statements

Discrimination is Against the Law

Medica complies with applicable Federal civil rights laws and will not discriminate against any person based on his or her race, color, creed, religion, national origin, sex, gender, gender identity, health status including mental and physical medical conditions, marital status, familial status, status with regard to public assistance, disability, sexual orientation, age, political beliefs, membership or activity in a local commission, or any other classification protected by law.

Medica:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as: TTY communication
  • Written information in other formats (large print, audio, other formats)
  • Provides free language services to people whose primary language is not English, such as: Qualified interpreters and information written in other languages

If you need these services, contact the number on the back of your identification card. If you believe that Medica has failed to provide these services or discriminated in another way on the basis of your race, color, creed, religion, national origin, sex, gender, gender identity, health status including mental and physical medical conditions, marital status, familial status, status with regard to public assistance, disability, sexual orientation, age, political beliefs, membership or activity in a local commission, or any other classification protected by law, you can file a grievance with:

Civil Rights Coordinator
Mail Route CP250
PO Box 9310
Minneapolis, MN 55443-9310
952-992-3422 (voice)
TTY: 711
civilrightscoordinator@medica.com

You can file a grievance in person or by mail, fax, or email. You may also contact the Civil Rights Coordinator if you need assistance with filing a complaint. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal Assistant, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue
SW Room 509F
HHH Building
Washington, D.C. 20201
1-800-368-1019
1-800-537-7697 (TTY)

Download complaint forms from the Office for Civil Rights at HHS.gov »


MCR 1116

Civil Rights Notice

Discrimination is against the law. Medica does not discriminate on the basis of any of the following:

  • Race
  • Color
  • National Origin
  • Creed
  • Religion
  • Sexual Orientation
  • Public Assistance Status
  • Age
  • Disability (including physical or mental impairment)
  • Sex (including sex stereotypes and gender identity)
  • Marital Status
  • Political Beliefs
  • Medical Condition
  • Health Status
  • Receipt of Health Care Services
  • Claims Experience
  • Medical History
  • Genetic Information

Auxiliary Aids and Services.Medica provides auxiliary aids and services, like qualified interpreters or information in accessible formats, free of charge and in a timely manner, to ensure an equal opportunity to participate in our health care programs. Contact Medica Customer Service at medica.com/contactmedicaid or call 1-888-347-3630 (toll free) or your preferred relay service.

Language Assistance Services. Medica provides translated documents and spoken language interpreting, free of charge and in a timely manner, when language assistance services are necessary to ensure limited English speakers have meaningful access to our information and services. Contact Medica Customer Service at medica.com/contactmedicaid or call 1-888-347-3630 (toll free) or your preferred relay service.

Civil Rights Complaints.
You have the right to file a discrimination complaint if you believe you were treated in a discriminatory way by Medica. You may contact any of the following four agencies directly to file a discrimination complaint.

U.S. Department of Health and Human Services’ Office for Civil Rights (OCR)
You have the right to file a complaint with the OCR, a federal agency, if you believe you have been discriminated against because of any of the following:

  • Race
  • Color
  • National Origin
  • Age
  • Disability
  • Sex (including sex stereotypes and gender identity)

Contact the OCR directly to file a complaint:

Director
U.S. Department of Health and Human Services’ Office for Civil Rights
200 Independence Avenue SW
Room 509F
HHH Building
Washington, DC 20201
800-368-1019 (Voice)
800-537-7697 (TDD)
Complaint Portal – https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

Minnesota Department of Human Rights (MDHR)
In Minnesota, you have the right to file a complaint with the MDHR if you believe you have been discriminated against because of any of the following:

  • Race
  • Color
  • National Origin
  • Religion
  • Creed
  • Sex
  • Sexual Orientation
  • Marital Status
  • Public Assistance Status
  • Disability

Contact the MDHR directly to file a complaint:

Minnesota Department of Human Rights
Freeman Building, 625 North Robert Street
St. Paul, MN 55155
651-539-1100 (voice)
800-657-3704 (toll free)
711 or 800-627-3529 (MN Relay)
651-296-9042 (Fax)
Info.MDHR@state.mn.us (Email)

Minnesota Department of Human Services (DHS)
You have the right to file a complaint with DHS if you believe you have been discriminated against in our health care programs because of any of the following:

  • Race
  • Color
  • National Origin
  • Creed
  • Religion
  • Sexual Orientation
  • Public Assistance Status
  • Age
  • Disability (including physical or mental impairment)
  • Sex (including sex stereotypes and gender identity)
  • Marital Status
  • Political Beliefs
  • Medical Condition
  • Health Status
  • Receipt of Health Care Services
  • Claims Experience
  • Medical History
  • Genetic Information

Complaints must be in writing and filed within 180 days of the date you discovered the alleged discrimination. The complaint must contain your name and address and describe the discrimination you are complaining about. After we get your complaint, we will review it and notify you in writing about whether we have authority to investigate. If we do, we will investigate the complaint.

DHS will notify you in writing of the investigation’s outcome. You have a right to appeal the outcome if you disagree with the decision. To appeal, you must send a written request to have DHS review the investigation outcome period. Be brief and state why you disagree with the decision. Include additional information you think is important.

If you file a complaint in this way, the people who work for the agency named in the complaint cannot retaliate against you. This means they cannot punish you in any way for filing a complaint. Filing a complaint in this way does not stop you from seeking out other legal or administration actions.

Contact DHS directly to file a discrimination complaint:

ATTN: Civil Rights Coordinator
Minnesota Department of Human Services
Equal Opportunity and Access Division
P.O. Box 64997
St. Paul, MN 55164-0997
651-431-3040 (voice) or use your preferred relay service

Medica Complaint Notice

Contact Medica directly to file a discrimination complaint:

Civil Rights Coordinator
Mail Route CP250
PO Box 9310
Minneapolis, MN 55443-9310
952-992-3422 (voice) or use your preferred relay service
civilrightscoordinator@medica.com

Date: 6/25/2017 7:10:20 AM Version: 4.0.30319.42000 Machine Name: PWIM4-CMSWEB01