Medica Elect

Getting a referral when you need one will ensure you receive your highest level of benefits. Here's what you need to know about referrals:

• When you see a specialist within your care system, you don't need a referral.
• If you need to see a doctor who's in the Medica Elect network but isn't in your care system, you'll need a referral from your primary care clinic.
• If you need to see a provider outside the Medica Elect network, you'll need a referral from your primary care clinic and pre-approval (called "prior authorization") from Medica.

With Medica Elect, you enroll in a primary care clinic (PCC). This clinic coordinates your overall care and will help you find a specialist when you need one. Whenever you need care (unless it's an emergency), always start at your primary care clinic.

Each family member on your plan can choose their own primary care clinic. For example, your child's PCC may be a pediatric clinic, while yours may be a family practice clinic.

To search for a PCC:

1. Select the "Menu," or click on the location displayed in the upper right corner and set your location area, then choose either the "Facilities by type" or "Facilities by name" tile.
2. Select the search spyglass icon but do not enter anything in the search bar.
3. From the results, select "More filters" and choose "Eligible Primary Care Clinic (PCC)" from the options.
4. View the PCC number and care system affiliation for that provider. Use the “More filters” option from your search results or the "Care System" tile on the dashboard to search for providers in your care system.
5. When you enroll, you will need to provide the PCC number for your selected primary care clinic. If no PCC Number is displayed, you can’t choose the clinic as a primary care clinic.

Want to change clinics?

You can change your primary care clinic as often as once a month. Just submit our change form.