X
We use cookies to ensure you get the best experience on our website. Cookie Policy 
OK
Return to previous page

My Prescriptions

For Medica AccessAbility Solution® Enhanced Members

Medica-Signin-Mandrinkingcoffee-g-945212784.jpg

Sign in to view your prescriptions.

View your prescriptions and check drug costs on mymedica.com.

Sign in to mymedica

What do you want to do today?

View 2022 Drug lists

View 2023 Drug lists

Find a pharmacy

About Prescription Drugs


The following is the comprehensive list of covered drugs (formulary) that includes over-the-counter drugs as well as drugs covered by Medicare Part B and Part D and Medical Assistance.

To receive a covered drug:

  • Have your health care provider write a prescription for it
  • Take the prescription to a pharmacy in the Medica network

The pharmacist will fill your prescription with a generic version of the drug if one is available. If there is no generic version, the pharmacist will give you a name brand version.

View 2022 drug list

View 2023 drug list

Need Help with Paying for Part D?

If you qualify for extra help, you’ll get a Low Income Subsidy (LIS) rider. This means that you will get help paying your monthly premium and prescription drug cost-sharing. There are three levels of extra help, based on your income. As a member of our plan, you'll get the same coverage as someone who is not getting extra help. Your membership in our plan will not be affected by the extra help. This also means that you must follow all the rules and procedures in your Member Handbook.

We offer coverage of some supplemental prescription drugs not normally covered in a Medicare Prescription Drug Plan. These drugs are covered through Medical Assistance (Medicaid). Please see the chart below:

2023 Level of Extra Help

Level

3

Monthly plan premium

$0

Yearly deductible

$0

Cost-sharing amount

No more than $0 per prescription for generic or preferred multi-source drugs

Cost-sharing amount for all other drugs

No more than $0 per prescription

Level

2

Monthly plan premium

$0

Yearly deductible

$0

Cost-sharing amount for generic or preferred multi-source drugs

No more than $1.45 per prescription

Cost-sharing amount for all other drugs

No more than $4.30 per prescription

Level

1

Monthly plan premium

$0

Yearly deductible

$0

Cost-sharing amount for generic or preferred multi-source drugs

No more than $4.15 per prescription

Cost-sharing amount for all other drugs

No more than $10.35 per prescription

These amounts are effective January 1, 2023.
Once the amount both you and Medicare pay (as the Extra Help) reaches $7,400 in a year, your copayment amount will go down to $0 per prescription

Some drugs need approval or prior authorization before you get your prescription filled. You or your health care provider can request prior authorization approval from Medica.

You must get approval from Medica before you can fill your prescription for these drugs or Medica may not cover the cost.

Prior Authorization

It is important for your health care provider to fill the form out as completely as possible and list which medications have been tried and failed. Please include the dosages that were used and the reason why the drugs didn't work (e.g.: side effects or effectiveness).

Prior Authorization Coverage Determination Request Form

Request for Prescription Drug Coverage Determination online form
Request for Prescription Drug Coverage Determination paper form (PDF)

Appeals and Denials

If your prior authorization request for coverage of a prescription drug was denied and you want to appeal the decision, please fill out the form below.

Coverage Redetermination Request Form

Request for Redetermination of Medicare Prescription Drug Denial online form
Request for Redetermination of Medicare Prescription Drug Denial paper form (PDF)

Additional Pharmacy Benefits

Prescription programs-jade.svg

Review Your Medications

Talk to a pharmacist and learn how to get the safest and most effective results from your drugs with Medication Therapy Management (MTM).
Learn about MTM
Grants.svg

Transition of Care

If your drug isn't on our List of Covered Drugs (Formulary), or if it has certain restrictions, you may be able to request coverage for a transition period.
Transition of Care Policy
Mail Order Perscriptions.svg

Mail Order

Your plan includes the option of having prescriptions filled through the mail.
Learn how to order your prescriptions through the mail

Contact Us

1-888-347-3630 (toll-free) (TTY: 711)

8 a.m. – 9 p.m. daily
Access to a representatives may be limited at times.


Mailing address:
Medica
P.O. Box 9310
Minneapolis, MN 55440

About Your Coverage

Plan documents
Plan material order form
ID card order form
Determinations, appeals and grievances

Resources

Member rights and responsibilities
Limited English Proficiency (LEP) plan (PDF)
How to Get the Care You Need (PDF)
Disability Hub MN

Medica AccessAbility Solution Enhanced is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in Medica 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 a 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.


Last Updated: December 2022

Y0088_1004793_C