We use cookies to ensure you get the best experience on our website. Cookie Policy 

Order Plan Materials by Mail

For Medica Individual & Family Plans Members

Member Information

Plan Materials

Select the materials you want sent to you via mail.

Information About Your Coverage

These documents tell you what services are covered under your plan, what you need to do to get covered services, and your rights and responsibilities.
"How to Get the Care You Need" booklet
Medica Privacy Notice
Policy of Coverage
Summary of Benefits and Coverage (SBC)

Plan Forms

Use the following forms to change your personal information or to request reimbursement of health care expenses.
Personal information change form
Eyewear claim form
Medical claim form
Pharmacy claim form
Dental reimbursement claim form