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2021 Medica Quest Plan Documents

To see your summary of benefits and coverage (SBC) and policy of coverage documents, select your state and plan below.

Looking for the 2020 documents?

Oklahoma Plans

Document Care Type  
Summary of Benefits and Coverage (SBC) Silver Copay (PDF) Bronze Copay (PDF)
Policy of Coverage
Silver Copay (PDF) Bronze Copay (PDF)
Document Care Type
Summary of Benefits and Coverage (SBC) Bronze HSA (PDF) 
Policy of Coverage
Bronze HSA (PDF)
Document Care Type
Summary of Benefits and Coverage (SBC) Gold Share (PDF) Bronze Share Plus (PDF)
Policy of Coverage
Gold Share (PDF) Bronze Share Plus (PDF)
Document Care Type
Summary of Benefits and Coverage (SBC) Bronze Value (PDF)
Policy of Coverage
Bronze Value (PDF)
Date: 5/8/2021 9:25:37 PM Version: 4.0.30319.42000 Machine Name: PWIM4-CDWEB01