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My Coverage

For Medica Group Advantage Solution Members

Looking for a quick overview of your plan benefits?

For a complete record of your plan benefits and any plan notices please refer to your Evidence of Coverage (EOC) or contact your benefits representative. You can also contact Medica Customer Service.

 

Plan Features

Primary Health System (PHS)

We encourage you to select a Primary Health System (PHS) from which you may receive care. A PHS is a group of network doctors and health care professionals who can help you manage your total health, from getting needed preventive screenings and care to coordinating care for multiple health conditions. Your PHS aims to help you achieve your health goals. You can still get care from other in-network doctors and health care professionals and you don’t need a referral for covered services.

Your PHS is identified on your Medica ID card. You can change your PHS for any reason, at any time. Simply call Member Services at the number on the back of your Medica ID card and request to make a change to your PHS.

Search all PHS providers

SilverSneakers®SilverSneakers

This plan includes a SilverSneakers® membership. This program gives members access to over 17,000 fitness locations nationwide. Your membership also includes access to a mobile app with workout programs, a location finder, and more.

Get started by calling toll free at 1-877-871-7053 (TTY: 711), 7 a.m. to 7 p.m. Central, Monday through Friday.

Or visit SilverSneakers website

Prescription Eyewear and Hearing Aid Allowances

Some Medica Group plans have coverage for supplemental eyewear and hearing aids. Please check your Evidence of Coverage for your plan or call Customer Service to determine whether this benefit is available to you.

If you have this coverage, pay the purchase amount when you receive the items, then complete and submit a claim form to us within 180 days from the date of service or purchase. We'll process your claim in about 30 days and send you a check.

Eyewear claim form (PDF) 

Hearing aid claim form (PDF)

Health Advocacy and Nurse LineHealth Advocate

You and your family have a place to turn for trusted advice and information when you need it most. Through one simple call, you can consult with a nurse to get support for non-urgent illnesses or receive guidance on treatment options. You can also work with a personal health advocate who can help you with a variety of health and insurance-related issues.

About HealthAdvocate

Preventive Care

Many preventive care services and screenings are covered at no cost to you when received from in-network providers. This includes immunizations such as flu and pneumonia shots. For easy access to recommended preventive screenings for men, women and children of all ages, view our preventive care information.

About preventive care

Discount Programs

As a Medica Medicare member, you can get discounts on a variety of health and leisure goods and services through our value-added programs at no extra cost.

Discounts on value-added services

Caregiving Resources

Caring for loved ones in need of your help is an honorable act. However, taking care of a seriously ill family member can be emotionally and physically exhausting.

We want to support you. Here are some resources that can help you manage your caregiving responsibilities.

Caregiving resources

Tobacco Cessation Counseling Support

If you use tobacco, but would like to quit, you have access to two levels of counseling support depending on your health status. Signs or symptoms of tobacco-related disease determine your eligibility of coverage for counseling quit attempts as a preventive service at no extra cost to you.

Get tobacco free


Last Updated: December 2020

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