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Medica Administrative Manual Home > Member Care

Member Care

Medica has several resources that participating providers can direct members to for answers and services. Medica recognizes that members often look to their health care providers for answers regarding their medical coverage. In most instances, the provider will not be able to (and is not expected to) answer all the specifics related to a particular member’s benefit document.

Please encourage members to review their benefit documents by viewing their secure member site, or by calling the Customer Service number on the back of their ID card.

Common Resources

For more information about the member complaint and appeal process, and the providers' role, refer to Medica's complaint review process.

Complaint and appeal process details

Members should log into their secure member site or call Customer Service for the following services:

  • Member enrollment information
  • Benefit document explanation
  • Clerical errors, including misspelled names, a wrong address or a wrong gender listed
  • Clarification of copayments, coinsurance and deductibles
  • Clarification of, or requests for, member packet information, e.g., a Provider Directory, replacement Medica identification cards, etc.
  • Information about, or application for, conversion to an individual policy when terminating coverage from a group policy
  • Status change forms to add/delete a dependent or to change address
  • Other information that affects the member’s coverage or benefit determinations
  • Requests for interpreter services (hearing impaired and foreign language)

Foreign language and American Sign Language (ASL) interpreter services are available to Medica Choice CareSM MSC+, Medica DUAL Solution® (MSHO) and Medica AccessAbility Solution® members while receiving plan-covered services. Most languages are covered by the interpreter service including:

  • Hmong
  • Russian
  • Somali
  • Spanish
  • Vietnamese

Requests for interpreter services may be submitted by the member, a family member, a friend of the member, or a participating provider by calling the appropriate Customer Service number listed on the back of the member's ID card.

Members enrolled in Medica's other products do not have interpreter benefits. Customer Service representatives are able to assist non-English speaking members.  

For more information, refer to the member benefit documents for Minnesota Health Care Programs members.

Date: 6/16/2019 5:57:03 AM Version: 4.0.30319.42000 Machine Name: PWIVE-CMSWEB01