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Health Improvement Programs

Medica offers several health improvement programs to help members manage and improve their health, focusing primarily on members who have chronic health conditions or behavioral issues. These clinical programs are designed to provide education and resources that help support members' ability to better manage their health.

To find out if Medica members are eligible for any of the programs listed below, direct them to the member section on medica.com.

Questions? For further information about these services and how to use them email us or call 1-866-905-7430.

 

Member Programs

Behavioral Health

We offer an integrated medical-behavioral program that supports members with depression, anxiety, stress, and other mood disorders. The liveandworkwell website offers many member resources including mental health tips, a clinician search, claim management and more.

Note: Access to this resource and services are not  available to Individual and Family plan members in Iowa, Kansas and Nebraska.

liveandworkwell.com

Case Management for Individual and Family Health Plan Members

Individual and Family Health Plan members living with a serious or chronic health condition may find the extra support a Medica Case Manager offers to be helpful. Case Managers can assist members with navigating the health system, understanding their health condition(s), managing their medications, evaluating treatment options, supporting a plan of care and following up on progress.

Medica Care Support℠ case management FAQ (PDF)

Condition Management for MN Health Care Program & Commercial Members

Medica provides support to members with chronic conditions. Programs offer telephonic or online support and include resources to help them better manage their health. Members of Minnesota Health Care programs (MHCP) and most Commercial plans are eligible.

Medica Health Support℠ condition management FAQ (PDF)

Condition Management for Individual and Family Health Plan Members

Individual and Family Health Plan members with chronic conditions such as asthma, diabetes, or hypertension may receive support through our no cost condition management services. A registered nurse is available to work with the member to complete an assessment, develop personal health goals and to provide support and follow up. Members are identified to participate in the voluntary program using a variety of sources such as claims data and referrals from other resources including providers. 

Medica Health SupportSM condition management FAQ (PDF)

Health and Wellness Coaching for Medica DUAL Solution Members

This program offers members support and tools to help make healthy lifestyle changes, such as managing weight, managing stress, eating healthy and being physically active. Members may self-enroll or be referred to the program.

Contact us at 1-866-905-7430 

Healthy Pregnancy

We offer online resources, a list of recommended services and detailed pregnancy information to members who are pregnant. Members identified as needing a little extra support during their pregnancy may have access to our Healthy Pregnancy Program. In this program, members can work one on one with a nurse to receive additional guidance and information. Learn about Medica’s resources for members who are pregnant.

Healthy Pregnancy resources for Commercial (group plan) members
Healthy Pregnancy resources for Minnesota Health Care Program members
Notify Medica of low birth weights (PDF)

Tobacco Cessation Program

Medica offers members enrolled in Minnesota Health Care Programs access to our telephonic tobacco cessation program. The program provides ongoing coaching from specialty trained health coaches to help members who are ready to quit using tobacco. Qualifying, enrolled participants also have the option to receive nicotine replacement therapy (patch, gum, and lozenge) at no extra cost. Members choose the level of support they want to make the program work for them.

Alternative tobacco cessation support is in place for members enrolled in other health plans. Learn more about how Medica supports members who are ready to quit tobacco.

Tobacco cessation support

Transplant Program

Our guidelines for organ and bone marrow/stem cell transplants are designed to help members get the care needed in the most effective setting, with the best possible outcome. We require prior authorization for all transplant services, including pre-transplant evaluations. We offer benefit coordination and readiness coaching. We also provide information about facilities ranked as Centers of Excellence for transplant procedures.

To request these services call 1-888-906-0958

Transplant prior authorization and notification form (PDF)
Transplant program provider guidelines and FAQ (PDF)

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