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Step therapy

For all Medica plan members

Your Health+ by Medica card is a great way to access your plan benefit allowances. Have questions on how to access or use your card? You’ll find answers here.

Don’t see your question covered here? Call the number on the back of your Medica ID card, and our Member Services team will help.

If you’re ready to activate your card or view your benefits, use the “Get started” button below.

 

 



Click each question below to see the answer:

How to activate your card and view your balance

There are three ways to do it:

  1. Go to MyBenefitsCenter.com and enter your 16-digit Health+ by Medica card number in the space provided, or
  2. Call 1-833-684-8472 and follow the prompts to enter your card number, or
  3. Use the OTC Network app (Android / iOS).

Once you activate your card, you can see the updated total of your benefit allowances in three ways:

  1. Visit MyBenefitsCenter.com and enter your 16-digit Health+ by Medica card number, or
  2. Download and use the OTC Network app (Android / iOS) on your phone, or
  3. Call the card activation and balance line at 1-833-684-8472.

What you need to know about your Health+ by Medica card:

Typically, no. There are two instances when you’d need to use paper reimbursement forms:

  1. If your Health+ by Medica card gets rejected when purchasing eligible eyewear or dental services.
  2. If you forget to use your Health+ by Medica card while paying for eligible eyewear or dental services and want to be reimbursed.

  • If you pay out of pocket for eligible eyewear or dental services, you can still submit a paper reimbursement form to recover the expenses under your Health+ by Medica card benefits. You can get a paper reimbursement form by calling the number on the back of your Medica member ID card.
  • If your plan covers over-the-counter (OTC), please note: OTC purchases aren't reimbursable (if applicable on your plan).

Yes. Just call the number on the back of your Medica member ID to ask for a replacement card.

  • Your eyewear and dental benefit allowances are available starting on your effective coverage date through the end of the plan year.
  • For Medicare Advantage individual plan members only: OTC benefit allowances get loaded onto your card quarterly at the beginning of the month in January, April, July, and October, and any balance remaining does not roll over at the end of each quarter.

How to use your card:

  • You can only use your OTC allowance, if applicable to your plan, at retailers that participate in the OTC Network. Here’s how to find a participating retailer:
  • Feel like your purchase was rejected in error? Call the number on the back of your Medica ID card.

If you’re on a Medicare Advantage individual plan, you can place over-the-counter orders a few different ways:

  • Go to MyBenefitsCenter.com, or
  • Use the OTC Network app, or
  • Call Convey OTC at 1-855-858-5937, or
  • You can use your Health+ by Medica card at all Walmart, Walgreens, CVS Pharmacy, Dollar General stores, and more. The full list is on the OTC Network App or at MyBenefitsCenter.com.

Group retiree plans with OTC benefit: You can continue to access your allowances through CVS OTC.

  • For Group retiree plan members: You can’t use your Health+ by Medica card for OTC purchases. You’ll find more details on your current CVS OTC benefit in Chapter 4 of your Evidence of Coverage (EOC), or here Cvs.com/Benefits. If you need a new copy of your EOC, call the number on the back of your Medica ID card to ask for one to be sent to you.

  • At any eyewear or dental provider in the U.S. that accepts debit cards.
  • Services must be provided where the primary business is eyewear or dental care.
  • Cosmetic procedures, teeth whitening, and orthodonture treatments aren’t covered. Please refer to your Evidence of Coverage (EOC) for more coverage details. If you need a new copy of your EOC, call the number on the back of your Medica ID card to ask for one to be sent to you.
  • You’ll need to purchase eligible eyewear or dental services from an eyewear location or freestanding eyewear or dental center in the U.S. or its territories.
  • If you visit an eyewear center or dentist that doesn’t participate in our network, call the number on the back of your Medica member ID card to let us know so we can address the issue.

Enter your five-digit ZIP code of the correspondence address registered with Medica (not a temporary address).

Use the credit option. And skip the PIN entry because you won’t have a PIN associated with your card.

That feature isn’t available right now. But you can use the OTC Network app’s scan-to-pay feature.

  • You can order one through the form you’ll find here: Order Materials For | Medica.
  • Or, call the number on the back of your Medica member ID card and we can order one to be sent directly to you.

Use your Health+ by Medica card, then pay for the remaining balance with another form of payment.

What should I know after I purchase?

Return the item to the retailer where you originally made the purchase. The credit will show up on your Health+ by Medica card balance.

Call the phone number on the back of your Medica member ID card right away.

 


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Last Updated: March 2024

1 Behavioral health services must be approved by Optum Health, Medica's behavioral health network administrator.

2 Receiving prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon many factors, including your eligibility and terms and conditions of the policy on the date you received services.

3 If your attending provider believes that an expedited review is warranted or Medica concludes that a delay could seriously jeopardize your life, health, or ability to regain maximum function, we will inform both you and your provider of the decision as soon as possible but not later than 72 hours from the time of the initial request.