We use cookies to ensure you get the best experience on our website. Cookie Policy 

Medicare plans FAQs

Get answers to common questions about Medicare. Find out about benefits and coverage, financial information, and more.


Plan Overview

Medicare is the federal health insurance program for people 65 or older, and people of any age with certain disabilities.


Sign in to your member account

Get personalized information and help

We're here to make sure you're in the know when it comes to Medicare. When you sign into your account, you'll find detailed information about:

  • Benefits and coverage
  • Prescription medications
  • Claim history
  • Network providers
  • And more
  • Parts of Medicare-White.svg

    Medicare Resources

    When Medicare's an option, you'll have new insurance choices to consider. We've created Medicare resources to help you figure out:

    • How Medicare works
    • What are the parts
    • Who's eligible
    • When to enroll
    • How to choose the right plan

    Getting Care

    Is my doctor covered by my plan?

    You can search for the doctors, specialists, and other providers covered by your specific plan.

    What care options do I have?

    Check out the programs and services covered by your specific plan.

    Should I go to urgent care or the emergency room?

    You’ll have to decide based on how you’re feeling. We can make that choice a little easier. 

    Is my prescription medication covered?

    Review the list of drugs to see which medications are covered.

    Is my annual check-up fully covered?

    When you receive preventive care, you won't have a copay. During that visit, if you also receive care that's not considered preventive care, then a copay will be charged. For example: If you go to your doctor for a seasonal flu shot and an annual wellness visit, you wouldn't have a copay because these are preventive care services. If during the same visit, you tell your doctor about a condition that requires an X-ray or you ask to have a skin tag removed, you would have a copay for those two services. That's because the X-ray is used to diagnose and the skin tag removal is a separate procedure, neither of which are considered preventive care. It's helpful to know what types of care are considered preventive. Preventive care includes:

    • An annual wellness visit that is a comprehensive, preventive medicine evaluation that results in a prevention plan based on your needs
    • Services to help you avoid illness or injury, including flu shots or pneumonia vaccines
    • Tests and screenings to detect undiagnosed diseases or problems, including routine cancer screenings, such as mammograms

    Preventive care does not include:

    • Diagnosis or monitoring of a problem or symptom you already have
    • Treatment of pain or other symptoms of an illness or disease
    • Treatment of problems found during a preventive care appointment

    Sign in to see your specific plan benefits. Or find your Medicare plan and refer to your plan documents for Evidence of Coverage.

    What type of wellness programs are offered by Medica?

    Sign in to see which wellness programs are offered for your specific plan. Or view our general wellness offerings.
    Parts of Medicare-White.svg

    Benefits + Coverage

    How can I find my benefits?

    How can I find my benefits?
    Sign In to see your specific plan benefits. Or find your Medicare plan documents and review your benefit coverage details.

    Plan documents for Medica Advantage Solution® members
    Plan documents for Medica Prime Solution ® members



    How do I read my invoice?

    We’ve broken down all the parts of your invoice to make it easy. 

    How do I make a payment?

    You can make payments online.
    Generic Document-White.svg

    Additional Plan Details

    How does my Member ID card work?

    Here’s how to understand all the parts of your ID card.

    How do I get forms related to my plan?

    We’ve pulled all our forms together to help you find what you need.
    Where can I see my pharmacy claims?
    In your member portal, you'll find a summary in "Claims Overview" under "Claims" in the navigation. To view details of a specific claim, click on the claim number. If your claim information isn't immediately available, keep in mind it takes time for a claim to arrive from your provider, be processed, and show up in your member website.
    What does the status of my pharmacy claim in my member portal mean?
    As you're reviewing your "Claims Overview," keep in mind current status will be shown. Claim history is not shown. You can find more detailed claim information at Express Scripts®.
    Information to help you
    We get it. There’s a lot to think about when it comes to Medicare. We’ll help you figure it all out.

    Last Updated: April 2023