Medica Advantage Solution
Plan management forms
Claim and reimbursement forms
Applies to Medica Advantage Solution (HMO, PPO, HMO-POS, HMO I-SNP) and Medica Group Advantage Solution (PPO) members
Applies to Medica Advantage Solution (HMO, PPO, HMO-POS, HMO I-SNP) and Medica Group Advantage Solution (PPO) members
Applies to Medica Advantage Solution (HMO I-SNP) and Medica Group Advantage Solution (PPO) members
Applies to Medica Advantage Solution (HMO, PPO, HMO-POS, HMO I-SNP) and Medica Group Advantage Solution (PPO) members
Applies to Medica Advantage Solution (HMO, PPO, HMO-POS, HMO I-SNP) and Medica Group Advantage Solution (PPO) members
2021 Advantage Solution claim forms
Applies to Medica Advantage Solution PPO and Medica Advantage Solution with CHI Health PPO and HMO members only
2021 Advantage Solution PartnerCare claim forms:
Determinations, appeals, and grievances
Enrollment forms
Medica Prime Solution (Cost)
Plan management forms
Claim reimbursement forms
Applies to Medica Prime Solution (Cost) and Medica Group Prime Solution (Cost) members
Applies to Medica Prime Solution (Cost) and Medica Group Prime Solution (Cost) members
Applies to Medica Prime Solution (Cost) and Medica Group Prime Solution (Cost) members
Applies to Medica Prime Solution (Cost) and Medica Group Prime Solution (Cost) members
2021 Prime Solution claim forms
Eyewear reimbursement claim forms: