Member plan documents

PLEASE NOTE: The 2024 Pharmacy Directory Inserts:

• 2024 Pharmacy Directory Insert for Standard & Standard w/Rx plans
• 2024 Pharmacy Directory Insert for all other MN and WI plans

• Search for 2023 pharmacies online
• Search for 2024 pharmacies online by locating the state where you live (listed below) and the plan of your choice.
• 2023 View or print Prime Solution pharmacy directory (PDF)

Over-the-counter (OTC) catalog for all Individual Medica Prime Solution (Cost) members with an OTC allowance

• 2023 View or print Medicare over-the-counter catalog (PDF)
• 2024 View or print Medicare over-the-counter catalog (PDF)

Iowa

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)
(2024 $138.00 monthly premium)

• Search for providers online
• 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)
• 2023 Annual notice of changes (PDF) updated 2/20/2023
• 2024 Annual notice of changes (PDF)
• 2023 Evidence of coverage (PDF) updated 2/20/2023
• 2024 Evidence of coverage (PDF)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)
(2024 $80.00 monthly premium)

• Search for providers online
• 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)
• 2023 Annual notice of changes (PDF) updated 2/20/2023
• 2024 Annual notice of changes (PDF)
• 2023 Evidence of coverage (PDF) updated 2/20/2023
• 2024 Evidence of coverage (PDF)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)
(2024 $43.00 monthly premium)

• Search for providers online
• 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)
• 2023 Evidence of coverage (PDF) updated 2/20/2023
• 2024 Evidence of coverage (PDF)
• 2023 Annual notice of changes (PDF) updated 2/20/2023
• 2024 Annual notice of changes (PDF)

Kansas

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)
(2024 $138.00 monthly premium)

• Search for providers online
• 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)
• 2023 Evidence of coverage (PDF) updated 2/20/2023
• 2024 Evidence of coverage (PDF)
• 2023 Annual notice of changes (PDF) updated 2/20/2023
• 2024 Annual notice of changes (PDF)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)
(2024 $80.00 monthly premium)

• Search for providers online
• 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)
• 2023 Evidence of coverage (PDF) updated 2/20/2023
• 2024 Evidence of coverage (PDF)
• 2023 Annual notice of changes (PDF) updated 2/20/2023
• 2024 Annual notice of changes (PDF)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)
(2024 $43.00 monthly premium)

• Search for providers online
• 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)
• 2023 Evidence of coverage (PDF) updated 2/20/2023
• 2024 Evidence of coverage (PDF)
• 2023 Annual notice of changes (PDF) updated 2/20/2023
• 2024 Annual notice of changes (PDF)

Minnesota

Medica Prime Solution Enhanced (Cost), Medica Prime Solution Enhanced w/Rx2

Medica Prime Solution Enhanced with Rx2 (Cost)
(2023 $242.30 monthly premium)
(2024 $247.40 monthly premium)

Medica Prime Solution Enhanced with no Rx (Cost)
(2023 $166.00 monthly premium)
(2024 $183.00 monthly premium)

Provider Directories

• Search for providers online
• 2023 View or print Prime Solution provider directory MN, WI (PDF)
• 2024 View or print Prime Solution provider directory MN, WI (PDF)

Pharmacy Directories

• Search for 2024 pharmacies online
• 2023 View or print Prime Solution pharmacy directory (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)

Evidence of Coverage documents

• 2023 Evidence of coverage with Rx2 (PDF) updated 2/20/2023
• 2024 Evidence of coverage with Rx2 (PDF)
• 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
• 2024 Evidence of coverage with no Rx (PDF)

Annual Notice of Changes documents

• 2023 Annual Notice of Changes with Rx transition to Rx2 (PDF) updated 2/20/2023
• 2023 Annual notice of changes with Rx2 (PDF) updated 2/20/2023
• 2024 Annual notice of changes with Rx2 (PDF)
• 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
• 2024 Annual notice of changes with no Rx (PDF)

Formulary (Drug List)

• 2023 Formulary (PDF)
• 2024 Formulary (PDF)

Medica Prime Solution Basic (Cost), Medica Prime Solution Basic w/Rx (Cost), Medica Prime Solution Basic w/Rx2 (Cost)

Medica Prime Solution Basic with Rx (Cost)
(2023 $131.80 monthly premium)
(2024 $134.00 monthly premium)

Medica Prime Solution Basic with Rx2 (Cost)
(2023 $169.60 monthly premium)
(2024 $172.40 monthly premium)

Medica Prime Solution Basic with no Rx (Cost)
(2023 $86.00 monthly premium)
(2024 $95.00 monthly premium)

Provider Directories

• Search for providers online
• 2023 View or print Prime Solution provider directory MN, WI (PDF)
• 2024 View or print Prime Solution provider directory MN, WI (PDF)

Pharmacy Directories

• Search for 2024 pharmacies online
• 2023 View or print Prime Solution pharmacy directory (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)

Evidence of Coverage documents

• 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
• 2024 Evidence of coverage with Rx (PDF)
• 2023 Evidence of coverage with Rx2 (PDF) updated 2/20/2023
• 2024 Evidence of coverage with Rx2 (PDF)
• 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
• 2024 Evidence of coverage with no Rx (PDF)

Annual Notice of Changes documents

• 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
• 2024 Annual notice of changes with Rx (PDF)
• 2023 Annual notice of changes with Rx2 (PDF) updated 2/20/2023
• 2024 Annual notice of changes with Rx2 (PDF)
• 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
• 2024 Annual notice of changes with no Rx (PDF)

Formulary (Drug List)

• 2023 Formulary (PDF)
• 2024 Formulary (PDF)

Medica Prime Solution Thrift (Cost), Medica Prime Solution Thrift w/Rx (Cost)

Medica Prime Solution Thrift with Rx (Cost)
(2023 $90.30 monthly premium)
(2024 $79.70 monthly premium)

Medica Prime Solution Thrift with no Rx (Cost)
(2023 $40.00 monthly premium)
(2024 $43.00 monthly premium)

Provider Directories

• Search for providers online
• 2023 View or print Prime Solution provider directory MN, WI (PDF)
• 2024 View or print Prime Solution provider directory MN, WI (PDF)

Pharmacy Directories

• Search for 2024 pharmacies online
• 2023 View or print Prime Solution pharmacy directory (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)

Evidence of Coverage documents

• 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
• 2024 Evidence of coverage with Rx (PDF)
• 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
• 2024 Evidence of coverage with no Rx (PDF)

Annual Notice of Changes

• 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
• 2024 Annual notice of changes with Rx (PDF)
• 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
• 2024 Annual notice of changes with no Rx (PDF)

Formulary (Drug List)

• 2023 Formulary (PDF)
• 2024 Formulary (PDF)

Medica Prime Solution Standard (Cost), Medica Prime Solution Standard w/Rx (Cost)

Medica Prime Solution Standard with Rx (Cost)
(2023 $49.40 monthly premium)
(2024 $49.30 monthly premium)

Medica Prime Solution Standard with no Rx (Cost)
(2023 $0.00 monthly premium)
(2024 $0.00 monthly premium)

Provider Directories

• Search for providers online
• 2023 View or print Prime Solution provider directory MN, WI (PDF)
• 2024 View or print Prime Solution provider directory MN, WI (PDF)

Pharmacy Directories

• Search for 2024 pharmacies online
• 2023 View or print Prime Solution pharmacy directory (PDF)
• 2024 View or print Prime Solution pharmacy directory (PDF)

Evidence of Coverage documents

• 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
• 2024 Evidence of coverage with Rx (PDF)
• 2023 Evidence of Coverage with no Rx (PDF) updated 2/20/2023
• 2024 Evidence of Coverage with no Rx (PDF)

Annual Notice of Changes

• • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)
  
  

  Missouri

  Medica Prime Solution Premier (Cost)

  (2023 $130.00 monthly premium)
  (2024 $138.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Medica Prime Solution Core (Cost)

  (2023 $76.00 monthly premium)
  (2024 $80.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Medica Prime Solution Thrift (Cost)

  (2023 $40.00 monthly premium)
  (2024 $43.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Nebraska

  Medica Prime Solution Standard (Cost)

  (2023 $0.00 monthly premium)
  (2024 $0.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Medica Prime Solution Core (Cost)

  (2023 $76.00 monthly premium)
  (2024 $82.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Medica Prime Solution Premier (Cost)

  (2023 $130.00 monthly premium)
  (2024 $140.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated updated 2/20/2023
  • 2024 Evidence of coverage (PDF) updated
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Medica Prime Solution Thrift (Cost)

  (2023 $40.00 monthly premium)
  (2024 $43.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  North Dakota & South Dakota

  Medica Prime Solution Premier (Cost), Medica Prime Solution Premier w/Rx (Cost)

  Medica Prime Solution Premier with Rx (Cost)
  (2023 $266.20 monthly premium)
  (2024 $264.70 monthly premium)

  Medica Prime Solution Premier with no Rx (Cost)
  (2023 $195.00 monthly premium)
  (2024 $205.00 monthly premium)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution provider directory ND, SD, WY (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with Rx (PDF)
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)
  
  

  Medica Prime Solution Core (Cost), Medica Prime Solution Core w/Rx (Cost)

  Medica Prime Solution Core with Rx (Cost)
  (2023 $149.10 monthly premium)
  (2024 $139.30 monthly premium)

  Medica Prime Solution Core with no Rx (Cost)
  (2023 $86.00 monthly premium)
  (2024 $90.00 monthly premium)

  Provider Directories

  • Search for providers online
  • Search for 2024 pharmacies online
  • 2024 View or print Prime Solution provider directory ND, SD, WY (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with Rx (PDF)
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)
  
  

  Medica Prime Solution Thrift (Cost), Medica Prime Solution Thrift w/Rx (Cost)

  Medica Prime Solution Thrift with Rx (Cost)
  (2023 $90.30 monthly premium)
  (2024 $79.70 monthly premium)

  Medica Prime Solution Thrift with no Rx (Cost)
  (2023 $40.00 monthly premium)
  (2024 $43.00 monthly premium)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution provider directory ND, SD, WY (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with Rx (PDF)
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)
  
  

  Medica Prime Solution Standard (Cost), Medica Prime Solution Standard w/Rx (Cost)

  Medica Prime Solution Standard (Cost)
  (2023 $0.00 monthly premium)
  (2024 $0.00 monthly premium)

  Medica Prime Solution Standard w/Rx (Cost)
  (2023 $49.40 monthly premium)
  (2024 $49.30 monthly premium)

  
  

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution provider directory ND, SD, WY (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2023 View or print Prime Solution pharmacy directory (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • • 2024 Evidence of coverage with Rx (PDF) 
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)
  
  

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)
  
  

  Oklahoma

  Medica Prime Solution Premier (Cost)

  (2023 $130.00 monthly premium)
  (2024 $138.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)

  Medica Prime Solution Core (Cost)

  (2023 $76.00 monthly premium)
  (2024 $80.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)

  Medica Prime Solution Thrift (Cost)

  (2023 $40.00 monthly premium)
  (2024 $43.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)

  Wisconsin

  Medica Prime Solution Standard (Cost)

  (2023 $0.00 monthly premium)
  (2024 $10.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory MN, WI (PDF)
  • 2024 View or print Prime Solution provider directory MN, WI (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Wisconsin Addendum to the Evidence of Coverage (PDF)
  • 2024 Wisconsin Addendum to the Evidence of Coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)

  Medica Prime Solution Focus (Cost), Medica Prime Solution Focus w/Rx (Cost)

  Medica Prime Solution Focus with Rx (Cost)
  (2023 $140.70 monthly premium)
  (2024 $141.80 monthly premium)

  Medica Prime Solution Focus with no Rx (Cost)
  (2023 $87.00 monthly premium)
  (2024 $99.00 monthly premium)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory MN, WI (PDF)
  • 2024 View or print Prime Solution provider directory MN, WI (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2023 View or print Prime Solution pharmacy directory (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with Rx (PDF)
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)
  • 2023 Wisconsin Addendum to the Evidence of Coverage (PDF)
  • 2024 Wisconsin Addendum to the Evidence of Coverage (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)

  Medica Prime Solution Total (Cost), Medica Prime Solution Total w/Rx (Cost)

  Medica Prime Solution Total with Rx (Cost)
  (2023 $258.70 monthly premium) $35 Wisconsin Rider (optional)
  (2024 $266.50 monthly premium) $39 Wisconsin Rider (optional)

  Medica Prime Solution Total with no Rx (Cost)
  (2023 $194.00 monthly premium) $35 Wisconsin Rider (optional)
  (2024 $215.00 monthly premium) $39 Wisconsin Rider (optional)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory MN, WI (PDF)
  • 2024 View or print Prime Solution provider directory MN, WI (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2023 View or print Prime Solution pharmacy directory (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with Rx (PDF)
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)
  • 2023 Wisconsin Addendum to the Evidence of Coverage (PDF)
  • 2024 Wisconsin Addendum to the Evidence of Coverage (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Evidence of coverage Wisconsin Rider

  • 2023 Evidence of coverage – Wisconsin Rider Total with Rx (PDF)
  • 2024 Evidence of coverage – Wisconsin Rider Total with Rx (PDF)
  • 2023 Evidence of coverage – Wisconsin Rider Total with no Rx (PDF)
  • 2024 Evidence of coverage – Wisconsin Rider Total with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)

  Medica Prime Solution Thrift (Cost), Medica Prime Solution Thrift w/Rx (Cost)

  Medica Prime Solution Thrift with Rx (Cost)
  (2023 $90.30 monthly premium)
  (2024 $79.70 monthly premium)

  Medica Prime Solution Thrift with no Rx (Cost)
  (2023 $40.00 monthly premium)
  (2024 $43.00 monthly premium)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory MN, WI (PDF)
  • 2024 View or print Prime Solution provider directory MN, WI (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2023 View or print Prime Solution pharmacy directory (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage with Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with Rx (PDF)
  • 2023 Evidence of coverage with no Rx (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)
  • 2023 Wisconsin Addendum to the Evidence of Coverage (PDF)
  • 2024 Wisconsin Addendum to the Evidence of Coverage (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes with Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with Rx (PDF)
  • 2023 Annual notice of changes with no Rx (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)

  Wyoming

  Medica Prime Solution Thrift (Cost), Medica Prime Solution Thrift with Rx (Cost)

  Medica Prime Solution Thrift (Cost)
  (2023 $40.00 monthly premium)
  (2024 $43.00 monthly premium)

  Medica Prime Solution Thrift with Rx (Cost)
  (2024 $79.70 monthly premium)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory ND SD WY (PDF)
  • 2024 View or print Prime Solution provider directory ND SD WY (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2023 View or print Prime Solution pharmacy directory (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage with no Rx (PDF)
  • 2024 Evidence of coverage with Rx (PDF)

  Annual Notice of Changes documents

  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes with no Rx (PDF)

  Formulary (Drug List)

  • 2024 Formulary (PDF)

  Medica Prime Solution Premier (Cost)

  (2023 $195.00 monthly premium)
  (2024 $205.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)

  Medica Prime Solution Core (Cost)

  (2023 $86.00 monthly premium)
  (2024 $90.00 monthly premium)

  • Search for providers online
  • 2023 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution provider directory ND, SD, WY (PDF)
  • 2024 View or print Prime Solution pharmacy directory (PDF)
  • 2023 Evidence of coverage (PDF) updated 2/20/2023
  • 2024 Evidence of coverage (PDF)
  • 2023 Annual notice of changes (PDF) updated 2/20/2023
  • 2024 Annual notice of changes (PDF)
  
  

  Medica Prime Solution Standard (Cost), Medica Prime Solution Standard w/Rx (Cost)

  Medica Prime Solution Standard (Cost)
  (2024 $0.00 monthly premium)

  Medica Prime Solution Standard with Rx (Cost)
  (2024 $49.30 monthly premium)

  Provider Directories

  • Search for 2024 providers online
  • 2024 View of print Prime Solution provider directory ND, SD, WY (PDF)

  Pharmacy Directories

  • Search for 2024 pharmacies online
  • 2024 View or print Prime Solution pharmacy directory (PDF)

  Evidence of Coverage documents

  • 2024 Evidence of coverage with Rx (PDF)
  • 2024 Evidence of coverage with no Rx (PDF)

  Formulary (Drug List)

  2024 Formulary (PDF)
  

  Group Prime Solution Documents

  Medica Group Prime Solution (Cost)

  Provider Directories

  • Search for providers online
  • 2023 View or print Prime Solution provider directory for IA, KS, MO, NE, OK (PDF)
  • 2024 View or print Prime Solution provider directory for IA, KS, MO, NE, OK (PDF)
  • 2023 View or print Prime Solution provider directory for MN, WI (PDF)
  • 2024 View or print Prime Solution provider directory for MN, WI (PDF)
  • 2023 View or print Prime Solution provider directory for ND, SD, WY (PDF)
  • 2024 View or print Prime Solution provider directory for ND, SD, WY (PDF)

  Evidence of Coverage (EOC)

  To get a copy of your Evidence of Coverage (EOC) or other plan documents, contact the Medica Member Services phone number on the back of your Medica ID card

  Pharmacy Directories

  Search for 2024 pharmacy providers online
  • 2023 View or print Group Prime Solution pharmacy directory
  • 2024 View or print Group Prime Solution pharmacy directory

  Formulary (Drug List)

  • 2023 Formulary (PDF)
  • 2024 Formulary (PDF)

Order Materials by Mail

The easiest way to access your plan materials is to view or download them at the links above. If you prefer, we are able to send materials to you via mail.

Order plan materials by mail