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For Medica Prime Solution (Cost) Members

Member plan documents

Find your state and then your plan name (Care Type on your ID card) below to see your legal plan documents.

The Pharmacy Directory and the over-the-counter catalog are the same for all Medica Prime Solution (Cost) members and available at the top of this page.

Pharmacy Directory for all Medica Prime Solution (Cost) members

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)

Iowa

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)

Kansas

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)

Minnesota

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

Medica Prime Solution Enhanced with Rx (Cost)
Available for 2023 is the Enhanced with Rx2 with $242.30 monthly premium

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

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 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)

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

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 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)

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes

Formulary (Drug List)

2023 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)

Medica Prime Solution Standard with no Rx (Cost)
(2023 $0 monthly premium)

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes

Formulary (Drug List)

2023 Formulary (PDF)

Missouri

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)

Nebraska

Medica Prime Solution Standard (Cost)

(2023 $0.00 monthly premium)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)

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)

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 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)

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 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)

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 Formulary (PDF)

Medica Prime Solution Standard (Cost)

(2023 $0 monthly premium)

Medica Prime Solution Standard w/Rx (Cost) - South Dakota Only

(2023 $49.40 monthly premium)

Provider Directories

Evidence of coverage documents

2023 Evidence of coverage with Rx (PDF) updated 2/20/2023

Annual Notice of Changes documents

2023 Annual notice of changes with Rx (PDF) updated 2/20/2023

Formulary (Drug List)

2023 Formulary (PDF)

Oklahoma

Medica Prime Solution Premier (Cost)

(2023 $130.00 monthly premium)

Medica Prime Solution Core (Cost)

(2023 $76.00 monthly premium)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)

Wisconsin

Medica Prime Solution Standard (Cost)

(2023 $0.00 monthly premium)

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

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

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 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)

Medica Prime Solution Total with no Rx (Cost)
(2023 $194.00 monthly premium)

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Evidence of coverage Wisconsin Rider

Formulary (Drug List)

2023 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)

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

Provider Directories

Evidence of Coverage documents

Annual Notice of Changes documents

Formulary (Drug List)

2023 Formulary (PDF)

Wyoming

Medica Prime Solution Premier (Cost)

(2023 $195.00 monthly premium)

Medica Prime Solution Core (Cost)

(2023 $86.00 monthly premium)

Medica Prime Solution Thrift (Cost)

(2023 $40.00 monthly premium)

Group Prime Solution Documents

Medica Group Prime Solution (Cost)

Provider Directories

Evidence of Coverage (EOC)

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

Formulary (Drug List)

2023 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

Contact Us

8 a.m. – 9 p.m. CT, daily

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Last Updated: January 2023