Iowa
Medica Prime Solution Premier
(2021 $125.00 monthly premium)
(2022 $125.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
2021 Annual notice of changes (PDF)
2022 Annual notice of changes (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Core
(2021 $69.00 monthly premium)
(2022 $69.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
2021 Annual notice of changes (PDF)
2022 Annual notice of changes (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Thrift
(2021 $34.00 monthly premium)
(2022 $34.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2021 Annual notice of changes (PDF)
2022 Annual notice of changes (PDF)
Kansas
Medica Prime Solution Premier
Premier
(2021 $125.00 monthly premium)
(2022 $125.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS NE OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2022 Annual notice of changes (PDF)
Medica Prime Solution Core
(2021 $69.00 monthly premium)
(2022 $69.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS NE OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2022 Annual notice of changes (PDF)
Medica Prime Solution Thrift
(2021 $34.00 monthly premium)
(2022 $34.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS NE OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2022 Annual notice of changes (PDF)
Minnesota
Medica Prime Solution Enhanced
Enhanced with Rx
(2021 $202.50 monthly premium)
(2022 $215.90 monthly premium)
Enhanced with Rx2
(2021 $223.10 monthly premium)
(2022 $229.30 monthly premium)
Enhanced with no Rx
(2021 $157.00 monthly premium)
(2022 $157.00 monthly premium)
Provider Directories for all Enhanced plans
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx and Rx2 plans
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with Rx2 (PDF)
2022 Evidence of coverage with Rx2 (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with Rx2 (PDF)
2022 Annual notice of changes with Rx2 (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Basic
Basic with Rx
(2021 $111.70 monthly premium)
(2022 $118.50 monthly premium)
Basic with Rx2
(2021 $143.20 monthly premium)
(2022 $155.50 monthly premium)
Basic with no Rx
(2021 $79.00 monthly premium)
(2022 $79.00 monthly premium)
Provider Directories for all Basic plans
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx and Rx2 plans
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with Rx2 (PDF)
2022 Evidence of coverage with Rx2 (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes documents
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with Rx2 (PDF)
2022 Annual notice of changes with Rx2 (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Value
(2021 $105.80 Value with Rx monthly premium)
(Available for 2022 is the Basic plan with $118.50 monthly premium)
(2021 $67.00 Value plan monthly premium)
(Available for 2022 is the Basic plan with $79.00 monthly premium)
Provider Directories for all Value plans
For the 2022 Prime Solution provider directory, see Medica Prime Solution Basic
Pharmacy Directories for Rx plan
Search online pharmacy directory
For the 2022 Prime Solution pharmacy directory, see Medica Prime Solution Basic
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Thrift
Thrift with Rx
(2021 $73.20 monthly premium)
(2022 $78.40 monthly premium)
Thrift with no Rx
(2021 $34.00 monthly premium)
(2022 $34.00 monthly premium)
Provider Directories for all Thrift plans
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Standard
Standard with Rx
(2021 $30.90 monthly premium)
(2022 $42.00 monthly premium)
Standard with no Rx
(2021 $0 monthly premium)
(2022 $0 monthly premium)
Provider Directories
2022 View or Print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of Coverage no Rx (PDF)
2022 Evidence of Coverage no Rx (PDF)
Annual notice of changes
2021 Annual notice of changes no Rx (PDF)
2022 Annual notice of changes no Rx (PDF)
2022 Annual notice of changes w/Rx (PDF)
Formulary (Drug List)
Missouri
Medica Prime Solution Premier
Premier (2022 $125.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Core
Core (2022 $69.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Thrift
Thrift (2022 $34.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Nebraska
Medica Prime Solution Standard
(2022 $0.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Core
(2021 $69.00 monthly premium)
(2022 $69.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS NE OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2021 Annual notice of changes (PDF)
2022 Annual notice of changes (PDF)
Medica Prime Solution Premier
(2021 $125.00 monthly premium)
(2022 $125.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS NE OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2021 Annual notice of changes (PDF)
2022 Annual notice of changes (PDF)
Medica Prime Solution Thrift
(2021 $34.00 monthly premium)
(2022 $34.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS NE OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2021 Annual notice of changes (PDF)
2022 Annual notice of changes (PDF)
North Dakota & South Dakota
Medica Prime Solution Premier
Premier with Rx
(2021 $250.60 monthly premier)
(2022 $253.80 monthly premier)
Premier with no Rx
(2021 $189.00 monthly premier)
(2022 $189.00 monthly premier)
Provider Directories for all Premier plans
2022 View or print Prime Solution provider directory ND SD (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes with Rx
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Core
Core with Rx
(2021 $132.00 monthly premium)
(2022 $139.70 monthly premium)
Core with no Rx
(2021 $79.00 monthly premium)
(2022 $79.00 monthly premium)
Provider Directories for all Core plans
2022 View or print Prime Solution provider directory ND SD (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Thrift
Thrift with Rx
(2021 $73.20 monthly premium)
(2022 $78.40 monthly premium)
Thrift with no Rx
(2021 $34.00 monthly premium)
(2022 $34.00 monthly premium)
Provider Directories for all Thrift plans
2022 View or print Prime Solution provider directory ND SD (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Standard
Standard with no Rx
(2021 $0 monthly premium)
(2022 $0 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory ND SD (PDF)
2021 Evidence of coverage (PDF)
2022 Evidence of coverage (PDF)
2022 Annual notice of changes (PDF)
Medica Prime Solution Standard with Rx - SD Only
Standard with Rx
(2021 $30.90 monthly premium)
(2022 $42.00 monthly premium)
Standard with no Rx
(2021 $0 monthly premium)
(2022 $0 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory ND SD (PDF)
Pharmacy Directories for Rx Plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
Annual notice of changes documents
2022 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes no Rx (PDF)
Formulary (Drug List)
Oklahoma
Medica Prime Solution Premier
Premier (2022 $125.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Core
Core (2022 $69.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Thrift
Thrift (2022 $34.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, MO, NE, OK (insert) (PDF)
2022 Evidence of coverage (PDF)
Wisconsin
Medica Prime Solution Standard
Standard (2022 $0.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory IA, MN, WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
2022 Evidence of coverage (PDF)
2022 Wisconsin Addendum to the Evidence of Coverage (PDF)
Medica Prime Solution Focus
Focus with Rx
(2021 $125.80 monthly premium)
(2022 $131.90 monthly premium)
Focus with no Rx
(2021 $89.00 monthly premium)
(2022 $79.00 monthly premium)
Provider Directories for all Focus plans
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
2021 Wisconsin Addendum to the Evidence of Coverage (PDF)
2022 Wisconsin Addendum to the Evidence of Coverage (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Total
Total with Rx
(2021 $241.70 monthly premium)
(2022 $249.80 monthly premium)
Total with no Rx
(2021 $185.00 monthly premium)
(2021 $185.00 monthly premium)
Provider Directories for all Total plans
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
2021 Wisconsin Addendum to the Evidence of Coverage (PDF)
2022 Wisconsin Addendum to the Evidence of Coverage (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Evidence of coverage Wisconsin Rider
2021 Evidence of coverage – Wisconsin Rider (H2450-040 & H2450-041) with Rx (PDF)
2022 Evidence of coverage – Wisconsin Rider (H2450-040 & H2450-041) with Rx (PDF)
2021 Evidence of coverage – Wisconsin Rider (H2450-040 & H2450-041) with no Rx (PDF)
2022 Evidence of coverage – Wisconsin Rider (H2450-040 & H2450-041) with no Rx (PDF)
Formulary (Drug List)
Medica Prime Solution Thrift
Thrift with Rx
(2021 $73.20 monthly premium)
(2022 $78.40 monthly premium)
Thrift with no Rx
(2021 $34.00 monthly premium)
(2022 $34.00 monthly premium)
Provider Directories for all Thrift plans
2022 View or print Prime Solution provider directory IA MN WI (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
Pharmacy Directories for Rx plan
Search online pharmacy directory
2022 View or print Prime Solution pharmacy directory (PDF)
Evidence of coverage documents
2021 Evidence of coverage with Rx (PDF)
2022 Evidence of coverage with Rx (PDF)
2021 Evidence of coverage with no Rx (PDF)
2022 Evidence of coverage with no Rx (PDF)
2021 Wisconsin Addendum to the Evidence of Coverage (PDF)
2022 Wisconsin Addendum to the Evidence of Coverage (PDF)
Annual notice of changes
2021 Annual notice of changes with Rx (PDF)
2022 Annual notice of changes with Rx (PDF)
2021 Annual notice of changes with no Rx (PDF)
2022 Annual notice of changes with no Rx (PDF)
Formulary (Drug List)
Wyoming
Medica Prime Solution Premier
Premier (2022 $189.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory ND SD WY (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Core
Core (2022 $79.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory ND SD WY (PDF)
2022 Evidence of coverage (PDF)
Medica Prime Solution Thrift
Thrift (2022 $34.00 monthly premium)
Provider Directories
2022 View or print Prime Solution provider directory ND SD WY (PDF)
2022 Evidence of coverage (PDF)
Group Prime Solution Documents
Medica Group Prime Solution
Provider Directories
2022 View or print Prime Solution provider directory for KS, MO, NE, OK (PDF)
2022 View or print Prime Solution additional providers KS, NE, SD, ND (insert) (PDF)
2022 View or print Prime Solution provider directory for MN, WI, IA (PDF)
2022 View or print Prime Solution additional providers IA MN WI (insert) (PDF)
2022 View or print Prime Solution provider directory for ND, SD, WY (PDF)
Pharmacy Directories
2022 View or print Prime Solution with Part D Coverage plans (PDF)
Evidence of Coverage (EOC)
To get a copy of your Evidence of Coverage (EOC) or other plan documents, contact the Medica Customer Service phone number on the back of you Medica ID card
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.
Last Updated: December 2021