Create and submit Medica health care forms electronically, or print them for submission through the mail. Forms available include Provider Directory Request, new ID Card Request, Change My Primary Care/Home Clinic, Coordination of Benefits Print Form, Statement of Claims Print Form and Prescription Claim Print Form.
Complete and print forms.
Cost and Quality Resources
Understanding the cost variations that exist among providers can help you make more informed, cost-conscious choices about your care. Main Street Medica allows you to see cost comparisons for a variety of common procedures and conditions at Minnesota facilities and primary care clinics. The comparisons are based on Medica Choice® network contract rates.
Visit Main Street Medica.
Learn how to file a complaint, grievance or appeal in writing, or by telephone. For assistance in completing the complaint/grievance form, Customer Service contact information is provided.
Submit a Complaint, Grievance or Appeal
Find answers to many questions regarding Medica, your benefits plan, and learn about your rights and responsibilities as a member.
View a list of Frequently Asked Questions
- Out of Network Costs: Find out how to get the most value out of your benefits by understanding how much more your out of pocket costs would be when using providers who are not in the Medica network.
- Saving With Generics: Learn how much you could save by comparing commonly prescribed non-Formulary brand-name drugs and their generic or Formulary alternatives.
- Deductibles, Co-Pays and Co-Insurance: Understand the differences in deductibles, co-payments and co-insurance, and find out what out of pocket costs you are responsible for under your plan.
- Referrals: Read answers to many questions regarding referrals, including how they work and when you need one.
- When and Where to Get Care: Find out how to decide when to seek care and what type of provider (Convenience Care, Doctor's Office, Urgent Care Center or Emergency Room) to visit.
- About HSAs: Learn about Health Savings Accounts (HSA), how they work and how they compare to FSAs and HRAs.
- About HRAs: Learn about Health Reimbursement Accounts (HRA), how they work and how they compare to FSAs and HSAs.
- About FSAs: Learn about Flexible Spending Accounts (FSA), how they work and how they compare to HSAs and HRAs.