ZIP code

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Effective date

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Birthdate

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Medicare Part A effective date

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Plan name

Medica’s Minnesota Medicare Supplement plans will have a premium rate change effective April 1, 2022. The change will affect all current Minnesota Medicare Supplement policyholders, including individuals who enrolled with a 01/01/2022, 02/01/2022, or 03/01/2022 effective date.

Plans available

To help us present all plans available to you, please answer the following question.

Do any of these statements apply to you?
Check all that apply.

My spouse is currently enrolled in a Medica Prime Solution plan I am currently covered under an employer group health plan that offers coverage for Medica Prime Solution I am new to Medicare and currently covered under another Medica plan None of these apply

No exceptions apply

It appears that none of the possible exceptions apply to you so you are not eligible to enroll in Medica Prime Solution (Cost). Call Medica at 1-877-704-7864 (TTY: 711) for information on other Medica coverage options that will be available in the near future.

Additional Benefit Options

Prescription Drug Coverage

You have selected a plan that does not have prescription drug (Part D) coverage.

I confirm that I am not adding prescription drug (Part D) coverage through Medica

Wisconsin Rider Coverage

Wisconsin Rider - $43.00 / month

Wisconsin Rider - $46.00 / month

Don't add Wisconsin Rider coverage

Premium total -

Oops that didn’t work

We’re having technical difficulties or you’ve entered a ZIP code for a county that isn’t in our service area.

The options you’re looking for might not be available in your area.

Note: Enrollment in 2022 Cost and Medicare Advantage plans begins on Oct 15.

It looks like the county you entered isn’t part of our service area. Please contact customer service at 1-800-575-2330 or your plan administrator.

Please double check your entries or call us at 1-877-704-7864 (TTY: 711)

We’d love to help you!

Attention

Welcome Medica retirees and Medica employee family members.

Please call us at 1-855-844-6395 to speak with a Medicare Consultant about the Medica Group Medicare plan. Our Medicare Consultants can assist with determining eligibility, answering questions about plan details, and assisting with your enrollment.

We look forward to speaking with you!

Before you start:

You will need your Medicare card when filling in this form
The enrollment form will take about 5 to 10 minutes to complete
You'll be able to review your information and make changes before submitting your completed form

Medica is a Cost and PPO plan with a Medicare contract. Enrollment in Medica depends on contract renewal.

Last Updated: 10/23

Enroll in a Medicare Plan

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