Medica employees out-of-area coverage for dependents and family

What to know

Out-of-area coverage

If you have a covered dependent (up to age 26) who resides outside the Medica service area, you might be eligible to have your medical claims covered as out-of-area. To find out more or search for providers visit First Health.

Find out how to search for a First Health provider.

If you have questions, contact the Customer Care Center at 833-942-2159.

Eligibility by zip code

To determine eligibility, review the list of Medica network ZIP codes to determine if you or your dependents qualify as out of area. If your home zip code is not listed, complete the out-of-area form.

If you have questions about this coverage, contact the Customer Care Center at 833-942-2159.

Dean ASO network (PDF)

P360 network (PDF)

Saint Louis area network (PDF)

Out-of-area dependent form

* Required field

Employee first name

Employee last name

Employee member number

Out-of-area dependent first name

Out-of-area dependent last name

City

State

Relocation date

Out-of-area dependent 2 first name

Out-of-area dependent 2 last name

City

State

Relocation date

Out-of-area dependent 3 first name

Out-of-area dependent 3 last name

City

State

Date Value

Out-of-area dependent 4 first name

Out-of-area dependent 4 last name

City

State

Relocation date

Please confirm