Our thoughts are with those impacted by the wildfires. Please stay safe.  If you are in an emergency situation, don't hesitate to reach us 24/7 at 1-800-804-0087.

Our thoughts are with those impacted by the weather events. Please stay safe. We are currently experiencing unusually high call volumes. If you are in an emergency situation, don't hesitate to reach us 24/7 at 1-800-804-0087.

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MEDOCĀ® SupplementalĀ Plan Change Form

We understand that plans change, so weā€™re making it easier for you to update your coverage online.

Ā 

Use this form to change your Supplemental Plan trip dates for this yearā€™s travel season, or downgrade to the Base Plan. Weā€™ll process your request within 5 to 10 business days and reach out if necessary.

Ā 

Please note, QCC members should call us at 1-866-606-3362 to make changes to their plans.

Member Details

The principal policyholder should fill out this section.

Up to 12 characters

Downgrade to Base Plan

Ā 

We'll cancel all of your supplemental trips, and you wonā€™t have coverage for any extended travelā€” beyond the number of days listed on your Base Plan policy.

Ā 

Donā€™t worry, if you change your mind, you can always add supplemental trips at a later date.

You can enter up to 3 trips

Downgrade to Base Plan

Ā 

We'll cancel all of your supplemental trips, and you wonā€™t have coverage for any extended travelā€” beyond the number of days listed on your Base Plan policy.

Ā 

Donā€™t worry, if you change your mind, you can always add supplemental trips at a later date.

You can enter up to 3 trips

Spouse details

Up to 12 characters

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