MercyCare Elite Walworth County, WI Medicare Advantage Plan
Medicare Advantage Plan Summary & Benefits
MercyCare Elite (H4123-004), Health Maintenance Organization Advantage Plan, Walworth County, WI by MercyCare Health Plans
MercyCare Elite is a Health Maintenance Organization (HMO) health insurance plan for seniors and other people with Medicare living in Walworth County, Wisconsin. It includes all of the benefits of Original Medicare and may include prescription drug coverage and other extras. The primary benefit of an HMO is that the out-of-pocket costs are lower and more predictable than with other types of plans. The monthly premium is $79.00.
Please note: You must use plan providers to avoid incurring additional costs. You will be responsible for the costs of out of network care. Referrals may be required for all but primary care physician visits.
Maximum Out-of-Pocket (MOOP) Expense
The new healthcare law allows for a maximum limit of $6,700 on your out of pocket medical costs for 2014 Medicare Advantage plans. This amount is commonly called the plan MOOP (Maximum Out of Pocket). A plan's MOOP does not include your prescriptions or the monthly premiums you pay for your health plan.
Although the mandatory MOOP limit is $6,700, the Affordable Care Act law allows for a “Voluntary MOOP” that can be as low as $3,400. The MOOP on this plan is $2,950. You need to take this figure into as much consideration as the premiums and the co-payments.
If you are comparing this Medicare Advantage plan with your Original Medicare benefits, take into consideration that the government does not have out-of-pocket limits on Medicare Parts A and B. With traditional Medicare the only way to protect yourself is to purchase a Medigap insurance policy to supplement your coverage.
CMS 5-Star Rating
To help shoppers compare private health insurance options, Medicare rates the quality of all Medicare Advantage plans. The Centers for Medicare and Medicare Services rates each plan using a one to five-star scale, with one star representing the lowest quality and five stars the highest.
The MercyCare Elite Medicare Advantage plan is new and has not yet been rated by CMS. This is why the plan's rating is listed as out of 5 stars (as of 15 October, 2013).
Compare Medicare Advantage Plans
Compare MercyCare Elite with these top rated Medicare Advantage Plans available in Walworth County:
- HumanaChoice R5826-023 P
- HumanaChoice R5826-009 P
- MercyCare Value
- Care Improvement Plus Medicare Advantage
- MercyCare Classic
Related Medicare Insurance in Walworth, WI
- Medicare Advantage Plans for Walworth County, WI Seniors
- Wisconsin Medicare Supplement Plans
- Wisconsin Dental Insurance for Seniors
- Wisconsin Prescription Drug Plans
This page was last updated on: 6/22/2014