MercyCare Elite Overview
MercyCare Elite for Walworth County, Wisconsin, by MercyCare Health Plans, is a Health Maintenance Organization Medicare Advantage Plan with a Point of Service Option (HMO-POS) available to seniors on Medicare. A HMO-POS plan has a flexible provider network that lets its members use healthcare providers outside of the plan network for certain situations or certain types of treatment. When out-of-network services are used members pay additional point-of-service fees.
The monthly premium for this HMO-POS plan is $79.00 In addition to the premium, members make co-payments when they use most healthcare services. A schedule of co-payments and co-insurances can be found on the co-payments page.
MercyCare Elite Quality Rating
The Centers for Medicare and Medicaid Services (CMS) reviews and rates the quality of all Medicare Advantage plans. The 1 (worst) to 5 (best) star ratings assist people considering plans and offer an unbiased measure of quality.
MercyCare Elite is a new plan. It has not yet been rated by the CMS. That is is why the star rating is displayed as out of 5 stars (as of 15 October, 2013).
MercyCare Elite Out-of-Pocket Expenses
Medicare Advantage plans are limited to a maximum out-of-pocket limit of $6,700 (annually). This out-of-pocket limit does not include your prescriptions or your monthly premiums. It only applies to your costs for healthcare services.
Although the mandatory limit is $6,700, the CMS allows plans to offer a lower limit that can be as low as $3,400. The out-of-pocket limit on this plan is $2,950. Be sure to take into consideration, along with the premium and the co-payments, when making your enrollment decision.
If you are comparing MercyCare Elite with your traditional Medicare benefits, it's important to remember that there are no limits to your out-of-pocket expenses with Medicare Part A or Medicare Part B. If you keep your traditional Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
Compare Medicare Health Insurance Plans
Make sure you get the best health insurance for your unique situation. Compare MercyCare Elite with these Medicare Advantage plans:
- HumanaChoice R5826-023 P
- HumanaChoice R5826-009 P
- MercyCare Value
- Care Improvement Plus Medicare Advantage
- MercyCare Classic
MercyCare Elite is available in the following Wisconsin cities: Darien, Delavan, East Troy, Elkhorn, Fontana, Genoa City, Honey Creek, Lake Geneva, Lyons, Pell Lake, Springfield, Walworth, Whitewater, Williams Bay, Zenda, Sharon, and all other areas of Walworth County.
CMS File Date: January 14, 2014.
This Medicare health insurance catalog is maintained by 9/16/2014.and was last updated on