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
After its first year on the market, the CMS (Centers for Medicare and Medicaid Services) gives each Medicare Advantage plan an overall one to five star rating. The unbiased quality assessment assists people when comparing plans. Medicare Advantage plans with five stars have the highest quality, whereas a one star plan has the lowest 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
One of the benefits built in to all Medicare Advantage plans is an annual out-of-pocket limit. The maximum is $6,700, but plans are allowed to offer a voluntary limit as low as $3,400 per year.
The most you will pay out-of-pocket if you enroll in this plan is $2,950. This amount is what you actually pay for your healthcare services. It does not include your monthly premium or your prescriptions. It's only the costs you pay out-of-pocket on co-payments and co-insurances.
It's important to do your homework and compare the co-payments and co-insurance with this plan to those of traditional Medicare. Also, be aware that Medicare Part A and Part B do not limit your out-of-pocket costs like Medicare Advantage. If you stay in traditional Medicare you must add supplemental Medicare insurance to cover the cost gaps.
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 9/30/2014.and was last updated on