Medical Associates Basic Plan (COST) Plan Details for Clayton County, IA
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*This plan is new and has not yet been rated by CMS.
Medical Associates Basic Plan (Cost) is a Medicare Advantage plan with a prescription drug plan. The 2025 Annual Enrollment period starts October 15. Plan benefits begin January 1
See more Medicare Advantage Plans in Clayton County, Iowa.
Medical Associates Basic Plan Basic Details
| Plan Basics | |
|---|---|
| Plan ID: | H1651-002-0 |
| Plan Type: | Cost |
| Plan Year: | 2025 |
| Premium: | $128.00/mo Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Out-of-Pocket Maximum: | Not Applicable/yr |
| Part B Reduction: | $0.00/mo |
| Drug Plan Benefit: | Not Included |
| Supplemental Benefits: | None |
| Availability: | Clayton County, IA |
| Insured By: | Medical Associates Health Plan, Inc. |
| Summary of Benefits |
|---|
Medical Associates Health Plan, Inc. Out-of-Pocket Costs
This Medical Associates Health Plan, Inc. Part C plan has cost-sharing. These are costs you pay out-of-pocket when you use approved health services. The following table summarizes the most common in-network out-of-pocket costs in plan H1651-002-0.
NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
Doctor's Office Visits
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | Not Covered |
Emergency, Urgent, and Inpatient Hospital Coverage
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | Not Covered |
| Urgent care: | Not Covered |
| Ground ambulance: | Not Covered |
| Inpatient hospital care: | |
| Skilled Nursing Facility: |
Foot Care
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | Not Covered |
| Routine Foot Care: | Not Covered |
Chiropractic Care
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | Not Covered |
| Routine chiropractic: | Not Covered |
Mental Health Services
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | Not Covered |
| Outpatient group therapy: | Not Covered |
| Inpatient psychiatric hospital care: |
Rehabilitation Services
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | Not Covered |
| Occupational therapy: | Not Covered |
Medical Equipment and Supplies
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | Not Covered |
| Durable medical equipment: | Not Covered |
| Prosthetics: | Not Covered |
Diagnostics, Lab Services, and Imaging
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | Not Covered |
| Lab services: | Not Covered |
| Outpatient x-rays: | Not Covered |
| Diagnostic tests and procedures: | Not Covered |
Medicare Part B Drugs
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | Not Covered |
| Other Part B drugs (Medicare-covered): | Not Covered |
Dental Services
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | Not Covered |
| Oral exam | Not Covered |
| Dental x-rays | Not Covered |
| Cleaning | Not Covered |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
Hearing Aids and Services
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Not Covered |
| Hearing aids | Not Covered |
| Hearing exam | Not Covered |
Vision Services
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | |
| Routine eye exam (in-network) | Not Covered |
| Eyewear benefits | None |
Feel free to download our Medical Associates Basic Plan Summary of Benefits information.
Prescription Drug Plan Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories using a 5-star rating system. Here are the most recent CMS ratings for Medical Associates Basic Plan .
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | Plan not required to report measure |
| Complaints and Changes in the Drug Plan | Plan not required to report measure |
| Member Experience with the Drug Plan | Plan not required to report measure |
| Drug Safety and Accuracy of Drug Pricing | Plan not required to report measure |
Additional Plan Options
The Medicare Part C program offers a myriad of HMO, PPO, and PFFS plan options, including these plans:
- Central Iowa Health Senior Plan
- Medical Associates Freedom Plan
- MercyOne North Iowa Senior Plan
- Medical Associates Community Plan
- Medical Associates Freedom Plan
- Medical Associates SmartPlan
- Medical Associates Community Plan
If you are enrolled in a Part C plan with prescription drug coverage, you cannot be enrolled in a stand-alone Medicare Part D plan, regardless of your chosen insurance company.
You cannot be enrolled in a Part C health plan and simultaneously hold Medicare Supplement Insurance (Medigap). Medicare Supplement plans are only compatible with Medicare Parts A and B.
Contact Medical Associates Health Plan, Inc.
| Website: | Medical Associates Health Plan, Inc. Plan Page |
|---|---|
| Providers: | Medical Associates Health Plan, Inc. Providers Page |
| New Member Health Plan Help: | (800)747-8900 |
| New Member Health Plan TTY: | (800)735-2942 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part C program on www.medicare.gov or call 1-800-MEDICARE.
Citations & References
- Medical Associates Health Plan, Inc., http://www.mahealthplans.com, Last Accessed February 20, 2024
- Medicare.gov, "Medicare Advantage Plans cover all Medicare services", Last Accessed February 20, 2024
- Medicare.gov, "How Original Medicare Works", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You", Last Accessed February 19, 2024
- Medicare.gov, "What Medicare Covers", Last Accessed February 7, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.