Medica Prime Solution Premier (Cost) – H2450-036-0
Coverage, cost, and availability details for Medica’s H2450-036-0 Medicare Advantage plan are presented here for 2025.
Health Plan Costs
💰 Monthly Premium, Deductible, Max Out-of-Pocket & Giveback
Monthly Premium: The total monthly premium is $217.00, including drug coverage. You must also pay your standard Medicare Part B premium.
Health Plan Deductible: Some health plans have a deductible (amount you pay before cost-sharing begins). This plan's deductible is $0.00.
Maximum Out-of-Pocket: All Medicare Advantage plans have an annual maximum out-of-pocket (MOOP) limit. This is the most you will pay for standard health services in a year before that plan begins paying all costs. This plan's MOOP is $3,000.00 for in-network services, excluding the cost of your Part D medications.
Part B Giveback: This plan offers a Part B premium giveback of $0.00.
Health Plan Out-of-Pocket Costs
🩺 Doctor’s Office Visits
- Primary: Not Covered
- Specialist: $10 Copay
- NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
🏥 Emergency, Urgent, and Inpatient Hospital Coverage
- Emergency room care: $100 Copay
- Urgent care: Not Covered
- Ground ambulance: Not Covered
- Inpatient hospital care: $200.00 per stay
- Skilled Nursing Facility: $0.00 per day for days 1 through 20
$100.00 per day for days 21 and beyond
🦶 Foot Care
- Foot Exams and Treatments (Medicare-covered): Not Covered
- Routine Foot Care: Not Covered
💆 Chiropractic Care
- Medicare-covered chiropractic: Not Covered
- Routine chiropractic: Not Covered
🧠 Mental Health Services
- Outpatient individual therapy: Not Covered
- Outpatient group therapy: Not Covered
- Inpatient psychiatric hospital care: $200.00 per stay
🏋️ Rehabilitation Services
- Physical therapy and speech and language therapy: Not Covered
- Occupational therapy: Not Covered
🧰 Medical Equipment and Supplies
- Diabetes supplies: 20% Coinsurance
- Durable medical equipment: Not Covered
- Prosthetics: Not Covered
🔬 Diagnostics, Lab Services, and Imaging
- Diagnostic radiology services: $100 Copay
- Lab services: Not Covered
- Outpatient x-rays: Not Covered
- Diagnostic tests and procedures: Not Covered
💉 Medicare Part B Drugs
- Chemotherapy: 20% Coinsurance
- Other Part B drugs (Medicare-covered): 20% Coinsurance
Supplemental Benefits
🦷 Dental Services
- Medicare Covered Preventive Dental: Not Covered
- Oral exam: $0
- Dental x-rays: $0
- Cleaning: $0
- Periodontics: Not Covered
- Endodontics: Not Covered
- Restorative Services: Not Covered
- Maximum dental benefit
- $400.00 (Every year)
👂 Hearing Aids and Services
- Fitting/evaluation: Covered
Limits may apply - Hearing aids: Not Covered
- Hearing exam: Covered
Limits may apply
👓 Vision Services
- Medicare-covered eye exam:
- Routine eye exam: Covered
Limits may apply - Eyewear benefits: None
Prescription Drug 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) and drug plans (Part D) in several major categories using a 5-star rating system. These ratings are designed to help you understand the quality of care and service you can expect if you join Medica Prime Solution Premier .
Plan Availability
Medica Prime Solution Premier (H2450-036-0) is available in the following locations (click to open):
Need Help Enrolling?
Call 1-855-728-0510 (TTY 711) to speak with a licensed insurance agent and learn more about this plan and others on this site.
Or enroll online through our trusted and secure platform:
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📄 View Plan Contact Information
| Website: | Medica Plan Page (opens in new tab) |
|---|---|
| Providers: | Medica Providers Page (opens in new tab) |
| New Member Health Plan Help: | (800)906-5432 |
| New Member TTY: | 711 |
🔍 Why This Information Matters
Many Medicare websites only show you their own phone numbers and redirect you to their sales team. We believe you deserve full access to your plan resources — including direct links to the official Medica site, provider directories, and support contacts.
That’s why we include this information here, clearly and transparently — so you can research and enroll with confidence.
🛡️ Official Medicare Enrollment Resources
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.
Frequently Asked Questions
📘 What does Medicare plan code H2450 036 mean?
The Medicare plan code H2450 036 identifies a specific Medicare Advantage plan. In this case, it refers to Medica Prime Solution Premier , a Cost plan offered by Medica.
- Plan Name: Medica Prime Solution Premier
- Plan Type: Cost
- Premium: $217.00/mo + your monthly Part B premium
- Out-of-Pocket Max: $3,000.00 (in-network)
- Drug Coverage: Does not include Medicare Part D prescription drug coverage.
- CMS Star Rating: 4 out of 5
- Contract Year: 2025
This information is based on official CMS data and is provided for educational purposes. Always review your plan’s official documents or contact the provider directly before making enrollment decisions.
📋 What type of plan is H2450 036?
This plan is a Cost — specifically, it's an Cost plan with a Medicare Advantage contract that's offered by Medica. It comes with defined provider network rules you should be aware of.
- Plan Marketing Name: Medica Prime Solution Premier
- Network Type: Cost plan combining Original Medicare with optional managed care benefits
- Referral Requirement: Referral rules vary under Cost plans. You may have access to both network and Medicare-approved providers.
- Prescription Coverage: Does not include Medicare Part D prescription drug coverage.
Plan types like HMOs and PPOs determine whether you can go out-of-network or need referrals to see specialists.
📦 What benefits are included in H2450 036?
This plan covers all Medicare Part A and Part B services. Depending on the plan, it may also include valuable extras like dental, vision, and hearing benefits.
- Medical Services: Hospital, doctor visits, preventive care
- Prescription Drugs: Not Included
- Dental: No — this plan does not include dental benefits.
- Vision: Yes — vision benefits are included. Review the vision section above for copay and limit details.
- Hearing: Yes — hearing benefits are included. See the coverage details above to learn what services are covered.
Benefit availability may vary by location and plan version. Confirm specific details in your plan's Evidence of Coverage (EOC).