Medical Associates SmartPlan (Cost) Plan H1651-003-0 Details
Medical Associates SmartPlan Cost is a 2024 Medicare Advantage plan, without a prescription drug plan. This page outlines all of the costs and benefits of Plan
This Medical Associates Health Plan, Inc. plan offers the same basic benefits as Original Medicare, but out-of-pocket costs differ. It may also include additional, valuable benefits not covered by Part A or Part B.
CMS rated this plan 5.0 (Excellent) stars, making it a top-rated plan from this insurance company.
Plan Basics | |
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Plan ID: | H1651 003 0 |
Plan Type: | Cost |
Plan Year: | 2024 |
Premium: | $128.00/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | /yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Not Included |
Rx Gap Coverage: | No |
Supplemental Benefits: | Vision |
Availability: | See List |
Insured By: | Medical Associates Health Plan, Inc. |
Summary of Benefits |
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Health Plan Cost Sharing
This Medical Associates Health Plan, Inc. Medicare Advantage plan has cost-sharing. These are costs you must pay out-of-pocket when you use approved health services.
NOTE: Most preventive services are covered 100% by the plan as a Part B benefit.
The following table summarizes the most common out-of-pocket costs you will incur if you join this plan unless you go out-of-network:
Healthcare Service | Member Cost |
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Doctor Visits (In-Network) | |
Primary: | $0 |
Specialist: | $0 |
Wellness programs (e.g., fitness, nursing hotline): | None |
Preventive care: | $0 |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $0 |
Routine foot care: | $0 |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $0 |
Routine chiropractic care: | Not Covered |
Emergency Care / Urgent Care | |
Emergency room care: | $0 |
Urgent care: | $0 |
Ground ambulance: | $0 |
Inpatient hospital coverage: | |
Outpatient hospital coverage: | $0 |
Skilled Nursing Facility: | |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $0 |
Outpatient group therapy visit with a psychiatrist: | $0 |
Inpatient hospital - psychiatric: | |
Outpatient group therapy visit: | $0 |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $0 |
Occupational therapy visit: | $0 |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | $0 |
Durable medical equipment (e.g., wheelchairs, oxygen): | $0 |
Prosthetics (e.g., braces, artificial limbs): | $0 |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | $0 |
Lab services: | $0 |
Outpatient x-rays: | $0 |
Diagnostic tests and procedures: | $0 |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | $0 |
Other Part B drugs (Medicare-covered) | $0 |
Feel free to download our Medical Associates SmartPlan Summary of Benefits information.
Supplemental Benefits
The following is a summary of the supplemental benefits Medical Associates Health Plan, Inc. includes with this plan:
Supplemental Healthcare Service | Member Cost |
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Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | Not Covered |
Hearing aids (In-Network) | Not Covered |
Hearing exam (In-Network) | Not Covered |
Vision | Maximum vision benefit: | Non Specified |
Eyeglasses (frames and lenses) (In-Network) | Not Covered |
Routine eye exam (In-Network) | Covered Limits may apply |
Contact lenses (In-Network) | Not Covered |
Additional Benefits
None specified.
Prescription Drug Plan Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Marks
The following table shows the quality ratings for this Medical Associates Health Plan, Inc. plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories based on a 5-star rating system. Here are the most recent ratings for Medical Associates SmartPlan.
CMS Measure | Star Rating |
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2024 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 | Not enough data available |
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 |
Plan Availability
Medical Associates SmartPlan (H1651-003-0) is available in the following locations (click to open):
Additional Medicare Advantage Plan Options
The Medicare Advantage program offers a myriad of options, including these plans:
- H1651-011-0: Central Iowa Health Senior Plan (Cost)
- H1651-002-0: Medical Associates Basic Plan (Cost)
- H1651-001-0: Medical Associates SmartPlan (Cost)
- H1651-016-0: Mercy Iowa City Senior Plan (Cost)
- H1651-015-0: MercyOne North Iowa Senior Plan (Cost)
Contact Medical Associates Health Plan, Inc.
Plan Website: | http://www.mahealthplans.com |
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Formulary Information: | http:// |
Pharmacy Information: | Medical Associates Health Plan, Inc. Pharmacy Page |
Prospective Members: | (800)747-8900 |
TTY Users: | (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 Advantage program on www.medicare.gov or call 1-800-MEDICARE.
Medicare Part C Compatibility
Medicare Part C plans (HMO, PPO, PFFS) typically do not work with other types of health insurance. If you have Medicare Part A and/or Part B and decide to join a Part C plan, you will be removed from Original Medicare.
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.
Veterans enrolled in a Part C plan who also have VA Health Benefits may be able to receive care at their local VA healthcare facility. However, depending on the plan, the plan may or may not cover VA out-of-pocket healthcare or drug costs. Speak with a licensed insurance agent to discuss your options.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- Medical Associates Health Plan, Inc., http://www.mahealthplans.com, Last Accessed February 20, 2024
- Medicare.gov, "Your health plan options", Last Accessed February 20, 2024
- Medicare.gov, "How Original Medicare Works", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You Handbook", 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
About This H1651-003-0 Plan Detail Page
The data on this Medical Associates SmartPlan plan detail page is derived from the 2024 Landscape Source Files, Plan Benefit Package, and Medicare Part C and Part D Performance Data published by CMS.
The author interprets these files, and their associated data dictionary, with great care, making every attempt to communicate the data submitted by Medical Associates Health Plan, Inc. to CMS as clearly and accurately as possible. Given the complexity of the data, the author recommends that all potential enrollees request an official Summary of Benefits from Medical Associates Health Plan, Inc., at (800)747-8900, prior to enrollment.