Plan H1181-001-0: Network Health Prime (MSA) – 2025 Coverage Details for Outagamie County, WI
This page provides coverage, cost, and availability details for Network Health Medicare Advantage Plans’s H1181-001-0 Medicare Advantage plan for 2025.
See more Medicare Advantage Plans in Outagamie County, Wisconsin.
*This plan is new and has not yet been rated by CMS.
Network Health Prime Basic Plan Details
- Plan ID
- H1181-001-0
- Plan Type
- MSA
- Plan Year
- 2025
- Premium
- $0.00/mo
Plus your Medicare Part B premium. - Health Plan Deductible
- $0.00
- Out-of-Pocket Maximum
- Not Applicable/yr (in-network)
- Part B Reduction
- $0.00/mo
- Drug Plan Benefit
- Not Included
- Supplemental Benefits
- None
- Availability
- Outagamie County, WI
- Insured By
- Network Health Medicare Advantage Plans
| Summary of Benefits |
|---|
Health Plan Out-of-Pocket Costs
This Network Health Medicare Advantage Plans 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 H1181-001-0.
NOTE: Certain preventive services are covered 100% by the plan as a Part B benefit.
Doctor's Office Visits
- Primary
- Not Covered
- Specialist
- Not Covered
Emergency, Urgent, and Inpatient Hospital Coverage
- Emergency room care
- Not Covered
- Urgent care
- Not Covered
- Ground ambulance
- Not Covered
- Inpatient hospital care
- Skilled Nursing Facility
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
Rehabilitation Services
- Physical therapy and speech and language therapy
- Not Covered
- Occupational therapy
- Not Covered
Medical Equipment and Supplies
- Diabetes supplies
- Not Covered
- Durable medical equipment
- Not Covered
- Prosthetics
- Not Covered
Diagnostics, Lab Services, and Imaging
- Diagnostic radiology services
- Not Covered
- Lab services
- Not Covered
- Outpatient x-rays
- Not Covered
- Diagnostic tests and procedures
- Not Covered
Medicare Part B Drugs
- Chemotherapy
- Not Covered
- Other Part B drugs (Medicare-covered)
- Not Covered
Dental Services
- 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
- Fitting/evaluation
- Not Covered
- Hearing aids
- Not Covered
- Hearing exam
- Not Covered
Vision Services
- Medicare-covered eye exam
- Routine eye exam
- Not Covered
- 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) 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 Network Health Prime .
| 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 | 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 |
Additional Plan Options
The Medicare Part C program offers a myriad of HMO, PPO, and PFFS plan options, including these plans:
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 Us About Network Health Medicare Advantage Plans
| Website: | Network Health Medicare Advantage Plans Plan Page (opens in new tab) |
|---|---|
| Providers: | Network Health Medicare Advantage Plans Providers Page (opens in new tab) |
| New Member Health Plan Help: | (800)983-7587 |
| New Member Health Plan TTY: | (800)947-3529 |
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
- Network Health Medicare Advantage Plans, https://networkhealth.com/, Last Accessed March 1, 2025
- 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", Last Accessed February 19, 2024
- Medicare.gov, "What Medicare Covers", Last Accessed March 19, 2025
- CMS.gov, Landscape Source Files, Last Accessed March 15, 2025
- CMS.gov, Medicare Part C & D Performance, Last Accessed March 15, 2025
- CMS.gov, Plan Benefits Package,Last Accessed March 15, 2025
Research Note: This content is based on independent analysis of CMS data by David Bynon, Medicare analyst and founder of MedicareWire.
For details on how this plan was analyzed and constructed using CMS data, see our Medicare Plan Research Methodology.
Disclaimer: MedicareWire does not endorse or rank Medicare plans. Plan information is provided for educational and research purposes only and may not reflect the most current data available from CMS or the plan provider.
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.