2023 NetworkPrime (MSA)

NetworkPrime (MSA) H1181-001 is a 2023 Medicare Advantage Plan or Part-C by Network Health Medicare Advantage Plans available to residents in Wisconsin. This plan does not provide extra prescription drug (Part-D) coverage. Network Health Medicare Advantage Plans NetworkPrime (MSA) has a monthly premium of and has an in-network maximum out-of-pocket limit of $- (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay $- out-of-pocket. This can be an extremely nice safety net.

Network Health Medicare Advantage Plans works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for NetworkPrime (MSA) you still retain Original Medicare. But you will get extra Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Network Health Medicare Advantage Plans and not Original Medicare. With 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all the benefits of Original Medicare from Network Health Medicare Advantage Plans except hospice care. Original Medicare still provides you with hospice care if you sign up for Medicare Advantage in Wisconsin.



2023 Network Health Medicare Advantage Plans Medicare Advantage Plan Overview

Name:NetworkPrime (MSA)
Plan ID:H1181 001 0
Provider:Network Health Medicare Advantage Plans
Year:2023
Type:MSA *
Combined Premium (C+D):/mo
MOOP:$-/yr
Similar Plan: H1181-001




What type of plan is NetworkPrime (MSA)

NetworkPrime (MSA) is a MSA *. A Medicare Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that combines a high deductible health plan with a medical savings account. Enrollees of Medicare MSA plans can initially use their savings account to help pay for health care, and then will have coverage through a high-deductible insurance plan once they reach their deductible. Medicare MSA plans can provide Medicare beneficiaries with more control over healthcare utilization, while still providing coverage against catastrophic health care expenses.

How much does NetworkPrime (MSA) cost?


Part-C Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Network Health Medicare Advantage Plans charges a premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.




2023 Summary of Benefits


The benefit information provided is a summary of what NetworkPrime (MSA) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Network Health Medicare Advantage Plans helps get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.

Wellness programs (e.g., fitness, nursing hotline)Not covered



Contact lenses


VisionNot covered



Eyeglass frames


VisionNot covered



Eyeglass lenses


VisionNot covered



Eyeglasses (frames and lenses)


VisionNot covered



Other


VisionNot covered



Routine eye exam


VisionNot covered



Upgrades


VisionNot covered




TransportationNot covered
Skilled Nursing Facility$0 copay after you pay your deductible



Occupational therapy visit


Rehabilitation services$0 copay after you pay your deductible



Physical therapy and speech and language therapy visit


Rehabilitation services$0 copay after you pay your deductible



Cleaning


Preventive dentalNot covered



Dental x-ray(s)


Preventive dentalNot covered



Fluoride treatment


Preventive dentalNot covered



Oral exam


Preventive dentalNot covered




Preventive care$0 copay
Outpatient hospital coverage$0 copay after you pay your deductible
In-Network Other health plan deductibles?No
Optional supplemental benefitsYes



Inpatient hospital - psychiatric


Mental health services$0 copay after you pay your deductible



Outpatient group therapy visit


Mental health services$0 copay after you pay your deductible



Outpatient group therapy visit with a psychiatrist


Mental health services$0 copay after you pay your deductible



Outpatient individual therapy visit


Mental health services$0 copay after you pay your deductible



Outpatient individual therapy visit with a psychiatrist


Mental health services$0 copay after you pay your deductible



Chemotherapy


Medicare Part B drugs$0 copay after you pay your deductible



Other Part B drugs


Medicare Part B drugs$0 copay after you pay your deductible



Diabetes supplies


Medical equipment/supplies$0 copay after you pay your deductible



Durable medical equipment (e.g., wheelchairs, oxygen)


Medical equipment/supplies$0 copay after you pay your deductible



Prosthetics (e.g., braces, artificial limbs)


Medical equipment/supplies$0 copay after you pay your deductible




Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)Not Applicable
Inpatient hospital coverage$0 copay after you pay your deductible



Fitting/evaluation


HearingNot covered



Hearing aids - inner ear


HearingNot covered



Hearing aids - outer ear


HearingNot covered



Hearing aids - over the ear


HearingNot covered



Hearing exam


Hearing$0 copay after you pay your deductible




Health plan deductible$5,100 annual deductible
Ground ambulance$0 copay after you pay your deductible



Foot exams and treatment


Foot care (podiatry services)$0 copay after you pay your deductible



Routine foot care


Foot care (podiatry services)Not covered



Emergency


Emergency care/Urgent care$0 copay after you pay your deductible



Urgent care


Emergency care/Urgent care$0 copay after you pay your deductible



Primary


Doctor visits$0 copay after you pay your deductible



Specialist


Doctor visits$0 copay after you pay your deductible



Diagnostic radiology services (e.g., MRI)


Diagnostic procedures/lab services/imaging$0 copay after you pay your deductible



Diagnostic tests and procedures


Diagnostic procedures/lab services/imaging$0 copay after you pay your deductible



Lab services


Diagnostic procedures/lab services/imaging$0 copay after you pay your deductible



Outpatient x-rays


Diagnostic procedures/lab services/imaging$0 copay after you pay your deductible



Diagnostic services


Comprehensive dentalNot covered



Endodontics


Comprehensive dentalNot covered



Extractions


Comprehensive dentalNot covered



Non-routine services


Comprehensive dentalNot covered



Periodontics


Comprehensive dentalNot covered



Prosthodontics, other oral/maxillofacial surgery, other services


Comprehensive dentalNot covered



Restorative services


Comprehensive dentalNot covered




In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?No




Coverage Area

(Click county or state to compare all available Advantage plans)

The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for NetworkPrime (MSA) requires you to live in that plan’s service area. The service area is listed below:



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How much does NetworkPrime (MSA) cost?

Network Health Medicare Advantage Plans charges a monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage. The premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

How much is NetworkPrime (MSA) MOOP?

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. NetworkPrime (MSA) by Network Health Medicare Advantage Plans MOOP is $-. Once you spend $- you will pay nothing for Part A or Part B covered services.

What type of plan is NetworkPrime (MSA)?

NetworkPrime (MSA) is a MSA *. A Medicare Medical Savings Account(MSA) plan combines a high deductible health plan with a medical savings account. Enrollees of MSA plans can initially use their savings account and still have coverage against catastrophic expenses.



Source:CMS. Data as of Oct 1, 2022.

Last updated on

Notes: Data are subject to change as contracts are finalized. For 2023, enhanced alternative may offer extra cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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