2022 Medica Prime Solution Thrift (Cost)


Medica Prime Solution Thrift (Cost) H2450-030 is a 2022 Medicare Advantage Plan or Part-C by Medica available to residents in Iowa and Nebraska. This plan does not provide additional prescription drug (Part-D) coverage. The Medica Prime Solution Thrift (Cost) has a monthly premium of $34.00 and has an in-network maximum out-of-pocket limit of $6,700 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,700 out-of-pocket. This can be a extremely nice safety net.

Medica Prime Solution Thrift (Cost) is a Cost * plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

Medica works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Medica Prime Solution Thrift (Cost) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Medica and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Medica except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.




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2022 Medica Medicare Advantage Plan Costs

Name:
Medica Prime Solution Thrift (Cost)
Plan ID:
H2450-030
Provider:Medica
Year:2022
Type: Cost *
Monthly Premium C+D: $34.00
Part C Premium:
MOOP: $6,700
Similar Plan: H2450-032
New Plan: 2023 H2450-032




2021 Medica Prime Solution Thrift (Cost) Summary of Benefits

*This will be updated with 2022 data when available.



Additional Benefits


No



Comprehensive Dental


Diagnostic services Not covered
Endodontics Not covered
Extractions Not covered
Non-routine services Not covered
Periodontics Not covered
Prosthodontics, other oral/maxillofacial surgery, other services Not covered
Restorative services Not covered



Deductible


$50 In-network



Diagnostic Tests and Procedures


Diagnostic radiology services (e.g., MRI) 20% coinsurance
Diagnostic tests and procedures 20% coinsurance
Lab services $0 copay
Outpatient x-rays 20% coinsurance



Doctor Visits


Primary 20% coinsurance per visit
Specialist 20% coinsurance per visit



Emergency care/Urgent Care


Emergency $50 copay per visit (always covered)
Urgent care $25 copay per visit (always covered)



Foot Care (podiatry services)


Foot exams and treatment 20% coinsurance
Routine foot care Not covered



Ground Ambulance


20% coinsurance



Hearing


Fitting/evaluation Not covered
Hearing aids - inner ear Not covered
Hearing aids - outer ear Not covered
Hearing aids - over the ear Not covered
Hearing exam 20% coinsurance



Inpatient Hospital Coverage


$300 per day for days 1 through 4
$0 per day for days 5 through 90



Medical Equipment/Supplies


Diabetes supplies 20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen) 20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs) 20% coinsurance per item



Medicare Part B Drugs


Chemotherapy 20% coinsurance
Other Part B drugs 20% coinsurance



Mental Health Services


Inpatient hospital - psychiatric $300 per day for days 1 through 4
$0 per day for days 5 through 90
Outpatient group therapy visit 20% coinsurance
Outpatient group therapy visit with a psychiatrist 20% coinsurance
Outpatient individual therapy visit 20% coinsurance
Outpatient individual therapy visit with a psychiatrist 20% coinsurance



MOOP


$6,700 In-network



Option


No



Optional supplemental benefits


No



Outpatient Hospital Coverage


20% coinsurance per visit



Preventive Care


$0 copay



Preventive Dental


Cleaning Not covered
Dental x-ray(s) Not covered
Fluoride treatment Not covered
Oral exam Not covered



Rehabilitation Services


Occupational therapy visit 20% coinsurance
Physical therapy and speech and language therapy visit 20% coinsurance



Skilled Nursing Facility


Coming soon



Transportation


Not covered



Vision


Contact lenses Not covered
Eyeglass frames Not covered
Eyeglass lenses Not covered
Eyeglasses (frames and lenses) Not covered
Other Not covered
Routine eye exam Not covered
Upgrades Not covered



Wellness Programs (e.g. fitness nursing hotline)


Covered




CMS Star Ratings for Medica Prime Solution Thrift (Cost) H2450



2021 Overall Rating
Part C Summary Rating
Part-D Summary 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
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancer Screening
Annual Flu Vaccine
Monitoring Physical Activity


Managing Chronic And Long Term Care for Older Adults

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Rheumatoid Arthritis
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy


Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Getting Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination


Member Complaints and Changes in Medica Prime Solution Thrift (Cost) Plans Performance

Total Rating
Complaints about Health Plan
Members Leaving the Plan
Health Plan Quality Improvement


Health Plan Customer Service Rating for Medica Prime Solution Thrift (Cost)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language


Medica Prime Solution Thrift (Cost) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language


Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement


Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs


Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR
Statin with Diabetes



Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST




Coverage Area for Medica Prime Solution Thrift (Cost)

(Click county to compare all available Advantage plans)



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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.