PARTC

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C)
Insurance Provider
Medical Associates
CMS Rating
Not Rated
Plan Type
Cost
Annual Deductible
$0.00

What To Know About This Plan

  • This is a health coverage only plan with no drug coverage

All cost-sharing assumes in-network healthcare providers.

Plan Details

Costs and Other Important Information

Plan Year:
2016
Monthly Drug Plan Premium
Not Applicable
Health Plan Deductible
$0
Choice of Doctors?
Plan Doctors for Most Services
Monthly Health Plan Premium
$136.00
Out-Of-Pocket Spending Limit
Not Applicable
Optional Supplemental Benefits?
No
Prescription Drugs Covered?
No
Other Health Plan Deductibles?
Yes

Benefits

Service
Cost
Ambulance
You pay nothing
Doctor's office visits
Primary Physician
You pay nothing
Specialist
You pay nothing
Durable medical equipment (wheelchairs, oxygen, etc.)
You pay nothing
Emergency care
You pay nothing
Home health care
You pay nothing
Mental health care
You pay nothing
Outpatient hospital
You pay nothing
Renal dialysis
You pay nothing
Inpatient hospital care
You pay nothing
Skilled Nursing Facility (SNF)
You pay nothing

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Not Rated
Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Not Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Not Rated
Reducing the risk of falling
Plan all-cause readmissions
Not Rated

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Not Rated
Reviewing appeals decisions
Not Rated
Call center – foreign language interpreter and TTY/TDD availability - Medical
Not Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
Appeals auto-forward
Not Rated
Appeals upheld
Not Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Not Rated
Members choosing to leave the drug plan
Not Rated
Beneficiary access and performance problems
Not Rated
Drug plan quality improvement
Not Rated

Member Experience with Drug Plan

Rating of drug plan
Not Rated
Getting needed prescription drugs
Not Rated

Drug Pricing and Patient Safety

MPF Price Accuracy
Not Rated
High risk medication
Not Rated
Part D medication adherence for diabetes
Not Rated
Part D medication adherence for hypertension
Not Rated
Part D medication adherence for cholesterol
Not Rated
Medication Therapy Management program completion rate
Not Rated

Physician Finder

Physicians that accept Medical Associates Community (Cost) for Iowa

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