2021 Medica Advantage Solution with CHI Health (HMO) H0798-001-000 in IA from Medical Associates | HealthPocket

Medica Advantage Solution with CHI Health (HMO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderMedical Associates
Plan IDH0798-001-000
Plan Year2021
CMS RatingNot Rated
Plan TypeHMO
Annual Deductible$250.00
Out-of-Pocket Maximum5500

What To Know About This Plan
  • This plan has health and drug coverage

Why We Like This Plan
  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Costs and Other Important Information

Plan Year2021
Prescription Drugs Covered?Yes
Health Plan Deductible$250
Monthly Drug Plan Premium$0
Monthly Health Plan Premium$0

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred Generic$0 copay$10 copayNot offeredNot offered
Tier 2: Generic$14 copay$20 copayNot offeredNot offered
Tier 3: Preferred Brand$47 copay$47 copayNot offeredNot offered
Tier 4: Non-Preferred Drug50% coinsurance50% coinsuranceNot offeredNot offered
Tier 5: Specialty Tier28% coinsurance28% coinsuranceNot offered28% coinsurance

90 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred Generic$0 copay$30 copayNot offered$0 copay
Tier 2: Generic$42 copay$60 copayNot offered$0 copay
Tier 3: Preferred Brand$141 copay$141 copayNot offered$131 copay
Tier 4: Non-Preferred Drug50% coinsurance50% coinsuranceNot offered50% coinsurance
Tier 5: Specialty Tier

Staying healthy - screenings, tests and vaccines

Breast cancer screeningNot Rated
Colorectal cancer screeningNot Rated
Annual flu vaccineNot Rated
Improving or maintaining physical healthNot Rated
Improving or maintaining mental healthNot Rated
Monitoring physical abilityNot Rated
Adult BMI assessmentNot Rated

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain assessmentNot Rated
Osteoporosis management in women who had a fractureNot Rated
Diabetes care – eye examNot Rated
Diabetes care – kidney disease monitoringNot Rated
Diabetes care – blood sugar controlledNot Rated
Rheumatoid arthritis managementNot Rated
Reducing the risk of fallingNot Rated
Improving bladder controlNot Rated
Medication reconciliation post-dischargeNot Rated
Statin Therapy for Patients with Cardiovascular DiseaseNot Rated

Member Experience with Health Plan

Getting needed careNot Rated
Getting appointments and care quicklyNot Rated
Customer serviceNot Rated
Rating of health care qualityNot Rated
Rating of health planNot Rated
Care CoordinationNot Rated

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health planNot Rated
Members choosing to leave the health planNot Rated
Health plan quality improvementNot Rated

Health Plan Customer Service

Plan makes timely decision about appealsNot Rated
Reviewing appeals decisionsNot Rated
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY availability
Appeals auto-forwardNot Rated
Appeals upheldNot Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug planNot Rated
Members choosing to leave the drug planNot Rated
Drug plan quality improvementNot Rated

Member Experience with Drug Plan

Rating of drug planNot Rated
Getting needed prescription drugsNot Rated

Drug Pricing and Patient Safety

MPF Price AccuracyNot Rated
Medication adherence for diabetes medicationsNot Rated
Medication adherence for hypertension - RAS antagonistsNot Rated
Medication adherence for cholesterol - StatinsNot Rated
MTM program completion rate for CMRNot Rated
Statin use in persons with diabetes - SUPDNot Rated

Physicians that accept Medica Advantage Solution with CHI Health (HMO) for Iowa

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HealthPocket.com is a free information source. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.