Medica Advantage Solution Edge (HMO-POS)

Medicare Advantage Plan for Minnesota

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderMedica
Plan IDH6154-1-0
CMS RatingNot Rated1
Plan TypeHMO-POS
Annual Deductible$250.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$5,900 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$24.60
Monthly Health Plan Premium
$40.80

Benefits

Service
Cost
Inpatient hospital coverage
In-Network:
$320 for days 1 through 5
$0 for days 6 through 90
Out-of-Network:
20% for days 1 through 90
Outpatient hospital coverage
In-Network:
$250-320 per visit. Out-of-Network:
20% per visit
Doctor visits
Primary:In-Network:
$25 per visit. Out-of-Network:
20% per visit
Specialist:In-Network:
$50 per visit. Out-of-Network:
20% per visit
Preventive care
In-Network:
$0 copay. Out-of-Network:
20%
Emergency care/Urgent care
Emergency:$80 per visit (always covered)
Urgent care:$40 per visit (always covered)
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:In-Network:
20%Out-of-Network:
20%
Lab services:In-Network:
$0 copay. Out-of-Network:
20%
Diagnostic radiology services (e.g., MRI):In-Network:
20%Out-of-Network:
20%
Outpatient x-rays:In-Network:
20%Out-of-Network:
20%
Mental health services
In-Network:
$320 for days 1 through 5
$0 for days 6 through 90
Out-of-Network:
20% for days 1 through 90
Outpatient group therapy visit with a psychiatrist:In-Network:
$30
Outpatient individual therapy visit with a psychiatrist:In-Network:
$30
Outpatient group therapy visit:In-Network:
$30
Outpatient individual therapy visit:In-Network:
$30
Skilled Nursing Facility
In-Network:
$0 for days 1 through 20
$150 for days 21 through 100
Out-of-Network:
20% for days 1 through 100
Rehabilitation services
Occupational therapy visit:In-Network:
$40Out-of-Network:
20%
Physical therapy and speech and language therapy visit:In-Network:
$40Out-of-Network:
20%
Ambulance
In-Network:
$250 or 20%Out-of-Network:
$0-250 or 0-20%
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:In-Network:
$50Out-of-Network:
20%
Routine foot care:Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):In-Network:
20% per item
Prosthetics (e.g., braces, artificial limbs):In-Network:
20% per item. Out-of-Network:
20% per item
Diabetes supplies:In-Network:
20% per item. Out-of-Network:
20% per item
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:In-Network:
20%Out-of-Network:
20%
Other Part B drugs:In-Network:
20%Out-of-Network:
20%

Coverage Area for Medica Advantage Solution Edge (HMO-POS)

StateMinnesota
CountyRamsey

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offereds$0 copayNot offered
Tier 2: Non-Preferred GenericNot offered$4 copayNot offered
Tier 3: Preferred Brand NameNot offered$40 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered50% coinsuranceNot offered
Tier 5: Specialty TierNot offered28% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$0 copayNot offered
Tier 2: Non-Preferred GenericNot offered$12 copayNot offered
Tier 3: Preferred Brand NameNot offered$120 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered50% coinsuranceNot offered
Tier 5: Specialty TierNot offered28% coinsuranceNot offered

Physician Finder

Physicians that accept Medica Advantage Solution Edge (HMO-POS) for Minnesota

/
REGIONS PROFESSIONAL GROUP
640 JACKSON ST
SAINT PAUL, MN 55101
HOKANSON, JONATHAN
640 JACKSON STREET
ST PAUL, MN 55101
SMALLEY, STEVE
640 JACKSON ST - MS 11102M
ST. PAUL, MN 55101
LEON, JORGE
166 4TH ST E
SAINT PAUL, MN 55101
ALBRECHT, LUKE
640 JACKSON ST
SAINT PAUL, MN 55101
MURPHY, BRONAGH
1580 BEAM AVE
MAPLEWOOD, MN 55109
HICKS, WILLIAM
3100 KENNARD ST
MAPLEWOOD, MN 55109
Details
REGIONS PROFESSIONAL GROUP
Phone Number
(651) 254-3908
Office Locations
640 JACKSON ST
SAINT PAUL, MN 55101
640 JACKSON ST SAINT PAUL MN, 55101

Similar Plans

PremiumPlan NameCMS Rating
from $20
Platinum Blue Core Plan with Rx (Cost)
Details
from $5
UCare for Seniors Prime (HMO-POS)
Details
from $33
Gundersen MN Senior Preferred Value (w/Rx) (HMO)
Details
from $20
Humana Walmart Rx Plan (PDP)
Details
from $22
Express Scripts Medicare - Saver (PDP)
Details

Related Articles

Related Searches

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. 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. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

{}