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

2022 Medica Medicare Advantage Plan Costs

2021 Medica Prime Solution Thrift (Cost) Summary of Benefits

*This will be updated with 2022 data when available.

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Additional Benefits

No

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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

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Deductible

$50 In-network

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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

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Doctor Visits

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

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Emergency care/Urgent Care

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

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Foot Care (podiatry services)

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

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Ground Ambulance

20% coinsurance

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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

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Inpatient Hospital Coverage

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

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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

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Medicare Part B Drugs

Chemotherapy	20% coinsurance
Other Part B drugs	20% coinsurance

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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

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MOOP

$6,700 In-network

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Option

No

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Optional supplemental benefits

No

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Outpatient Hospital Coverage

20% coinsurance per visit

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Preventive Care

$0 copay

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Preventive Dental

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

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Rehabilitation Services

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

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Skilled Nursing Facility

Coming soon

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Transportation

Not covered

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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

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Wellness Programs (e.g. fitness nursing hotline)

Covered

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

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

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

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

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

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Drug Safety and Accuracy of Drug Pricing

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.