2022 Mercy Iowa City Senior Plan (Cost)

Mercy Iowa City Senior Plan (Cost) H1651-016 is a 2022 Medicare Advantage Plan or Part-C by Medical Associates Health Plan, Inc. available to residents in Iowa. This plan does not provide additional prescription drug (Part-D) coverage. The Mercy Iowa City Senior Plan (Cost) has a monthly premium of $147.00 and has an in-network maximum out-of-pocket limit of $- (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $- out-of-pocket. This can be a extremely nice safety net.

Mercy Iowa City Senior Plan (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.

Medical Associates Health Plan, Inc. works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Mercy Iowa City Senior Plan (Cost) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Medical Associates Health Plan, Inc. 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 Medical Associates Health Plan, Inc. 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 Medical Associates Health Plan, Inc. Medicare Advantage Plan Costs

2021 Mercy Iowa City Senior Plan (Cost) Summary of Benefits

*This will be updated with 2022 data when available.

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Additional Benefits

Yes

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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

$0

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Diagnostic Tests and Procedures

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

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Doctor Visits

Primary	$0 copay
Specialist	$0 copay

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Emergency care/Urgent Care

Emergency	$0 copay
Urgent care	$0 copay

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Foot Care (podiatry services)

Foot exams and treatment	$0 copay
Routine foot care	$0 copay

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Ground Ambulance

$0 copay

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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	$0 copay

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Inpatient Hospital Coverage

$0 copay

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Medical Equipment/Supplies

Diabetes supplies	$0 copay
Durable medical equipment (e.g., wheelchairs, oxygen)	$0 copay
Prosthetics (e.g., braces, artificial limbs)	$0 copay

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Medicare Part B Drugs

Chemotherapy	$0 copay
Other Part B drugs	$0 copay

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Mental Health Services

Inpatient hospital - psychiatric	$0 copay
Outpatient group therapy visit	$0 copay
Outpatient group therapy visit with a psychiatrist	$0 copay
Outpatient individual therapy visit	$0 copay
Outpatient individual therapy visit with a psychiatrist	$0 copay

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MOOP

Not Applicable

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Option

No

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Optional supplemental benefits

No

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Outpatient Hospital Coverage

$0 copay

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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	$0 copay
Physical therapy and speech and language therapy visit	$0 copay

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Skilled Nursing Facility

$0 copay

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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	$0 copay
Upgrades	Not covered

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Wellness Programs (e.g. fitness nursing hotline)

Not covered

Ready to Enroll?

Click Here

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

Coverage Area for Mercy Iowa City Senior Plan (Cost)

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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.