2022 NetworkPrime (MSA)

NetworkPrime (MSA) H1181-001 is a 2022 Medicare Advantage Plan or Part-C by Network Health Medicare Advantage Plans available to residents in Wisconsin. This plan does not provide additional prescription drug (Part-D) coverage. The NetworkPrime (MSA) has a monthly premium of 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.

Network Health Medicare Advantage Plans works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for NetworkPrime (MSA) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Network Health Medicare Advantage Plans 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 Network Health Medicare Advantage Plans except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.

Ready to Enroll?

Click Here

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

2022 Network Health Medicare Advantage Plans Medicare Advantage Plan Costs

2021 NetworkPrime (MSA) 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

$5,100 annual deductible

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Diagnostic Tests and Procedures

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

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Doctor Visits

Primary	$0 copay after you pay your deductible
Specialist	$0 copay after you pay your deductible

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Emergency care/Urgent Care

Emergency	$0 copay after you pay your deductible
Urgent care	$0 copay after you pay your deductible

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Foot Care (podiatry services)

Foot exams and treatment	$0 copay after you pay your deductible
Routine foot care	Not covered

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Ground Ambulance

$0 copay after you pay your deductible

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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 after you pay your deductible

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Inpatient Hospital Coverage

$0 copay after you pay your deductible

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Medical Equipment/Supplies

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

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Medicare Part B Drugs

Chemotherapy	$0 copay after you pay your deductible
Other Part B drugs	$0 copay after you pay your deductible

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Mental Health Services

Inpatient hospital - psychiatric	$0 copay after you pay your deductible
Outpatient group therapy visit	$0 copay after you pay your deductible
Outpatient group therapy visit with a psychiatrist	$0 copay after you pay your deductible
Outpatient individual therapy visit	$0 copay after you pay your deductible
Outpatient individual therapy visit with a psychiatrist	$0 copay after you pay your deductible

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MOOP

Not Applicable

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Option

No

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Optional supplemental benefits

Yes

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Outpatient Hospital Coverage

$0 copay after you pay your deductible

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Package #1

Deductible	$100.00
Monthly Premium	$38.00

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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 after you pay your deductible
Physical therapy and speech and language therapy visit	$0 copay after you pay your deductible

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Skilled Nursing Facility

$0 copay after you pay your deductible

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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)

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 NetworkPrime (MSA)

(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.