NetworkPrime (MSA) H1181-001 is a 2023 Medicare Advantage Plan or Part-C by Network Health Medicare Advantage Plans available to residents in Wisconsin. This plan does not provide extra prescription drug (Part-D) coverage. Network Health Medicare Advantage Plans 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 an 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 extra Part A (Hospital Insurance)
and Part B (Medical Insurance) coverage from Network Health Medicare Advantage Plans and not Original Medicare. With 2023 Medicare Advantage Plan 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 if you sign up for
Medicare Advantage in Wisconsin.
NetworkPrime (MSA) is a MSA *. A Medicare Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that combines a high deductible health plan with a medical savings account. Enrollees of Medicare MSA plans can initially use their savings account to help pay for health care, and then will have coverage through a high-deductible insurance plan once they reach their deductible. Medicare MSA plans can provide Medicare beneficiaries with more control over healthcare utilization, while still providing coverage against catastrophic health care expenses.
How much does NetworkPrime (MSA) cost?
Part-C Premium
A monthly premium is the fee you pay to the plan in exchange for coverage. Network Health Medicare Advantage Plans charges a premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
2023 Summary of Benefits
The benefit information provided is a summary of what NetworkPrime (MSA) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Network Health Medicare Advantage Plans helps
get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.
Physical therapy and speech and language therapy visit
Rehabilitation services
$0 copay after you pay your deductible
Cleaning
Preventive dental
Not covered
Dental x-ray(s)
Preventive dental
Not covered
Fluoride treatment
Preventive dental
Not covered
Oral exam
Preventive dental
Not covered
Preventive care
$0 copay
Outpatient hospital coverage
$0 copay after you pay your deductible
In-Network Other health plan deductibles?
No
Optional supplemental benefits
Yes
Inpatient hospital - psychiatric
Mental health services
$0 copay after you pay your deductible
Outpatient group therapy visit
Mental health services
$0 copay after you pay your deductible
Outpatient group therapy visit with a psychiatrist
Mental health services
$0 copay after you pay your deductible
Outpatient individual therapy visit
Mental health services
$0 copay after you pay your deductible
Outpatient individual therapy visit with a psychiatrist
Mental health services
$0 copay after you pay your deductible
Chemotherapy
Medicare Part B drugs
$0 copay after you pay your deductible
Other Part B drugs
Medicare Part B drugs
$0 copay after you pay your deductible
Diabetes supplies
Medical equipment/supplies
$0 copay after you pay your deductible
Durable medical equipment (e.g., wheelchairs, oxygen)
Medical equipment/supplies
$0 copay after you pay your deductible
Prosthetics (e.g., braces, artificial limbs)
Medical equipment/supplies
$0 copay after you pay your deductible
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
Not Applicable
Inpatient hospital coverage
$0 copay after you pay your deductible
Fitting/evaluation
Hearing
Not covered
Hearing aids - inner ear
Hearing
Not covered
Hearing aids - outer ear
Hearing
Not covered
Hearing aids - over the ear
Hearing
Not covered
Hearing exam
Hearing
$0 copay after you pay your deductible
Health plan deductible
$5,100 annual deductible
Ground ambulance
$0 copay after you pay your deductible
Foot exams and treatment
Foot care (podiatry services)
$0 copay after you pay your deductible
Routine foot care
Foot care (podiatry services)
Not covered
Emergency
Emergency care/Urgent care
$0 copay after you pay your deductible
Urgent care
Emergency care/Urgent care
$0 copay after you pay your deductible
Primary
Doctor visits
$0 copay after you pay your deductible
Specialist
Doctor visits
$0 copay after you pay your deductible
Diagnostic radiology services (e.g., MRI)
Diagnostic procedures/lab services/imaging
$0 copay after you pay your deductible
Diagnostic tests and procedures
Diagnostic procedures/lab services/imaging
$0 copay after you pay your deductible
Lab services
Diagnostic procedures/lab services/imaging
$0 copay after you pay your deductible
Outpatient x-rays
Diagnostic procedures/lab services/imaging
$0 copay after you pay your deductible
Diagnostic services
Comprehensive dental
Not covered
Endodontics
Comprehensive dental
Not covered
Extractions
Comprehensive dental
Not covered
Non-routine services
Comprehensive dental
Not covered
Periodontics
Comprehensive dental
Not covered
Prosthodontics, other oral/maxillofacial surgery, other services
Comprehensive dental
Not covered
Restorative services
Comprehensive dental
Not covered
In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
No
Coverage Area
(Click county or state to compare all available Advantage plans)
The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for NetworkPrime (MSA) requires you to live in that plan’s service area. The service area is listed below:
Network Health Medicare Advantage Plans charges a monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage. The premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
How much is NetworkPrime (MSA) MOOP?
The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. NetworkPrime (MSA) by Network Health Medicare Advantage Plans MOOP is $-. Once you spend $- you will pay nothing for Part A or Part B covered services.
What type of plan is NetworkPrime (MSA)?
NetworkPrime (MSA) is a MSA *. A Medicare Medical Savings Account(MSA) plan combines a high deductible health plan with a medical savings account. Enrollees of MSA plans can initially use their savings account and still have coverage against catastrophic expenses.
Notes: Data are subject to change as contracts are finalized. For 2023, enhanced alternative may offer extra cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
Site Search:
MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.
Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.
Every year, Medicare evaluates plans based on a 5-star rating system.
