Medica Prime Solution Premier (Cost)

Iowa Medicare Advantage Plan (2025 Plan)


Monthly Premium

Your Cost
$152
by Medica

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.0
out of 5 stars

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Plan Name
Medica Prime Solution Premier (Cost)
Insurance Carrier
Medica
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
COST

Medica Prime Solution Premier (Cost) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Iowa and offered by the health insurance company Medica. This plan’s network type is COST which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$152
Annual Deductible
$0
Max Out-of-Pocket
$3,000
Primary doctor visit
$0 copay
Specialist visit
$0 copay
ER visit
$100 copay per visit (always covered)
Ambulance
$0 copay

Medica Prime Solution Premier (Cost) has a monthly premium cost of $152 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $3,000 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Medica Prime Solution Premier (Cost) are defined below.

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Medica Prime Solution Premier (Cost) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Medica Prime Solution Premier (Cost) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Medica Prime Solution Premier (Cost) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2025, Medica Prime Solution Premier (Cost) received an overall government quality rating of 4.0 stars out of 5 stars.

Medica Prime Solution Premier (Cost) performed the same as Iowa’s State average overall quality score of 4.0 stars.

This Plan’s 5-star Gov’t Quality Score
Iowa State Average Score
Overall Government 5 Star Quality Rating
 4.0
 4.0
Summary rating of health plan quality
 4.5
 3.9
Staying healthy: screenings, tests, & vaccines
 3
 3.8
Managing chronic (long term) conditions
 3
 3.2
Member experience with health plan
 4
 4.1
Member complaints & changes in the health plan's performance
 5
 4.3
Health plan customer service
 5
 3.7

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Medica Prime Solution Premier (Cost) received 4.5 stars for its health plan quality score which is better than the Iowa State average health plan quality score of 3.9 stars.


Monthly Premium
$152
Health Portion of Premium
$152
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$3,000 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link

Doctor Services

Primary doctor visit
$0 copay
Specialist visit
$0 copay

Tests, labs, & imaging

Diagnostic tests & procedures
$0 copay
Lab services
$0 copay
Diagnostic radiology services (like MRI)
$100 copay
Outpatient x-rays
$0 copay
Emergency care
$100 copay per visit (always covered)
Urgent care
$0 copay

Hospital Services

Inpatient hospital coverage
$200 per stay
Outpatient hospital coverage
$100 copay per visit

Skilled nursing facility

Skilled nursing facility
$0 per day for days 1 through 20
$100 per day for days 21 through 100

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$0 copay

Therapy services

Occupational therapy visit
$0 copay
Physical therapy & speech & language therapy visit
$0 copay

Mental health services

Outpatient group therapy with a psychiatrist
$0 copay
Outpatient individual therapy with a psychiatrist
$0 copay
Outpatient group therapy visit
$0 copay
Outpatient individual therapy visit
$0 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
$0 copay
Prosthetics (like braces, artificial limbs)
$0 copay
Diabetes supplies
0-20% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance

Hearing

Hearing exam
$0 copay
Fitting/evaluation
$0 copay
Hearing aids - All types
$0 copay

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: $0 copay
Implant services
In-network: $0 copay
Out-of-network: $0 copay
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
In-network: $0 copay
Out-of-network: $0 copay
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
$0 copay
Eyeglass lenses (only)
$0 copay
Upgrades
$0 copay

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