Medica Advantage Solution H8889-009 (PPO)

by Medica

2026 Medicare Advantage plan available in Iowa

Plan ID H8889-009-0

Additional coverage:

HearingVisionDental

Medicare Advantage PPO $0 premium 3.5 Overall

Monthly plan premium $0 / mo

Annual deductible $0 / yr

Max out-of-pocket · in-network $6,750 / yr

3.5 Overall Government Star Rating 2026 · out of 5 stars

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Plan Overview

Medica Advantage Solution H8889-009 (PPO) 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 PPO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name Medica Advantage Solution H8889-009 (PPO)

Insurance Carrier Medica

Plan Type Medicare Advantage Plan Without Prescription Drugs

Network Type PPO

Cost Summary

Medica Advantage Solution H8889-009 (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $6,750. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $0 / mo

Annual Deductible $0 / yr

Max Out-of-Pocket · in-network $6,750 / yr

Primary doctor visit $0 copay

Specialist visit $50 copay

ER visit $130 copay

Ambulance $395 copay

Additional Benefits and Coverage

Medica Advantage Solution H8889-009 (PPO) 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 Advantage Solution H8889-009 (PPO) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage No

Dental Yes

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Limited coverage

In-home support services Not covered

Home & bathroom safety devices Not covered

Meals for short duration Not covered

Annual physical exams Limited coverage

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $0 copay
Out-of-network: $30 copay

Specialist visit In-network: $50 copay
Out-of-network: $65 copay

Tests, labs & imaging

Diagnostic tests & procedures In-network: $0-$90 copay
Out-of-network: $0-$90 copay

Lab services In-network: $0 copay
Out-of-network: $0 copay

Diagnostic radiology services (like MRI) In-network: $0-$90 copay
Out-of-network: $0-$90 copay

Outpatient x-rays In-network: $25 copay
Out-of-network: $25 copay

Emergency care $130 copay

Urgent care $0-$45 copay

Hospital Services

Inpatient hospital coverage In-network:
  Tier 1
  $405 per day for days 1-6
  $0 per day for days 7-90
  $0 per stay
Out-of-network:
  $455 per day for days 1-6
  $0 per day for days 7-90
  $0 per stay

Outpatient hospital coverage In-network: $0-$375 copay
Out-of-network: $0-$425 copay

Skilled nursing facility

Skilled nursing facility In-network:
  Tier 1
  $0 per day for days 1-20
  $218 per day for days 21-52
  $0 per day for days 53-100
Out-of-network:
  $100 per day for days 1-20
  $218 per day for days 21-43
  $0 per day for days 44-100
  $0 per stay

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: $395 copay
Out-of-network: $395 copay

Therapy services

Occupational therapy visit In-network: $50 copay
Out-of-network: $65 copay

Physical therapy & speech & language therapy visit In-network: $50 copay
Out-of-network: $65 copay

Mental health services

Outpatient group therapy with a psychiatrist In-network: $30 copay
Out-of-network: $55 copay

Outpatient individual therapy with a psychiatrist In-network: $40 copay
Out-of-network: $55 copay

Outpatient group therapy visit In-network: $30 copay
Out-of-network: $55 copay

Outpatient individual therapy visit In-network: $40 copay
Out-of-network: $55 copay

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 0%-20% coinsurance
Out-of-network: 0%-30% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Diabetes supplies In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Medicare star rating

Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, Medica Advantage Solution (PPO) earned an overall rating of 3.5 stars — worse than Iowa's state average of 4.0 stars.

Rating category This plan State average

Overall star rating ★ 3.5 4.0

Health plan quality

Summary rating of health plan quality ★ 3.5 3.9

Staying healthy: screenings, tests & vaccines ★ 4.0 3.8

Managing chronic (long-term) conditions ★ 3.0 3.2

Member experience with health plan ★ 4.0 4.1

Member complaints & changes in performance ★ 4.0 4.2

Health plan customer service ★ 3.0 4.0

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay

Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - prescription In-network: $549-$1299 copay
Out-of-network: $549-$1299 copay

Hearing aids - over the counter In-network: $499.5 copay
Out-of-network: $499.5 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 Not covered

Adjunctive general services In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay

Contact lenses In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay

Upgrades In-network: $0 copay
Out-of-network: $0 copay

Plan documents & tools

Plan details (carrier site)Provider directory Drug list (formulary)

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