Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
PPO
Medica Advantage Preferred (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Iowa and offered by the health insurance company Medica. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Monthly Premium
$137
Annual Deductible
$0
Max Out-of-Pocket
$2,500
Primary doctor visit
$0 copay
Specialist visit
$10 copay per visit
ER visit
$120 copay per visit (always covered)
Ambulance
$100 copay
Medica Advantage Preferred (PPO) has a monthly premium cost of $137 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $2,500 In and Out-of-network
$2,500 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 Advantage Preferred (PPO) are defined below.
Additional Benefits and Coverage
Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing
Medica Advantage Preferred (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Medica Advantage Preferred (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Medica Advantage Preferred (PPO) 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
Comparing the Quality Score of Medica Advantage Preferred (PPO) to Other Plans in Iowa
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 Advantage Preferred (PPO) received an overall government quality rating of 3.5 stars out of 5 stars.
Medica Advantage Preferred (PPO) performed worse than 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
3.5
4.0
Summary rating of health plan quality
3.5
3.9
Staying healthy: screenings, tests, & vaccines
4
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
3
3.7
Summary rating of drug plan quality
4
3.8
Drug plan customer service
4
3.9
Member complaints & changes in the drug plan's performance
4
4.0
Member experience with the drug plan
3
3.5
Drug safety & accuracy of drug pricing
4
3.5
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 Advantage Preferred (PPO) received 3.5 stars for its health plan quality score which is worse than the Iowa State average health plan quality score of 3.9 stars.
Medica Advantage Preferred (PPO) received 4 stars for its drug plan quality score which is better than the Iowa State average drug plan quality score of 3.8 stars.
In-network: $100 per stay
Out-of-network: $150 per stay
Outpatient hospital coverage
In-network: $0-150 copay per visit
Out-of-network: $0-250 copay per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$150 per day for days 21 through 40
$0 per day for days 41 through 100
Out-of-network: $50 per day for days 1 through 20
$150 per day for days 21 through 40
$0 per day for days 41 through 100
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $100 copay
Out-of-network: $100 copay
Therapy services
Occupational therapy visit
In-network: $10 copay
Out-of-network: $25 copay
Physical therapy & speech & language therapy visit
In-network: $10 copay
Out-of-network: $25 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $10 copay
Out-of-network: $25 copay
Outpatient individual therapy with a psychiatrist
In-network: $10 copay
Out-of-network: $25 copay
Outpatient group therapy visit
In-network: $10 copay
Out-of-network: $25 copay
Outpatient individual therapy visit
In-network: $10 copay
Out-of-network: $25 copay
Opioid treatment services
Opioid treatment services
Covered
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Diabetes supplies
In-network: 0-20% coinsurance per item
Out-of-network: 0-20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
In this article we rank Iowa Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.
The Medicare landscape in Iowa is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Iowa.
Health Plan Radar