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Medica Prime Solution Thrift (Cost)

Medica
by Medica
2026 Medicare Advantage plan available in Iowa
Plan ID H2450-030-0
Additional coverage:
Hearing
Medicare Advantage COST 3.5 Overall
Monthly plan premium $49 / mo
Annual deductible $50 / 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 Prime Solution Thrift (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 the in-network doctors who accept the plan and whether a referral is needed.

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

Cost Summary

Medica Prime Solution Thrift (Cost) has a monthly premium cost of $49 per month, with an annual deductible of $50 In-network 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 $49 / mo
Annual Deductible $50 In-network / yr
Max Out-of-Pocket · in-network $6,750 / yr
Primary doctor visit 20% coinsurance
Specialist visit 20% coinsurance
ER visit $125 copay
Ambulance 20% coinsurance

Additional Benefits and Coverage

Medica Prime Solution Thrift (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 Thrift (Cost) includes coverage for hearing.

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

Other benefits

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

Medical Benefits

Doctor Services

Primary doctor visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Specialist visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Tests, labs & imaging

Diagnostic tests & procedures In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI) In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient x-rays In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Emergency care $125 copay
Urgent care $25 copay

Hospital Services

Inpatient hospital coverage Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Outpatient hospital coverage In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Skilled nursing facility

Skilled nursing facility Tier 1
$0 per day for days 1-20
$218 per day for days 21-100

Preventive services

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

Ambulance

Ground ambulance In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Therapy services

Occupational therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Physical therapy & speech & language therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy with a psychiatrist In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diabetes supplies In-network: 20% coinsurance
Out-of-network: 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 Prime Solution Thrift (Cost) 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 ★ 3.0 3.8
Managing chronic (long-term) conditions ★ 2.0 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 Not covered
Cleaning Not covered
Fluoride treatment Not covered
Dental x-rays Not covered

Comprehensive dental

Restorative services Not covered
Endodontics Not covered
Periodontics Not covered
Prosthodontics, removable Not covered
Prosthodontics, fixed Not covered
Maxillofacial prosthetics Not covered
Implant services Not covered
Oral and maxillofacial surgery Not covered
Orthodontics Not covered
Adjunctive general services Not covered

Vision

Routine eye exam Not covered
Contact lenses Not covered
Eyeglasses (frames & lenses) Not covered
Eyeglass frames (only) Not covered
Eyeglass lenses (only) Not covered
Upgrades Not covered

Plan documents & tools

Plan details (carrier site)Provider directoryDrug list (formulary)

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