Health Plan RadarIn this article we rank Illinois Medicare Advantage plans based on our evaluation of government 5-star quality scores.
Read more →Medical Associates Community Plan (Cost)
by Medical Associates Health Plan, Inc.
2026 Medicare Advantage plan available in Illinois
Plan ID H1651-005-0
Additional coverage:
Vision
Medicare Advantage COST 5.0 Overall
Monthly plan premium $160 / mo
Annual deductible $0 / yr
Max out-of-pocket · in-network Not Applicable / yr
5.0 Overall Government Star Rating 2026 · out of 5 stars
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Plan Overview
Medical Associates Community Plan (Cost) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Illinois and offered by the health insurance company Medical Associates Health Plan, Inc.. 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 Medical Associates Community Plan (Cost)
Insurance Carrier Medical Associates Health Plan, Inc.
Plan Type Medicare Advantage Plan Without Prescription Drugs
Network Type COST
Cost Summary
Medical Associates Community Plan (Cost) has a monthly premium cost of $160 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of Not Applicable. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.
Monthly Premium $160 / mo
Annual Deductible $0 / yr
Max Out-of-Pocket · in-network Not Applicable / yr
Primary doctor visit $0 copay
Specialist visit $0 copay
ER visit $0 copay
Ambulance $0 copay
Additional Benefits and Coverage
Medical Associates Community Plan (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. Medical Associates Community Plan (Cost) includes coverage for vision.
Part D Prescription Drug Coverage No
Dental No
Vision Yes
Hearing No
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 Limited coverage
Telehealth Not covered
Medical Benefits
Doctor Services
Primary doctor visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Specialist visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Tests, labs & imaging
Diagnostic tests & procedures In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Lab services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Emergency care $0 copay
Urgent care $0 copay
Hospital Services
Inpatient hospital coverage Tier 1
$0 per stay
$0 per stay
Outpatient hospital coverage In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Skilled nursing facility
Skilled nursing facility
$0 copay
$0 copay
Preventive services
Preventive services In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Therapy services
Occupational therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Physical therapy & speech & language therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Mental health services
Outpatient group therapy with a psychiatrist In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy with a psychiatrist In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient group therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Outpatient individual therapy visit In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Opioid treatment services
Opioid treatment services Covered
Other services
Durable medical equipment (like wheelchairs & oxygen) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Prosthetics (like braces, artificial limbs) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Diabetes supplies In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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, Medical Associates Community Plan (Cost) earned an overall rating of 5.0 stars — better than Illinois's state average of 3.6 stars.
Rating category This plan State average
Overall star rating ★ 5.0 3.6
Health plan quality
Summary rating of health plan quality ★ 5.0 3.6
Staying healthy: screenings, tests & vaccines ★ 4.0 3.5
Managing chronic (long-term) conditions ★ 3.0 3.4
Member experience with health plan ★ 5.0 3.5
Member complaints & changes in performance ★ 5.0 3.7
Health plan customer service – 4.1
Extra Benefits
Hearing
Hearing exam Not covered
Fitting/evaluation Not covered
Hearing aids - prescription Not covered
Hearing aids - over the counter Not covered
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 In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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
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