Medica Prime Solution Core (Cost)
Medicare Plan Details
2021 Plan
Monthly Premium
| (select county for price) |
by Medica
Additional Coverage
Hearing
Vision
Dental
Overall Government Star Rating
4.0out of 5 stars
State: Nebraska
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Plan Type
Medicare Advantage (Part C)
Medicare Advantage combines Part A and Part B. This plan = Part A + Part B
Plan Details
Medical Benefits
Doctor Services
$0 copay
$20 copay per visit
Tests, labs, & imaging
$10 copay
$0 copay
$30 copay
$10 copay
$50 copay per visit (always covered)
$0-20 copay per visit (always covered)
Hospital Services
$350 per stay
$100 copay per visit
Skilled nursing facility
$0 per day for days 1 through 20
$50 per day for days 21 through 100
$50 per day for days 21 through 100
Preventive services
$0 copay
Ambulance
$50 copay
Therapy services
$20 copay
$20 copay
Mental health services
$20 copay
$20 copay
$20 copay
$20 copay
Opioid treatment services
Covered
Other services
20% coinsurance per item
20% coinsurance per item
20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
20% coinsurance
20% coinsurance
Extra Benefits
Hearing
$0-20 copay
$0 copay
$0 copay
Preventive Dental
$0 copay
$0 copay
$0 copay
$0 copay
Comprehensive dental
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Vision
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Other benefits
Limited coverage
Not covered
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Health Plan Star Ratings
(government star ratings are out of 5 stars)
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