Network Health Prime (MSA)

Wisconsin Medicare Advantage Plan (2024 Plan)


Monthly Premium

Your Cost
$0
by Network Health Medicare Advantage Plans

Additional Coverage

Hearing

Overall Government Star Rating

 4.0
out of 5 stars

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Plan Name
Network Health Prime (MSA)
Insurance Carrier
Network Health Medicare Advantage Plans
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
MSA

Network Health Prime (MSA) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Wisconsin and offered by the health insurance company Network Health Medicare Advantage Plans. This plan’s network type is MSA which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$5,100 annual deductible
Max Out-of-Pocket
Not Applicable
Primary doctor visit
$0 copay after you pay your deductible
Specialist visit
$0 copay after you pay your deductible
ER visit
$0 copay after you pay your deductible
Ambulance
$0 copay after you pay your deductible

Network Health Prime (MSA) has a monthly premium cost of $0 per month, with an annual deductible of $5,100 annual deductible and a maximum out of pocket cost sharing of Not Applicable. 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 Network Health Prime (MSA) are defined below.

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

Network Health Prime (MSA) 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. Network Health Prime (MSA) includes coverage for hearing.

Medicare Advantage health plans can offer even more additional benefits. Network Health Prime (MSA) includes coverage for the following additional benefits:

Other benefits

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

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 2024, Network Health Prime (MSA) received an overall government quality rating of 4.0 stars out of 5 stars.

Network Health Prime (MSA) performed worse than Wisconsin’s State average overall quality score of 4.3 stars.

This Plan’s 5-star Gov’t Quality Score
Wisconsin State Average Score
Overall Government 5 Star Quality Rating
 4.0
 4.3
Summary rating of health plan quality
 4
 4.3
Staying healthy: screenings, tests, & vaccines
 2
 4.1
Managing chronic (long term) conditions
 4
 3.7
Member experience with health plan
 4
 4.2
Member complaints & changes in the health plan's performance
 3
 4.2
Health plan customer service
No Rating (new plan)
 4.4

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.

Network Health Prime (MSA) received 4 stars for its health plan quality score which is worse than the Wisconsin State average health plan quality score of 4.3 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$5,100 annual deductible
Health Plan Max Out-of-Pocket
Not Applicable
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
No
Dental Coverage included
No
Doctor Lookup Link

Doctor Services

Primary doctor visit
$0 copay after you pay your deductible
Specialist visit
$0 copay after you pay your deductible

Tests, labs, & imaging

Diagnostic tests & procedures
$0 copay after you pay your deductible
Lab services
$0 copay after you pay your deductible
Diagnostic radiology services (like MRI)
$0 copay after you pay your deductible
Outpatient x-rays
$0 copay after you pay your deductible
Emergency care
$0 copay after you pay your deductible
Urgent care
$0 copay after you pay your deductible

Hospital Services

Inpatient hospital coverage
$0 copay after you pay your deductible
Outpatient hospital coverage
$0 copay after you pay your deductible

Skilled nursing facility

Skilled nursing facility
$0 copay after you pay your deductible

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$0 copay after you pay your deductible

Therapy services

Occupational therapy visit
$0 copay after you pay your deductible
Physical therapy & speech & language therapy visit
$0 copay after you pay your deductible

Mental health services

Outpatient group therapy with a psychiatrist
$0 copay after you pay your deductible
Outpatient individual therapy with a psychiatrist
$0 copay after you pay your deductible
Outpatient group therapy visit
$0 copay after you pay your deductible
Outpatient individual therapy visit
$0 copay after you pay your deductible

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
$0 copay after you pay your deductible
Prosthetics (like braces, artificial limbs)
$0 copay after you pay your deductible
Diabetes supplies
$0 copay after you pay your deductible

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
$0 copay after you pay your deductible
Other Part B drugs
$0 copay after you pay your deductible

Hearing

Hearing exam
$0 copay after you pay your deductible
Fitting/evaluation
Not covered
Hearing aids - Inner ear
Not covered
Hearing aids - Outer ear
Not covered
Hearing aids - Over the ear
Not covered

Preventive Dental

Oral exam
Not covered
Cleaning
Not covered
Fluoride treatment
Not covered
Dental x-rays
Not covered

Comprehensive dental

Non-routine services
Not covered
Diagnostic services
Not covered
Restorative services
Not covered
Endodontics
Not covered
Periodontics
Not covered
Extractions
Not covered
Prosthodontics, other oral/maxillofacial surgery, other 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

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