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Network Health Prime (MSA)

Wisconsin Medicare Advantage Plan (2026 Plan)

Monthly Premium

Your Cost
$0
by Network Health Medicare Advantage Plans

Additional Coverage

(none)

Overall Government Star Rating

 3.5
out of 5 stars

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Plan Overview

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.

Cost Summary

Monthly Premium
$0
Annual Deductible
$4,000 annual deductible
Max Out-of-Pocket
Not Applicable
Primary doctor visit
No Data
Specialist visit
No Data
ER visit
No Data
Ambulance
No Data

Network Health Prime (MSA) has a monthly premium cost of $0 per month, with an annual deductible of $4,000 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.

Additional Benefits and Coverage

No
Part D Prescription Drug Coverage
No
Dental
No
Vision
No
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 neither.

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

Comparing the Quality Score of Network Health Prime (MSA) to Other Plans in Wisconsin

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 2026, Network Health Prime (MSA) received an overall government quality rating of 3.5 stars out of 5 stars.

Network Health Prime (MSA) performed worse than Wisconsin’s State average overall quality score of 4.0 stars.

This Plan’s 5-star Gov’t Quality Score
Wisconsin State Average Score
Overall Government 5 Star Quality Rating
 3.5
 4.0
Summary rating of health plan quality
 3.5
 4.0
Staying healthy: screenings, tests, & vaccines
 2
 3.8
Managing chronic (long term) conditions
 4
 3.3
Member experience with health plan
 4
 4.1
Member complaints & changes in the health plan's performance
 4
 4.3
Health plan customer service
 4
 3.9

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 3.5 stars for its health plan quality score which is worse than the Wisconsin State average health plan quality score of 4.0 stars.

Plan Benefits and Coverage Details

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$4,000 annual deductible
Health Plan Max Out-of-Pocket
Not Applicable
Nationwide Coverage included
No
Hearing Coverage included
No
Vision Coverage included
No
Dental Coverage included
No
Doctor Lookup Link
https://networkhealth.com/
Plan Link
https://networkhealth.com/

Medical Benefits

Doctor Services

Primary doctor visit
In-network: No Data
Out-of-network: No Data
Specialist visit
In-network: No Data
Out-of-network: No Data

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: No Data
Out-of-network: No Data
Lab services
In-network: No Data
Out-of-network: No Data
Diagnostic radiology services (like MRI)
In-network: No Data
Out-of-network: No Data
Outpatient x-rays
In-network: No Data
Out-of-network: No Data
Emergency care
In-network: No Data
Out-of-network: No Data
Urgent care
In-network: No Data
Out-of-network: No Data

Hospital Services

Inpatient hospital coverage
In-network: No Data
Out-of-network: No Data
Outpatient hospital coverage
In-network: No Data
Out-of-network: No Data

Skilled nursing facility

Skilled nursing facility
In-network: No Data
Out-of-network: No Data

Preventive services

Preventive services
In-network: No Data
Out-of-network: No Data

Ambulance

Ground ambulance
In-network: No Data
Out-of-network: No Data

Therapy services

Occupational therapy visit
In-network: No Data
Out-of-network: No Data
Physical therapy & speech & language therapy visit
In-network: No Data
Out-of-network: No Data

Mental health services

Outpatient group therapy with a psychiatrist
In-network: No Data
Out-of-network: No Data
Outpatient individual therapy with a psychiatrist
In-network: No Data
Out-of-network: No Data
Outpatient group therapy visit
In-network: No Data
Out-of-network: No Data
Outpatient individual therapy visit
In-network: No Data
Out-of-network: No Data

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: No Data
Out-of-network: No Data
Prosthetics (like braces, artificial limbs)
In-network: No Data
Out-of-network: No Data
Diabetes supplies
In-network: No Data
Out-of-network: No Data

Prescription Drug Benefits

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

Part B Drugs

Chemotherapy drugs
In-network: No Data
Out-of-network: No Data
Other Part B drugs
In-network: No Data
Out-of-network: No Data

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
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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