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Medicare Advantage · 1876 Cost
Medical Associates Clinic Health Plan of Wisconsin
Plan year 2026

Mercy Cedar Rapids Senior Plan (Cost) H5256-005

Monthly premium
$160
+ your Part B premium
Max out-of-pocket
Not published
in-network annual cap
Primary care
$0
per visit copay
Specialist
$0
per visit
This plan does not include Part D drug coverage
Before enrolling, confirm how your prescriptions will be covered. Whether you can add a standalone Part D plan depends on the Medicare Advantage plan type; pairing one with most MA HMO or PPO plans can disenroll you from Medicare Advantage. A gap in creditable drug coverage may lead to a Part D late enrollment penalty later.

Part D late enrollment penalty

If you go 63 days or more in a row after your Part D initial enrollment period without Part D or other creditable prescription drug coverage, you may owe a penalty if you join Part D later. The penalty is 1% of the national base beneficiary premium ($38.99 in 2026) for each full uncovered month. It is added to your monthly Part D premium for as long as you have Part D, and the base premium can change each year.

Who this type of plan may fit

MA-Only plans are generally considered by people who already have creditable prescription drug coverage, such as coverage from the VA, TRICARE, or a current or former employer or union. Your coverage provider—not this page—must tell you whether your current drug coverage is creditable.

Before you enroll
  • Find your current plan's annual Notice of Creditable Coverage or ask its benefits administrator.
  • Confirm in this plan's official documents whether adding a standalone drug plan is allowed.
  • Do not drop existing drug coverage until you understand how the change affects both coverages.
Review the creditable coverage checklist

Your costs at a glanceIn-network, for the 2026 plan year

Drug coverage
Not included
Outpatient surgery
$0
Emergency room
$0
Urgent care
$0

What's included, and what it's actually worth1 benefits included. Tap any card for the detail

Meals

Meal benefit
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$0 copay
In-network$0 copay per visit
Outpatient Surgery$0 copay
In-network$0 copay per procedure

Your coverageCheck your coverageFrom the doctors you added

Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Summary of Benefits
No online copy available — call the plan at (800)747-8900 to request the Summary of Benefits
Check Your Doctors
See if your doctors accept this plan
Documentos en español
Llame al (800)747-8900 (TTY: (800)735-2942) para solicitar documentos en español

Helpful next steps

The Pocket Protector · NPN 21126942 · 1-866-764-3312 (TTY: 711) · thepocketprotector.com

Plan benefits, premiums, and copays may vary by county and plan. You must continue to pay your Medicare Part B premium. Benefits and costs may vary by service area. Contact the plan or CMS for complete details.

We do not offer every plan available in your area. Currently we represent a limited number of organizations which offer a limited number of products in your area. Please contact Medicare.gov, 1-800-MEDICARE (TTY: 1-877-486-2048), or your local State Health Insurance Program (SHIP) to get information on all of your options.

Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you to contact the plan.

Dental, hearing, vision, and other supplemental benefits may have limitations and restrictions. These benefits vary by plan. Please refer to the plan's Evidence of Coverage for details.

Benefits shown are based on CMS public plan data. Actual benefits vary by county. Not all plans available in all areas. Speak with a licensed agent before enrolling.

  1. The Pocket Protector represents Medicare Advantage HMO, PPO, and PFFS organizations and stand-alone PDP prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal.
  2. The Pocket Protector is not connected with or endorsed by the United States government or the federal Medicare program.

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Mercy Cedar Rapids Senior Plan (Cost) - Medical Associates Clinic Health Plan of Wisconsin | The Pocket Protector