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Medicare Advantage · 1876 Cost
Medica
Plan year 2026
Medica Prime Solution Thrift w/Rx (Cost) H2450-007
Monthly premium
$92.80
+ your Part B premium
Max out-of-pocket
$6,750
in-network annual cap
Primary care
20%
per visit copay
Specialist
20%
per visit
Your costs at a glanceIn-network, for the 2026 plan year
Medical deductible
$50
Rx deductible
$615
Inpatient hospital
Days 1-5: $350/day, Days 6-90: $0/day
Inpatient mental health
Days 1-5: $350/day, Days 6-90: $0/day
Emergency room
$125
Urgent care
$25
What's included, and what it's actually worth3 benefits included. Tap any card for the detail
Hearing
$549–$1,299copay per hearing aid
Details$549–$1,299 copay per hearing aid
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP20%
Doctor Visits: Specialist20%
Inpatient Hospital$350/day, days 1–5
Mental HealthDays 1-5: $350/day, Days 6-90: $0/day
VisionRoutine vision benefit
MealsMeal benefit
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Tier 1
$7
Preferred Generic
Tier 2
$14
Generic
Tier 3
17%
Preferred Brand· after deductible
Tier 4
50%
Non-Pref Brand· after deductible
Tier 5
25%
Specialty· after deductible
Our take
Things to know before you enroll
This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
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)906-5432 to request the Summary of Benefits
Evidence of Coverage (PDF)
Complete plan details and rules
Check Your Doctors
See if your doctors accept this plan
Documentos en español
Llame al (800)906-5432 (TTY: 711) para solicitar documentos en español