Medicare Advantage · 1876 Cost · 2027
Medica Prime Solution Standard w/Rx (Cost)
No referral needed to see a specialist
At a glance: $549–$1,299 copay per hearing aid.
- Monthly premium
- Not published
- Part B premium separate
- Yearly limit
- $7,150
- Most you’d pay for in-network care
- Hearing
- $549–$1,299
- Copay per hearing aid
- Doctor visits
- $15
- Primary care · specialists $60
Check this plan for you
Add your doctors and prescriptions to see how they work with this plan.
- HearingCopay per hearing aid
- $549–$1,299
- OTC allowancePer 6 months OTC allowance
- $25
- DentalRoutine dental benefit
- Included
- VisionRoutine vision benefit
- Included
- Fitness$0 fitness benefit
- Included
This is a supplemental benefit with plan-specific limits. See plan documents for details.
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TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST
Costs and copays
Deductibles, yearly limit, visits, hospital stays and drug tiers
- DeductiblesMedical · $500 for drugs
- $200
- Yearly limitIn-network care, not counting drugs
- $7,150
- Primary doctorPer visit
- $15
- SpecialistPer visit · no referral needed
- $60
- Hospital stayNo limit on covered hospital days
- Days 1-5: $425/day, Days 6-90: $0/day
- Inpatient mental healthHospital stay
- Days 1-5: $425/day, Days 6-90: $0/day
- Outpatient surgeryPer procedure
- $500
- Emergency roomPer visit
- $130
- Urgent carePer visit
- $50
- Tier 1 · Preferred Generic30-day supply at a retail pharmacy
- $0
- Tier 2 · Generic30-day supply at a retail pharmacy
- $15
- Tier 3 · Preferred Brand30-day supply at a retail pharmacy, after deductible
- 15%
- Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy, after deductible
- 25%
- Tier 5 · Specialty30-day supply at a retail pharmacy, after deductible
- 28%
Similar plans
Other Medicare Advantage plans offered in Minnesota, North Dakota, and South Dakota
Browse the full 2027 Medicare Advantage with drug coverage directory. This plan is offered in Minnesota, North Dakota, and South Dakota. Plan availability can vary by county.
More Medicare Advantage with drug coverage options
These plans are offered in at least one of the same states. Check your ZIP or county before choosing a plan.
- Medica Prime Solution Thrift w/Rx (Cost)Medica · H2450-007Offered in Minnesota, North Dakota, and South Dakota
- AARP Medicare Advantage from UHC FG-0001 (PPO)UnitedHealthcare · H2001-118Offered in Minnesota and North Dakota
- AARP Medicare Advantage from UHC FG-0002 (PPO)UnitedHealthcare · H2001-119Offered in Minnesota and North Dakota
- Align SecureChoice (PPO)Align powered by Sanford Health Plan · H8385-005Offered in North Dakota and South Dakota
- Align SecureChoice Gold (PPO)Align powered by Sanford Health Plan · H8385-006Offered in North Dakota and South Dakota
- Medica Prime Solution Basic w/Rx (Cost)Medica · H2450-016Offered in Minnesota
Common questions
6 answers about this plan
What does Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) cover?
Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 5 formulary tiers. Published supplemental benefits include dental (Routine dental benefit), vision (Routine vision benefit), hearing ($549–$1,299 copay per hearing aid), and over-the-counter (OTC) ($25 per 6 months OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.
Learn about Medicare AdvantageHow much does Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) cost in 2027?
The current 2027 plan record does not list a monthly plan premium for Medica Prime Solution Standard w/Rx (Cost) (1876 Cost). Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $200. The listed Part D deductible is $500. The in-network medical out-of-pocket maximum is $7,150; it does not include Part D drug spending. Published visit costs include primary care $15 and specialist visits $60. These figures are plan data, not a personal yearly-cost estimate. Ask the plan to confirm its current costs.
Understand Medicare drug-cost limitsCan I use my current doctors with Medica Prime Solution Standard w/Rx (Cost) (1876 Cost)?
CMS lists Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) as a 1876 Cost plan. The plan record says specialist referrals are not required. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.
Check your doctorsDoes Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) cover my prescriptions?
Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) has 5 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $15, Tier 3 at 15%, Tier 4 at 25%, and Tier 5 at 28%. The listed Part D deductible is $500. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.
Check your prescriptionsWhat dental, vision, and hearing benefits does Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) include?
The current plan record for Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) lists dental (Routine dental benefit), vision (Routine vision benefit), and hearing ($549–$1,299 copay per hearing aid). It also lists over-the-counter (OTC) ($25 per 6 months OTC allowance). Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.
When can I enroll in Medica Prime Solution Standard w/Rx (Cost) (1876 Cost)?
Medica Prime Solution Standard w/Rx (Cost) (1876 Cost) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.
Review Medicare enrollment periodsPlan documents
Summary of Benefits and Evidence of Coverage
- Summary of Benefits (PDF)Download the plan's official Summary of Benefits document
- Evidence of Coverage (PDF)Complete plan details and rules
- Check Your DoctorsSee if your doctors accept this plan
- Documentos en españolLlame a The Pocket Protector al 1-866-764-3312 (TTY: 711) para recibir ayuda con documentos en español
Talk to a licensed agent
Talk with a licensed advisor
A licensed agent can review this plan and other plans in your area that fit your needs.
TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST
