2027 Medicare Cost plan

Medical Associates Freedom Plan (Cost): 2027 benefits and costs

Medical Associates Clinic Health Plan of Wisconsin Cost

CMS plan ID: H5256-004-0 · Plan year: 2027

Medical Associates Freedom Plan (Cost) is a 2027 Medicare Cost plan offered by Medical Associates Clinic Health Plan of Wisconsin. It is listed in Wisconsin.

2027 plan costs at a glance

Monthly plan premium$270.00

Organization: Medical Associates Clinic Health Plan of Wisconsin
Plan organization: MEDICAL ASSOCIATES CLINIC HEALTH PLAN
Parent company: Medical Associates Clinic, P.C.
Plan type: Cost
Part C premium: $270.00
Prescription drug coverage: No
2027 CMS Star Rating

Standard monthly Medicare Part B premium: $209.50 (estimated)

You must continue to pay your Medicare Part B premium.

In-network medical deductible: None
In-network medical maximum: Not applicable

2027 benefit summary

Doctor visits and medical care

Common medical services and member costs
Service	In-network	What to know
Primary care doctor	$0 Service-specific deductible No
Specialist visit	$0 Service-specific deductible No	Approval required No Referral required No
Emergency care	$0
Urgent care	$0
Home health	$0 Service-specific deductible No	Approval required No Referral required No
Dialysis	$0 Service-specific deductible No	Approval required No Referral required No
Kidney disease education services	$0 Service-specific deductible No	Approval required No Referral required No
Medicare-covered chiropractic	$0 Service-specific deductible No	Approval required No Referral required No
Medicare-covered foot care	$0 Service-specific deductible No	Approval required No Referral required No
Other health professionals	$0 Service-specific deductible No	Approval required No Referral required No

Hospital, outpatient surgery and observation care

Hospital, outpatient surgery and observation care and member costs
Service	In-network	What to know
Outpatient hospital care	$0 Service-specific deductible No
Hospital observation services	$0 Service-specific deductible No
Ambulatory surgical center	$0 Service-specific deductible No	Approval required No Referral required No
Outpatient blood	$0 Service-specific deductible No	Approval required No Referral required No

Tests, imaging and laboratory services

Tests, imaging and laboratory services and member costs
Service	In-network	What to know
Diagnostic procedures and tests	$0 Service-specific deductible No	Approval required No Referral required No
Laboratory services	$0 Service-specific deductible No	Approval required No Referral required No
Diagnostic radiology (CT, MRI)	$0 Service-specific deductible No	Approval required No Referral required No
Therapeutic radiology	$0 Service-specific deductible No	Approval required No Referral required No
X-rays	$0 Service-specific deductible No	Approval required No Referral required No

Mental health and substance use treatment

Mental health and substance use treatment and member costs
Service	In-network	What to know
Partial hospitalization	$0 Service-specific deductible No	Approval required No Referral required No
Intensive outpatient program	$0 Service-specific deductible No	Approval required No Referral required No
Substance use treatment, individual sessions	$0 Service-specific deductible No	Approval required No Referral required No
Substance use treatment, group sessions	$0 Service-specific deductible No	Approval required No Referral required No
Opioid treatment program	$0 Service-specific deductible No	Approval required No Referral required No
Mental health, individual sessions	$0 Service-specific deductible No	Approval required No Referral required No
Mental health, group sessions	$0 Service-specific deductible No	Approval required No Referral required No
Psychiatry, individual sessions	$0 Service-specific deductible No	Approval required No Referral required No
Psychiatry, group sessions	$0 Service-specific deductible No	Approval required No Referral required No

Therapy and rehabilitation

Therapy and rehabilitation and member costs
Service	In-network	What to know
Occupational therapy	$0 Service-specific deductible No	Approval required No Referral required No
Physical and speech therapy	$0 Service-specific deductible No	Approval required No Referral required No
Cardiac rehabilitation	$0 Service-specific deductible No	Approval required No Referral required No
Intensive cardiac rehabilitation	$0 Service-specific deductible No	Approval required No Referral required No
Pulmonary rehabilitation	$0 Service-specific deductible No	Approval required No Referral required No
Supervised exercise for peripheral artery disease	$0 Service-specific deductible No	Approval required No Referral required No

Ambulance, medical equipment and supplies

Ambulance, medical equipment and supplies and member costs
Service	In-network	What to know
Ground ambulance	$0 Service-specific deductible No	Approval required No
Air ambulance	$0 Service-specific deductible No	Approval required No
Durable medical equipment	$0 Service-specific deductible No	Approval required No
Prosthetic devices	$0 Service-specific deductible No	Approval required No
Medical supplies	$0 Service-specific deductible No	Approval required No
Diabetic supplies	$0 Service-specific deductible No	Approval required No
Diabetic shoes and inserts	$0 Service-specific deductible No	Approval required No
Diabetic monitors	$0 Service-specific deductible No	Approval required No

Dental benefits

Dental benefits and member costs
Service	In-network	What to know
Medicare-covered dental	$0

Vision benefits

Vision benefits and member costs
Service	In-network	What to know
Medicare-covered eye exams	$0 Service-specific deductible No	Approval required No Referral required No
Routine eye examsAdditional plan benefit	$0	Approval required No Referral required No
Medicare-covered eyewear	$0 Service-specific deductible No	Approval required No Referral required No

Hearing benefits

Hearing benefits and member costs
Service	In-network	What to know
Medicare-covered hearing exams	$0 Service-specific deductible No	Approval required No Referral required No

Extra benefits

Extra benefits and member costs
Service	In-network	What to know
Annual physical examAdditional plan benefit	$0 Service-specific deductible No	Approval required No Referral required No

Prescription drug coverage

This plan does not include a Part D prescription drug benefit.

Where this plan is offered

CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.