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NetworkPrime (MSA)
H1181 - 001 - 0
(3.5 / 5)
NetworkPrime (MSA) is a Medicare Advantage (Part C) Plan by Network Health Medicare Advantage Plans.
This page features plan details for 2023 NetworkPrime (MSA) H1181 – 001 – 0 available in Wisconsin.
IMPORTANT: This page has been updated with plan and premium data for 2023.
Locations
NetworkPrime (MSA) is offered in the following locations.
Plan Overview
NetworkPrime (MSA) offers the following coverage and cost-sharing.
| Insurer: | Network Health Medicare Advantage Plans |
| Health Plan Deductible: | $5,100 annual deductible |
| MOOP: | |
| Drugs Covered: | No |
Please Note:
- Additional restrictions apply to enrollment in an MSA plan. Please contact this plan to enroll. Once you reach the plan deductible, Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met.
- Please note, preventive services are also subject to satisfying your MSA plan deductible, so once you've met your deductible you'll then pay nothing
Ready to sign up for NetworkPrime (MSA) ?
Get help from a licensed Medicare agent.
Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.
Premium Breakdown
NetworkPrime (MSA) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.| Part B | Part C | Part B Give Back | Total |
|---|---|---|---|
| $164.90 | $0.00 | $0.00 | $164.90 |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
Additional Benefits
NetworkPrime (MSA) also provides the following benefits.
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
| In-Network: No |
Dental (comprehensive)
| Diagnostic services: | Not covered |
| Endodontics: | Not covered |
| Extractions: | Not covered |
| Non-routine services: | Not covered |
| Periodontics: | Not covered |
| Prosthodontics, other oral/maxillofacial surgery, other services: | Not covered |
| Restorative services: | Not covered |
Dental (preventive)
| Cleaning: | Not covered |
| Dental x-ray(s): | Not covered |
| Fluoride treatment: | Not covered |
| Oral exam: | Not covered |
Diagnostic procedures/lab services/imaging
| Diagnostic radiology services (e.g., MRI): | $0 copay after you pay your deductible |
| Diagnostic tests and procedures: | $0 copay after you pay your deductible |
| Lab services: | $0 copay after you pay your deductible |
| Outpatient x-rays: | $0 copay after you pay your deductible |
Doctor visits
| Primary: | $0 copay after you pay your deductible |
| Specialist: | $0 copay after you pay your deductible |
Emergency care/Urgent care
| Emergency: | $0 copay after you pay your deductible |
| Urgent care: | $0 copay after you pay your deductible |
Foot care (podiatry services)
| Foot exams and treatment: | $0 copay after you pay your deductible |
| Routine foot care: | Not covered |
Ground ambulance
| $0 copay after you pay your deductible |
Health plan deductible
| $5,100 annual deductible |
Health plan deductibles (other)
| In-Network: No |
Hearing
| Fitting/evaluation: | Not covered |
| Hearing aids – inner ear: | Not covered |
| Hearing aids – outer ear: | Not covered |
| Hearing aids – over the ear: | Not covered |
| Hearing exam: | $0 copay after you pay your deductible |
Hospital coverage (inpatient)
| $0 copay after you pay your deductible |
Hospital coverage (outpatient)
| $0 copay after you pay your deductible |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
| Not Applicable |
Medical equipment/supplies
| Diabetes supplies: | $0 copay after you pay your deductible |
| Durable medical equipment (e.g., wheelchairs, oxygen): | $0 copay after you pay your deductible |
| Prosthetics (e.g., braces, artificial limbs): | $0 copay after you pay your deductible |
Medicare Part B drugs
| Chemotherapy: | $0 copay after you pay your deductible |
| Other Part B drugs: | $0 copay after you pay your deductible |
Mental health services
| Inpatient hospital – psychiatric: | $0 copay after you pay your deductible |
| Outpatient group therapy visit: | $0 copay after you pay your deductible |
| Outpatient group therapy visit with a psychiatrist: | $0 copay after you pay your deductible |
| Outpatient individual therapy visit: | $0 copay after you pay your deductible |
| Outpatient individual therapy visit with a psychiatrist: | $0 copay after you pay your deductible |
Optional supplemental benefits
| Yes |
Preventive care
| $0 copay |
Rehabilitation services
| Occupational therapy visit: | $0 copay after you pay your deductible |
| Physical therapy and speech and language therapy visit: | $0 copay after you pay your deductible |
Skilled Nursing Facility
| $0 copay after you pay your deductible |
Transportation
| Not covered |
Vision
| Contact lenses: | Not covered |
| Eyeglass frames: | Not covered |
| Eyeglass lenses: | Not covered |
| Eyeglasses (frames and lenses): | Not covered |
| Other: | Not covered |
| Routine eye exam: | Not covered |
| Upgrades: | Not covered |
Wellness programs (e.g., fitness, nursing hotline)
| Not covered |
Optional Benefits
Package #1
| Preventive dental: | Monthly Premium: | $39.00 |
| Preventive dental: | Deductible: | $100.00 |
| Comprehensive dental: | Monthly Premium: | $39.00 |
| Comprehensive dental: | Deductible: | $100.00 |
Ready to sign up for NetworkPrime (MSA) ?
Get help from a licensed Medicare agent.
Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.