A non-government entity
Network Health Prime (MSA)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Network Health Prime (MSA). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Network Health Prime (MSA) in 2026, please refer to our full plan details page.
Network Health Prime (MSA) is a MSA plan offered by Network Health, Inc. available for enrollment in 2025 to people living in Wisconsin. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Network Health Prime (MSA) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Network Health Prime (MSA).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Network Health Prime (MSA), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Network Health Prime (MSA)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by Network Health Prime (MSA).
Additional Benefits
The Network Health Prime (MSA) plan offers extremely limited coverage, with nearly all standard medical and routine services excluded from the plan. Notably, there is no coverage for inpatient or outpatient hospital stays, emergency services, primary care, preventive care, dental, or hearing services. The only category with any coverage is vision services, though specific benefits are limited and routine eye exams and eyewear are not covered. Because the vast majority of services are excluded, members will be responsible for the full cost of almost all healthcare needs, including ambulance services, durable medical equipment, and diagnostic testing. While insulin is covered, other Medicare Part B drugs, home health care, and skilled nursing facility stays are not covered. Prospective members should expect to pay out-of-pocket for nearly all medical care under this plan.
Inpatient Hospital See details
Network Health Prime (MSA) does not provide coverage for inpatient hospital services, as both acute and psychiatric inpatient hospital stays are excluded from coverage.
Outpatient Services See details
Outpatient Services are not covered under Network Health Prime (MSA), which excludes coverage for outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is not covered under the Network Health Prime (MSA) plan.
Ambulance and Transportation Services See details
Ambulance and transportation services, including ground ambulance, air ambulance, and trips to health-related locations, are not covered under the Network Health Prime (MSA) plan.
Emergency Services See details
Emergency services are not covered under the Network Health Prime (MSA) plan, which provides no coverage for urgently needed services, worldwide emergency and urgent care, or worldwide emergency transportation.
Primary Care See details
Primary care benefits are not covered under the Network Health Prime (MSA) plan, as all sub-services, including primary care physician visits, specialist services, therapies, and mental health care, are excluded from coverage.
Preventive Services See details
Preventive services are not covered by Network Health Prime (MSA) as all associated sub-services, including annual physical exams and Medicare-covered zero-dollar preventive services, are excluded from coverage.
Hearing Services See details
Hearing services are not covered under the Network Health Prime (MSA) plan, which means there is no coverage for routine hearing exams, hearing aid fittings, or prescription and over-the-counter hearing aids.
Vision Services See details
Vision Services are covered by Network Health Prime (MSA), but in practice, some services are covered while routine eye exams, other eye exams, and eyewear like contact lenses and eyeglasses are not covered.
Dental Services See details
Dental services are not covered under Network Health Prime (MSA), as no preventive, comprehensive, or Medicare-covered dental sub-services are covered in practice.
Home Infusion bundled Services See details
Network Health Prime (MSA) does not cover home infusion bundled services, Medicare Part B chemotherapy or radiation drugs, or other Medicare Part B drugs. While insulin is covered, Medicare Part B insulin drugs are not covered under this plan.
Dialysis Services See details
Dialysis Services are not covered under the Network Health Prime (MSA) plan, meaning no coverage, copay, or coinsurance is provided for these treatments.
Medical Equipment See details
Medical equipment is not covered under the Network Health Prime (MSA) plan, as durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment and supplies are all excluded from coverage.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are not covered under the Network Health Prime (MSA) plan, as all diagnostic procedures, lab services, and radiological services are excluded from coverage.
Home Health Services See details
Home health services are not covered under the Network Health Prime (MSA) plan, meaning members will be responsible for the full cost of these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Network Health Prime (MSA) plan. This non-coverage extends to intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is not covered under the Network Health Prime (MSA) plan, which includes no coverage for additional days beyond the standard Medicare limit.
Other Services See details
Other services are not covered under the Network Health Prime (MSA) plan, which does not provide coverage for acupuncture, over-the-counter (OTC) items, or meal benefits. Since these services are not covered, members will be responsible for the full cost of these care options.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
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