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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 2025, 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 2025.

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.

Overview IconKey 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:

Regular visits to your primary care doctor are not covered.

Specialist Visits:

Visits to specialists are not covered.

Emergency Room:

Trips to the Emergency Room are not covered.

Urgent Care:

Trips to Urgent Care are notcovered.

Sign up for Network Health Prime (MSA)

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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 IconDrug Coverage

Prescription drugs are not covered by Network Health Prime (MSA).

Additional Benefits IconAdditional Benefits

The Network Health Prime (MSA) plan does not offer any coverage for a wide range of healthcare services. This includes inpatient and outpatient hospital services, emergency services, primary care, preventive services, hearing, vision, and dental services. Additionally, the plan does not cover medical equipment, diagnostic services, home health, or skilled nursing facilities.

Inpatient Hospital See details

Inpatient Hospital benefits are not covered by the Network Health Prime (MSA) plan.

Outpatient Services See details

Outpatient Services are not covered by the Network Health Prime (MSA) plan. This includes all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services (including individual and group sessions), and outpatient blood services.

Partial Hospitalization See details

Partial Hospitalization is not covered by the Network Health Prime (MSA) plan.

Ambulance and Transportation Services See details

Ambulance and Transportation Services are not covered under the Network Health Prime (MSA) plan. This includes all ambulance services and transportation services to any health-related location.

Emergency Services See details

Emergency Services are not covered by Network Health Prime (MSA).

Primary Care See details

The Network Health Prime (MSA) plan does not cover primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, or opioid treatment program services. This plan does not offer coverage for any primary care benefits.

Preventive Services See details

Preventive Services are not covered by the Network Health Prime (MSA) plan.

Hearing Services See details

Hearing Services are not covered by the Network Health Prime (MSA) plan. Specifically, hearing exams, fitting/evaluations for hearing aids, prescription hearing aids, and OTC hearing aids are not covered.

Vision Services See details

Vision services are not covered by the Network Health Prime (MSA) plan. Neither eye exams nor eyewear, including contact lenses, eyeglass lenses, and eyeglass frames are covered.

Dental Services See details

For the Network Health Prime (MSA) plan, dental services are not covered.

Home Infusion bundled Services See details

Home Infusion bundled Services are not covered by the Network Health Prime (MSA) plan.

Dialysis Services See details

Dialysis Services are not covered by the Network Health Prime (MSA) plan.

Medical Equipment See details

Medical equipment is not covered by the Network Health Prime (MSA) plan. The plan does not cover durable medical equipment, prosthetic devices, medical supplies, diabetic supplies, or diabetic therapeutic shoes/inserts.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services are not covered under the Network Health Prime (MSA) plan. This includes all diagnostic services, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services.

Home Health Services See details

Home Health Services are not covered by the Network Health Prime (MSA) plan.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are not covered by the Network Health Prime (MSA) plan.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are not covered by the Network Health Prime (MSA) plan.

Other Services See details

Other Services are not covered by the Network Health Prime (MSA) plan, including acupuncture, over-the-counter items, meal benefits, and dual eligible SNPs with highly integrated services.

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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.

Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period

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.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.

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