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Medical Associates Community Plan (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Medical Associates Community Plan (Cost). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Medical Associates Community Plan (Cost) in 2026, please refer to our full plan details page.
Medical Associates Community Plan (Cost) is a Cost plan offered by Medical Associates Clinic, P.C. available for enrollment in 2025 to people living in Dubuque, Clayton, Delaware, Jackson,Jones Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Medical Associates Community Plan (Cost) 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 Medical Associates Community Plan (Cost).
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 Medical Associates Community Plan (Cost), 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 Medical Associates Community Plan (Cost)
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 Medical Associates Community Plan (Cost).
Additional Benefits
The Medical Associates Community Plan (Cost) provides robust coverage for essential medical services with no copay and no coinsurance, including inpatient hospital stays, primary and specialist care, outpatient services, and home health care. Members also benefit from no-cost coverage for emergency services, dialysis, durable medical equipment, and skilled nursing facility care. However, while standard services are highly covered, specialized services like cardiac rehabilitation, home infusion, and routine dental and vision eyewear are excluded from the plan. Preventive care, diagnostic hearing tests, and one routine eye exam per year are covered with no copay, though routine dental cleanings and hearing aids are not covered. Worldwide emergency and urgent care services are available with no copay, but are subject to a deductible and a twenty percent coinsurance up to a fifty thousand dollar maximum. Overall, this plan minimizes out-of-pocket costs for standard medical necessities while excluding non-Medicare-covered extras like fitness programs and over-the-counter items.
Inpatient Hospital See details
Medical Associates Community Plan (Cost) inpatient hospital benefits are partially covered, offering acute and psychiatric care with no copay and no coinsurance. However, additional hospital days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
Medical Associates Community Plan (Cost) covers outpatient hospital, ambulatory surgical center, and outpatient blood services with no copay and no coinsurance. While some outpatient substance abuse services are covered with no copay and no coinsurance, individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by the Medical Associates Community Plan (Cost) with no copay and no coinsurance.
Ambulance and Transportation Services See details
Medical Associates Community Plan (Cost) provides coverage for ambulance and transportation services with no copay and no coinsurance, though some services are covered while ground ambulance, air ambulance, and health-related transportation services are not covered.
Emergency Services See details
Emergency Services under the Medical Associates Community Plan (Cost) are covered with no copay and no coinsurance for standard emergency and urgently needed care. Worldwide emergency, urgent, and transportation services are also covered with no copay, but are subject to a deductible and 20% coinsurance up to a maximum plan benefit of $50,000.
Primary Care See details
Medical Associates Community Plan (Cost) covers primary care, specialist, occupational, physical, and speech therapy, podiatry, and opioid treatment services with no copay and no coinsurance. While some chiropractic, mental health, and psychiatric services are covered, routine and other chiropractic care, individual and group mental health specialty sessions, and individual and group psychiatric sessions are not covered, and additional telehealth benefits are also excluded.
Preventive Services See details
Preventive Services are partially covered by Medical Associates Community Plan (Cost) with no copay and no coinsurance for annual physical exams, kidney disease education, and other Medicare-covered preventive care. However, additional preventive services—including fitness benefits, health education, weight management programs, and in-home support services—are not covered.
Hearing Services See details
Medical Associates Community Plan (Cost) covers diagnostic hearing exams with no copay and no coinsurance, though routine hearing exams and fitting or evaluation services are not covered. For prescription hearing aids, some services are covered but all types, including inner ear, outer ear, and over the ear hearing aids, are not covered, and OTC hearing aids are also not covered.
Vision Services See details
Vision Services under the Medical Associates Community Plan (Cost) are partially covered, offering one routine eye exam per year with no copay, no coinsurance, and no deductible. Other eye exams and all eyewear services, including contact lenses and eyeglasses, are not covered.
Dental Services See details
Dental services are partially covered under the Medical Associates Community Plan (Cost), which provides Medicare-covered dental services with no copay and no coinsurance. However, other dental services, including oral exams, cleanings, x-rays, restorative services, and orthodontics, are not covered.
Home Infusion bundled Services See details
Medical Associates Community Plan (Cost) does not cover Home Infusion bundled services, Medicare Part B chemotherapy and radiation drugs, or other Medicare Part B drugs. Insulin is partially covered, with Medicare Part B insulin drugs specifically excluded from coverage.
Dialysis Services See details
Dialysis services are covered under the Medical Associates Community Plan (Cost) with no copay and no coinsurance.
Medical Equipment See details
Medical Equipment is partially covered by the Medical Associates Community Plan (Cost), featuring Durable Medical Equipment (DME) with no copay and no coinsurance. While some services are covered, prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered with no copay and no coinsurance under the Medical Associates Community Plan (Cost), meaning some services are covered. However, diagnostic procedures and tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services are not covered.
Home Health Services See details
Home Health Services are covered by the Medical Associates Community Plan (Cost) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the Medical Associates Community Plan (Cost). This includes cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Medical Associates Community Plan (Cost) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, following Original Medicare rules. A prior three-day inpatient hospital stay is required for admission, and no additional days beyond the standard Medicare-covered days are provided.
Other Services See details
Other Services are not covered under the Medical Associates Community Plan (Cost), as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage. This plan does not provide any benefits or cost-sharing options for these services.
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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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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