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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 JoDaviess County. 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) offers coverage for essential medical services with no copay and no coinsurance. This includes coverage for inpatient and outpatient hospital stays, worldwide emergency and urgent care, primary and specialist visits, and preventive screenings. Members also receive dialysis, home health services, durable medical equipment, and skilled nursing facility care at no cost. Despite these coverages, the plan does not cover several common services. Exclusions include ambulance and transportation services, routine dental and vision wear, routine hearing exams, and hearing aids. Telehealth, wellness benefits, and most Medicare Part B drugs are also not covered by this plan.
Inpatient Hospital See details
Medical Associates Community Plan (Cost) covers inpatient hospital acute and psychiatric services with no copay and no coinsurance. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Medical Associates Community Plan (Cost) covers outpatient hospital, ambulatory surgical center, and blood services with no copay and no coinsurance. For outpatient substance abuse, some services are covered with no copay and no coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are 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) does not cover ambulance or transportation services, as ground ambulance, air ambulance, and transportation to health-related locations are all excluded.
Emergency Services See details
Medical Associates Community Plan (Cost) offers comprehensive coverage for Emergency Services and Urgently Needed Services with no copay and no coinsurance. Worldwide emergency services, including emergency care, urgent care, and emergency transportation, are also fully covered with no copay and no coinsurance.
Primary Care See details
Medical Associates Community Plan (Cost) offers primary care, specialist visits, physical, occupational, and speech therapies, opioid treatment, and up to four routine podiatry visits per year with no copay and no coinsurance. Telehealth is not covered, and although some chiropractic, mental health specialty, and psychiatric services are covered, routine chiropractic, other chiropractic services, and individual and group therapy sessions are not covered.
Preventive Services See details
Preventive services are covered by Medical Associates Community Plan (Cost) with no copay and no coinsurance for annual physical exams, kidney education, and other screenings. While additional preventive services are listed, some services are covered but health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, fitness benefits, disease management, telemonitoring, remote technologies, home modifications, and counseling are not covered.
Hearing Services See details
Hearing exams are partially covered under the Medical Associates Community Plan (Cost) with no copay and no coinsurance, though routine exams and fitting evaluations are not covered. Some prescription hearing aid services are covered, but inner ear, outer ear, and over the ear hearing aids are not covered, and over-the-counter hearing aids are also excluded from coverage.
Vision Services See details
Medical Associates Community Plan (Cost) covers vision services with no copay and no coinsurance, which includes one routine eye exam per year with no deductible. Other eye exam services are not covered, and while eyewear is technically covered, contact lenses, eyeglasses, frames, lenses, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the Medical Associates Community Plan (Cost), which offers Medicare-covered dental services with no copay and no coinsurance. However, routine and comprehensive dental services, including oral exams, cleanings, x-rays, restorative care, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are not covered by the Medical Associates Community Plan (Cost), although insulin is covered. Medicare Part B insulin drugs, chemotherapy or radiation drugs, and other Part B drugs are not covered.
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 Associates Community Plan (Cost) covers durable medical equipment (DME) with no copay and no coinsurance. However, other medical equipment benefits are not covered in practice, as there is no coverage for prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Medical Associates Community Plan (Cost) with no copay and no coinsurance. While some services are covered, 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
Medical Associates Community Plan (Cost) covers Home Health Services with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Medical Associates Community Plan (Cost) covers some services with no copay and no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Medical Associates Community Plan (Cost) covers Skilled Nursing Facility (SNF) care with no copay and no coinsurance, adhering to Original Medicare benefit periods. A prior three-day inpatient hospital stay is required for admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Medical Associates Community Plan (Cost) does not cover other services, including acupuncture, over-the-counter (OTC) items, and meal benefits. Since these services are not covered by the plan, there are no copays or coinsurance, and members must pay the full cost out-of-pocket.
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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