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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 2025, 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 2025.
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 a variety of services, including emergency, primary care, preventive, vision, dental, dialysis, medical equipment, diagnostic, and home health services. Many of these services have no copay, such as primary care visits, preventive services, and home health services. However, this plan has limited coverage for some services. Hearing services, skilled nursing facility services, and many dental services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, but additional days for Inpatient Hospital-Acute, Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. The copay and coinsurance for covered services are not mentioned in the provided information.
Outpatient Services See details
Outpatient Services are covered by the Medical Associates Community Plan (Cost), including all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by the Medical Associates Community Plan (Cost), with no copay or coinsurance for all ambulance services, but ground ambulance services, air ambulance services, transportation services to a plan-approved health-related location, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered with no copay and no coinsurance.
Primary Care See details
The Medical Associates Community Plan (Cost) covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Physical Therapy, Speech-Language Pathology Services, and Opioid Treatment Program Services with no copay and no coinsurance for Occupational Therapy and Physical Therapy. This plan does not cover Routine Chiropractic Care, Individual and Group Sessions for Mental Health Specialty Services, Individual and Group Sessions for Psychiatric Services, and Additional Telehealth Benefits.
Preventive Services See details
The Medical Associates Community Plan (Cost) covers preventive services, including Medicare-covered services with no copay, annual physical exams with no copay, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit with no copay. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other additional preventive services are not covered.
Hearing Services See details
Hearing services are not covered under the Medical Associates Community Plan (Cost).
Vision Services See details
The Medical Associates Community Plan (Cost) covers vision services, including routine eye exams once per year with no deductible, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are partially covered under the Medical Associates Community Plan (Cost), with Medicare Dental Services covered, but Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are not covered by the Medical Associates Community Plan (Cost).
Dialysis Services See details
Dialysis Services are covered with this plan. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), and Prosthetics/Medical Supplies - Non-Medicare benefit, with no copay or coinsurance; however, Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Diabetic Equipment is covered, but limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Medical Associates Community Plan (Cost), but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the services covered.
Home Health Services See details
Home Health Services are covered by the Medical Associates Community Plan (Cost) with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the sub-services, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are not covered by the Medical Associates Community Plan (Cost). Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are also not covered.
Other Services See details
The Medical Associates Community Plan (Cost) does not cover acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. No authorization or referrals are required for additional 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.
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