A non-government entity
MercyOne North Iowa Senior Plan (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MercyOne North Iowa Senior Plan (Cost). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MercyOne North Iowa Senior Plan (Cost) in 2025, please refer to our full plan details page.
MercyOne North Iowa Senior Plan (Cost) is a Cost plan offered by Medical Associates Clinic, P.C. available for enrollment in 2025 to people living in North Iowa. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that MercyOne North Iowa Senior 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 MercyOne North Iowa Senior 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 MercyOne North Iowa Senior 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 MercyOne North Iowa Senior 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 MercyOne North Iowa Senior Plan (Cost).
Additional Benefits
The MercyOne North Iowa Senior Plan (Cost) offers coverage for a range of healthcare services. Many services have no copay, including ambulance services, emergency services, primary care, preventive services, dialysis services, medical equipment, diagnostic and radiological services, and home health services. The plan provides some vision and dental coverage, covering routine eye exams and Medicare dental services, respectively. However, some services are not covered, including hearing services, home infusion, cardiac rehabilitation, and many "other services". Additionally, there are exclusions within covered categories, such as specific vision and dental procedures, and limitations on medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the MercyOne North Iowa Senior Plan (Cost), but the plan does not cover additional days for Inpatient Hospital-Acute or Inpatient Hospital Psychiatric, non-Medicare-covered stays for Inpatient Hospital-Acute or Inpatient Hospital Psychiatric, or upgrades for Inpatient Hospital-Acute. The plan follows Original Medicare for the periodicity of these services.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered. Individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the MercyOne North Iowa Senior Plan (Cost). There is no information about the cost of this benefit in the provided snippet.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no copay and no coinsurance for all ambulance services. However, 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, and Worldwide Emergency Services are covered by the MercyOne North Iowa Senior Plan (Cost). Emergency and Urgently Needed Services have no copay and no coinsurance, while Worldwide Emergency Services have a $250 deductible and 20% coinsurance for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
Primary care services are covered, but routine chiropractic care, individual and group sessions for mental health specialty services, and individual and group sessions for psychiatric services are not covered. Occupational therapy and physical therapy/speech-language pathology services are covered with no copay and no coinsurance. Podiatry services include routine foot care for 6 visits per year.
Preventive Services See details
Preventive services, including Medicare-covered preventive services, annual physical exams, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, are covered with no copay. Additional preventive services such as health education, in-home safety assessment, personal emergency response systems, medical nutrition therapy, and others are not covered.
Hearing Services See details
Hearing services are not covered by the MercyOne North Iowa Senior Plan (Cost). Hearing exams, prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear benefits. Routine eye exams are covered once per year, and there is no copay or coinsurance, 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 MercyOne North Iowa Senior Plan (Cost), but Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered. Medicare Dental Services are covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are not covered by this plan.
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 is covered, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, both with no copay or coinsurance, but 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 the MercyOne North Iowa Senior 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 covered services.
Home Health Services See details
Home Health Services are covered by the MercyOne North Iowa Senior Plan (Cost) with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. This means that there is no coverage for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the MercyOne North Iowa Senior Plan (Cost), but additional days beyond Medicare coverage and non-Medicare-covered stays are not covered.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management, Institution for Mental Disease Services, Services in an Intermediate Care Facility, Case Management, Tobacco Cessation Counseling, 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 referrals or authorizations are required for these services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
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.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved