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UW Health Quartz Med Advantage Elite (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for UW Health Quartz Med Advantage Elite (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on UW Health Quartz Med Advantage Elite (HMO) in 2026, please refer to our full plan details page.
UW Health Quartz Med Advantage Elite (HMO) is a HMO plan offered by University of Wisconsin Hospitals and Clincs Autho available for enrollment in 2026 to people living in Counties: Dane, Columbia, Green. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that UW Health Quartz Med Advantage Elite (HMO) 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 UW Health Quartz Med Advantage Elite (HMO).
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 UW Health Quartz Med Advantage Elite (HMO), 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
This plan has a Maximum Out-Of-Pocket cost of $4200.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 UW Health Quartz Med Advantage Elite (HMO)
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Drug Coverage
Prescription drugs are not covered by UW Health Quartz Med Advantage Elite (HMO).
Additional Benefits
The UW Health Quartz Med Advantage Elite (HMO) offers comprehensive medical coverage with predictable costs, featuring a $10 copay for primary care visits and a $35 copay for specialist consultations. Inpatient hospital stays require a $350 copay per admission with no coinsurance, while emergency room visits carry a $150 copay that is waived if you are admitted. Outpatient services and diagnostic tests are covered with no coinsurance and low-to-moderate copays, ensuring affordable access to essential medical care. Members benefit from robust preventive care with no copays, alongside routine dental, vision, and hearing services that feature low copays and generous annual allowances for eyewear, hearing aids, and dental treatments. While most services have no coinsurance, specialized needs like durable medical equipment and dialysis require a twenty percent coinsurance. Additional perks include a five-hundred-dollar annual fitness benefit and a quarterly reimbursement for over-the-counter health items with no copay.
Inpatient Hospital See details
UW Health Quartz Med Advantage Elite (HMO) covers inpatient acute and psychiatric hospital stays with a $350 copay per admission and no coinsurance, requiring prior authorization. Unlimited additional days are covered with no copay, but non-Medicare-covered stays and upgrades for acute stays are not covered.
Outpatient Services See details
UW Health Quartz Med Advantage Elite (HMO) covers outpatient services with no coinsurance, featuring a $0 to $200 copay for outpatient hospital services and a $35 copay for outpatient substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the UW Health Quartz Med Advantage Elite (HMO) with no coinsurance and either no copay or a $55 copay depending on the service. Prior authorization is required for services with the $55 copay.
Ambulance and Transportation Services See details
UW Health Quartz Med Advantage Elite (HMO) covers ground and air ambulance services with no coinsurance and a $250 copay, though prior authorization is required. Some transportation services are covered, but transportation to plan-approved or any other health-related locations is not covered.
Emergency Services See details
UW Health Quartz Med Advantage Elite (HMO) covers emergency services with a $150 copay, which is waived if admitted to the hospital within three days, and no coinsurance. Urgently needed services require a $35 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $20,000 maximum with no coinsurance and copays ranging from $35 to $250.
Primary Care See details
Primary care and specialist services under the UW Health Quartz Med Advantage Elite (HMO) are covered with no coinsurance, featuring a $10 copay for primary care visits and a $35 copay for specialists, mental health, and podiatry. Physical, occupational, and speech therapy require a $50 copay with no coinsurance, while telehealth services range from no copay up to a $50 copay with no coinsurance.
Preventive Services See details
UW Health Quartz Med Advantage Elite (HMO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, featuring counseling, a $500 annual fitness benefit, and up to 12 therapeutic massages, while excluding services such as health education, weight management programs, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by the UW Health Quartz Med Advantage Elite (HMO), which offers routine hearing exams once a year for a $30 copay and no coinsurance, while fitting and evaluation exams are not covered. Some prescription hearing aid services are covered with no copay and no coinsurance up to a $1,500 maximum every two years, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
UW Health Quartz Med Advantage Elite (HMO) covers annual routine eye exams with a $30 copay and no coinsurance. Eyewear is also covered with no copay, no coinsurance, and no deductible, offering up to a $350 combined maximum benefit per year for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by the UW Health Quartz Med Advantage Elite (HMO), offering Medicare-covered dental care for a $35 copay and no coinsurance, alongside preventive and comprehensive services with no copay and no coinsurance up to a $1,000 annual limit. While implants and prosthodontics require no copay and 50% coinsurance, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the UW Health Quartz Med Advantage Elite (HMO) with no copay, though prior authorization is required. This benefit covers Medicare Part B insulin drugs for a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the UW Health Quartz Med Advantage Elite (HMO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
UW Health Quartz Med Advantage Elite (HMO) partially covers medical equipment with no copays and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes and inserts. Diabetic supplies are not covered under this plan, and prior authorization is required for durable medical equipment and prosthetics.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the UW Health Quartz Med Advantage Elite (HMO) with no coinsurance, though prior authorization is required for diagnostic services. Members will pay a $15 copay for diagnostic procedures, tests, and lab services, a $25 copay for outpatient X-rays, and minimum copays of $60 for therapeutic radiological services and $125 for diagnostic radiological services.
Home Health Services See details
Home health services are covered under the UW Health Quartz Med Advantage Elite (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
UW Health Quartz Med Advantage Elite (HMO) covers cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services with a $20 copay per session and no coinsurance. These covered benefits are unlimited, ensuring affordable and continuous support for your rehabilitation and recovery needs.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the UW Health Quartz Med Advantage Elite (HMO) with no coinsurance, featuring no copay for days 1 through 20 and a $215 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
UW Health Quartz Med Advantage Elite (HMO) partially covers other services, featuring over-the-counter (OTC) items with no copay and no coinsurance up to a $30 reimbursement every three months. Acupuncture and meal benefits are not covered under this benefit.
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