Medical Associates Community Plan (COST) 2025 Plan Details for Clayton County, Iowa Residents
Medical Associates Community Plan (COST) 2025 Plan Details for Clayton County, Iowa Residents
When selecting a Medicare Advantage plan in Clayton County for 2025, it's important to compare all your options. Medical Associates Community Plan (COST) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
As of May 31, 2025, plan enrollments topped 4,120 members, with 122 in Clayton County, Iowa.
Medical Associates Community Plan Overview
| Plan ID H1651-004-0 Overview | |
|---|---|
| Health Plan ID: | H1651-004-0 |
| Medicare Advantage Plan Type: | Cost |
| Plan Year: | 2025 |
| Monthly Premium: | $154.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $Not Applicable (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Vision |
| Availability: | Clayton County, IA |
| Insured By: | Medical Associates Health Plan, Inc. |
What You Need to Know
- This is a Medicare Cost Contract Option health plan.
- Medical Associates Community Plan offers the same basic hospital and medical coverage as Medicare Part A and Part B (Original Medicare).
- The plan may offer additional benefits that Medicare Part A and Part B do not cover.
- The monthly premium is $154.00.
- You must continue paying your Medicare Part B premium.
- This plan does not offer a Medicare Part B premium reduction (no giveback benefit).
- The health plan does not have an annual deductible.
- Medical Associates Community Plan has a maximum out-of-pocket limit of Not Applicable per year (in-network).
- The out-of-pocket limit does not include premiums or the cost of your prescriptions.
- It does not include a Medicare Part D plan for prescription drug coverage.
- It offers the following supplemental benefits: Vision (limitations apply, see below).
With a Medicare Cost plan you are not required to use the plan's network of healthcare providers. That's because providers outside of Medical Associates Health Plan, Inc.'s network are paid by a Medicare intermediary.
Cost plans are only available in select areas. When Cost plan members use providers in the plan's network their out-of-pocket costs are typically lower. But, out-of-network providers are covered under the same rules as Original Medicare.
| We're Here to Help You Enroll |
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Cost-Sharing Overview
Medical Associates Community Plan includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H1651-004-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | Not Covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | Not Covered |
| Urgent care: | Not Covered |
| Ground ambulance: | Not Covered |
| Inpatient hospital care: | |
| Skilled Nursing Facility: |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | Not Covered |
| Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | Not Covered |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | Not Covered |
| Outpatient group therapy: | Not Covered |
| Inpatient psychiatric hospital care: |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | Not Covered |
| Occupational therapy: | Not Covered |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | Not Covered |
| Durable medical equipment: | Not Covered |
| Prosthetics: | Not Covered |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | Not Covered |
| Lab services: | Not Covered |
| Outpatient x-rays: | Not Covered |
| Diagnostic tests and procedures: | Not Covered |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | Not Covered |
| Other Part B drugs (Medicare-covered): | Not Covered |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | Not Covered |
| Oral exam | |
| Dental x-rays | |
| Cleaning | |
| Periodontics | |
| Endodontics | |
| Restorative Services |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Not Covered |
| Hearing aids | Not Covered |
| Hearing exam | Not Covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | |
| Routine eye exam (in-network) | Covered Limits may apply |
| Eyewear benefits | None |
Certain preventive services are covered 100% by Medical Associates Community Plan as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | Plan not required to report measure |
| Complaints and Changes in the Drug Plan | Plan not required to report measure |
| Member Experience with the Drug Plan | Plan not required to report measure |
| Drug Safety and Accuracy of Drug Pricing | Plan not required to report measure |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Am I Eligible for Medical Associates Community Plan ?
To qualify for enrollment in Medical Associates Community Plan , you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
If you fulfill these criteria, you can enroll in Medical Associates Community Plan and enjoy the extensive healthcare benefits it offers.
When Can I Enroll in Medical Associates Community Plan ?
Understanding the right time to enroll in Medical Associates Community Plan is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
How to Sign Up for Medical Associates Community Plan
Joining Medical Associates Community Plan is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Medical Associates Community Plan .
- Direct Enrollment: You can also choose to enroll directly with Medical Associates Community Plan . The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H1651-004-0:
Is there a premium for this plan in 2025?
Members pay their Part B premium and the plan's of $154.00 per month to be in this 2025 plan.
What’s the MOOP for Medical Associates Community Plan in 2025?
The annual in-network MOOP is $Not Applicable, protecting you from larger bills once you hit that limit.
How is this plan rated by Medicare?
The latest CMS score is ★0.0 out of 5 stars; anything 4 or higher earns quality bonuses.
How many members does Medical Associates Community Plan have?
CMS reports 4,120 members in the latest file.
Contact Medical Associates Health Plan, Inc.
| Website: | Medical Associates Health Plan, Inc. Plan Page |
|---|---|
| Providers: | Medical Associates Health Plan, Inc. Providers Page |
| New Member Health Plan Help: | (800)747-8900 |
| New Member Health Plan TTY: | (800)735-2942 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance — Last accessed October 15, 2024
- CMS.gov, Plan Benefits Package — Last accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed July 31, 2025
Learn more about how we use CMS data.
- Medical Associates Health Plan, Inc., http://www.mahealthplans.com — Last accessed June 1, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
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Page content managed by David Bynon, Medicare Analyst.
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