Medical Associates SmartPlan (COST) H1651-001-0 Plan Details
Medical Associates SmartPlan (COST) H1651-001-0 Plan Details
Navigating your Medicare Advantage options for 2025 can be overwhelming, but we're here to help. With Medical Associates SmartPlan (COST) included in your plan options, you can evaluate it alongside other plans to make an informed decision. Enroll online quickly, or consult with a licensed agent if you need assistance.
Based on May, 2025 CMS enrollment data, an estimated 6,806 Medicare beneficiaries are enrolled in this plan.
Medical Associates SmartPlan Overview
| Plan ID H1651-001-0 Overview | |
|---|---|
| Health Plan ID: | H1651-001-0 |
| Medicare Advantage Plan Type: | Cost |
| Plan Year: | 2025 |
| Monthly Premium: | $131.00 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: | See List |
| Insured By: | Medical Associates Health Plan, Inc. |
Plan Availability
Medical Associates SmartPlan (H1651-001-0) is available in the following locations (click to open):
Why Consider Medical Associates SmartPlan ?
Medical Associates SmartPlan is a Medicare Advantage Prescription Drug (MAPD) Health Maintenance Organization (HMO) plan that delivers comprehensive healthcare benefits. With a monthly premium of $131.00, it covers the core services of Medicare Part A and Part B, along with additional benefits like prescription drug coverage. There is no annual deductible. Cost sharing begins with your first prescription. As an HMO plan, you’ll generally need to use providers within the plan’s network, except in emergencies.
A key benefit of Medical Associates SmartPlan is the financial protection it offers, with an annual maximum out-of-pocket (MOOP) limit of Not Applicable. After reaching this limit, the plan covers 100% of your in-network healthcare costs for the rest of the year. This makes Medical Associates SmartPlan a dependable option for those seeking a combination of medical and prescription drug coverage with predictable out-of-pocket expenses.
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Cost-Sharing Overview
Medical Associates SmartPlan has cost-sharing, meaning you'll have out-of-pocket costs when using approved healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H1651-001-0.
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 SmartPlan as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
How CMS Star Ratings Guide Your Choice
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| 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.
Eligibility Requirements for Medical Associates SmartPlan
To qualify for enrollment in Medical Associates SmartPlan , 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 SmartPlan and enjoy the extensive healthcare benefits it offers.
When Should You Enroll in Medical Associates SmartPlan ?
To ensure you don’t miss your chance to enroll in Medical Associates SmartPlan , be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your 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, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
Steps to Enroll in Medical Associates SmartPlan
Joining Medical Associates SmartPlan 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 SmartPlan .
- Direct Enrollment: You can also choose to enroll directly with Medical Associates SmartPlan . 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.
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.
- 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, "Explore your Medicare coverage options", Last Accessed 25 May, 2025
- 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 June 6, 2025
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