Mercy Cedar Rapids Senior Plan (COST) H5256-005-0 Plan Details
Mercy Cedar Rapids Senior Plan (COST) H5256-005-0 Plan Details
Choosing the right Medicare Advantage plan is crucial for your healthcare needs in 2025. With Mercy Cedar Rapids Senior Plan (COST) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data (May, 2025), there are approximately 850 members enrolled in this plan.
Mercy Cedar Rapids Senior Plan Overview
| Plan ID H5256-005-0 Overview | |
|---|---|
| Health Plan ID: | H5256-005-0 |
| 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: | See List |
| Insured By: | Medical Associates Clinic Health Plan of Wisconsin |
Plan Availability
Mercy Cedar Rapids Senior Plan (H5256-005-0) is available in the following locations (click to open):
What You Need to Know
- This is a Medicare Advantage Cost (Cost Contract Option) health plan offered by Medical Associates Clinic Health Plan of Wisconsin.
- With Mercy Cedar Rapids Senior Plan you are not limited to the carrier's network of healthcare providers.
- When members use in-network providers their out-of-pocket costs are generaly lower.
- If a member uses a Medicare-approved provider outside of the plan's network, the provider will be paid using the same rules as Original Medicare.
- The plan provides the same coverage benefits as Original Medicare (Part A and Part B).
- It may offer extra benefits that Original Medicare does not cover.
- The monthly premium is $154.00, which does not replace your monthly 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.
- The maximum out-of-pocket cost with this plan is Not Applicable (in-network).
- It does not include a Medicare Part D plan for prescription drug coverage.
- It offers the following supplemental benefits: Vision (limitations apply, see below).
NOTE: In some instances it is possible to enroll in a Medicare Cost plan with only Medicare Part B. Call 1-800-MEDICARE to see if you qualify.
| We're Here to Help You Enroll |
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Out-of-Pocket Expenses
Mercy Cedar Rapids Senior 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 H5256-005-0.
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 Mercy Cedar Rapids Senior Plan as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Overview
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 | Not enough data available |
| 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 Mercy Cedar Rapids Senior Plan
To qualify for enrollment in Mercy Cedar Rapids Senior 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 Mercy Cedar Rapids Senior Plan and enjoy the extensive healthcare benefits it offers.
When Can I Enroll in Mercy Cedar Rapids Senior Plan ?
To ensure you don’t miss your chance to enroll in Mercy Cedar Rapids Senior Plan , 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.
How to Enroll in Mercy Cedar Rapids Senior Plan
Getting started with Mercy Cedar Rapids Senior Plan is simple. Here are your options:
- Online Enrollment: Easily enroll online using a secure form. Visit the MedicareEnrollment.com enrollment page and follow the steps to complete your enrollment.
- By Phone: Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will guide you through the process and answer any questions.
- Through Medicare.gov: Enroll through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the instructions to join a Medicare Advantage plan.
- Directly with the Plan: You can also enroll directly with Mercy Cedar Rapids Senior Plan . The plan's contact information is available below in the "Contact" section.
Be sure to enroll during the appropriate period to ensure your coverage begins without delay.
Here are some of the most frequently asked questions people have about plan ID H5256-005-0:
What’s the monthly premium for Mercy Cedar Rapids Senior Plan (Cost)?
The 2025 premium is $154.00 each month, and you must continue to pay your Part B premium.
How high can my costs go in a worst-case year?
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?
For 2025, plan H5256-005-0 has a ★0.0 rating. The best rating is 5 stars.
How many members does Mercy Cedar Rapids Senior Plan have?
CMS reports 850 members in the latest file.
Contact Medical Associates Clinic Health Plan of Wisconsin
| Website: | Medical Associates Clinic Health Plan of Wisconsin Plan Page |
|---|---|
| Providers: | Medical Associates Clinic Health Plan of Wisconsin 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 Clinic Health Plan of Wisconsin, http://www.mahealthplans.com, Last Accessed June 1, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans", Last Accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You", Last Accessed 25 May, 2025
- Medicare.gov, "Your 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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