Medicare Advantage Plan H5262-004-0 in Monroe County, WI Gundersen Quartz Med Advantage Value (HMO) • 2026
Plan-ID H5262-004-0 refers to Gundersen Quartz Med Advantage Value (HMO), a Medicare Advantage Plan (Part C) offered by Quartz Medicare Advantage (HMO) for the 2026 plan year. This plan is a Health Maintenance Organization (HMO) model without Part D prescription drug coverage.
According to CMS enrollment data, an estimated 885 beneficiaries are enrolled in this plan, 132 enrollees reside in Monroe County.
Gundersen Quartz Med Advantage Value Overview
Plan Overview for H5262-004-0 |
|
|---|---|
| CMS Plan ID: |
H5262-004-0
|
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | Coming soon |
| Maximum Out-of-Pocket: | $4200.00 (In-Network) |
| Part B Give Back: | Coming soon |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | None |
| Service Area: | Monroe County, WI |
| Enrollment (Nationwide): | 885 beneficiaries |
| Enrollment (CMS – Local) | 132 beneficiaries in Monroe County |
| Provided By: | Quartz Medicare Advantage (HMO) |
To learn more about your plan options, costs, and enrollment periods without agent assistance, try our helpful Medicare Resources below (click to open).
Frequently Asked Questions About Gundersen Quartz Med Advantage Value (HMO)
Here are some of the most frequently asked questions people have about Plan ID H5262-004-0:
What is the 2026 premium for Plan ID H5262-004-0?
Plan ID H5262-004-0 has a monthly premium of $0.00 for 2026, in addition to any Medicare Part B premium you must pay.
What is the out-of-pocket maximum for Plan ID H5262-004-0?
Plan ID H5262-004-0 has a 2026 in-network maximum out-of-pocket (MOOP) limit of $4200.00. After you reach this limit, the plan pays covered in-network Part A and Part B costs for the remainder of the year.
How is Plan ID H5262-004-0 rated by CMS?
Plan ID H5262-004-0 is included under contract H5262, which has a ★4.0 out of 5 CMS Star Rating for 2026.
What type of provider network does Gundersen Quartz Med Advantage Value use?
Gundersen Quartz Med Advantage Value uses a Health Maintenance Organization (HMO) provider network.
What is the enrollment for Plan ID H5262-004-0?
The most recent CMS enrollment data shows approximately 885 beneficiaries enrolled in Plan ID H5262-004-0.
Who provides Gundersen Quartz Med Advantage Value (HMO)?
Quartz Medicare Advantage (HMO) provides Gundersen Quartz Med Advantage Value (HMO).
Covered Services & Costs
Office Visits
This plan lists in-network cost sharing for primary care and specialist visits, along with related office-based services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | Coming soon |
| Specialist: | Coming soon |
Preventive and Wellness Services
Preventive and wellness benefits may include routine exams, telehealth, fitness programs, health education, and other in-network services.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | Coming soon |
| Telehealth benefit: | Coming soon |
| Routine chiropractic: | Coming soon |
| Fitness benefits: | Coming soon |
| Health education: | Coming soon |
| Counseling services: | Coming soon |
| Over-the-counter drug benefits: | Coming soon |
| Health transportation (non-emergency): | Coming soon |
Diagnostic, Lab, and Imaging Services
Diagnostic coverage includes in-network cost sharing for lab tests, x-rays, radiology, and other diagnostic procedures used to evaluate health conditions.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | Coming soon |
| Lab services: | Coming soon |
| Outpatient x-rays: | Coming soon |
| Diagnostic tests and procedures: | Coming soon |
Emergency and Urgent Care Services
Emergency and inpatient coverage includes cost sharing for urgent care, emergency room visits, ambulance transportation, hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | Coming soon |
| Worldwide emergency care: | Coming soon |
| Urgent care: | Coming soon |
| Inpatient hospital care: | Coming soon |
| Skilled Nursing Facility: | Coming soon |
| Ground ambulance: | Coming soon |
Mental Health Services
Mental health coverage includes in-network cost sharing for outpatient individual and group therapy, as well as inpatient psychiatric hospital care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | Coming soon |
| Outpatient group therapy: | Coming soon |
| Inpatient psychiatric hospital care: | Coming soon |
Rehabilitation Services
Rehabilitation coverage includes in-network cost sharing for physical therapy, speech and language therapy, and occupational therapy services.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | Coming soon |
| Occupational therapy: | Coming soon |
Medical Equipment and Supplies
Medical equipment coverage includes in-network cost sharing for diabetes supplies, durable medical equipment, prosthetics, and related supplies.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | Coming soon |
| Durable medical equipment: | Coming soon |
| Prosthetics: | Coming soon |
Medicare Part B Drugs
Medicare Part B drug coverage includes in-network cost sharing for chemotherapy and other medications covered under Medicare Part B.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | Coming soon |
| Other Part B drugs (Medicare-covered): | Coming soon |
Dental Services
Dental coverage includes in-network cost sharing for preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | Coming soon |
| Dental x-rays: | Coming soon |
| Cleaning: | Coming soon |
| Periodontics: | Coming soon |
| Endodontics: | Coming soon |
| Restorative services: | Coming soon |
| Implant services: | Coming soon |
| Orthodontics: | Coming soon |
| Oral/Maxillofacial surgery: | Coming soon |
Vision Services
Vision coverage includes in-network cost sharing for routine eye exams, contact lenses, eyeglass frames and lenses, and related eyewear services.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | Coming soon |
| Contact lenses: | Coming soon |
| Eyeglass frames only: | Coming soon |
| Eyeglass lenses only: | Coming soon |
| Eyeglasses (frames & lenses): | Coming soon |
| Upgrades: | Coming soon |
Hearing Services
Hearing coverage includes in-network cost sharing for hearing exams, fittings and evaluations, prescription hearing aids, and over-the-counter hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | Coming soon |
| Fitting/evaluation: | Coming soon |
| Prescription hearing aids: | Coming soon |
| OTC hearing aids: | Coming soon |
Additional and Special Needs Services
Additional benefits may include in-network services for adult day health, palliative care, personal emergency response systems, weight management, alternative therapies, and home safety needs.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Coming soon |
| Home-based palliative care: | Coming soon |
| Personal emergency response system: | Coming soon |
| Weight management programs: | Coming soon |
| Wigs for chemotherapy-related hair loss: | Coming soon |
| Alternative therapies: | Coming soon |
| Massage therapy: | Coming soon |
| Home/bathroom safety devices: | Coming soon |
Gundersen Quartz Med Advantage Value covers 100% of certain preventive services as a required Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS Medicare Star Ratings
The Centers for Medicare & Medicaid Services (CMS) annually rates Medicare Advantage HMOs in nine key categories using a 5-star system. These ratings help you gauge the quality of care and service you might receive with this Quartz Medicare Advantage (HMO) plan.
| CMS Measure | Star Rating |
|---|---|
| 2026 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 | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Quartz Medicare Advantage (HMO)
Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .
| Contact Type | Details |
|---|---|
| Website: | Quartz Medicare Advantage (HMO) Plan Page |
| New Members: | Coming soon |
| Existing Members: | Coming soon |
| Plan Address: | Coming soon |
Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | 202608 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-08 |
| Publisher | Reference | Last Accessed |
|---|---|---|
| Quartz Medicare Advantage (HMO) (official source) | http://quartzbenefits.com/medicareadvantage | October 13, 2025 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
Medicare.org independently compiles and interprets Medicare plan information using data published by the Centers for Medicare & Medicaid Services (CMS), official plan information, and other authoritative Medicare sources. The sources used for this plan are documented below.
Medicare.org is an independent Medicare information and enrollment resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program. Enrollment assistance is provided through HealthCompare, an Allstate company.
Medicare plan data and editorial content curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for Medicare plan interpretation and publication.