Tri-State Health Senior Plans
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Tri-State Health offers 3 network plan options.

2019 Information

1. SmartPlan (Cost) 

  • 2019 - $115.00 month

In Network:

  • MAHP Network (Medical Associates Clinics and outlying primary care physicians)
  • No deductibles or copayments
  • Referral: Iowa City/Madison
  • Emergency Coverage Worldwide

Out of Network:

  • Original Medicare Cost Sharing

2019 Summary of Benefits 
Iowa SmartPlan SB - CMS Accepted 10012018
Illinois SmartPlan SB - CMS Accepted 10012018
Wisconsin SmartPlan SB - CMS Accepted 10012018

2019 - Evidence of Coverage
Iowa SmartPlan EOC - CMS Accepted 10112018
Illinois SmartPlan EOC - CMS Accepted 10112018
Wisconsin SmartPlan EOC - CMS Accepted 10112018

SmartPlan Provider Directory

2. Community Plan (Cost)         

  • 2019 - $145.00 month

In Network:

  • MAHP Network (Medical Associates Clinics and outlying primary care physicians); and
  • IPA (Independent Physicians Association)
  • No deductibles or copayments
  • Referral: Iowa City/Madison
  • Emergency Coverage Worldwide

Out of Network:

  • Original Medicare Cost Sharing

2019 Summary of Benefits
Iowa Community Plan SB - CMS Accepted 10012018
Illinois Community Plan SB - CMS Accepted 10012018
Wisconsin Community Plan SB - CMS Accepted 10012018

2019 Annual Notice of Change - Evidence of Coverage
Iowa Community Plan EOC - CMS Accepted 10112018
Illinois Community Plan EOC - CMS Accepted 10112018
Wisconsin Community Plan EOC - CMS Accepted 10112018

Community Plan Provider Directory

3. Freedom Plan (Cost)

  • 2019 - $170.00 month

In Network:

  • MAHP Network (Medical Associates Clinics and outlying primary care physicians); and
  • IPA (Independent Physicians Association)
  • No deductibles or copayments
  • Referral: Iowa City/Madison
  • Emergency Coverage Worldwide

Out of Network:

  • Any doctor/provider in the United States who will see Medicare beneficiaries for Medicare eligible services
  • Copayments:
    • $15.00 office visit copay
    • $15.00 rehabilitative service copay per visit
    • $75.00 outpatient surgery copay
    • $100.00 inpatient copay – up to $500 maximum
  • Part B excess charges

2019 Summary of Benefits
Iowa Freedom Plan SB - CMS Accepted 10012018
Illinois Freedom Plan SB - CMS Accepted 10012018
Wisconsin Freedom Plan SB - CMS Accepted 10012018

2019 Annual Notice of Change - Evidence of Coverage
Iowa Freedom Plan EOC - CMS Accepted 10112018
Illinois Freedom Plan EOC - CMS Accepted 10112018
Wisconsin Freedom Plan EOC - CMS Accepted 10112018

Freedom Plan Provider Directory

2018 Information​

1. SmartPlan (Cost) 

  • 2018 - $112.00 month

In Network:

  • MAHP Network (Medical Associates Clinics and outlying primary care physicians)
  • No deductibles or copayments
  • Referral: Iowa City/Madison
  • Emergency Coverage Worldwide

Out of Network:

  • Original Medicare Cost Sharing

2018 Summary of Benefits 
Iowa SmartPlan SB - CMS Accepted 09292017
Illinois SmartPlan SB - CMS Accepted 09292017
Wisconsin SmartPlan SB - CMS Accepted 09292017

2018 Annual Notice of Change - Evidence of Coverage
Iowa SmartPlan ANOC EOC - CMS Accepted 08212017
Illinois SmartPlan ANOC EOC - CMS Accepted 08212017
Wisconsin SmartPlan ANOC EOC - CMS Accepted 08212017

SmartPlan Provider Directory

2. Community Plan (Cost)         

  • 2018 - $142.00 month

In Network:

  • MAHP Network (Medical Associates Clinics and outlying primary care physicians); and
  • IPA (Independent Physicians Association)
  • No deductibles or copayments
  • Referral: Iowa City/Madison
  • Emergency Coverage Worldwide

Out of Network:

  • Original Medicare Cost Sharing

2018 Summary of Benefits
Iowa Community Plan SB - CMS Accepted 09292017
Illinois Community Plan SB - CMS Accepted 09292017
Wisconsin Community Plan SB - CMS Accepted 09292017

2018 Annual Notice of Change - Evidence of Coverage
Iowa Community Plan ANOC EOC - CMS Accepted 08212017
Illinois Community Plan ANOC EOC - CMS Accepted 08212017
Wisconsin Community Plan ANOC EOC - CMS Accepted 08212017

Community Plan Provider Directory

3. Freedom Plan (Cost)

  • 2018 - $168.00 month

In Network:

  • MAHP Network (Medical Associates Clinics and outlying primary care physicians); and
  • IPA (Independent Physicians Association)
  • No deductibles or copayments
  • Referral: Iowa City/Madison
  • Emergency Coverage Worldwide

Out of Network:

  • Any doctor/provider in the United States who will see Medicare beneficiaries for Medicare eligible services
  • Copayments:
    • $15.00 office visit copay
    • $15.00 rehabilitative service copay per visit
    • $75.00 outpatient surgery copay
    • $100.00 inpatient copay – up to $500 maximum
  • Part B excess charges

2018 Summary of Benefits
Iowa Freedom Plan SB - CMS Accepted 09292017
Illinois Freedom Plan SB - CMS Accepted 09292017
Wisconsin Freedom Plan SB - CMS Accepted 09292017

2018 Annual Notice of Change - Evidence of Coverage
Iowa Freedom Plan ANOC EOC - CMS Accepted 08212017
Illinois Freedom Plan ANOC EOC - CMS Accepted 08212017
Wisconsin Freedom Plan ANOC EOC - CMS Accepted 08212017

Freedom Plan Provider Directory

 

Medical Associates Health Plans (MAHP) is a Cost Plan with a Medicare contract. Enrollment in MAHP depends on contract renewal.

Medical Associates Health Plan complies with applicable Federal Civil Rights Laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

This page describes the essential features of the Medical Associates Health Plans Medicare Plans in general terms, and is not intended to be a full description. The complete program is described in the Evidence of Coverage which is issued to all members and is available on this website or upon request.

Participating Provider Locations

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