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2010 Advantage SolutionSM Standard and Choice Plan Options

Monthly
Premium*

Annual
Premium

 Medica Advantage Solution Standard 
 Private Fee-for-Service

Summary of Benefits
Application

Evidence of Coverage


$9.00


$108.00

 Medica Advantage Solution Standard  
 Private Fee-for-Service with Rx
 

Summary of Benefits
Application
Evidence of Coverage


$0.00**


$0.00

  Medica Advantage Solution Choice

Summary of Benefits
Application

Evidence of Coverage


$14.70


$176.40

 * You must continue to pay your Part B premium.
** Although the monthly premium is $0 with this plan, benefits for inpatient hospital, initial 3 pints of blood, and hearing exam are reduced; please refer the Medica Advantage Solution Standard Summaries of Benefits for details

Medicare beneficiaries may enroll in Medica Advantage Solution plans through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at http://www.medicare.gov / Medicare Options Compare (MOC) and Medicare Prescription Drug Finder (MPDPF) / Online Enrollment Center (OEC).  Contact the Medica Center for Healthy Aging for details at 952-992-2345 or 1-800-906-5432. TTY users may call the National Relay at 1-800-234-8819 and ask to be transferred to 1-800-906-5432. Hours of operation are 8 am - 8 pm (CST), seven days a week. Please note that access to a representative may be limited evenings and weekends during certain times of the year.

Medica Advantage SolutionSM Standard is a Medicare Advantage health plan product offered by Medica Health Plans, a health maintenance organization with a Medicare contract. The contract with CMS is renewed annually, so availability of coverage beyond the current contract year is not guaranteed.

Do You Need Extra Help with Medicare Part D?   You may qualify for extra help to pay for your prescription drug premiums and costs. To learn more, see our Low Income Subsidy Summary Table for Medica Advantage Solution Standard Private Fee-for-Service Plan with Rx Prescription Drug Coverage and Medica Advantage Solution Choice with Rx Prescription Drug Coverage.

You may also contact:

  • 1-800-MEDICARE (1-800-633-4227) 24 hours a day, seven days a week. TTY/TDD users should call 1-877-486-2048;
  • The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m, Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
  • Your State Medicaid Office.

H2410_2282 (XX-2009)
Content updated 10/01/2009 - pending CMS approval