2026 Quartz Dual Eligible with Rx plan
Learn what it means to have neighborly service and coverage with a
2026 Gundersen Quartz Dual Eligible with Rx plan.
Enjoy quality coverage from two trusted names in Medicare
Quartz Dual Eligible with Rx, in partnership with Emplify Health by Gundersen, offers you a plan with various benefits, prescriptions drug coverage, and valuable extras – all for little to no extra cost per month.*
*Available in La Crosse County only.
Our 2026 Dual Eligible plans include:
- $0 copay for preventive services
- $0 copay for doctor visits
- $0 copay for initial routine eye exams
- Nourishing meal program
- Diabetes prevention and support
- Travel benefits outside our service area and the U.S.
- Mental well-being programs
- Quartz Champion for local, personalized support
- Quarterly allowances for over-the-counter health items, groceries, and utilities
For full plan details, here are some helpful documents
Provider directory (Regular print | Large print)
Pharmacy directory (Regular print | Large print)
2026 Summary of Benefits | Evidence of Coverage | Annual Notice of Coverage
DSNP Enrollment Application | Search for Network providers
Explore more details below about our 2026 Gundersen Quartz Medicare Advantage Dual Eligible with Rx plan.
|
2026 Gundersen Quartz Medicare Advantage Dual Eligible with Rx
|
|
|---|---|
|
Monthly premium |
$0 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$0 |
|
Specialist office visit copay |
$0 |
|
Urgent care visits* |
$0 |
|
Emergency care visits* (copay waived if admitted within three days) |
$0 |
|
Lab services per day (not per lab) |
$0 |
|
Maximum out-of-pocket (does not include Part D Rx) |
$9,250 |
|
Inpatient hospital coverage copay per day (up to Medicare limits) |
$0 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$0 |
|
Skilled nursing facility copay per day |
$0 |
|
Vision: Annual initial routine eye exam copay |
$0 |
|
Vision: Annual limit for contacts, frames, lenses, and upgrades |
$500 |
|
Hearing: Annual routine hearing exam copay |
$0 |
|
Hearing: Plan payment every two years for hearing aids |
$3,000 |
|
Dental: Annual limit** |
$3,000 |
|
Dental: Basic and major procedures (e.g., cleanings, fillings, |
Covered 100% |
|
Dental: Prosthodontics (e.g., removable and fixed |
50% coinsurance |
*$20,000 annual limit for urgent care, emergency, and transportation services received outside the United States and its territories.
**Receive in-network pricing with providers in the Delta Dental Medicare Advantage Network. Open network access is available with balance billing.
2026 Quartz Dual Eligible pharmacy copay amounts
If you have Extra Help for your Part D benefits, you will pay reduced cost-sharing for your Part D drugs. Please see the chart below for the Extra Help cost-sharing, copays, and standard benefits.
|
Extra Help Copay if you have LIS Level 3
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|
|
Generic drugs |
$0 |
$0 |
$0 |
|
Brand/Other drugs |
$0 |
$0 |
$0 |
|
Select Care drugs |
$0 |
$0 |
$0 |
|
Vaccines |
$0 |
$0 |
$0 |
|
Extra Help Copay if you have LIS Level 2
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|
|
Generic drugs |
$1.60 |
$1.60 |
$1.60 |
|
Brand/Other drugs |
$4.90 |
$4.90 |
$4.90 |
|
Select Care drugs |
$0 |
$0 |
$0 |
|
Vaccines |
$0 |
$0 |
$0 |
|
Extra Help Copay if you have LIS Level 1
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|
|
Generic drugs |
$5.10 |
$5.10 |
$5.10 |
|
Brand/Other drugs |
$12.65 |
$12.65 |
$12.65 |
|
Select Care drugs |
$0 |
$0 |
$0 |
|
Vaccines |
$0 |
$0 |
$0 |
|
Standard Part D Benefit – Does not receive Extra Help
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|
|
Generic drugs |
Deductible $615, |
Deductible $615, |
Deductible $615, |
|
Brand/Other drugs |
Deductible $615, |
Deductible $615, |
Deductible $615, |
|
Insulins |
$35 or 25% |
$70 or 25% |
$105 or 25% |
|
Select Care drugs |
$0 |
$0 |
$0 |
|
Vaccines |
$0 |
$0 |
$0 |
Note: You can fill your prescriptions at any in-network retail or mail-order pharmacy (except Tier 5).
Tier 5 (Specialty) 30-day supply is available in retail locations only. Not available through mail-order pharmacy benefit.
This plan is available in LaCrosse County.
Our Star Rating
The Star Ratings from the Centers for Medicare and Medicaid Services help you quickly compare Medicare plans based on quality and performance. Visit medicare.gov/plan-compare (By clicking this link you will leave the Quartz Medicare Advantage website) for more information and to compare Star Ratings for this and other plans. You can view and print our Medicare Star Ratings for 2026 here: WI, IL, IA residents | MN residents.
Enroll today
Take the next step and enroll in a Quartz Dual Eligible plan today. If you need help enrolling, we’re here to help.
Still have questions?
Attend a seminar
Call a Quartz Medicare expert:
(866) 491-1335 (TTY: 711)
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