2027 UW Health Quartz Medicare Advantage
Dual Eligible Plan
About our UW Health Quartz Medicare Advantage Dual Eligible with Rx plan*
Welcome to Quartz Dual Eligible! We’re happy to have you as a member. You deserve more than the basics, and we’ll help you get the most out of your health care plan.
Our Quartz Dual Eligible plans maintain separate county eligibility requirements, premiums, and benefits. While you need to enroll in a Quartz Dual Eligible plan for the county service area where you live, you can see any provider in the entire Quartz Medicare Advantage network.
*Available in Dane County only.
Your 2027 plan includes:
Preventive care and screening services
$0 copay when you see an in-network provider for most screenings and other preventive services approved by Original Medicare.
Diabetes prevention and management
Whether you’re looking to prevent diabetes or manage it, Quartz is here to help. Eligible members can access resources, prevention and treatment programs, personalized support, and more. Learn more
$0 copay virtual visits.
Get urgent medical care virtually with a video call, from the comfort of home – or wherever you happen to be.
Travel benefit
For up to six months each year, get covered services at in-network costs when traveling nationwide outside of Illinois, Iowa, Minnesota, and Wisconsin. Urgent and emergency care is covered with an annual limit of $20,000 for services received outside of the United States and its territories.
$0 copay for doctor visits
Hearing benefits
$3,000 every two years for hearing aids. Stay connected to the people in your life.
Mental well-being
Whether you’re managing stress, anxiety, depression or supporting a loved one, Quartz has resources designed around you. Learn more
Quartz Nourishing Meal Program
Get healthy meals delivered to your home at no extra cost. You may qualify after a hospital or skilled nursing stay or if you are managing congestive heart failure.
Vision benefits
$500 annual limit for contacts, frames, and lenses.
Dental benefits
$2,500/year for basic and major dental procedures (like cleanings, fillings, crowns, and oral surgery) plus 50% coinsurance for removable or fixed prosthodontics, including bridges and implant coverage.
Quartz CashCard®
Get a yearly allowance for fitness memberships and rides to routine medical appointments, plus quarterly allowances for over-the-counter health products, groceries, and utility bills.
Care Management
Whether you’re adjusting to a new diagnosis, managing multiple appointments, or working toward a health goal, the Quartz Care Management team is here to support you. Learn more
2027 UW Health Quartz Medicare Advantage
Dual Eligible with Rx
$0
monthly premium
For full plan details, here are some helpful documents
Provider directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage | Annual Notice of Coverage
DSNP Enrollment Application | Search for network providers
|
2027 UW Health 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 |
|
Medical maximum out-of-pocket (covered by Medicaid if the member maintains eligibility) |
$9,850 |
|
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** |
$2,500 |
|
Dental: Basic and major procedures (e.g., cleanings, fillings, crowns, and oral surgery) |
Covered 100% |
|
Dental: Prosthodontics (e.g., removable and fixed prosthodontics, including bridges and implant coverage) |
50% coinsurance |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. $0 copay for Medicare-covered items
-
Quartz® CashCard
$75 per quarter for utilities and groceries
$500 per year for fitness membership or rides to routine medical appointments
$325 per quarter for approved over-the-counter health-related items
You may be responsible for coinsurance if you lose your full Medicaid benefit and are no longer a qualified Medicare beneficiary.
For some Dual Eligible Medicaid members, small copays may occur under the Medicaid benefit.
* $20,000 annual limit for urgent care, emergency, and transportation services received outside the United States and its territories.
** Receive coverage with a provider in the Delta Dental Medicare Advantage Network who also accepts Medicaid. Continue to pay in-network pricing. Open network access is available with balance billing.
***For travel outside the states of Wisconsin, Illinois, Minnesota, or Iowa. Call to activate travel benefit.
This plan is available in Dane County.
2027 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 |
$1.65 |
$1.65 |
$1.65 |
|
Brand/Other drugs |
$5.00 |
$5.00 |
$5.00 |
|
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 |
$5.80 |
$5.80 |
$5.80 |
|
Brand/Other drugs |
$14.40 |
$14.40 |
$14.40 |
|
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 $700, |
Deductible $700, |
Deductible $700, |
|
Brand/Other drugs |
Deductible $700, |
Deductible $700, |
Deductible $700, |
|
Insulins |
$35 or 25% |
$70 or 25% |
$105 or 25% |
|
Select Care drugs |
$0 |
$0 |
$0 |
|
Vaccines |
$0 |
$0 |
$0 |
Note: 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 and specialty pharmacy locations only; not available through mail-order pharmacies. Covered opioid pain medications limited to a 30-day supply.
Our Star Rating
Every year, Medicare evaluates plans based on a 5-Star Rating system. Star Ratings are calculated each year and may change from one year to the next. 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 residents
Welcome! We’re happy you’re here.
Thank you for choosing Quartz Dual Eligible!
We’re dedicated to providing the quality coverage you deserve. We’re here for you if you have questions.
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