2026 Gundersen Quartz Medicare Advantage
Dual Eligible Plan
About our Gundersen 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 have the freedom to see any provider in the entire Quartz Medicare Advantage network.
*Available in La Crosse County only.
Get more of the benefits you want
Care Management
All Quartz Medicare Advantage Dual Eligible with Rx members have access to care management services upon enrollment at no extra cost.
A dedicated care team works with members to ensure they get the most out of their benefits, including:
- Coordinate care and services
- Develop care plans
- Create and meet health goals
How does Care Management work?
The Care Management team includes a registered nurse and/or social work care manager. They work closely with you and your caregivers to help you get the best care possible.
Your team will connect with you at least once a year. More often, if needed. If you have not yet connected with your team, please call (866) 884-4601.
Health information
By clicking the links below you will leave the Quartz Dual Eligible website
Free health information and resources in your community are a call or click away:
- Great Rivers 2-1-1
- Dial 2-1-1 or (800) 362-8255
- 211wisconsin.communityos.org
- 211.org
Quartz dental benefits will put a smile on your face
Get preventive and comprehensive dental coverage with $3,000 annual limits to help pay for services. Save money and get balance-billing protection by seeing a Delta Dental Medicare Advantage network provider.
Search for a Medicare Advantage network provider who also accepts Medicaid near you. Find a doctor
Travel more, worry less
If you plan to travel, your coverage can travel with you. For up to six months a year, you can get covered services at in-network prices by activating your travel benefit. Plus, urgent and emergency care are always covered.
Gundersen Quartz Dual Eligible offers extra benefits.
Extra benefits are quick and easy ways to manage your health — leaving you more time to live your life.
Quartz® CashCard
Get $500 a year to use toward:
- Fitness memberships online and at licensed facilities
- Rides to routine medical appointments
Get $325 a quarter to buy over-the-counter health-related items at participating retailers, such as: Walmart, Family Dollar, Walgreens, and CVS.
Get $80 a quarter at participating retailers for groceries and utilities like:
- Internet
- Phone
- Cable services
- Electric and gas bills
Well-living programs
We all have aspects of our health we’d like to improve, and Quartz is your resource to help. From physical health and mental resiliency to social well-being, let us connect you to the right program to support you in well-living. Learn more.
Care Management
This program coordinates the care and services for members who need extra support with their medical and social needs.
At no extra cost, a registered nurse will work with you to coordinate your health care services — ensuring you get the care you need. Learn more.
Virtual visits
Gundersen virtual care allows you to get non-urgent medical care right from your phone or online with MyChart at MyChart.EmplifyHealth.org. Virtual care options include video visits, an online MyChart questionnaire, or MyChart messages provided by a physician or other medical professional. Learn more.
Accu-Chek & OneTouch® blood glucose meters and test strips
Access to high-quality supplies to help you manage diabetes. Our preferred brands of blood glucose monitoring supplies are the Accu-Chek and OneTouch® blood glucose meters and their associated test strips.
All are available at no extra cost to you.
The Quartz Nourishing Meal Program
We offer the Quartz Nourishing Meals Program to eligible Quartz Medicare Advantage (HMO) and Dual Eligible members enrolled in a Quartz Care Management program, for members with congestive heart failure, and for members recovering from an in-patient hospital stay or skilled nursing facility stay. Let us handle the cooking so you can focus on your recovery.
Learn more in your plan’s Evidence of Coverage found in your Quartz MyChart account.
Personal Emergency Response System
You have access to a 24/7 wearable monitoring Personal Emergency Response System. Maintain your independence while knowing help is near in the event of an emergency. Eligibility for a Personal Emergency Response System will be determined by various factors including, but not limited to: living situation, living alone, history of falls, mobility and fall risk, and medical diagnoses.
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
Search for network providers
Annual Notice of Changes
|
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 coverage with a provider in the Delta Dental Medicare Advantage Network.
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 Dane 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.
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.