Gundersen Quartz Medicare Advantage (HMO) plans
About our 2027 Gundersen Quartz Medicare Advantage plans
With our 2027 Gundersen Quartz Medicare Advantage plans, you have access to trusted providers and specialists throughout the Quartz Medicare Advantage network, personalized support from your dedicated Quartz Champion team, and valuable benefits that support your health and well-being.
Your plan includes:
Vision benefits
All Quartz Medicare Advantage plans include coverage for a routine eye exam each year, at no extra cost to you. For most plans, you also get an annual allowance* toward the purchase of contacts, lenses, frames, and upgrades from an in-network provider.
* Does not apply to Basic D plan.
Hearing benefits
All Quartz Medicare Advantage plans include coverage for an annual routine hearing exam, and an allowance for hearing aids every two years for most plans.*
* Does not apply to Basic D plan.
Dental benefits
All plans offer access to the Delta Dental Medicare Advantage Network™. You can choose any dentist, but you may pay less when you use a network dentist.*
- Most plans include an annual allowance toward covered dental services. See plan details for information.
- Add $1,000 in dental coverage for an extra monthly cost.
*Balance billing may apply when using an out-of-network dentist, depending on your plan.
Preventive care and screening services
$0 copay when you see an in-network provider for screenings and other preventive services recommended by Original Medicare.
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.
Have prescriptions? Our plans can help
Quartz Medicare Advantage offers plan options with and without prescription drug coverage, giving you the flexibility to choose the coverage that fits your needs.
Our Part D prescription drug plans:
Are available at varying costs, with some including a $0 deductible
Cover drugs approved for Medicare Part D, including insulin and vaccines
Cover Medicare Part B drugs, such as chemotherapy and some drugs administered by your provider
Understanding your drug costs
Quartz Medicare Advantage has a list of all covered drugs, called a Part D formulary. This organizes medications into six tiers of costs:
|
|
|
|---|---|
|
Tier 1 |
Preferred generic |
|
Tier 2 |
Generic |
|
Tier 3 |
Preferred brands |
|
Tier 4 |
Non-preferred |
|
Tier 5 |
Specialty |
|
Tier 6 |
Select Care Drugs |
How to check your drug costs
To see what your prescription drugs may cost with a Quartz Medicare Advantage plan, take a moment to search our Part D formulary. Costs will depend on your drug’s tier level.
Support your whole health
Quartz Well offers programs and resources to help you live well at every stage of life.
Behavioral health
Whether you’re managing stress, anxiety, depression or supporting a loved one, Quartz has resources designed around you. Learn more
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
Diabetes prevention and support
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
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.
2027 Gundersen Quartz Medicare Advantage
Value (no Rx)
$0
monthly premium
Because choosing the right Medicare plan for you is an important decision, we’ve made it easy for you to view highlights of our 2027 Gundersen Quartz Medicare Advantage Value plan (no Rx) below.
For full plan details, here are some helpful documents
If you’d like to compare plan highlights in your region, you can view or download your 2027 Gundersen Quartz Medicare Advantage plan options.
Provider Directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage
Annual Notice of Change
Search for network providers
|
2027 Gundersen Quartz Medicare Advantage (HMO) - Value plan (no Rx)
|
|
|---|---|
|
Monthly premium |
$0 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$15 |
|
Specialist office visit copay |
$50 |
|
Urgent care visits* |
$60 |
|
Emergency care visits* (copay waived if admitted within three days) |
$150 |
|
Lab services per day (not per lab) |
$10 |
|
Medical maximum out-of-pocket |
$4,450 |
|
Inpatient hospital coverage copay per day |
Days 1 - 6: $225 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$200
|
|
Skilled nursing facility copay per day |
Days 1 - 20: $0 |
|
Vision: annual initial routine eye exam copay |
$0 |
|
Vision: annual limit for contacts, frames, lenses, and upgrades |
$225 |
|
Hearing: annual routine hearing exam copay |
$35 |
|
Hearing: plan payment every two years for hearing aids |
$1,500 |
|
Dental: annual limit** |
$1,000 |
|
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 |
|
Dental: optional rider for an extra $1,000 coverage |
$48 per month |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. 20% cost-share for Medicare-covered items
* $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. 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 the following states and counties:
Iowa: Allamakee, Fayette, and Winneshiek
Wisconsin: Buffalo, La Crosse, Monroe, Pepin, and Trempealeau
2027 Gundersen Quartz Medicare Advantage
Elite (no Rx)
$124
monthly premium
Because choosing the right Medicare plan for you is an important decision, we’ve made it easy for you to view highlights of our 2027 Gundersen Quartz Medicare Advantage Elite plan (no Rx) below.
For full plan details, here are some helpful documents
If you’d like to compare plan highlights in your region, you can view or download your 2027 Gundersen Quartz Medicare Advantage plan options.
Provider Directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage
Annual Notice of Change
Search for network providers
|
2027 Gundersen Quartz Medicare Advantage (HMO) - Elite plan (no Rx)
|
|
|---|---|
|
Monthly premium |
$124 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$10 |
|
Specialist office visit copay |
$45 |
|
Urgent care visits* |
$50 |
|
Emergency care visits* (copay waived if admitted within three days) |
$150 |
|
Lab services per day (not per lab) |
$10 |
|
Medical maximum out-of-pocket |
$4,000 |
|
Inpatient hospital coverage copay per stay |
$300 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$150
|
|
Skilled nursing facility copay per day |
Days 1 - 20: $0 |
|
Vision: annual initial routine eye exam copay |
$0 |
|
Vision: annual limit for contacts, frames, lenses, and upgrades |
$300 |
|
Hearing: annual routine hearing exam copay |
$25 |
|
Hearing: plan payment every two years for hearing aids |
$1,500 |
|
Dental: annual limit** |
$1,000 |
|
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 |
|
Dental: optional rider for an extra $1,000 coverage |
$48 per month |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. 20% cost-share for Medicare-covered items
* $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. 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 the following states and counties:
Iowa: Allamakee, Fayette, and Winneshiek
Wisconsin: Buffalo, La Crosse, Monroe, Pepin, and Trempealeau
2027 Gundersen Quartz Medicare Advantage
Basic D (with Rx)
$0
monthly premium
Because choosing the right Medicare plan for you is an important decision, we’ve made it easy for you to view highlights of our 2027 Gundersen Quartz Medicare Advantage Basic D plan (with Rx) below.
For full plan details, here are some helpful documents
If you’d like to compare plan highlights in your region, you can view or download your 2027 Gundersen Quartz Medicare Advantage plan options.
Provider Directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage
Annual Notice of Change
Search for network providers
|
2027 Gundersen Quartz Medicare Advantage (HMO) - Basic D plan (with Rx)
|
|
|---|---|
|
Monthly premium |
$0 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$35 |
|
Specialist office visit copay |
$75 |
|
Urgent care visits* |
$50 |
|
Emergency care visits* (copay waived if admitted within three days) |
$130 |
|
Lab services per day (not per lab) |
$60 |
|
Medical maximum out-of-pocket |
$7,150 |
|
Inpatient hospital coverage copay per day |
Days 1 - 7: $325 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$375
|
|
Skilled nursing facility copay per day |
Days 1 - 20: $0 |
|
Vision: annual initial routine eye exam copay |
$0 |
|
Vision: annual limit for contacts, frames, lenses, and upgrades |
No coverage |
|
Hearing: annual routine hearing exam copay |
$40 |
|
Hearing: plan payment every two years for hearing aids |
No coverage |
|
Dental: annual limit** |
No coverage |
|
Dental: oral exam and prophylaxis (cleaning) once every other calendar year |
Covered 100% |
|
Dental: prosthodontics (e.g., removable and fixed prosthodontics, including bridges and implant coverage) |
No coverage |
|
Dental: optional rider for an extra $1,000 coverage |
$56 per month |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. 20% cost-share for Medicare-covered items
- Part D prescription drugs. Details below
* $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. 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.
Basic D 2027 prescription drug coverage
Quartz Medicare Advantage has a list of all covered drugs that you can search online or download. The drug list organizes medications into six tiers of costs.
What you pay for prescription drugs in 2027
Your plan has a deductible of $270 for drugs only in Tiers 3, 4, and 5. Deductible does not apply to medications in Tiers 1, 2, or 6. Once you reach the deductible, they are subject to a copay or coinsurance. After reaching the annual TrOOP (True Out-of-Pocket) limit of $2,400, your plan will cover all of your Part D drug costs for the rest of the year. See the image below to learn about the coverage stages.
|
Plan deductible: $270
|
Deductible applies?
|
Your share
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|---|---|
|
Tier 1 (Preferred generic) |
× No |
Copay |
$0 |
$0 |
$0 |
|
Tier 2 (Generic) |
× No |
Copay |
$10 |
$20 |
$25 |
|
Tier 3* (Preferred brand) |
✓ Yes |
Coinsurance |
20% |
20% |
20% |
|
Tier 4 (Non-preferred drugs) |
✓ Yes |
Coinsurance |
35% |
35% |
35% |
|
Tier 5** (Specialty) |
✓ Yes |
Coinsurance |
28% retail only |
Not available** |
Not available** |
|
Tier 6*** (Select Care drugs) |
× No |
Copay |
$0 |
$0 |
$0 |
You can fill your prescriptions at any in-network retail or mail-order pharmacy.
*Tier 3 includes many common brand-name drugs, some higher-cost generic drugs, and insulin.
**Tier 5 (Specialty) 30-day supply available in and specialty pharmacy locations only; not available through mail-order pharmacies.
***Tier 6 includes many low-cost medications that treat diabetes, high blood pressure, high cholesterol, osteoporosis, and other conditions.
This plan is available in the following states and counties:
Iowa: Allamakee, Fayette, and Winneshiek
Wisconsin: Buffalo, La Crosse, Monroe, Pepin, and Trempealeau
2027 Gundersen Quartz Medicare Advantage
Core D (with Rx)
$42
monthly premium
Because choosing the right Medicare plan for you is an important decision, we’ve made it easy for you to view highlights of our 2027 Gundersen Quartz Medicare Advantage Core D plan (with Rx) below.
For full plan details, here are some helpful documents
If you’d like to compare plan highlights in your region, you can view or download your 2027 Gundersen Quartz Medicare Advantage plan options.
Provider Directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage
Annual Notice of Change
Search for network providers
|
2027 Gundersen Quartz Medicare Advantage (HMO) - Core D plan (with Rx)
|
|
|---|---|
|
Monthly premium |
$42 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$25 |
|
Specialist office visit copay |
$60 |
|
Urgent care visits* |
$50 |
|
Emergency care visits* (copay waived if admitted within three days) |
$130 |
|
Lab services per day (not per lab) |
$30 |
|
Medical maximum out-of-pocket |
$5,900 |
|
Inpatient hospital coverage copay per day |
Days 1 - 6: $290 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$350
|
|
Skilled nursing facility copay per day |
Days 1 - 20: $0 |
|
Vision: annual initial routine eye exam copay |
$0 |
|
Vision: annual limit for contacts, frames, lenses, and upgrades |
$100 |
|
Hearing: annual routine hearing exam copay |
$40 |
|
Hearing: plan payment every two years for hearing aids |
$1,000 |
|
Dental: annual limit** |
$350 |
|
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 |
|
Dental: optional rider for an extra $1,000 coverage |
$56 per month |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. 20% cost-share for Medicare-covered items
- Part D prescription drugs. Details below
* $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. 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.
Core D 2027 prescription drug coverage
Quartz Medicare Advantage has a list of all covered drugs that you can search online or download. The drug list organizes medications into six tiers of costs.
What you pay for prescription drugs in 2027
Your plan has a deductible of $270 for drugs only in Tiers 3, 4, and 5. Deductible does not apply to medications in Tiers 1, 2, or 6. Once you reach the deductible, they are subject to a copay or coinsurance. After reaching the annual TrOOP (True Out-of-Pocket) limit of $2,400, your plan will cover all of your Part D drug costs for the rest of the year. See the image below to learn about the coverage stages.
|
Plan deductible: $270
|
Deductible applies?
|
Your share
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|---|---|
|
Tier 1 (Preferred generic) |
× No |
Copay |
$0 |
$0 |
$0 |
|
Tier 2 (Generic) |
× No |
Copay |
$10 |
$20 |
$25 |
|
Tier 3* (Preferred brand) |
✓ Yes |
Coinsurance |
20% |
20% |
20% |
|
Tier 4 (Non-preferred drugs) |
✓ Yes |
Coinsurance |
35% |
35% |
35% |
|
Tier 5** (Specialty) |
✓ Yes |
Coinsurance |
28% retail only |
Not available** |
Not available** |
|
Tier 6*** (Select Care drugs) |
× No |
Copay |
$0 |
$0 |
$0 |
You can fill your prescriptions at any in-network retail or mail-order pharmacy.
*Tier 3 includes many common brand-name drugs, some higher-cost generic drugs, and insulin.
**Tier 5 (Specialty) 30-day supply available in and specialty pharmacy locations only; not available through mail-order pharmacies.
***Tier 6 includes many low-cost medications that treat diabetes, high blood pressure, high cholesterol, osteoporosis, and other conditions.
This plan is available in the following states and counties:
Iowa: Allamakee, Fayette, and Winneshiek
Wisconsin: Buffalo, La Crosse, Monroe, Pepin, and Trempealeau
2027 Gundersen Quartz Medicare Advantage
Value D (with Rx)
$97
monthly premium
Because choosing the right Medicare plan for you is an important decision, we’ve made it easy for you to view highlights of our 2027 Gundersen Quartz Medicare Advantage Value D plan (with Rx) below.
For full plan details, here are some helpful documents
If you’d like to compare plan highlights in your region, you can view or download your 2027 Gundersen Quartz Medicare Advantage plan options.
Provider Directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage
Annual Notice of Change
Search for network providers
|
2027 Gundersen Quartz Medicare Advantage (HMO) - Value D plan (with Rx)
|
|
|---|---|
|
Monthly premium |
$97 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$15 |
|
Specialist office visit copay |
$50 |
|
Urgent care visits* |
$50 |
|
Emergency care visits* (copay waived if admitted within three days) |
$130 |
|
Lab services per day (not per lab) |
$15 |
|
Medical maximum out-of-pocket |
$4,900 |
|
Inpatient hospital coverage copay per day |
Days 1 - 6: $275 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$200
|
|
Skilled nursing facility copay per day |
Days 1 - 20: $0 |
|
Vision: annual initial routine eye exam copay |
$0 |
|
Vision: Annual limit for contacts, frames, lenses, and upgrades |
$175 |
|
Hearing: annual routine hearing exam copay |
$35 |
|
Hearing: Plan payment every two years for hearing aids |
$1,250 |
|
Dental: annual limit** |
$375 |
|
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 |
|
Dental: optional rider for an extra $1,000 coverage |
$48 per month |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. 20% cost-share for Medicare-covered items
- Part D prescription drugs. Details below
* $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. 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.
Value D 2027 prescription drug coverage
Quartz Medicare Advantage has a list of all covered drugs that you can search online or download. The drug list organizes medications into six tiers of costs.
What you pay for prescription drugs in 2027
Your plan has a deductible of $225 for drugs only in Tiers 3, 4, and 5. Deductible does not apply to medications in Tiers 1, 2, or 6. Once you reach the deductible, they are subject to a copay or coinsurance. After reaching the annual TrOOP (True Out-of-Pocket) limit of $2,400, your plan will cover all of your Part D drug costs for the rest of the year. See the image below to learn about the coverage stages.
|
Plan deductible: $225
|
Deductible applies?
|
Your share
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|---|---|
|
Tier 1 (Preferred generic) |
× No |
Copay |
$0 |
$0 |
$0 |
|
Tier 2 (Generic) |
× No |
Copay |
$10 |
$20 |
$25 |
|
Tier 3* (Preferred brand) |
✓ Yes |
Coinsurance |
20% |
20% |
20% |
|
Tier 4 (Non-preferred drugs) |
✓ Yes |
Coinsurance |
35% |
35% |
35% |
|
Tier 5** (Specialty) |
✓ Yes |
Coinsurance |
30% retail only |
Not available** |
Not available** |
|
Tier 6*** (Select Care drugs) |
× No |
Copay |
$0 |
$0 |
$0 |
You can fill your prescriptions at any in-network retail or mail-order pharmacy.
*Tier 3 includes many common brand-name drugs, some higher-cost generic drugs, and insulin.
**Tier 5 (Specialty) 30-day supply available in and specialty pharmacy locations only; not available through mail-order pharmacies.
***Tier 6 includes many low-cost medications that treat diabetes, high blood pressure, high cholesterol, osteoporosis, and other conditions.
This plan is available in the following states and counties:
Iowa: Allamakee, Fayette, and Winneshiek
Wisconsin: Buffalo, La Crosse, Monroe, Pepin, and Trempealeau
2027 Gundersen Quartz Medicare Advantage
Elite D (with Rx)
$202
monthly premium
Because choosing the right Medicare plan for you is an important decision, we’ve made it easy for you to view highlights of our 2027 Gundersen Quartz Medicare Advantage Elite D plan (with Rx) below.
For full plan details, here are some helpful documents
If you’d like to compare plan highlights in your region, you can view or download your 2027 Gundersen Quartz Medicare Advantage plan options.
Provider Directory (Regular print | Large print)
Pharmacy Directory (Regular print | Large print)
2027 Summary of Benefits | Evidence of Coverage
Annual Notice of Change
Search for network providers
|
2027 Gundersen Quartz Medicare Advantage (HMO) - Elite D plan (with Rx)
|
|
|---|---|
|
Monthly premium |
$202 |
|
Preventive services copay |
$0 |
|
Primary care visit copay |
$10 |
|
Specialist office visit copay |
$45 |
|
Urgent care visits* |
$50 |
|
Emergency care visits* (copay waived if admitted within three days) |
$150 |
|
Lab services per day (not per lab) |
$10 |
|
Medical maximum out-of-pocket |
$4,000 |
|
Inpatient hospital coverage copay per stay |
$300 |
|
Outpatient surgery at Ambulatory Surgical Centers (ASCs) or hospitals |
$150
|
|
Skilled nursing facility copay per day |
Days 1 - 20: $0 |
|
Vision: annual initial routine eye exam copay |
$0 |
|
Vision: annual limit for contacts, frames, lenses, and upgrades |
$250 |
|
Hearing: annual routine hearing exam copay |
$25 |
|
Hearing: plan payment every two years for hearing aids |
$1,500 |
|
Dental: annual limit** |
$550 |
|
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 |
|
Dental: optional rider for an extra $1,000 coverage |
$48 per month |
ALSO INCLUDED:
- Travel benefits. Get covered care at in-network costs for up to 6 months per year***
- Durable medical equipment and related supplies. 20% cost-share for Medicare-covered items
- Part D prescription drugs. Details below
* $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. 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.
Elite D 2027 prescription drug coverage
Quartz Medicare Advantage has a list of all covered drugs that you can search online or download. The drug list organizes medications into six tiers of costs.
What you pay for prescription drugs in 2027
Your plan has a deductible of $200 for drugs only in Tiers 3, 4, and 5. Deductible does not apply to medications in Tiers 1, 2, or 6. Once you reach the deductible, they are subject to a copay or coinsurance. After reaching the annual TrOOP (True Out-of-Pocket) limit of $2,400, your plan will cover all of your Part D drug costs for the rest of the year. See the image below to learn about the coverage stages.
|
Plan deductible: $200
|
Deductible applies?
|
Your share
|
30-day
|
31 to 60-day
|
61 to 100-day
|
|---|---|---|---|---|---|
|
Tier 1 (Preferred generic) |
× No |
Copay |
$0 |
$0 |
$0 |
|
Tier 2 (Generic) |
× No |
Copay |
$10 |
$20 |
$25 |
|
Tier 3* (Preferred brand) |
✓ Yes |
Coinsurance |
20% |
20% |
20% |
|
Tier 4 (Non-preferred drugs) |
✓ Yes |
Coinsurance |
35% |
35% |
35% |
|
Tier 5** (Specialty) |
✓ Yes |
Coinsurance |
31% retail only |
Not available** |
Not available** |
|
Tier 6*** (Select Care drugs) |
× No |
Copay |
$0 |
$0 |
$0 |
You can fill your prescriptions at any in-network retail or mail-order pharmacy.
*Tier 3 includes many common brand-name drugs, some higher-cost generic drugs, and insulin.
**Tier 5 (Specialty) 30-day supply available in and specialty pharmacy locations only; not available through mail-order pharmacies.
***Tier 6 includes many low-cost medications that treat diabetes, high blood pressure, high cholesterol, osteoporosis, and other conditions.
This plan is available in the following states and counties:
Iowa: Allamakee, Fayette, and Winneshiek
Wisconsin: Buffalo, La Crosse, Monroe, Pepin, and Trempealeau
We are here for you.
Thanks for choosing Quartz Medicare Advantage. If you have questions or need support, your local Quartz Champion is here for you.
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