Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Medica Prime Solution Thrift w/Rx, 2027

H2450Contract007Plan

Cost · 125 counties in Minnesota, North Dakota, South Dakota, Wisconsin

Run by Medica Insurance Company (contract H2450), sold as Medica, owned by Medica Holding Company

Renews in fewer counties

2026 star rating, contract H2450: 3.5 of 5

Medica Prime Solution Thrift w/Rx (H2450-007) costs $91 a month in 2027, down $1.80 from 2026, with an in-network out-of-pocket limit of $7,150 ($6,750 in 2026). It leaves 14 counties it served in 2026, where 22 of its members lived; they choose another plan for 2027 (the counties are listed below).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
Monthly premium	$92.80	$91	down $1.80
In-network out-of-pocket limit	$6,750	$7,150	up $400
Drug deductible	$615	$700	up $85
Emergency room	$125 copay	$130 copay	up $5
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	up $30for a 30-day stay
Counties served	139	125	down 14
Drug tier 1, preferred generic	$7	$0	down $7
Drug tier 2, generic	$14	$10	down $4
Drug tier 3, preferred brand	17% of the cost	19% of the cost	up 2 points
Drug tier 4, non-preferred drug	50% of the cost	45% of the cost	down 5 points
11 lines do not change
Part B premium reduction, monthly	none	none	no change
Primary care visit	20% of the cost	20% of the cost	no change
Specialist visit	20% of the cost	20% of the cost	no change
Medical deductible, in network	none	none	no change
Hospital stay, in network	$350 a day for days 1–5, then $0 a day for days 6–90	$350 a day for days 1–5, then $0 a day for days 6–90	no change
Ground ambulance, in network	20% of the cost	20% of the cost	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	not offered	not offered	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	not offered	not offered	no change
Drug tier 5, specialty tier	25% of the cost	25% of the cost	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$7	$0
Tier 2	Generic	$14	$10
Tier 3	Preferred Brand	17% of the cost	19% of the cost
Tier 4	Non-Preferred Drug	50% of the cost	45% of the cost
Tier 5	Specialty Tier	25% of the cost	25% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 65 plans open to everyone are sold for 2027, this one included. Against the others, 37 plans have a lower out-of-pocket limit, 20 the same, 5 a higher one. On the premium, 40 plans have a lower premium, 22 a higher one.

Out-of-pocket limits of the 65 plans open to everyone

$0 to under $2,0000 plans

$2,000 to under $4,0007 plans

$4,000 to under $6,00021 plans

$6,000 to under $8,000 (this plan)32 plans

$8,000 to $10,0003 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

It stops serving 14 counties it served in 2026 (listed in the next section).

The premium and the out-of-pocket limit are the same in all 125 counties: $91 a month and $7,150.

Minnesota North Dakota South Dakota Wisconsin

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

What if you live in a county it leaves?

Its 2026 members in the 14 counties listed below cannot stay in it for 2027; each county page lists the 2027 plans sold there.

Your coverage: This plan ends for you on December 31, 2026, because it is no longer sold where you live.
October 15 to December 7, 2026: Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
December 8, 2026 to the end of February 2027: A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
If you do nothing: You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one (with Extra Help or full Medicaid, Medicare enrolls you in one).
Without a drug plan: Going 63 days or more in a row without drug coverage can mean a late enrollment penalty if you join a drug plan later; joining by the end of February keeps a January and February gap under 63 days, waiting longer does not.
If you choose Original Medicare: You have a guaranteed right to buy Medigap Plan A, B, C, D, F, G, K or L sold in your state by any insurance company; if you were new to Medicare on or after January 1, 2020, Plans D and G take the place of C and F. Apply from 60 days before to 63 days after the plan ends; the policy starts once your Medicare Advantage coverage ends. Other Medigap plans are not covered by this right.

The 14 counties it leaves, most members first
County	Members, Sept. 2026
Eau Claire, WI	22
Buffalo, WI	fewer than 11
Campbell, SD	fewer than 11
Chippewa, WI	fewer than 11
Corson, SD	fewer than 11
Dewey, SD	fewer than 11
Haakon, SD	fewer than 11
Harding, SD	fewer than 11
Jackson, SD	fewer than 11
Jackson, WI	fewer than 11
Perkins, SD	fewer than 11
Rusk, WI	fewer than 11
Walworth, SD	fewer than 11
Ziebach, SD	fewer than 11

Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); Medicare.gov, “Special enrollment periods” and “When can I buy Medigap?” (read Oct. 7, 2026).

Who runs this plan?

Plan ID: H2450-007
Legal name of the contract: Medica Insurance Company
Sold as: Medica
Parent company: Medica Holding Company
Plan type: Cost
2026 star rating of the contract: 3.5 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
Members, September 2026: 440
Plan website, as filed with CMS: medica.com

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in St. Croix, WIWhere most of its members live; premiums and limits side by side
Every Medica plan for 2027Its contracts, counties and plans that end
The other 14 plans of contract H2450Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.