MSA · Special Needs Plan · Contract H5256 · 2026
Medical Associates Clinic Health Plan
Medical Associates Clinic Health Plan is a MSA Medicare Advantage plan from Medical Associates Clinic Health Plan of Wisconsin, available in 2 states. Here is its CMS quality rating, drug coverage, and benefits.
- N/R
- Overall CMS rating
- -
- Premium/mo
- 2
- States available
Medical Associates Clinic Health Plan plan score
A single 0-100 verdict combining Medical Associates Clinic Health Plan's nationwide standing on 1 of 4 CMS-filed measures: quality, affordability, cost protection, and supplemental-benefit richness, each from its own CMS source file. A missing filing drops out and redistributes its weight rather than deflating the score.
1/100
Percentile-weighted across 1 of 4 measures
- CMS quality (star rating)
- N/A not on file
- Affordability (premium)
- N/A not on file
- Cost protection (deductible)
- N/A not on file
- Benefit richness (supplemental coverage)
- F 1 benefits
1th percentile nationwide
Benchmarked live against every plan or plan-county row reporting each measure in the current CMS extract (CY2026 Star Ratings, Landscape file, and Plan Benefit Package). Not a CMS-endorsed score; PlainMedicare's own weighting (quality 40%, affordability 25%, cost protection 15%, benefit richness 20%).
What the CMS Data Shows About Medical Associates Clinic Health Plan
Medical Associates Clinic Health Plan operates under CMS contract H5256, issued by Medical Associates Clinic Health Plan of Wisconsin (parent organization Medical Associates Clinic, P.C.). The contract is classified as a MSA product, which governs how enrollees access care: the product rules govern provider access and cost-sharing for this contract. This contract is also flagged in CMS data as a Special Needs Plan (SNP), meaning enrollment is restricted to beneficiaries meeting specific eligibility criteria, chronic condition, dual Medicare-Medicaid status, or institutional residence. Service area spans 2 states (IA, WI) and 5 counties, a geography set at the CMS service-area definition level.
The overall CMS Star Rating for this contract is not yet published by CMS. This rating synthesizes 22 individual quality measures spanning 4 CMS domains, including clinical outcomes, patient experience (CAHPS), member complaints and appeals, and plan operations. Ratings at 4+ stars trigger federal Quality Bonus Payments that insurers typically reinvest in supplemental benefits.
On costs, this contract lists a monthly plan premium of not listed, from the CMS CY2026 Landscape file; every enrollee also pays the standard Part B premium. Beyond standard Medicare Parts A and B, the contract documents 4 supplemental benefits in the CMS benefits file, coverage extras such as dental, vision, hearing aids, fitness programs, and OTC allowances that Original Medicare does not provide. Before enrolling, verify that your preferred providers participate in the plan's network for your specific county, review the current Summary of Benefits, and confirm that your prescriptions appear on the plan formulary. All figures shown come from CMS public-use files for the 2026 contract year; this page is informational only and is not personalized Medicare counseling advice.
Quality Measures by Domain
Managing Chronic Conditions
7 measuresControlling High Blood Pressure
Diabetes Care – Blood Sugar Controlled
Getting Needed Care
Improving Bladder Control
Kidney Health Evaluation for Patients with Diabetes
Medication Reconciliation Post-Discharge
Reducing the Risk of Falling
Member Experience
6 measuresCare Coordination
Complaints about the Health Plan
Customer Service
Getting Appointments and Care Quickly
Rating of Health Care Quality
Rating of Health Plan
Complaints & Changes
3 measuresHealth Plan Quality Improvement
Members Choosing to Leave the Plan
Plan Makes Timely Decisions about Appeals
Tests & Vaccines
6 measuresAnnual Flu Vaccine
Colorectal Cancer Screening
Improving or Maintaining Mental Health
Improving or Maintaining Physical Health
Monitoring Physical Activity
Special Needs Plan (SNP) Care Management
Supplemental Benefits
| Benefit | Covered | Max Benefit |
|---|---|---|
| Vision, Eye Exam | ✓ Yes | - |
Medicare Advantage Guides
Official Medicare resources
Frequently Asked Questions
What is the star rating for Medical Associates Clinic Health Plan?
Medical Associates Clinic Health Plan (Contract H5256) by Medical Associates Clinic Health Plan of Wisconsin has an overall CMS star rating of Not yet rated out of 5. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.
How much does Medical Associates Clinic Health Plan cost per month?
Medical Associates Clinic Health Plan has a monthly plan premium (Part C + D combined) of not listed for this contract. Every enrollee also pays the standard Part B premium (about $202.90/month in 2026). Premiums are from the CMS CY2026 Landscape file and can vary by county; confirm current costs on Medicare.gov.
What type of plan is Medical Associates Clinic Health Plan?
Medical Associates Clinic Health Plan is a MSA Medicare Advantage plan offered by Medical Associates Clinic Health Plan of Wisconsin. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs.
Where is Medical Associates Clinic Health Plan available?
Medical Associates Clinic Health Plan is available in 2 states (IA, WI) across 5 counties. Coverage area can vary, check with the insurer or Medicare.gov for exact availability in your ZIP code.
What supplemental benefits does Medical Associates Clinic Health Plan offer?
Medical Associates Clinic Health Plan covers 4 supplemental benefits beyond standard Medicare, including vision eye exam. Many Medicare Advantage plans include dental, vision, and hearing coverage not available under Original Medicare.
How is Medical Associates Clinic Health Plan rated on quality measures?
CMS evaluates Medical Associates Clinic Health Plan across 22 individual quality measures spanning 4 domains, including HD2: Managing Chronic (Long Term) Conditions, HD3: Member Experience with Health Plan, HD4: Member Complaints and Changes in the Health Plan's Performance and more. These measures cover clinical outcomes, patient experience, and plan operations.
Data Source
Data from CMS Medicare Advantage 2026 Star Ratings and Plan Finder datasets. Contract ID: H5256. Last updated: 2026 plan year.
Related
Before you enroll in Medical Associates Clinic Health Plan
Star rating and network fit matter more than the premium alone.
- This contract's premium is not listed for this contract - compare it against other plans before enrolling. Browse all plans
- Check that your doctors and drugs are in-network before you enroll, and confirm the plan on Medicare.gov. Medicare Plan Compare
- This plan documents 4 supplemental benefits beyond Original Medicare - see how it stacks up against Original Medicare's coverage. MA vs Original Medicare
Figures are from CMS CY2026 public files for this contract; benefits and premiums can vary by the specific plan you enroll in and your county.
PlainMedicare is rendered directly from CMS Medicare Advantage and Part D public files, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a correction. Data current as of 2026-09-01.
CMS lists 131,985 Medicare Advantage and Part D plan records in the current public files. PlainMedicare refreshes this registry with each annual release.