Gundersen Quartz Med Advantage Value (HMO)
Medicare Advantage Plan H5262-004 • 2026 • Fayette County, IA
Gundersen Quartz Med Advantage Value (HMO) Medicare Advantage Plan H5262-004 • 2026 • Fayette County, IA
CMS Plan ID H5262-004 identifies the Medicare Advantage plan Gundersen Quartz Med Advantage Value, a HMO Part C plan offered by Quartz Medicare Advantage (HMO) for the 2026 plan year. This plan uses a Health Maintenance Organization (HMO) provider network and comes without Part D prescription drug coverage.
Gundersen Quartz Med Advantage Value Overview
Plan Overview for H5262-004-0 |
|
|---|---|
| CMS Plan ID: | H5262-004-0 |
| Plan Type: | HMO |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Medical Deductible: | Coming soon |
| Maximum Out-of-Pocket: | $4200.00 (In-Network) |
| Part B Give Back: | Coming soon |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | None |
| Service Area: | Fayette County, IA |
| Enrollment (Nationwide) | 884 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Fayette County |
| Provided By: | Quartz Medicare Advantage (HMO) |
Plan Overview for Gundersen Quartz Med Advantage Value
This Medicare Advantage Health Maintenance Organization (HMO) plan provides Medicare Part A and Part B coverage through a network of participating providers. The monthly premium is $0.00, and services are generally covered when received from in-network providers, except in emergency situations.
Primary care visits have a Coming soon, specialist visits come with a Coming soon, lab services cost {lab_services_cost}, urgent care services carry a Coming soon, and ambulance transportation is Coming soon. These costs apply toward the annual out-of-pocket maximum (MOOP) of $4200.00. After this limit is reached, in-network services are fully covered for the remainder of the year.
This plan is listed by CMS under Plan ID {title_plan_id}. Cost-sharing details for key services are provided below.
Cost Sharing Expenses
Gundersen Quartz Med Advantage Value has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H5262-004.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | Coming soon |
| Specialist: | Coming soon |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | Coming soon |
| Telehealth benefit: | Coming soon |
| Routine chiropractic: | Coming soon |
| Fitness benefits: | Coming soon |
| Health education: | Coming soon |
| Counseling services: | Coming soon |
| Over-the-counter drug benefits: | Coming soon |
| Health transportation (non-emergency): | Coming soon |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | Coming soon |
| Lab services: | Coming soon |
| Outpatient x-rays: | Coming soon |
| Diagnostic tests and procedures: | Coming soon |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | Coming soon |
| Worldwide emergency care: | Coming soon |
| Urgent care: | Coming soon |
| Inpatient hospital care: | Coming soon |
| Skilled Nursing Facility: | Coming soon |
| Ground ambulance: | Coming soon |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | Coming soon |
| Outpatient group therapy: | Coming soon |
| Inpatient psychiatric hospital care: | Coming soon |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | Coming soon |
| Occupational therapy: | Coming soon |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | Coming soon |
| Durable medical equipment: | Coming soon |
| Prosthetics: | Coming soon |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | Coming soon |
| Other Part B drugs (Medicare-covered): | Coming soon |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | Coming soon |
| Dental x-rays: | Coming soon |
| Cleaning: | Coming soon |
| Periodontics: | Coming soon |
| Endodontics: | Coming soon |
| Restorative services: | Coming soon |
| Implant services: | Coming soon |
| Orthodontics: | Coming soon |
| Oral/Maxillofacial surgery: | Coming soon |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | Coming soon |
| Contact lenses: | Coming soon |
| Eyeglass frames only: | Coming soon |
| Eyeglass lenses only: | Coming soon |
| Eyeglasses (frames & lenses): | Coming soon |
| Upgrades: | Coming soon |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | Coming soon |
| Fitting/evaluation: | Coming soon |
| Prescription hearing aids: | Coming soon |
| OTC hearing aids: | Coming soon |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Coming soon |
| Home-based palliative care: | Coming soon |
| Personal emergency response system: | Coming soon |
| Weight management programs: | Coming soon |
| Wigs for chemotherapy-related hair loss: | Coming soon |
| Alternative therapies: | Coming soon |
| Massage therapy: | Coming soon |
| Home/bathroom safety devices: | Coming soon |
Certain preventive services are covered 100% by Gundersen Quartz Med Advantage Value as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How much does plan H5262-004 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the MOOP for Gundersen Quartz Med Advantage Value in 2026?
The 2026 in-network MOOP is $4200.00. Once this limit is reached, covered in-network costs are fully covered.
How many beneficiaries are enrolled in this plan?
CMS reports 884 beneficiaries enrolled in this plan.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $0.00.
Contact Information for Quartz Medicare Advantage (HMO)
| Contact Type | Details |
|---|---|
| Website: | Quartz Medicare Advantage (HMO) Plan Page |
| New Members: | Coming soon |
| Existing Members: | Coming soon |
| Plan Address: | Coming soon |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance — Last accessed May 2, 2026
- CMS.gov, Plan Benefits Package — Last accessed May 2, 2026
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed May 2, 2026
Data sources and methodology documentation..
- Quartz Medicare Advantage (HMO) (official source), http://quartzbenefits.com/medicareadvantage — Last accessed October 13, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
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