Understanding Medicare

Eligibility, Enrollment, Disenrollment, & Payment Options

Here’s what you need to know to get started.

Eligibility

  • You must be enrolled in Medicare Part A (Hospital) and Part B (Medical)
  • You must continue to pay your Part B premium
  • You must live within the service area of the plan you wish to enroll
  • Medicare beneficiaries diagnosed with End Stage Renal Disease may not be eligible to enroll

Enrollment

  • Your application needs to be completed and received by our office by the last working day of the month to be eligible for coverage to begin the first of the following month, (i.e. sign up by January 31st to be eligible for February 1st)
  • Enrollment Instructions

2025 Enrollment Applications

  • Iowa (Tri-States)
  • Iowa (MercyOne North Iowa, Mercy One Cedar Valley, MercyOne Clinton Community, Quad Cities Health, Central Iowa Health, Mercy Cedar Rapids)
  • Illinois
  • Wisconsin

2024 Enrollment Applications

  • Iowa (Tri-States)
  • Iowa (MercyOne North Iowa, Mercy One Cedar Valley, MercyOne Clinton Community, Quad Cities Health, Central Iowa Health, Mercy Cedar Rapids, Mercy Iowa City)
  • Illinois
  • Wisconsin

Disenrollment

  • You may disenroll from MAHP at any time for any reason.
  • MAHP needs to receive your disenrollment request in writing and coverage will end the last day of the month. Your request needs to be our office by the last day of the month to disenroll for that month.
  • You will receive written confirmation from MAHP of your disenrollment effective date. Any paid, unused premium will be returned to you.

Medicare Plan Rating Information

Medicare evaluates plans based on a 5-star rating system.

The Overall Star Rating combines scores for the types of services each plan offers. For plans covering health services, the overall score for quality of those services covers many different topics that fall into 5 categories:

  • Staying healthy: screenings, tests, and vaccines. Includes whether members got various screening tests, vaccines, and other check-ups that help them stay healthy.
  • Managing chronic (long-term) conditions: Includes how often members with different conditions got certain tests and treatments that help them manage their condition.
  • Member experience with the health plan: Includes ratings of member satisfaction with the plan.
  • Member complaints and changes in the health plan’s performance: Includes how often Medicare found problems with the plan and how often members had problems with the plan. Includes how much the plan’s performance has improved (if at all) over time.
  • Health plan customer service: Includes how well the plan handles member appeals.

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

2025 Ratings

H1651 - Iowa/Illinois Plan: Awarded 4.5 out of five (5) stars by Medicare

H5256 - Wisconsin Plan: Awarded 5 out of five (5) stars by Medicare

2024 Ratings

H1651 - Iowa/Illinois Plan: Awarded 5 out of five (5) stars by Medicare

H5256 - Wisconsin Plan: Awarded 5 out of five (5) stars by Medicare

Initial Decisions, Appeals, & Grievances (Complaint) Process

Our Member Services Department will assist you with any questions.

If you have a problem or concern of any type, call our Member Services Department and they will assist in answering your question or direct you to the appropriate resource to address your concern.

Initial Decisions, Appeals and Grievance Handout

CMS Complaint Form †

Appointment of Representative Form †

† Medical Associates is not responsible for the content or policies of external internet sites.

Other Important Medicare Information

New Technology:

MAHP has established a policy to formalize the process by which MAHP evaluates the inclusion of new medical technologies and the new application of existing technologies such as medical procedures, drugs, and devices into the benefit package.

For new medical technology to be covered, established Medicare and MAHP criteria must be met. Requests for certification of new medical technologies and/or new uses of existing technologies will be reviewed by the MAHP Medical Director, Utilization Management Committee and Quality Improvement Committee, with the ultimate decision resting on the Medical Associates Clinic Board of Directors.

Preventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over

Advance Directives