Shuman Roy is an entrepreneur, business owner, and musician. He started RoysNoys, LLC in 2013 as a music production and education service company. He also offers small business consulting and advisory services to help businesses get from start-up mode to turn-key operations. Shuman earned his M.B.A from the Stern School of Business in 2001 and has an undergraduate degree from Manhattan College in ...

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Joel Ohman is the CEO of a private equity-backed digital media company. He is a CERTIFIED FINANCIAL PLANNER™, author, angel investor, and serial entrepreneur who loves creating new things, whether books or businesses. He has also previously served as the founder and resident CFP® of a national insurance agency, Real Time Health Quotes. He has an MBA from the University of South Florida. Joel...

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Founder, CFP®

UPDATED: Oct 29, 2021

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The Highlights

  • There are 54 plans that cost the same as your original Medicare in WI
  • There are 22 Medicare Avantage companies in Wisconsin
  • If you choose Medicare Advantage, you’ll still need to pay your Wisconsin original Medicare premium

There are several options in Wisconsin for Medicare Advantage plans. Medicare Advantage (Medicare Part C) is offered by 22 companies in Wisconsin; and options such as HMO, PPO, and POS may be available depending on which county you live in.

To make sure you’re getting the best WI Medicare provider and plan for your needs, compare rates and out-of-pocket costs to find the ideal coverage and cost combination for you.

If you’re ready to compare Medicare plans from the top companies in your county or across Wisconsin, enter your ZIP code for fast, free WI Medicare quotes today.

Table of Contents

The Complete List of Wisconsin Medicare Advantage Companies

There are many companies offering Part C Medicare Advantage in WI. Below, you’ll find a complete listing of health insurance companies that offer Medicare Advantage plans in Wisconsin, the counties those plans are offered in, and the number of plans each company offers.

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Medicare Advantage Companies in Wisconsin

Company Number of Plans Counties
Aetna Medicare 3 Walworth, Milwaukee, Green Lake, Kewaunee, Shawano, Manitowoc, Green, Waushara, Brown, Waukesha, Rock, Racine, Sheboygan, Calumet, Washington, Outagamie, Kenosha, Ozaukee, Winnebago
Allwell 1 Waupaca, Walworth, Marquette, Milwaukee, Green Lake, Jefferson, Kewaunee, Taylor, Shawano, Fond du Lac, Manitowoc, Wood, Waushara, Marinette, Brown, Columbia, Waukesha, Oconto, Clark, Racine, Sheboygan, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Ozaukee, Adams, Dodge, Dane, Winnebago
Anthem 1 Waupaca, Iron, Walworth, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Lafayette, Oconto, Clark, Price, Racine, Sheboygan, Door, Florence, Calumet, Portage, Iowa, Vilas, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Bayfield, Ozaukee, Adams, Dodge, Forest, Winnebago
Anthem Blue Cross and Blue Shield 4 Waupaca, Iron, Walworth, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Lafayette, Oconto, Clark, Price, Racine, Sheboygan, Door, Florence, Calumet, Portage, Iowa, Vilas, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Bayfield, Ozaukee, Adams, Dodge, Forest, Winnebago
Aspirus Health Plan 3 Iron, Marquette, Taylor, Shawano, Juneau, Wood, Waushara, Oneida, Columbia, Clark, Price, Florence, Portage, Marathon, Langlade, Lincoln, Adams, Forest
Community Care 1 Waupaca, Milwaukee, Waukesha, Racine, Calumet, Washington, Outagamie, Kenosha, Ozaukee
Dean Advantage, Prevea360 Medicare Advantage 8 Jefferson, Sauk, Fond du Lac, Green, Columbia, Rock, Iowa, Dodge, Dane, Kewaunee, Brown, Oconto, Sheboygan, Door
Dean Health Plan, Inc 3 Grant, Jefferson, Sauk, Columbia, Rock, Iowa, Dodge, Dane
Group Health Cooperative of Eau Claire 1 Chippewa, Eau Claire, Trempealeau, Barron
HealthPartners 5 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Manitowoc, Waushara, Marinette, Brown, Oconto, Florence, Calumet, Menominee, Outagamie, Winnebago, Douglas, Burnett, Pierce, Washburn, Polk, St. Croix, Dunn
Humana 17 Waupaca, Marquette, Milwaukee, Green Lake, Kewaunee, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Forest, Winnebago, Shawano, Crawford, Walworth, Richland, Douglas, Jefferson, Sauk, Green, Columbia, Rock, Lafayette, Iowa, Dane, Grant, Iron, Sawyer, Chippewa, Jackson, Eau Claire, Burnett, Taylor, Ashland, Juneau, Wood, Oneida, Vernon, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Buffalo, Vilas, Pepin, Langlade, Polk, Rusk, St. Croix, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron
Medica 3 Sawyer, Douglas, Chippewa, Eau Claire, Burnett, Ashland, Pierce, Washburn, Polk, St. Croix, Dunn, Bayfield, Barron
Medical Associates Clinic Health Plan of Wisconsi 3 Grant, Crawford, Lafayette, Iowa
Molina Healthcare 1 Waupaca, Walworth, Marquette, Milwaukee, Green Lake, Jefferson, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Portage, Washington, Outagamie, Langlade, Kenosha, Ozaukee, Dodge, Forest, Winnebago
My Choice Wisconsin 2 Waupaca, Grant, Crawford, Walworth, Marquette, Green Lake, Jefferson, Sauk, Kewaunee, Shawano, Fond du Lac, Juneau, Green, Waushara, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Calumet, Iowa, Washington, Outagamie, Ozaukee, Adams, Dodge, Dane, Winnebago
Network Health 1 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago
Network Health Medicare Advantage Plans 10 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago, Grant, Iron, Crawford, Walworth, Sawyer, Richland, Milwaukee, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Taylor, Ashland, Juneau, Wood, Green, Oneida, Marinette, Vernon, Columbia, Waukesha, Rock, Lafayette, Pierce, Clark, Washburn, Price, Racine, Monroe, Door, Florence, La Crosse, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Langlade, Polk, Rusk, St. Croix, Kenosha, Lincoln, Dunn, Bayfield, Ozaukee, Adams, Trempealeau, Barron, Forest, Dane
Quartz Medicare Advantage 6 Crawford, Jackson, Juneau, Vernon, Monroe, La Crosse, Buffalo, Trempealeau, Walworth, Milwaukee, Manitowoc, Brown, Waukesha, Racine, Sheboygan, Washington, Kenosha, Ozaukee, Winnebago, Richland, Marquette, Jefferson, Sauk, Columbia, Iowa, Adams, Dane
Security Health 1 Chippewa, Eau Claire, Taylor, Wood, Oneida, Clark, Price, Portage, Marathon, Rusk, Lincoln, Barron
Security Health Plan of Wisconsin, Inc 10 Waupaca, Iron, Crawford, Sawyer, Richland, Marquette, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Green, Waushara, Oneida, Vernon, Columbia, Waukesha, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest, Dane, Grant, Walworth, Milwaukee, Kewaunee, Fond du Lac, Manitowoc, Marinette, Brown, Rock, Lafayette, Oconto, Racine, Sheboygan, Door, Calumet, Menominee, Washington, Outagamie, St. Croix, Kenosha, Ozaukee, Dodge, Winnebago
UCare 3 Douglas, Washburn, Bayfield
UnitedHealthcare 17 Waupaca, Milwaukee, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Wood, Waushara, Oneida, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Langlade, Lincoln, Ozaukee, Dodge, Forest, Winnebago, Walworth, Clark, Kenosha, Grant, Jefferson, Green, Rock, Marquette, Sauk, Columbia, Lafayette, Iowa, Adams, Dane, Iron, Crawford, Richland, Douglas, Chippewa, Jackson, Burnett, Taylor, Ashland, Juneau, Vernon, Pierce, Price, Monroe, La Crosse, Buffalo, Vilas, Pepin, Polk, Rusk, St. Croix, Dunn, Bayfield, Trempealeau, Barron

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Wisconsin Medicare Advantage Plans by Company

We’ve put together a list of all of plans available from each WI Medicare company to help you compare Medicare Advantage plans by company in Wisconsin. Take a look at the plans here.

Medicare Plans in Wisconsin Offered by UnitedHealthcare

Though plans can vary from county to county, UnitedHealthcare offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
AARP Medicare Advantage Value (HMO-POS) H5253-034 Waupaca, Milwaukee, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Wood, Waushara, Oneida, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Langlade, Lincoln, Ozaukee, Dodge, Forest, Winnebago Local HMO $0.00
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP) H0710-043 Waupaca, Walworth, Milwaukee, Shawano, Fond du Lac, Manitowoc, Wood, Oneida, Marinette, Brown, Waukesha, Clark, Racine, Sheboygan, Marathon, Washington, Outagamie, Kenosha, Lincoln, Ozaukee, Dodge, Winnebago Local PPO $38.80
AARP Medicare Advantage (HMO-POS) H5253-011 Waupaca, Grant, Walworth, Milwaukee, Green Lake, Jefferson, Kewaunee, Shawano, Fond du Lac, Manitowoc, Wood, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Ozaukee, Dodge, Forest, Winnebago Local HMO $27.00
AARP Medicare Advantage Open Plan 1 (PPO) H0294-004 Waupaca, Grant, Walworth, Marquette, Milwaukee, Green Lake, Jefferson, Sauk, Kewaunee, Shawano, Fond du Lac, Manitowoc, Green, Waushara, Marinette, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Iowa, Menominee, Washington, Outagamie, Langlade, Kenosha, Ozaukee, Adams, Dodge, Forest, Dane, Winnebago Local PPO $47.00
UnitedHealthcare Dual Complete LP1 (HMO D-SNP) H3794-002 Waupaca, Grant, Iron, Crawford, Walworth, Richland, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Burnett, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Wood, Green, Waushara, Oneida, Marinette, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Pierce, Clark, Price, Racine, Monroe, Sheboygan, Door, Florence, La Crosse, Calumet, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Outagamie, Langlade, Polk, Rusk, St. Croix, Kenosha, Lincoln, Dunn, Bayfield, Ozaukee, Adams, Trempealeau, Dodge, Barron, Forest, Dane, Winnebago Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
UnitedHealthcare Assisted Living Plan (HMO-POS I-SNP) H5253-064 Waupaca, Milwaukee, Fond du Lac, Manitowoc, Brown, Waukesha, Racine, Sheboygan, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Winnebago Local HMO $40.70
AARP Medicare Advantage Patriot Plan 2 (HMO-POS) H5253-021 Waupaca, Grant, Walworth, Milwaukee, Green Lake, Jefferson, Kewaunee, Shawano, Fond du Lac, Manitowoc, Wood, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Ozaukee, Dodge, Forest, Winnebago Local HMO * $0.00
UnitedHealthcare Nursing Home Plan 1 (HMO-POS I-SNP) H5253-007 Waupaca, Walworth, Milwaukee, Shawano, Fond du Lac, Manitowoc, Wood, Brown, Waukesha, Racine, Sheboygan, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Winnebago Local HMO $38.10
UnitedHealthcare Dual Complete LP (HMO D-SNP) H5253-024 Waupaca, Milwaukee, Green Lake, Kewaunee, Shawano, Waushara, Vernon, Brown, Waukesha, Oconto, Racine, Monroe, Sheboygan, La Crosse, Calumet, Washington, Outagamie, Ozaukee, Trempealeau, Winnebago Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
UnitedHealthcare Medicare Advantage Assist (PPO C-SNP) H0294-002 Waupaca, Grant, Iron, Crawford, Walworth, Richland, Marquette, Milwaukee, Green Lake, Jefferson, Sauk, Jackson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Wood, Green, Waushara, Oneida, Marinette, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Pierce, Clark, Price, Racine, Monroe, Sheboygan, Door, Florence, La Crosse, Calumet, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Ozaukee, Adams, Trempealeau, Dodge, Forest, Dane, Winnebago Local PPO $14.00
AARP Medicare Advantage Value (HMO) H5253-097 Grant, Walworth, Jefferson, Green, Rock, Kenosha Local HMO $0.00
AARP Medicare Advantage Open (PPO) H0294-011 Iron, Crawford, Richland, Jackson, Taylor, Ashland, Juneau, Wood, Oneida, Vernon, Pierce, Clark, Price, Monroe, La Crosse, Portage, Buffalo, Vilas, Pepin, Marathon, Lincoln, Trempealeau Local PPO $47.00
AARP Medicare Advantage Patriot Plan 1 (PPO) H0294-014 Iron, Crawford, Richland, Marquette, Sauk, Jackson, Taylor, Ashland, Juneau, Wood, Oneida, Vernon, Columbia, Lafayette, Pierce, Clark, Price, Monroe, La Crosse, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Lincoln, Adams, Trempealeau, Dane Local PPO* $0.00
AARP Medicare Advantage Open Premier (PPO) H0294-012 Iron, Crawford, Richland, Jackson, Taylor, Ashland, Juneau, Wood, Oneida, Vernon, Pierce, Clark, Price, Monroe, La Crosse, Portage, Buffalo, Vilas, Pepin, Marathon, Lincoln, Trempealeau Local PPO $112.00
AARP Medicare Advantage Open Plan 2 (PPO) H0294-016 Jefferson, Green, Rock, Lafayette, Iowa, Dane Local PPO $29.00
UnitedHealthcare Assisted Living Plan (PPO I-SNP) H0710-042 Kewaunee, Marinette, Oconto, Door Local PPO $40.70
AARP Medicare Advantage Walgreens (PPO) H0294-015 Kewaunee, Fond du Lac, Manitowoc, Brown, Sheboygan, Calumet, Outagamie, Winnebago Local PPO $0.00

Medicare Plans in Wisconsin Offered by Security Health Plan of Wisconsin, Inc

Though plans can vary from county to county, Security Health Plan of Wisconsin, Inc offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Spirit Rx (HMO-POS) H5211-004 Waupaca, Iron, Crawford, Sawyer, Richland, Marquette, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Green, Waushara, Oneida, Vernon, Columbia, Waukesha, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest, Dane Local HMO $226.00
Spirit (HMO-POS) H5211-001 Waupaca, Iron, Crawford, Sawyer, Richland, Marquette, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Green, Waushara, Oneida, Vernon, Columbia, Waukesha, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest, Dane Local HMO * $0.00
Secure Saver (MSA) H4388-001 Waupaca, Grant, Iron, Crawford, Walworth, Sawyer, Richland, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Wood, Green, Waushara, Oneida, Marinette, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Pierce, Clark, Washburn, Price, Racine, Monroe, Sheboygan, Door, Florence, La Crosse, Calumet, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Outagamie, Langlade, Polk, Rusk, St. Croix, Kenosha, Lincoln, Dunn, Bayfield, Ozaukee, Adams, Trempealeau, Dodge, Barron, Forest, Dane, Winnebago MSA* MSAs do not have a monthly premium.
Esteem Rx (HMO-POS) H5211-012 Waupaca, Iron, Crawford, Sawyer, Douglas, Chippewa, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Waushara, Oneida, Vernon, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest Local HMO $0.00
Essence Rx (HMO-POS) H5211-002 Waupaca, Iron, Crawford, Sawyer, Richland, Marquette, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Green, Waushara, Oneida, Vernon, Columbia, Waukesha, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest, Dane Local HMO $85.00
Ascend Rx (HMO-POS) H5211-013 Waupaca, Iron, Crawford, Sawyer, Douglas, Chippewa, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Waushara, Oneida, Vernon, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest Local HMO $40.00
Essence (HMO-POS) H5211-003 Waupaca, Iron, Crawford, Sawyer, Richland, Marquette, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Taylor, Ashland, Shawano, Juneau, Wood, Green, Waushara, Oneida, Vernon, Columbia, Waukesha, Pierce, Clark, Washburn, Price, Monroe, Florence, La Crosse, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Langlade, Polk, Rusk, Lincoln, Dunn, Bayfield, Adams, Trempealeau, Barron, Forest, Dane Local HMO * $0.00
Assurance Rx (HMO-POS) H5211-007 Richland, Marquette, Green Lake, Jefferson, Sauk, Green, Columbia, Waukesha, Iowa, Dane Local HMO $0.00
Promise Rx (HMO-POS) H5211-009 Kewaunee, Marinette, Brown, Oconto, Outagamie, Winnebago Local HMO $73.00
Surety Rx (HMO-POS) H5211-008 Kewaunee, Marinette, Brown, Oconto, Outagamie, Winnebago Local HMO $0.00

Medicare Plans in Wisconsin Offered by Network Health Medicare Advantage Plans

Though plans can vary from county to county, Network Health Medicare Advantage Plans offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Network PlatinumPremier Pharmacy (PPO) H5215-005 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO $297.00
Network PlatinumPremier (PPO) H5215-006 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO* $0.00
Network PlatinumChoice (PPO) H5215-011 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO $31.00
Network PlatinumPlus Pharmacy (PPO) H5215-002 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO $124.00
NetworkPrime (MSA) H1181-001 Waupaca, Grant, Iron, Crawford, Walworth, Sawyer, Richland, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Wood, Green, Waushara, Oneida, Marinette, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Pierce, Clark, Washburn, Price, Racine, Monroe, Sheboygan, Door, Florence, La Crosse, Calumet, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Outagamie, Langlade, Polk, Rusk, St. Croix, Kenosha, Lincoln, Dunn, Bayfield, Ozaukee, Adams, Trempealeau, Dodge, Barron, Forest, Dane, Winnebago MSA* MSAs do not have a monthly premium.
Network PlatinumPlus (PPO) H5215-001 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO* $0.00
Network PlatinumSelect (PPO) H5215-008 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO $0.00
Network Health Medicare Anywhere (PPO) H5215-010 Milwaukee, Waukesha, Racine, Washington, Ozaukee Local PPO $35.00
Network Health Medicare Explore (HMO) H5644-002 Milwaukee, Waukesha, Racine, Washington, Kenosha, Ozaukee Local HMO $11.00
Network Health Medicare Go (PPO) H5215-009 Milwaukee, Waukesha, Racine, Washington, Ozaukee Local PPO $0.00

Medicare Plans in Wisconsin Offered by Anthem Blue Cross and Blue Shield

Though plans can vary from county to county, Anthem Blue Cross and Blue Shield offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Anthem MediBlue Plus (HMO) H9525-006 Waupaca, Iron, Walworth, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Lafayette, Oconto, Clark, Price, Racine, Sheboygan, Door, Florence, Calumet, Portage, Iowa, Vilas, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Bayfield, Ozaukee, Adams, Dodge, Forest, Winnebago Local HMO $0.00
Anthem MediBlue Access Core (PPO) H4036-016 Waupaca, Iron, Walworth, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Lafayette, Oconto, Clark, Price, Racine, Sheboygan, Door, Florence, Calumet, Portage, Iowa, Vilas, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Bayfield, Ozaukee, Adams, Dodge, Forest, Winnebago Local PPO* $0.00
Anthem MediBlue Access (PPO) H4036-009 Waupaca, Iron, Walworth, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Lafayette, Oconto, Clark, Price, Racine, Sheboygan, Door, Florence, Calumet, Portage, Iowa, Vilas, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Bayfield, Ozaukee, Adams, Dodge, Forest, Winnebago Local PPO $37.00
Anthem MediBlue Access Plus (PPO) H4036-020 Waupaca, Milwaukee, Fond du Lac, Manitowoc, Brown, Waukesha, Oconto, Racine, Sheboygan, Calumet, Marathon, Washington, Outagamie, Ozaukee, Dodge, Winnebago Local PPO $0.00

Medicare Plans in Wisconsin Offered by HealthPartners

Though plans can vary from county to county, HealthPartners offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
HealthPartners Robin Maple (PPO) H4882-005 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Manitowoc, Waushara, Marinette, Brown, Oconto, Florence, Calumet, Menominee, Outagamie, Winnebago Local PPO $26.00
HealthPartners Robin Birch (PPO) H4882-004 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Manitowoc, Waushara, Marinette, Brown, Oconto, Florence, Calumet, Menominee, Outagamie, Winnebago Local PPO $0.00
HealthPartners Freedom Basic WI (Cost) H2462-026 Douglas, Burnett, Pierce, Washburn, Polk, St. Croix, Dunn Cost * $33.60
HealthPartners Freedom Balance WI (Cost) H2462-028 Douglas, Burnett, Pierce, Washburn, Polk, St. Croix, Dunn Cost * $82.60
HealthPartners Freedom Vital WI (Cost) H2462-027 Douglas, Burnett, Pierce, Washburn, Polk, St. Croix, Dunn Cost * $39.70

Medicare Plans in Wisconsin Offered by Humana

Though plans can vary from county to county, Humana offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
HumanaChoice H5216-001 (PPO) H5216-001 Waupaca, Marquette, Milwaukee, Green Lake, Kewaunee, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Forest, Winnebago Local PPO $78.00
HumanaChoice H5216-253 (PPO) H5216-253 Waupaca, Marquette, Milwaukee, Green Lake, Kewaunee, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Forest, Winnebago Local PPO $0.00
Humana Gold Plus H6622-001 (HMO) H6622-001 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Oconto, Calumet, Marathon, Outagamie, Winnebago Local HMO $0.00
Humana Value Plus H5216-173 (PPO) H5216-173 Waupaca, Crawford, Walworth, Richland, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Sauk, Kewaunee, Fond du Lac, Manitowoc, Green, Waushara, Marinette, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Racine, Sheboygan, Door, Calumet, Portage, Iowa, Marathon, Menominee, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Forest, Dane, Winnebago Local PPO $33.00
HumanaChoice R5361-001 (Regional PPO) R5361-001 Waupaca, Grant, Iron, Crawford, Walworth, Sawyer, Richland, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Wood, Green, Waushara, Oneida, Marinette, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Pierce, Clark, Washburn, Price, Racine, Monroe, Sheboygan, Door, Florence, La Crosse, Calumet, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Outagamie, Langlade, Polk, Rusk, St. Croix, Kenosha, Lincoln, Dunn, Bayfield, Ozaukee, Adams, Trempealeau, Dodge, Barron, Forest, Dane, Winnebago Regional PPO* $0.00
Humana Gold Choice H8145-006 (PFFS) H8145-006 Waupaca, Walworth, Richland, Marquette, Milwaukee, Green Lake, Jefferson, Sauk, Eau Claire, Shawano, Fond du Lac, Manitowoc, Juneau, Oneida, Brown, Waukesha, Lafayette, Clark, Racine, Sheboygan, Vilas, Marathon, Washington, Outagamie, Langlade, Kenosha, Lincoln, Ozaukee, Adams, Trempealeau, Dodge, Barron, Forest, Dane, Winnebago PFFS $81.00
HumanaChoice H5216-252 (PPO) H5216-252 Waupaca, Marquette, Milwaukee, Green Lake, Kewaunee, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Kenosha, Ozaukee, Dodge, Forest, Winnebago Local PPO $0.00
HumanaChoice R5361-002 (Regional PPO) R5361-002 Waupaca, Grant, Iron, Crawford, Walworth, Sawyer, Richland, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Chippewa, Sauk, Jackson, Eau Claire, Burnett, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Wood, Green, Waushara, Oneida, Marinette, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Pierce, Clark, Washburn, Price, Racine, Monroe, Sheboygan, Door, Florence, La Crosse, Calumet, Portage, Iowa, Buffalo, Vilas, Pepin, Marathon, Menominee, Washington, Outagamie, Langlade, Polk, Rusk, St. Croix, Kenosha, Lincoln, Dunn, Bayfield, Ozaukee, Adams, Trempealeau, Dodge, Barron, Forest, Dane, Winnebago Regional PPO $120.00
HumanaChoice H5216-006 (PPO) H5216-006 Crawford, Walworth, Richland, Jefferson, Sauk, Green, Columbia, Rock, Lafayette, Iowa, Dane Local PPO $48.00
HumanaChoice H5216-168 (PPO) H5216-168 Crawford, Walworth, Richland, Jefferson, Sauk, Green, Columbia, Rock, Lafayette, Iowa, Dane Local PPO $120.00
Humana Honor (PPO) H5216-258 Walworth, Milwaukee, Douglas, Jefferson, Sauk, Kewaunee, Green, Marinette, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Racine, Sheboygan, Door, Calumet, Iowa, Marathon, Washington, Outagamie, St. Croix, Kenosha, Ozaukee, Dodge, Dane Local PPO* $0.00
Humana Gold Plus H6622-040 (HMO) H6622-040 Milwaukee, Brown, Waukesha, Racine, Sheboygan, Washington, Outagamie, Kenosha, Ozaukee, Winnebago Local HMO $0.00
Humana Gold Plus H6622-002 (HMO) H6622-002 Milwaukee, Waukesha, Racine, Sheboygan, Washington, Kenosha, Ozaukee Local HMO $38.00
Humana Gold Plus H6622-034 (HMO) H6622-034 Milwaukee, Waukesha, Racine, Sheboygan, Washington, Kenosha, Ozaukee Local HMO $0.00
HumanaChoice H5216-080 (PPO) H5216-080 Douglas Local PPO $109.00
HumanaChoice H5216-063 (PPO) H5216-063 St. Croix Local PPO $106.00
HumanaChoice H5216-167 (PPO) H5216-167 St. Croix Local PPO $89.00

Medicare Plans in Wisconsin Offered by Network Health

Though plans can vary from county to county, Network Health offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
NetworkCares (PPO D-SNP) H5215-007 Waupaca, Marquette, Green Lake, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Brown, Oconto, Sheboygan, Calumet, Portage, Outagamie, Dodge, Winnebago Local PPO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by My Choice Wisconsin

Though plans can vary from county to county, My Choice Wisconsin offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
My Choice Wisconsin Medicare Dual Advantage Plan (HMO D-SNP) H5209-004 Waupaca, Grant, Crawford, Walworth, Marquette, Green Lake, Jefferson, Sauk, Kewaunee, Shawano, Fond du Lac, Juneau, Green, Waushara, Vernon, Brown, Columbia, Waukesha, Rock, Lafayette, Oconto, Calumet, Iowa, Washington, Outagamie, Ozaukee, Adams, Dodge, Dane, Winnebago Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
My Choice Wisconsin Partnership Plan (HMO D-SNP) H5209-002 Jefferson, Sauk, Columbia, Waukesha, Washington, Ozaukee, Dodge, Dane Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by Anthem

Though plans can vary from county to county, Anthem offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Anthem MediBlue Dual Advantage (HMO D-SNP) H9525-003 Waupaca, Iron, Walworth, Marquette, Milwaukee, Green Lake, Douglas, Jefferson, Kewaunee, Taylor, Ashland, Shawano, Fond du Lac, Manitowoc, Juneau, Green, Waushara, Oneida, Marinette, Brown, Waukesha, Rock, Lafayette, Oconto, Clark, Price, Racine, Sheboygan, Door, Florence, Calumet, Portage, Iowa, Vilas, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Bayfield, Ozaukee, Adams, Dodge, Forest, Winnebago Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by Community Care

Though plans can vary from county to county, Community Care offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Community Care’s Partnership Program (HMO D-SNP) H2034-001 Waupaca, Milwaukee, Waukesha, Racine, Calumet, Washington, Outagamie, Kenosha, Ozaukee Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by Molina Healthcare

Though plans can vary from county to county, Molina Healthcare offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Molina Medicare Complete Care (HMO D-SNP) H2879-001 Waupaca, Walworth, Marquette, Milwaukee, Green Lake, Jefferson, Kewaunee, Shawano, Fond du Lac, Manitowoc, Waushara, Marinette, Brown, Waukesha, Oconto, Racine, Sheboygan, Door, Florence, Calumet, Portage, Washington, Outagamie, Langlade, Kenosha, Ozaukee, Dodge, Forest, Winnebago Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by Allwell

Though plans can vary from county to county, Allwell offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Allwell Dual Medicare (HMO D-SNP) H8189-001 Waupaca, Walworth, Marquette, Milwaukee, Green Lake, Jefferson, Kewaunee, Taylor, Shawano, Fond du Lac, Manitowoc, Wood, Waushara, Marinette, Brown, Columbia, Waukesha, Oconto, Clark, Racine, Sheboygan, Calumet, Portage, Marathon, Menominee, Washington, Outagamie, Langlade, Kenosha, Lincoln, Ozaukee, Adams, Dodge, Dane, Winnebago Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by Medical Associates Clinic Health Plan of Wisconsi

Though plans can vary from county to county, Medical Associates Clinic Health Plan of Wisconsi offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Medical Associates Freedom Plan (Cost) H5256-004 Grant, Crawford, Lafayette, Iowa Cost * $0.00
Medical Associates SmartPlan (Cost) H5256-001 Grant, Crawford, Lafayette, Iowa Cost * $0.00
Medical Associates Community Plan (Cost) H5256-002 Grant, Crawford, Lafayette, Iowa Cost * $0.00

Medicare Plans in Wisconsin Offered by Dean Health Plan, Inc

Though plans can vary from county to county, Dean Health Plan, Inc offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
DeanCare Gold Basic (Cost) H5264-003 Grant, Jefferson, Sauk, Columbia, Rock, Iowa, Dodge, Dane Cost * $0.00
DeanCare Gold Shared Value (Cost) H5264-005 Grant, Jefferson, Sauk, Columbia, Rock, Iowa, Dodge, Dane Cost * $0.00
DeanCare Gold Enhanced (Cost) H5264-002 Grant, Jefferson, Sauk, Columbia, Rock, Iowa, Dodge, Dane Cost * $0.00

Medicare Plans in Wisconsin Offered by Aspirus Health Plan

Though plans can vary from county to county, Aspirus Health Plan offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Elite (PPO) H6874-003 Iron, Marquette, Taylor, Shawano, Juneau, Wood, Waushara, Oneida, Columbia, Clark, Price, Florence, Portage, Marathon, Langlade, Lincoln, Adams, Forest Local PPO* $0.00
Elite Rx (PPO) H6874-002 Iron, Marquette, Taylor, Shawano, Juneau, Wood, Waushara, Oneida, Columbia, Clark, Price, Florence, Portage, Marathon, Langlade, Lincoln, Adams, Forest Local PPO $79.00
Essential Rx (PPO) H6874-001 Iron, Marquette, Taylor, Shawano, Juneau, Wood, Waushara, Oneida, Columbia, Clark, Price, Florence, Portage, Marathon, Langlade, Lincoln, Adams, Forest Local PPO $0.00

Medicare Plans in Wisconsin Offered by Quartz Medicare Advantage

Though plans can vary from county to county, Quartz Medicare Advantage offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Gundersen Quartz Med Advantage Elite (HMO) H5262-005 Crawford, Jackson, Juneau, Vernon, Monroe, La Crosse, Buffalo, Trempealeau Local HMO * $0.00
Gundersen Quartz Med Advantage Value (HMO) H5262-004 Crawford, Jackson, Juneau, Vernon, Monroe, La Crosse, Buffalo, Trempealeau Local HMO * $0.00
Aurora Health Quartz Med Advantage Value (HMO) H5262-013 Walworth, Milwaukee, Manitowoc, Brown, Waukesha, Racine, Sheboygan, Washington, Kenosha, Ozaukee, Winnebago Local HMO * $0.00
Aurora Health Quartz Med Advantage Elite (HMO) H5262-025 Walworth, Milwaukee, Manitowoc, Brown, Waukesha, Racine, Sheboygan, Washington, Kenosha, Ozaukee, Winnebago Local HMO * $40.00
UW Health Quartz Med Advantage Value (HMO) H5262-009 Richland, Marquette, Jefferson, Sauk, Columbia, Iowa, Adams, Dane Local HMO * $0.00
UW Health Quartz Med Advantage Elite (HMO) H5262-010 Richland, Marquette, Jefferson, Sauk, Columbia, Iowa, Adams, Dane Local HMO * $0.00

Medicare Plans in Wisconsin Offered by Aetna Medicare

Though plans can vary from county to county, Aetna Medicare offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Aetna Medicare Value (PPO) H5521-195 Walworth, Milwaukee, Green Lake, Kewaunee, Shawano, Manitowoc, Green, Waushara, Brown, Waukesha, Rock, Racine, Sheboygan, Calumet, Washington, Outagamie, Kenosha, Ozaukee, Winnebago Local PPO $0.00
Aetna Medicare Premier (PPO) H5521-150 Walworth, Milwaukee, Green Lake, Kewaunee, Shawano, Manitowoc, Waushara, Brown, Waukesha, Racine, Sheboygan, Calumet, Washington, Outagamie, Kenosha, Ozaukee, Winnebago Local PPO $26.00
Aetna Medicare Eagle (PPO) H5521-286 Walworth, Milwaukee, Green Lake, Kewaunee, Shawano, Manitowoc, Green, Waushara, Brown, Waukesha, Rock, Racine, Sheboygan, Calumet, Washington, Outagamie, Kenosha, Ozaukee, Winnebago Local PPO* $0.00

Medicare Plans in Wisconsin Offered by Medica

Though plans can vary from county to county, Medica offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Medica Prime Solution Focus (Cost) H2450-038 Sawyer, Douglas, Chippewa, Eau Claire, Burnett, Ashland, Pierce, Washburn, Polk, St. Croix, Dunn, Bayfield, Barron Cost * $0.00
Medica Prime Solution Thrift (Cost) H2450-030 Sawyer, Douglas, Chippewa, Eau Claire, Burnett, Ashland, Pierce, Washburn, Polk, St. Croix, Dunn, Bayfield, Barron Cost * $0.00
Medica Prime Solution Total (Cost) H2450-040 Sawyer, Douglas, Chippewa, Eau Claire, Burnett, Ashland, Pierce, Washburn, Polk, St. Croix, Dunn, Bayfield, Barron Cost * $0.00

Medicare Plans in Wisconsin Offered by UCare

Though plans can vary from county to county, UCare offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
EssentiaCare Secure (PPO) H8783-001 Douglas, Washburn, Bayfield Local PPO $35.00
EssentiaCare Grand (PPO) H8783-002 Douglas, Washburn, Bayfield Local PPO $109.00
EssentiaCare Access (PPO) H8783-003 Douglas, Washburn, Bayfield Local PPO $0.00

Medicare Plans in Wisconsin Offered by Dean Advantage, Prevea360 Medicare Advantage

Though plans can vary from county to county, Dean Advantage, Prevea360 Medicare Advantage offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Dean Advantage Assurance (HMO-POS) H9096-001 Jefferson, Sauk, Fond du Lac, Green, Columbia, Rock, Iowa, Dodge, Dane Local HMO $40.00
Dean Advantage Complete (HMO) H9096-005 Jefferson, Sauk, Fond du Lac, Green, Columbia, Rock, Iowa, Dodge, Dane Local HMO $241.00
Dean Advantage Balance (HMO-POS) H9096-002 Jefferson, Sauk, Fond du Lac, Green, Columbia, Rock, Iowa, Dodge, Dane Local HMO $82.00
Dean Advantage Essential (HMO) H9096-004 Jefferson, Sauk, Fond du Lac, Green, Columbia, Rock, Iowa, Dodge, Dane Local HMO $0.00
Dean Advantage Harmony (HMO-POS) H9096-010 Jefferson, Sauk, Fond du Lac, Green, Columbia, Rock, Iowa, Dodge, Dane Local HMO * $0.00
Prevea360 Harmony (HMO-POS) H9096-011 Kewaunee, Brown, Oconto, Sheboygan, Door Local HMO * $0.00
Prevea360 Complete (HMO-POS) H9096-009 Kewaunee, Brown, Oconto, Sheboygan, Door Local HMO $226.00
Prevea360 Essential (HMO-POS) H9096-006 Kewaunee, Brown, Oconto, Sheboygan, Door Local HMO $0.00

Medicare Plans in Wisconsin Offered by Security Health

Though plans can vary from county to county, Security Health offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Ally Rx (HMO D-SNP) H5211-010 Chippewa, Eau Claire, Taylor, Wood, Oneida, Clark, Price, Portage, Marathon, Rusk, Lincoln, Barron Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Wisconsin Offered by Group Health Cooperative of Eau Claire

Though plans can vary from county to county, Group Health Cooperative of Eau Claire offers these Medicare plans in Wisconsin.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Cooperative Advantage (HMO I-SNP) H7598-002 Chippewa, Eau Claire, Trempealeau, Barron Local HMO $40.70

Wisconsin Medicare Advantage Plans With No Additional Cost

If you decide to get Medicare Advantage in Wisconsin, you still have to pay your original Medicare Part B premium. Many WI Medicare companies offer Advantage plans that don’t cost any more than your original Medicare premium. Take a look at your options.

Zero-Cost {?{?state}} Medicare Advantage Plans

Plan Name County Preferred Pharmacy Copay/ Coinsurance 30-Day Supply MOOP for Part A & B Benefits
NetworkPrime (MSA) – H1181-001-0 Burnett, Forest, Columbia, Green, Vilas, St. Croix, Door, Kewaunee, Shawano, Ashland, Menominee, Jackson, Kenosha, Rusk, Sheboygan, Lincoln, Douglas, Juneau, Fond du Lac, Clark, Lafayette, Green Lake, Washburn, Trempealeau, Brown, Marathon, Pepin, Langlade, Vernon, Buffalo, Richland, Dane, Wood, Waupaca, Manitowoc, Waukesha, La Crosse, Iron, Winnebago, Oconto, Dodge, Marquette, Portage, Oneida, Monroe, Racine, Bayfield, Jefferson, Crawford, Taylor, Calumet, Milwaukee, Rock, Pierce, Eau Claire, Walworth, Florence, Sauk, Chippewa, Adams, Dunn, Outagamie, Grant, Washington, Sawyer, Ozaukee, Waushara, Price, Iowa, Barron, Marinette, Polk This Plan does NOT include prescription drug coverage. N/A
Secure Saver (MSA) – H4388-001-0 Burnett, Forest, Columbia, Green, Vilas, St. Croix, Door, Kewaunee, Shawano, Ashland, Menominee, Jackson, Kenosha, Rusk, Sheboygan, Lincoln, Douglas, Juneau, Fond du Lac, Clark, Lafayette, Green Lake, Washburn, Trempealeau, Brown, Marathon, Pepin, Langlade, Vernon, Buffalo, Richland, Dane, Wood, Waupaca, Manitowoc, Waukesha, La Crosse, Iron, Winnebago, Oconto, Dodge, Marquette, Portage, Oneida, Monroe, Racine, Bayfield, Jefferson, Crawford, Taylor, Calumet, Milwaukee, Rock, Pierce, Eau Claire, Walworth, Florence, Sauk, Chippewa, Adams, Dunn, Outagamie, Grant, Washington, Sawyer, Ozaukee, Waushara, Price, Iowa, Barron, Marinette, Polk This Plan does NOT include prescription drug coverage. N/A
Esteem Rx (HMO-POS) – H5211-012-0 Columbia, Vilas, Ashland, Jackson, Lincoln, Juneau, Clark, Lafayette, Trempealeau, Marathon, Pepin, Vernon, Buffalo, Richland, Dane, Wood, La Crosse, Iron, Marquette, Portage, Oneida, Monroe, Crawford, Taylor, Pierce, Sauk, Adams, Price, Iowa Preferred Generic: $6.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28%, Vaccines: $0.00 $5,000
HumanaChoice R5361-001 (Regional PPO) – R5361-001-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee This Plan does NOT include prescription drug coverage. $6,700
UnitedHealthcare Dual Complete LP1 (HMO D-SNP) – H3794-002-0 Rusk, Lincoln, Clark, Marathon, Wood, Portage, Oneida, Taylor, Eau Claire, Chippewa, Price, Barron Tier 1: 15%, Tier 2: 15%, Tier 3: 15%, Tier 4: 15%, Tier 5: 15% N/A
AARP Medicare Advantage Patriot Plan 2 (HMO-POS) – H5253-021-0 Columbia, Vilas, Ashland, Jackson, Lincoln, Juneau, Clark, Lafayette, Trempealeau, Marathon, Pepin, Vernon, Buffalo, Richland, Dane, Wood, La Crosse, Iron, Marquette, Portage, Oneida, Monroe, Crawford, Taylor, Pierce, Sauk, Adams, Price, Iowa This Plan does NOT include prescription drug coverage. $4,900
AARP Medicare Advantage Value (HMO-POS) – H5253-034-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $3.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% $4,900
Anthem MediBlue Access Core (PPO) – H4036-016-0 Douglas, Washburn, Bayfield This Plan does NOT include prescription drug coverage. $5,500
Anthem MediBlue Plus (HMO) – H9525-004-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Walworth, Washington, Ozaukee Preferred Generic: $2.00, Generic: $9.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 30%, Select Care Drugs: $0.00 $4,900
Elite (PPO) – H6874-003-0 Kewaunee, Shawano, Green Lake, Brown, Manitowoc, Winnebago, Calumet, Outagamie, Waushara This Plan does NOT include prescription drug coverage. $4,000
Essential Rx (PPO) – H6874-001-0 Rusk, Lincoln, Clark, Marathon, Wood, Portage, Oneida, Taylor, Eau Claire, Chippewa, Price, Barron Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $40.00, Non-Preferred Drug: 45%, Specialty Tier: 27% $5,900
HumanaChoice H5216-252 (PPO) – H5216-252-0 Kenosha, Sheboygan, Brown, Manitowoc, Waukesha, Winnebago, Racine, Milwaukee, Walworth, Washington, Ozaukee Preferred Generic: $6.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $4,900
HumanaChoice H5216-253 (PPO) – H5216-253-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $6.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $4,200
Anthem MediBlue Dual Advantage (HMO D-SNP) – H9525-003-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $0.00, Generic: $4.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 N/A
Molina Medicare Complete Care (HMO D-SNP) – H2879-001-0 Lafayette, Crawford, Grant, Iowa Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: 34%, Specialty Tier: 25% N/A
AARP Medicare Advantage Patriot Plan 1 (PPO) – H0294-014-0 Columbia, Vilas, Ashland, Jackson, Lincoln, Juneau, Clark, Lafayette, Trempealeau, Marathon, Pepin, Vernon, Buffalo, Richland, Dane, Wood, La Crosse, Iron, Marquette, Portage, Oneida, Monroe, Crawford, Taylor, Pierce, Sauk, Adams, Price, Iowa This Plan does NOT include prescription drug coverage. $6,700
Assurance Rx (HMO-POS) – H5211-007-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $7.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26%, Vaccines: $0.00 $6,500
Dean Advantage Essential (HMO) – H9096-004-0 Douglas, Washburn, Bayfield Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $40.00, Non-Preferred Brand: $90.00, Specialty Tier: 28%, Vaccines: $0.00 $6,500
Dean Advantage Harmony (HMO-POS) – H9096-010-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Walworth, Washington, Ozaukee This Plan does NOT include prescription drug coverage. $4,500
Humana Honor (PPO) – H5216-258-0 Sheboygan, Fond du Lac, Brown, Marathon, Waupaca, Manitowoc, Waukesha, Winnebago, Oconto, Dodge, Racine, Calumet, Milwaukee, Outagamie, Washington, Ozaukee This Plan does NOT include prescription drug coverage. $6,700
UW Health Quartz Med Advantage Core D (w/Rx) (HMO) – H5262-023-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $3.00, Generic: $15.00, Preferred Brand: $45.00, Non-Preferred Drug: 40%, Specialty Tier: 30% $5,600
UW Health Quartz Med Advantage Value (HMO) – H5262-009-0 Kenosha, Sheboygan, Brown, Waukesha, Winnebago, Racine, Milwaukee, Outagamie, Washington, Ozaukee This Plan does NOT include prescription drug coverage. $4,900
My Choice Wisconsin Medicare Dual Advantage Plan (HMO D-SNP) – H5209-004-0 Douglas, Washburn, Bayfield Tier 1: $0.00 N/A
My Choice Wisconsin Partnership Plan (HMO D-SNP) – H5209-002-0 Jackson, Juneau, Trempealeau, Vernon, Buffalo, La Crosse, Monroe, Crawford Tier 1: $0.00 N/A
Allwell Dual Medicare (HMO D-SNP) – H8189-001-0 Trempealeau, Eau Claire, Chippewa, Barron Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 29% N/A
iCare Medicare Plan (HMO D-SNP) – H2237-001-0 Lafayette, Crawford, Grant, Iowa Generic: $15.00, Brand: $45.00, Specialty Tier: 25% N/A
AARP Medicare Advantage Value (HMO) – H5253-097-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $4.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% $5,900
Aetna Medicare Eagle (PPO) – H5521-286-0 Douglas, Washburn, Bayfield This Plan does NOT include prescription drug coverage. $5,900
Aetna Medicare Value (PPO) – H5521-289-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Walworth, Washington, Ozaukee Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $4,975
Anthem MediBlue Plus (HMO) – H9525-006-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Walworth, Washington, Ozaukee Preferred Generic: $2.00, Generic: $9.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 30%, Select Care Drugs: $0.00 $4,300
Prevea360 Essential (HMO-POS) – H9096-006-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $40.00, Non-Preferred Brand: $90.00, Specialty Tier: 28%, Vaccines: $0.00 $4,500
Prevea360 Harmony (HMO-POS) – H9096-011-0 Kenosha, Sheboygan, Brown, Waukesha, Winnebago, Racine, Milwaukee, Outagamie, Washington, Ozaukee This Plan does NOT include prescription drug coverage. $4,500
AARP Medicare Advantage Walgreens (PPO) – H0294-015-0 Douglas, Washburn, Bayfield Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $4,700
Aetna Medicare Value (PPO) – H5521-283-0 Kewaunee, Shawano, Green Lake, Brown, Manitowoc, Winnebago, Calumet, Outagamie, Waushara Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $4,500
HealthPartners Robin Birch (PPO) – H4882-004-0 Kenosha, Sheboygan, Brown, Manitowoc, Waukesha, Winnebago, Racine, Milwaukee, Walworth, Washington, Ozaukee Preferred Generic: $2.00, Generic: $9.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $5,100
Humana Gold Plus H6622-001 (HMO) – H6622-001-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $6.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $4,500
Network PlatinumSelect (PPO) – H5215-008-0 Jackson, Juneau, Trempealeau, Vernon, Buffalo, La Crosse, Monroe, Crawford Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $42.00, Non-Preferred Brand: $90.00, Specialty Tier: 25% $4,900
Surety Rx (HMO-POS) – H5211-008-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $8.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26%, Vaccines: $0.00 $6,500
UnitedHealthcare Dual Complete LP (HMO D-SNP) – H5253-024-0 Kenosha, Sheboygan, Brown, Manitowoc, Waukesha, Winnebago, Racine, Milwaukee, Walworth, Washington, Ozaukee Tier 1: 15%, Tier 2: 15%, Tier 3: 15%, Tier 4: 15%, Tier 5: 15% N/A
NetworkCares (PPO D-SNP) – H5215-007-0 Kewaunee, Shawano, Sheboygan, Fond du Lac, Green Lake, Brown, Waupaca, Manitowoc, Winnebago, Oconto, Dodge, Marquette, Portage, Calumet, Outagamie, Waushara Preferred Generic: $4.00, Generic: $8.00, Preferred Brand: $42.00, Non-Preferred Brand: $90.00, Specialty Tier: 25% N/A
Gundersen Quartz Med Advantage Core D (w/Rx) (HMO) – H5262-021-0 Douglas, Washburn, Bayfield Preferred Generic: $3.00, Generic: $15.00, Preferred Brand: $45.00, Non-Preferred Drug: 40%, Specialty Tier: 30% $5,900
Aetna Medicare Value (PPO) – H5521-195-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Walworth, Washington, Ozaukee Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $4,975
Aurora Health Quartz Med Advantage Core D (w/Rx) (HMO) – H5262-012-0 Sheboygan, Fond du Lac, Brown, Marathon, Waupaca, Manitowoc, Waukesha, Winnebago, Oconto, Dodge, Racine, Calumet, Milwaukee, Outagamie, Washington, Ozaukee Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: 30%, Specialty Tier: 30% $5,900
Aurora Health Quartz Med Advantage Value (HMO) – H5262-013-0 Kenosha, Sheboygan, Brown, Manitowoc, Waukesha, Winnebago, Racine, Milwaukee, Walworth, Washington, Ozaukee This Plan does NOT include prescription drug coverage. $4,900
Humana Gold Plus H6622-034 (HMO) – H6622-034-0 Kenosha, Sheboygan, Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $6.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $4,500
Humana Gold Plus H6622-040 (HMO) – H6622-040-0 Kenosha, Sheboygan, Brown, Waukesha, Winnebago, Racine, Milwaukee, Outagamie, Washington, Ozaukee Preferred Generic: $6.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $6,700
Community Care’s Partnership Program (HMO D-SNP) – H2034-001-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Tier 1: $0.00 N/A
iCare Family Care Partnership (HMO D-SNP) – H2237-007-0 Kenosha, Dane, Racine, Milwaukee, Sauk Generic: $11.00, Brand: $46.00, Specialty Tier: 25% N/A
Ally Rx (HMO D-SNP) – H5211-010-0 Rusk, Lincoln, Clark, Marathon, Wood, Portage, Oneida, Taylor, Eau Claire, Chippewa, Price, Barron Tier 1: 15% N/A
Anthem MediBlue Access Plus (PPO) – H4036-020-0 Sheboygan, Fond du Lac, Brown, Marathon, Waupaca, Manitowoc, Waukesha, Winnebago, Oconto, Dodge, Racine, Calumet, Milwaukee, Outagamie, Washington, Ozaukee Preferred Generic: $5.00, Generic: $15.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29%, Select Care Drugs: $0.00 $4,500
AARP Medicare Advantage Value (HMO-POS) – H5253-072-0 Douglas, Washburn, Bayfield Preferred Generic: $4.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 26% $6,400
EssentiaCare Access (PPO) – H8783-003-0 Douglas, Washburn, Bayfield Preferred Generic: $3.00, Generic: $10.00, Preferred Brand: 17%, Non-Preferred Drug: 45%, Specialty Tier: 25% $5,500
AARP Medicare Advantage Value (HMO-POS) – H5253-033-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $4.00, Generic: $14.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $4,900
Network Health Medicare Go (PPO) – H5215-009-0 Waukesha, Racine, Milwaukee, Washington, Ozaukee Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $42.00, Non-Preferred Brand: $90.00, Specialty Tier: 28% $4,900

Standalone Medicare Part D Plans in Wisconsin

There is a wide variety of Medicare Part D plans available in every state, and Wisconsin is no exception. Keep in mind that plans vary by county, and don’t forget to check that your WI Medicare Advantage plan doesn’t already include Part D prescription drug coverage.

Standalone Medicare Part D Plans in Wisconsin

Plan Details Tiers
AARP MedicareRx Preferred (PDP)
S5820 – 015 – 0
by UnitedHealthcare
Monthly Premium: $92.80
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $5.00
Tier 2: $10.00
Tier 3: $45.00
Tier 4: 40%
Tier 5: 33%
AARP MedicareRx Saver Plus (PDP)
S5921 – 361 – 0
by UnitedHealthcare
Monthly Premium: $40.00
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $7.00
Tier 3: $31.00
Tier 4: 40%
Tier 5: 25%
AARP MedicareRx Walgreens (PDP)
S5921 – 397 – 0
by UnitedHealthcare
Monthly Premium: $32.00
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Anthem MediBlue Rx Enhanced (PDP)
S5596 – 080 – 0
by Anthem MediBlue Rx (PDP)
Monthly Premium: $24.60
Annual Deductible: $290
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 37%
Tier 5: 26%
Anthem MediBlue Rx Plus (PDP)
S5596 – 057 – 0
by Anthem MediBlue Rx (PDP)
Monthly Premium: $54.30
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $43.00
Tier 4: 45%
Tier 5: 33%
Anthem MediBlue Rx Standard (PDP)
S5596 – 056 – 0
by Anthem MediBlue Rx (PDP)
Monthly Premium: $54.90
Annual Deductible: $320
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $2.00
Tier 3: $30.00
Tier 4: 35%
Tier 5: 25%
Cigna Secure Rx (PDP)
S5617 – 223 – 0
by Cigna
Monthly Premium: $32.10
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $2.00
Tier 3: $30.00
Tier 4: 50%
Tier 5: 25%
Cigna Secure-Essential Rx (PDP)
S5617 – 295 – 0
by Cigna
Monthly Premium: $24.00
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 18%
Tier 4: 46%
Tier 5: 25%
Cigna Secure-Extra Rx (PDP)
S5617 – 261 – 0
by Cigna
Monthly Premium: $54.60
Annual Deductible: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $4.00
Tier 2: $10.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Clear Spring Health Premier Rx (PDP)
S6946 – 042 – 0
by Clear Spring Health
Monthly Premium: $13.60
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $40.00
Tier 4: 44%
Tier 5: 25%
Clear Spring Health Value Rx (PDP)
S6946 – 013 – 0
by Clear Spring Health
Monthly Premium: $29.30
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $42.00
Tier 4: 34%
Tier 5: 25%
Elixir RxPlus (PDP)
S7694 – 016 – 0
by Elixir Insurance
Monthly Premium: $39.10
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: 15%
Tier 4: 25%
Tier 5: 25%
Express Scripts Medicare – Choice (PDP)
S5660 – 186 – 0
by Express Scripts Medicare
Monthly Premium: $80.80
Annual Deductible: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Express Scripts Medicare – Saver (PDP)
S5660 – 232 – 0
by Express Scripts Medicare
Monthly Premium: $27.50
Annual Deductible: $285
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $35.00
Tier 4: 50%
Tier 5: 28%
Express Scripts Medicare – Value (PDP)
S5660 – 118 – 0
by Express Scripts Medicare
Monthly Premium: $31.60
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $30.00
Tier 4: 50%
Tier 5: 25%
Humana Basic Rx Plan (PDP)
S5884 – 139 – 0
by Humana
Monthly Premium: $37.90
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $1.00
Tier 3: 20%
Tier 4: 35%
Tier 5: 25%
Humana Premier Rx Plan (PDP)
S5884 – 162 – 0
by Humana
Monthly Premium: $63.30
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $45.00
Tier 4: 49%
Tier 5: 25%
Humana Walmart Value Rx Plan (PDP)
S5884 – 195 – 0
by Humana
Monthly Premium: $17.20
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: 19%
Tier 4: 35%
Tier 5: 25%
Mutual of Omaha Rx Plus (PDP)
S7126 – 015 – 0
by Mutual of Omaha Rx
Monthly Premium: $86.60
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 37%
Tier 5: 25%
Mutual of Omaha Rx Premier (PDP)
S7126 – 085 – 0
by Mutual of Omaha Rx
Monthly Premium: $24.00
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 23%
Tier 4: 46%
Tier 5: 25%
SilverScript Choice (PDP)
S5601 – 032 – 0
by Aetna Medicare
Monthly Premium: $36.00
Annual Deductible: $205
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $5.00
Tier 3: $35.00
Tier 4: 42%
Tier 5: 29%
SilverScript Plus (PDP)
S5601 – 033 – 0
by Aetna Medicare
Monthly Premium: $52.20
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $47.00
Tier 4: 50%
Tier 5: 33%
SilverScript SmartRx (PDP)
S5601 – 191 – 0
by Aetna Medicare
Monthly Premium: $7.30
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $19.00
Tier 3: $46.00
Tier 4: 46%
Tier 5: 25%
WPS MedicareRx Plan 1 (PDP)
S5753 – 006 – 0
by WPS Health Insurance
Monthly Premium: $79.30
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $3.00
Tier 2: $15.00
Tier 3: $42.00
Tier 4: 49%
Tier 5: 25%
WPS MedicareRx Plan 2 (PDP)
S5753 – 007 – 0
by WPS Health Insurance
Monthly Premium: $132.30
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $11.00
Tier 3: $42.00
Tier 4: 45%
Tier 5: 33%
WellCare Classic (PDP)
S4802 – 097 – 0
by WellCare
Monthly Premium: $33.90
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $30.00
Tier 4: 33%
Tier 5: 25%
WellCare Medicare Rx Saver (PDP)
S5810 – 050 – 0
by WellCare
Monthly Premium: $39.50
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $35.00
Tier 4: 37%
Tier 5: 25%
WellCare Medicare Rx Select (PDP)
S5810 – 290 – 0
by WellCare
Monthly Premium: $26.80
Annual Deductible: $300
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $47.00
Tier 4: 42%
Tier 5: 27%
WellCare Medicare Rx Value Plus (PDP)
S5768 – 139 – 0
by WellCare
Monthly Premium: $76.10
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $47.00
Tier 4: 45%
Tier 5: 33%
WellCare Value Script (PDP)
S4802 – 132 – 0
by WellCare
Monthly Premium: $14.80
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $43.00
Tier 4: 47%
Tier 5: 25%
WellCare Wellness Rx (PDP)
S4802 – 185 – 0
by WellCare
Monthly Premium: $14.60
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $7.00
Tier 3: $43.00
Tier 4: 47%
Tier 5: 25%

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