More Wisconsin residents choose Medicare Advantage plans as they become aware of the incredible benefits. There are 515,314 beneficiaries with Medicare Advantage in the state. The majority of enrollees live in Milwaukee.

With various coverage options, it’s essential to know how specific Medicare Advantage plans will affect you and understand which benefits you get.

Wisconsin Medicare Advantage Plans

Medicare Advantage plans are alternative insurance plans from private carriers that take the place of Original Medicare. These plans cover medical expenses and more. Some offer prescription drug coverage, but plan details vary among carriers.

Most Wisconsin counties feature between 26 and 39 plans, while several counties offer 11 to 25 plans.

Medicare Advantage Plans Offers in Wisconsin

Unlike Medigap plans, the government doesn’t standardize Medicare Advantage plans. Instead, Wisconsin Medicare Advantage plans are different per carrier and state. In addition, costs and benefits will vary in different zip codes.

The following sections will detail popular Wisconsin Medicare Advantage plans, some with zero-dollar premiums, zero-dollar deductibles, five-star ratings, and Part B reductions.

Medicare Advantage Plans with a Zero Dollar Premium in Wisconsin

While a zero-dollar premium reduces monthly expenses, it typically incurs higher out-of-pocket costs before your insurance provider pays the full amount. When selecting a Part C plan to get the most savings, be mindful of this.

Dean Advantage (HMO-POS) offers a five-star rating with a $4,500 maximum out-of-pocket cost (MOOP) per year. It is essential to remember that you must still pay the Part B premium with this option.

Aetna (Local PPO) features a four-star rating for its balance of performance and affordability. Beneficiaries enrolled in this plan have a low MOOP of $5,500.

Wisconsin patients choose Quartz Advantage (HMO) for its excellent five-star coverage, including meal delivery after hospital stays. There is a $0 monthly premium and a low MOOP of $4,400.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Dean Advantage $0 $4,500 HMO-POS 5
Anthem BCBS $0 $6,700 LOCAL PPO 4
Quartz Advantage $0 $4,400 HMO 5
Humana $0 $6,700 REGIONAL PPO 4
Aetna $0 $5,500 LOCAL PPO 4

Medicare Advantage Plans with a Zero Dollar Drug Deductible in Wisconsin

Oppositely, Wisconsin Medicare Advantage plans with a zero-dollar drug deductible will have higher premiums. There’s also no wait before your carrier covers your expenses.

Aetna offers two Local PPO plans, one with no premium and a $4,500 MOOP, and another with a $16 premium and a $3,900 maximum out-of-pocket cost. Both feature four-star ratings.

UnitedHealthcare and Security Health are both HMO-POS plans. UnitedHealthcare’s five-star plan incurs a $27 monthly premium and a $4,200 MOOP. Security Health costs $229 monthly with an impressively low $1,200 maximum out-of-pocket.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Aetna $0 $4,500 LOCAL PPO 4
Aetna $16 $3,900 LOCAL PPO 4
UnitedHealthcare $27 $4,200 HMOPOS 5
Security Health $229 $1,200 HMOPOS 4

Medicare Advantage Plans with a 5-Star Rating in Wisconsin

You may get a Special Enrollment Period to switch plans if you have a five-star plan option in your area. The next plans feature five-star ratings for overall performance and value.

The Quartz Medicare (HMO) plan is the least expensive. It features a zero-dollar premium and a $4,400 max out-of-pocket cost.

You’ll pay no premium for UnitedHealthcare (HMO-POS). The maximum yearly out-of-pocket cost is $4,900. Another plan from Dean Advantage (HMO) also features a zero-dollar monthly premium but has a $6,500 MOOP.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Quartz Medicare $0 $4,400 HMO 5
UnitedHealthcare $0 $4,900 HMOPOS 5
Dean Advantage $0 $6,500 HMO 5

Medicare Advantage Plans with a Part B Reduction in Wisconsin

As Wisconsin Medicare Advantage plans vary between locations, your zip code may not offer a Part B reduction. In addition, the zip codes with Part B premium reduction benefits may not all offer the same reduction amount.

The following plans feature a zero-dollar premium, but maximum out-of-pocket costs and reductions vary. Dean Advantage features a $4,500 maximum out-of-pocket and reduces Part B expenses by $25 per month. In addition, it boasts a five-star rating.

Anthem BCBS reduces Part B by $50 every month and has a MOOP of $6,700. Humana offers no star rating but includes a $5,500 maximum out-of-pocket cost. Wisconsinites get a $35 reduction of Part B expenses every month with this plan.

PLAN PREMIUM MOOP PART B REDUCTION STAR RATINGS
Dean Advantage $0 $4,500 $25 5
Anthem BCBS $0 $6,700 $50 4
Aetna $0 $5,500 $35 4
UnitedHealthcare $0 $4,900 $30 5
Humana $0 $5,900 $35

Ancillary/DVH

Many Medicare Advantage plans offer extra benefits that Medigap and Original Medicare don’t provide. You can easily find a carrier offering Medicare Advantage with prescription drug coverage, dental insurance, or vision insurance. Note that not all carriers provide the same benefits.

FAQs

Is Medicare Advantage available in Wisconsin?

Medicare Advantage, or Medicare Part C, is available in Wisconsin. Patients have a total of 110 plans available in the entire state. Top carriers include Humana, Aetna, Dean Advantage, and UnitedHealthcare.

Can I drop my Medicare Advantage plan and go back to Original Medicare in Wisconsin?

Yes, you can drop your Medicare Advantage plan to switch to Original Medicare in Wisconsin. You must switch during specific enrollment periods.

Three windows occur at different points: your one-time birthday enrollment window, an annual application window, and a period for special enrollment.

Can you be denied a Medicare Advantage plan in Wisconsin?

Yes, it’s possible to get a Medicare Advantage coverage denial in Wisconsin. Your carrier may deny coverage if you receive unnecessary medical treatments or use an out-of-network doctor.

Some insurance providers require approval before paying for specific treatments. They could deny coverage if you received treatment during clinical trials without consent. By following all plan rules, you will avoid coverage denial.

What is the most widely accepted Medicare Advantage plan in Wisconsin?

The most widely accepted Medicare Advantage plan in Wisconsin is from Aetna. This four-star plan features high rankings from multiple insurance companies and healthcare organizations.

What are four types of Medicare Advantage plans in Wisconsin?

Four types of Wisconsin plans include:

  • PPO plans
  • HMO
  • PFFS
  • SNPs

These plans have specific requirements, and some may limit you to in-network medical facilities and providers. Special Needs Plans include coverage suitable for those with special needs and chronic conditions.

How to Get Help Enrolling in a Wisconsin Medicare Advantage Plan

When you need help enrolling in a Medicare Advantage or Medigap plan in Wisconsin, our agents can help. We have current information on supplemental Medicare plans in your area, so you don’t have to spend hours comparing plans.

We compare the top Wisconsin Medicare Advantage plans to help you find one that fits your budget and healthcare needs.

Call us today for assistance enrolling in Wisconsin. Or fill out our online rate form to get the best rates in your area.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.