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.Medicare Advantage Plans
Medicare Advantage plans are alternative insurance plans from private carriers that replace 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 offers 11 to 25.
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.
While a zero-dollar premium reduces monthly expenses, it typically incurs higher out-of-pocket costs before your insurance provider pays the full amount. Be mindful when selecting a Part C plan to get the most savings. Dean Advantage (HMO-POS) offers a five-star rating of $4,500 maximum out-of-pocket cost (MOOP) per year. It’s 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 |
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.
and Security Health are both HMO-POS plans. 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 |
| $27 | $4,200 | HMO-POS | 5 | |
| Security Health | $229 | $1,200 | HMO-POS | 4 |
You may get a Special Enrollment Period to switch plans if you have a five-star plan option in your area. The following 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 Dean Advantage (HMO) plan also features a zero-dollar monthly premium but a $6,500 MOOP.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| Quartz Medicare | $0 | $4,400 | HMO | 5 |
| $0 | $4,900 | HMO-POS | 5 | |
| Dean Advantage | $0 | $6,500 | HMO | 5 |
Wisconsin Medicare Advantage plans vary between locations, so 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, reducing Part B expenses by $25 per month. In addition, it boasts a five-star rating.
Anthem BCBS reduces Part B by $50 monthly and has a MOOP of $6,700, and Humana offers no star rating but includes a $5,500 maximum out-of-pocket cost. Wisconsinites get a $35 monthly reduction of Part B expenses 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 |
| $0 | $4,900 | $30 | 5 | |
| Humana | $0 | $5,900 | $35 |
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 or vision insurance. Note that not all carriers offer the same benefits.
Estimated Premiums for Medicare Advantage programs for the listed cities can be viewed using the charts provided in the link below:
Medicare Part C is available in Wisconsin. Patients have a total of 110 plans available in the entire state. Top insurance companies include Humana, Aetna, Dean Advantage, and .
You can drop your Medicare Part C 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.
Yes, getting a Medicare Advantage coverage denial in Wisconsin is possible. 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.
The most widely accepted Medicare plan in Wisconsin is from Aetna. This four-star plan features high rankings from multiple insurance companies and healthcare organizations.
Four types of Wisconsin plans include:
These plans have specific requirements; 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.
When you need help enrolling in a Medicare Part C 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.
Written By:
Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications 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.
Reviewed By:Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.
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