bestMedicare AdvantageWisconsinMoneyGeek utilized the Centers for Medicare & Medicaid Services (CMS) five-star quality rating system to find the widely available and highest-rated Medicare Advantage plans in Wisconsin. We found the best plans based on type, with or without prescription drug coverage and maximum-out-of-pocket (MOOP) limits.
Our findings are generalized recommendations. The best way to find the Medicare Advantage plan in Wisconsin that’s most suitable for your needs and includes your local hospitals and providers within the network is to shop around.
bestMedicare AdvantageWisconsinBest Medicare Advantage Plans in Wisconsin
Best plan overall - AARP
Best HMO plan - Quartz Health Plan MN Corporation
Best plan without drug coverage - Quartz Health Plan MN Corporation
Best plan for low out-of-pocket costs - Aetna Medicare
Best Medicare Advantage Plan in Wisconsin - Overall
The best Medicare Advantage plan in Wisconsin depends on a person’s needs and situation. For people looking for a preferred provider organization (PPO) plan with drug coverage, six common core benefits and a high star rating from the CMS, MoneyGeek recommends AARP Medicare Advantage Open Plan 1 by UnitedHealthcare as the top choice.
A PPO health insurance plan gives you access to a broader network of doctors, hospitals and treatment centers. Also, you do not need a referral when seeing specialists with a PPO Medicare Advantage plan in Wisconsin. However, a PPO does have a higher premium.
AARP
Based on MoneyGeek’s research, AARP Medicare Advantage Open Plan 1 is the best PPO plan in Wisconsin. Its planholders can expect:
- Monthly premium of approximately $47
- Enhanced drug coverage with a deductible of $325
- In-network max-out-of-pocket limit of $5,900 a year
- CMS rating of 5 out of 5
AARP Medicare Advantage Open Plan 1 has the six core benefits: vision, dental, hearing, fitness, worldwide emergency and telehealth. It has the highest rating from CMS and offers Part D drug coverage. It’s also ideal for frequent travelers due to its worldwide emergency benefit.
Still, the best Medicare Advantage PPO plan in Wisconsin depends on your medical needs and financial situation.
Best HMO Medicare Advantage Plan in Wisconsin
Your situation and medical needs ultimately decide the best health maintenance organization (HMO) Medicare Advantage plan for you.
If you’re looking for an HMO plan in Wisconsin with drug coverage, the six core benefits and a high star rating from the CMS, Quartz Medicare Advantage’s Aurora Health Quartz Med Advantage Core D (w/Rx) is MoneyGeek’s top choice.
An HMO is the most common and cheapest type of health insurance plan in the market. However, it requires you to stay within your provider’s network (except in an emergency) to guarantee coverage, and you must obtain a referral to visit a specialist.
Nonetheless, an HMO’s affordable premium makes it an excellent choice if in-network providers are easily accessible to you.
Quartz Health Plan MN Corporation
MoneyGeek’s study shows that Aurora Health Quartz Med Advantage Core D (w/Rx) is an excellent option for an HMO in Wisconsin. Its features include:
- No monthly premium
- Enhanced drug coverage with a deductible of $150
- In-network MOOP limit of $4,900 a year
- CMS rating of 5 out of 5
Aurora Health Quartz Med Advantage Core D (w/Rx) provides the six core benefits of vision, dental, hearing, fitness, worldwide emergency and telehealth. Plus, it has over-the-counter drug and transportation benefits. It also offers Part D drug coverage and has a perfect rating from the CMS.
In spite of those merits, your health and financial situation determine which Medicare Advantage HMO plan in Wisconsin best suits you.
Best Medicare Advantage Plan in Wisconsin Without Drug Coverage
People that don’t require Part D drug coverage have more health insurance options in Wisconsin.
Aurora Health Quartz Med Advantage Value from Quartz Medicare Advantage is the best Medicare Advantage plan in Wisconsin, according to MoneyGeek’s research, for people that only want the six core benefits and a high star rating from the CMS and don’t need prescription drug coverage.
Quartz Health Plan MN Corporation
MoneyGeek ranks Aurora Health Quartz Med Advantage Value as the best choice in Wisconsin for people that don’t need drug coverage in their Medicare Advantage plan. It has the following features:
- No monthly premium
- An in-network max-out-of-pocket limit of $4,400 a year
- A CMS overall star rating of 5 out of 5
Although Aurora Health Quartz Med Advantage Value doesn’t have drug coverage, it provides common benefits like vision, dental, hearing, fitness, worldwide emergency and telehealth. Planholders also get over-the-counter drug and transportation benefits. It also has a high rating from the CMS.
Best Medicare Advantage Plan in Wisconsin for Low Max Out-of-Pocket Costs
While many Medicare Advantage plans in Wisconsin offer a low or zero monthly premium, you may still pay thousands of dollars a year due to out-of-pocket costs. A low MOOP limit plan can help you avoid that.
For the best Wisconsin Medicare Advantage plan with a low in-network MOOP limit that includes drug coverage, six core benefits and a high star rating from the CMS, MoneyGeek’s research recommends Aetna Medicare Value offered by Aetna Medicare.
Aetna Medicare
In Wisconsin, Aetna Medicare Value may be the best option for a Medicare Advantage plan whether you need drug coverage or not. MoneyGeek removed plans with high MOOP limits in this analysis. With Aetna Medicare Value, you can expect:
- No monthly premium
- In-network MOOP limit of $4,500 a year
- A CMS overall star rating of 4.5 out of 5
A low max-out-of-pocket limit plan can help keep your costs to a minimum if you have substantial medical needs in a given year. Aetna Medicare Value pays for in-network coverage once you reach the MOOP limit of $4,500. Because it’s a PPO plan, it has a different MOOP for out-of-network coverage at $8,500.
Medicare Advantage Plan in Wisconsin - Statistics
In Wisconsin, there are 15 healthcare organizations that offer Medicare Advantage plans. MoneyGeek sourced relevant Medicare Advantage statistics in Wisconsin to help people figure out whether plan components are rare or common.
1
Wisconsin Medicare Advantage Plans are a mix of PPO, HMO, Cost, MSA and PFFS, with 62.1% offering drug coverage
Medicare Advantage plans in Wisconsin are 43.8% preferred provider organization (PPO) plans and 40.5% health maintenance organizations (HMO) plans. Cost, medical savings account (MSA) and private fee-for-service (PFFS) plans make up the remaining plans. In Wisconsin, 62.1% of plans have drug coverage.
2
36% of Medicare Advantage plans in Wisconsin have a $0 premium
In Wisconsin, 36% of Medicare Advantage plans in the market have a $0 premium. Those that require a premium payment have an average cost of $86.70 per month.
3
Hearing, worldwide emergency and telehealth benefits are common in Wisconsin, with most plans offering them
The most common benefits from Medicare Advantage plans in Wisconsin are hearing, worldwide emergency and telehealth. All plans offer hearing, while 95% include telehealth and worldwide emergency. In-home support, home safety devices and modifications and emergency response device are the rarest Medicare Advantage benefits in Wisconsin.
Methodology
MoneyGeek collected data from the Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files released in October 2021. Plans in Wisconsin were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of Wisconsin based on county availability.
About Mark Fitzpatrick
