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The 2023 Medicare Advantage Plans in Outagamie County WI.
2022 Outagamie County Wisconsin
Medicare Advantage Plans
There are 44 Medicare Advantage Plans available in Outagamie County WI from 9 different health insurance providers. 13 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $1200 and the highest out of pocket is $7550. Outagamie County Wisconsin residents can also pick from 15 Medicare Special Needs Plans. The best Medicare Advantage plan in Outagamie County Wisconsin received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars.
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Ozaukee County Medicare Advantage
Medicare Advantage Health Plans Without Drug Coverage
| Plan Name ⇅ | Premium | Type | MOOP | Overall Rating |
|---|---|---|---|---|
| AARP Medicare Advantage Patriot Plan 2 (HMO-POS) (H5253-021) | $0 | Local HMO * | $4,900 | |
| Aetna Medicare Eagle (PPO) (H5521-286) | $0 | Local PPO * | $5,500 | |
| Anthem MediBlue Service (PPO) (H4036-024) | $0 | Local PPO * | $6,700 | |
| Aurora Health Quartz Med Advantage Elite (HMO) (H5262-025) | $40.00 | Local HMO * | $3,900 | |
| Aurora Health Quartz Med Advantage Value (HMO) (H5262-013) | $0 | Local HMO * | $4,400 | |
| Essence (HMO-POS) (H5211-003) | $18.00 | Local HMO * | $3,400 | |
| Humana Honor (PPO) (H5216-258) | $0 | Local PPO * | $5,900 | |
| HumanaChoice R5361-001 (Regional PPO) (R5361-001) | $0 | Regional PPO * | $6,700 | |
| Network PlatinumPlus (PPO) (H5215-001) | $51.00 | Local PPO * | $3,400 | |
| Network PlatinumPremier (PPO) (H5215-006) | $177.00 | Local PPO * | $3,400 | |
| NetworkPrime (MSA) (H1181-001) | MSA * | $- | NA | |
| Secure Saver (MSA) (H4388-001) | MSA * | $- | NA | |
| Spirit (HMO-POS) (H5211-001) | $150.00 | Local HMO * | $1,200 |
2022 Medicare Special Needs Plans in Outagamie county Wisconsin
| Plan Name ⇅ | Monthly Premium |
Part D Deductible |
Gap | Special Needs Type |
Overall Rating |
|---|---|---|---|---|---|
| Anthem MediBlue Dual Advantage (HMO D-SNP) | $40.50 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Anthem MediBlue Dual Connect (HMO D-SNP) | $41.90 | $480.0 | Some Generics | Dual-Eligible | |
| Community Cares Partnership Program (HMO D-SNP) | $42.30 | $480.0 | No Gap Coverage | Dual-Eligible | NA |
| Humana Together in Health I-SNP (HMO I-SNP) | $24.40 | $410.0 | No Gap Coverage | Institutional | |
| Humana Together in Health IE-SNP (HMO I-SNP) | $24.40 | $410.0 | No Gap Coverage | Institutional | |
| iCare Medicare Plan (HMO D-SNP) | $42.30 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Molina Medicare Complete Care (HMO D-SNP) | $42.30 | $480.0 | No Gap Coverage | Dual-Eligible | |
| My Choice Wisconsin Medicare Dual Advantage Plan (HMO D-S | $30.50 | $480.0 | No Gap Coverage | Dual-Eligible | |
| NetworkCares (PPO D-SNP) | $42.30 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Assisted Living Plan (HMO-POS I-SNP) | $42.30 | $200.0 | No Gap Coverage | Institutional | |
| UnitedHealthcare Dual Complete LP (HMO D-SNP) | $38.90 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Dual Complete LP1 (HMO D-SNP) | $42.30 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Medicare Advantage Assist (PPO C-SNP) | $14.00 | $300.0 | Some Generics | Chronic or Disabling Condition | |
| UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) | $42.30 | $480.0 | No Gap Coverage | Institutional | |
| Wellcare Dual Access (HMO D-SNP) | $35.70 | $480.0 | Some Generics | Dual-Eligible |
Plan Type Is the type of organization offering the Medicare Plan.
- HMO - Health Maintenance Organization
- PPO - Preferred Provider Organization
- PDP - Prescription Drug Plan
- SNP - Special Needs Plan
- POS - Point of Service
- PFFS - Private Fee For Service
Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.
Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.
Benefit Type- (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
- (DS) Defined Standard Benefit
- (BA) Basic Alternative
- (AE) Actuarially Equivalent Standard
GAP
- Many - Many Generics and Some Brands
- Some - Some Generics and Few Brands
Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable
Source: CMS.
Data as of September 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.