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Medicare Advantage Plans in Shawano County, Wisconsin

Below are Medicare Advantage plans available to residents of Shawano county, Wisconsin. 7 carriers offer 26 plans throughout the county of Shawano. Residents may choose plans from carriers such as Anthem Blue Cross and Blue Shield, Security Health Plan of Wisconsin Inc. and Network Platinum Medicare Advantage Plans. This data has been made available by the Centers for Medicare & Medicaid Services (CMS) and is for informational purposes only. Some data may be inaccurate or incomplete. Please note that plans can vary by city, county, and state and all plans listed may not be available in all areas. To speak to an advisor and find the Medicare Advantage plan in Shawano county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Shawano

Carrier	Plan Title	Plan Type
Anthem Blue Cross and Blue Shield	Anthem Medicare Preferred Select (PPO) (H4036-003)	Local Preferred Provider Organization
Premium and Other Important Information Package: 1 - Preventive Dental Package: Package: 2 - Comprehensive Dental and Vision Package: Package: 3 - Combination Package: $12 monthly premium in addition to your $36 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental $30 monthly premium in addition to your $36 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear $43 monthly premium in addition to your $36 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compre $3 400 out-of-pocket limit. All plan services included. $36 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits. $15 to $20 copay for each primary care doctor visit $30 copay for each specialist visit
Anthem Blue Cross and Blue Shield	Anthem Medicare Preferred Core (PPO) (H4036-004)	Local Preferred Provider Organization
Premium and Other Important Information Package: 1 - Preventive Dental Package: Package: 2 - Comprehensive Dental and Vision Package: Package: 3 - Combination Package: $12 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental $30 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear $43 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compreh $4 500 out-of-pocket limit. All plan services included. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $45 copay for each in-area network urgent care Medicare-covered visit $45 copay for each specialist visit for Medicare-covered benefits. $35 to $45 copay for each primary care doctor visit $50 copay for each specialist visit
Security Health Plan of Wisconsin Inc.	Advocare Spirit (HMO-POS) (H5211-001)	HMO with POS Option
Premium and Other Important Information $900 out-of-pocket limit. All plan services included. $5 000 annual deductible. Contact the plan for services that apply. $5 000 out-of-pocket limit. All plan services included. $118.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $20 copay for each specialist visit for Medicare-covered benefits.
Security Health Plan of Wisconsin Inc.	Advocare Essence Rx (HMO-POS) (H5211-002)	HMO with POS Option
Premium and Other Important Information $3 400 out-of-pocket limit. All plan services included. $5 000 annual deductible. Contact the plan for services that apply. $5 000 out-of-pocket limit. All plan services included. $39 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $20 copay for each specialist visit for Medicare-covered benefits.
Security Health Plan of Wisconsin Inc.	Advocare Essence (HMO-POS) (H5211-003)	HMO with POS Option
Premium and Other Important Information $3 400 out-of-pocket limit. All plan services included. $5 000 annual deductible. Contact the plan for services that apply. $5 000 out-of-pocket limit. All plan services included. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $20 copay for each specialist visit for Medicare-covered benefits.
Security Health Plan of Wisconsin Inc.	Advocare Spirit Rx (HMO-POS) (H5211-004)	HMO with POS Option
Premium and Other Important Information $900 out-of-pocket limit. All plan services included. $5 000 annual deductible. Contact the plan for services that apply. $5 000 out-of-pocket limit. All plan services included. $167 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $20 copay for each specialist visit for Medicare-covered benefits.
Security Health Plan of Wisconsin Inc.	Advocare Vitality Rx (HMO-POS) (H5211-005)	HMO with POS Option
Premium and Other Important Information In this plan you will have no cost sharing responsibility for Medicare-covered services and Non-Medicare Supplemental Services. $5 000 annual deductible. Contact the plan for services that apply. $5 000 out-of-pocket limit. All plan services included. $254 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $0 copay for each specialist doctor visit for Medicare-covered benefits.
Security Health Plan of Wisconsin Inc.	Advocare Vitality (HMO-POS) (H5211-006)	HMO with POS Option
Premium and Other Important Information In this plan you will have no cost sharing responsibility for Medicare-covered services and Non-Medicare Supplemental Services. $5 000 annual deductible. Contact the plan for services that apply. $5 000 out-of-pocket limit. All plan services included. $192.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $0 copay for each specialist doctor visit for Medicare-covered benefits.
Network Platinum Medicare Advantage Plans	Network PlatinumPlus (PPO) (H5215-001)	Local Preferred Provider Organization
Premium and Other Important Information $2 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $2 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $36.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Network Platinum Medicare Advantage Plans	Network PlatinumPlus Pharmacy (PPO) (H5215-002)	Local Preferred Provider Organization
Premium and Other Important Information $2 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $2 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $74 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Network Platinum Medicare Advantage Plans	Network PlatinumPremier Pharmacy (PPO) (H5215-005)	Local Preferred Provider Organization
Premium and Other Important Information $2 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $2 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $135 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $15 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $25 copay for each specialist visit
Network Platinum Medicare Advantage Plans	Network PlatinumPremier (PPO) (H5215-006)	Local Preferred Provider Organization
Premium and Other Important Information $2 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $2 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $77.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. $0 copay for the cost of each in-area network urgent care Medicare-covered visit. $15 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $25 copay for each specialist visit
Network Platinum Medicare Advantage Plans	Network PlatinumSelect (PPO) (H5215-008)	Local Preferred Provider Organization
Premium and Other Important Information $2 900 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $2 900 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $15 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Humana Insurance Company	HumanaChoice H5216-003 (PPO) (H5216-003)	Local Preferred Provider Organization
Premium and Other Important Information $4 500 out-of-pocket limit for Medicare-covered services. $6 000 out-of-pocket limit for Medicare-covered services. $41 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $35 copay for each primary care doctor visit $35 copay for each specialist visit
UnitedHealthcare	UnitedHealthcare Nursing Home Plan (HMO-POS SNP) (H5253-007)	HMO with POS Option
Premium and Other Important Information $5 000 out-of-pocket limit for Medicare-covered services. $35.3 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $0 copay for each primary care doctor visit for Medicare-covered benefits. 20% of the cost for each in-area network urgent care Medicare-covered visit 0% to 20% of the cost for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	AARP MedicareComplete Plus (HMO-POS) (H5253-011)	HMO with POS Option
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits.
UnitedHealthcare	UnitedHealthcare Dual Complete LP (HMO SNP) (H5253-024)	HMO
Premium and Other Important Information * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply. ** Please consult with your plan about cost sharing when receiving services from out-of-network providers. $6 700 out-of-pocket limit for Medicare-covered services.* $36.7 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.* 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit* 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Universal American Corp.	Today's Options Advantage Plus 450B (PPO) (H5378-183)	Local Preferred Provider Organization
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $36 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $25 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $50 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $60 copay for each specialist visit
Universal American Corp.	Today's Options Advantage Plus 250A (PPO) (H5378-199)	Local Preferred Provider Organization
Premium and Other Important Information $3 250 out-of-pocket limit for Medicare-covered services. $52 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $5 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $10 copay for each primary care doctor visit $40 copay for each specialist visit
Universal American Corp.	Today's Options Premier 400 (PFFS) (H6169-012)	Private Fee for Service
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $20.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $25 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $50 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $60 copay for each specialist visit
Universal American Corp.	Today's Options Premier Plus 450B (PFFS) (H6169-032)	Private Fee for Service
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $59 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $25 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $50 copay for each specialist visit for Medicare-covered benefits. $30 copay for each primary care doctor visit $60 copay for each specialist visit
Universal American Corp.	Today's Options Premier 200 (PFFS) (H6169-050)	Private Fee for Service
Premium and Other Important Information $3 250 out-of-pocket limit for Medicare-covered services. $50.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $5 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $10 copay for each primary care doctor visit $40 copay for each specialist visit
Universal American Corp.	Today's Options Premier Plus 250A (PFFS) (H6169-054)	Private Fee for Service
Premium and Other Important Information $3 250 out-of-pocket limit for Medicare-covered services. $112 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $5 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $10 copay for each primary care doctor visit $40 copay for each specialist visit
Humana WisconsinHealth Organization Insurance Corp	Humana Gold Plus H6622-001 (HMO-POS) (H6622-001)	HMO with POS Option
Premium and Other Important Information Package: 1 - MyOption Vision: Package: 2 - MyOption Enhanced Dental HMO: $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear $35 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $290 plan coverage limit every year for these benefits. $3 400 out-of-pocket limit for Medicare-covered services. $0 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Doctor Office Visits Authorization rules may apply. $10 copay for each primary care doctor visit for Medicare-covered benefits. $20 copay for each in-area network urgent care Medicare-covered visit $20 [or 20% of the cost] for each specialist visit for Medicare-covered benefits.
Humana Insurance Company	Humana Gold Choice H8145-006 (PFFS) (H8145-006)	Private Fee for Service
Premium and Other Important Information Package: 1 - MyOption Dental High PPO: Package: 2 - MyOption Dental Low PPO: Package: 3 - MyOption Vision: Package: 4 - MyOption Plus: $31 monthly premium in addition to your $61 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $19 monthly premium in addition to your $61 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $15 monthly premium in addition to your $61 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear $30 monthly premium in addition to your $61 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear $1 500 plan coverage limit every year for these benefits. $1 000 plan coverage limit every year for these benefits. $290 plan coverage limit every year for these benefits. $6 000 out-of-pocket limit for Medicare-covered services. $61 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $15 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $35 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $35 copay for each specialist visit
Humana Insurance Company	Humana Gold Choice H8145-121 (PFFS) (H8145-121)	Private Fee for Service
Premium and Other Important Information Package: 1 - MyOption Dental High PPO: Package: 2 - MyOption Dental Low PPO: $31 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $19 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental $1 500 plan coverage limit every year for these benefits. $1 000 plan coverage limit every year for these benefits. $5 000 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. 15% of the cost for each primary care doctor visit for Medicare-covered benefits. 15% of the cost for each in-area network urgent care Medicare-covered visit 15% of the cost for each specialist visit for Medicare-covered benefits. 20% of the cost for each primary care doctor visit 20% of the cost for each specialist visit

Wisconsin Plan Data by County

• Adams, WI Medicare Advantage Plans
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Wisconsin Plan Data by City

• Green Bay, WI Medicare Advantage Plans

• Madison, WI Medicare Advantage Plans