Medicare Advantage Plans in Wisconsin 2026
Last reviewed: June 2026 · Data sourced from CMS.gov
Wisconsin has about 41 percent of Medicare beneficiaries in Advantage plans. Milwaukee and Madison have the most competitive markets. Dean Health Plan, Security Health Plan, and national carriers like UnitedHealthcare and Humana all operate here.
Plan availability varies by county. Enter your ZIP code to see the exact plans, premiums, and coverage available where you live in Wisconsin.
What to Look for in a Wisconsin Medicare Advantage Plan
- ✓ Whether your current doctors and specialists are in-network
- ✓ Drug formulary — does it cover your prescriptions at a reasonable cost?
- ✓ Monthly premium and annual out-of-pocket maximum
- ✓ Extra benefits: dental, vision, hearing, fitness programs
- ✓ Star rating — CMS rates plans from 1 to 5 stars based on quality and member experience
- ✓ HMO vs. PPO — HMOs require referrals and restrict out-of-network care; PPOs are more flexible
2026 Medicare Advantage Costs in Wisconsin
| Cost | Typical Range |
|---|---|
| Monthly premium | $0 to $50 (many plans at $0) |
| Annual out-of-pocket maximum | Up to $9,350 in-network (2026 CMS limit) |
| Primary care visit copay | $0 to $20 typical |
| Specialist visit copay | $20 to $50 typical |
| Inpatient hospital stay | $250 to $350/day for first few days (varies by plan) |
| Part B premium (always required) | $202.90/month standard (2026) |
Medicare Advantage vs. Medigap in Wisconsin
Wisconsin does not use the federal A through N Medigap plan structure. Instead, the state offers its own Basic plan with optional riders covering things like at-home recovery, foreign travel emergencies, and skilled nursing coinsurance. A Wisconsin-licensed agent can help you build out the right combination of riders.