Medicare Advantage Plans for Sheboygan County, Wisconsin

  • 57 Total Plans
  • 26,942 Seniors Eligible for Medicare
  • 15,390 Seniors on Medicare Advantage (57%)
  • 7 plans with 842 seniors have enough OTC benefit to fully cover MDHearing hearing aids
  • 35 plans with 13,321 seniors have OTC benefits that partially cover MDHearing hearing aids
  • 53% of seniors can partially or fully cover OTC hearing aids from MDHearing (if their plan has MDHearing hearing aids)
OTC Supplemental Benefits Prescription Hearing Aid Coverage
Company Plan name Plan type OTC Supplement OTC Rolls Over? Annual OTC Supplement Coverage? Covered Amount Covers OTC Aids? Coinsurance? Copay? Prior Authorization? Need Referral? Wisconsin Enrollees
UnitedHealthcare AARP Medicare Advantage (HMO-POS)
H5253-011-0 		HMOPOS $40 per Quarter No $160 Yes Yes No Yes Yes No 3,183
UnitedHealthcare AARP Medicare Advantage Walgreens (PPO)
H0294-015-0 		Local PPO $40 per Quarter No $160 Yes Yes No Yes Yes No 2,557
Network Health Medicare Advantage Plans Network PlatinumSelect (PPO)
H5215-008-0 		Local PPO $0 per Month No $0 Yes No No Yes No No 2,343
UnitedHealthcare UnitedHealthcare Dual Complete LP1 (HMO-POS D-SNP)
H3794-002-0 		HMOPOS $189 per Month No $0 Yes $2,500 Yes No Yes Yes No 690
UnitedHealthcare AARP Medicare Advantage Value (HMO-POS)
H5253-034-0 		HMOPOS $40 per Quarter No $160 Yes Yes No Yes Yes No 683
Network Health Medicare Advantage Plans Network PlatinumChoice (PPO)
H5215-011-0 		Local PPO $75 per Quarter No $300 Yes No No Yes No No 675
Humana Humana Gold Plus H6622-034 (HMO)
H6622-034-0 		HMO $100 per Quarter Yes $400 Yes $1,500 No No Yes No No 517
UnitedHealthcare AARP Medicare Advantage Patriot Plan 2 (HMO-POS)
H5253-021-0 		HMOPOS $60 per Quarter No $240 Yes Yes No Yes Yes No 385
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-816-0 		Local PPO No $0 No 290
UnitedHealthcare UnitedHealthcare Dual Complete LP (HMO-POS D-SNP)
H5253-024-0 		HMOPOS $174 per Month No $0 Yes $2,500 Yes No Yes Yes No 281
Anthem Blue Cross and Blue Shield Anthem MediBlue Plus (HMO)
H9525-006-0 		HMO $65 per Quarter Yes $260 Yes $3,000 Yes No Yes Yes No 258
Humana HumanaChoice H5216-253 (PPO)
H5216-253-0 		Local PPO $45 per Quarter Yes $180 Yes No No Yes No No 254
Aetna Medicare Aetna Medicare Value (PPO)
H5521-195-0 		Local PPO $105 per Quarter No $420 Yes $1,500 No No Yes No No 234
Anthem Blue Cross and Blue Shield Anthem MediBlue Dual Advantage (HMO D-SNP)
H9525-003-0 		HMO $175 per Month No $0 Yes $3,000 Yes No Yes Yes No 197
Humana Humana Medicare Employer (PPO)
H5216-805-0 		Local PPO No $0 No 175
Network Health Medicare Advantage Plans Network PlatinumPlus Pharmacy (PPO)
H5215-002-0 		Local PPO $225 per Quarter No $900 Yes No No Yes No No 163
Anthem Blue Cross and Blue Shield Anthem MediBlue Access Plus (PPO)
H4036-020-0 		Local PPO $35 per Quarter Yes $140 Yes $1,500 Yes No Yes Yes No 152
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-150-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 146
Network Health Medicare Advantage Plans Network Health Medicare Advantage PlatinumZero (PPO)
H5215-012-0 		Local PPO $0 per Month No $0 Yes No No Yes No No 136
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-826-0 		Local PPO No $0 No 134
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-817-0 		Local PPO No $0 No 119
Quartz Medicare Advantage Aurora Health Quartz Med Advantage Core D (w/Rx) (HMO)
H5262-012-0 		HMO $75 per Quarter No $300 Yes $1,500 Yes No No No No 109
UnitedHealthcare UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP)
H5253-007-0 		HMOPOS $300 per Quarter Yes $1,200 Yes $2,000 Yes No Yes Yes No 103
Humana HumanaChoice H5216-252 (PPO)
H5216-252-0 		Local PPO $30 per Quarter Yes $120 Yes No No Yes No No 102
Anthem Blue Cross and Blue Shield Anthem MediBlue Access (PPO)
H4036-008-0 		Local PPO $44 per Quarter Yes $176 Yes $3,000 Yes No Yes Yes No 91
Network Health Medicare Advantage Plans NetworkCares (PPO D-SNP)
H5215-007-0 		Local PPO $175 per Quarter No $700 Yes No No Yes No No 88
iCare iCare Medicare Plan (HMO D-SNP)
H2237-001-0 		HMO $1,800 per Month No $0 Yes No No Yes No No 85
UnitedHealthcare UnitedHealthcare Medicare Advantage Assist (PPO C-SNP)
H0294-002-0 		Local PPO $40 per Month No $0 Yes Yes No Yes Yes No 81
Humana HumanaChoice H5216-001 (PPO)
H5216-001-0 		Local PPO $50 per Quarter No $200 Yes No No Yes No No 79
Aetna Medicare Aetna Medicare Plan (PPO)
H5521-801-0 		Local PPO No $0 No 71
UnitedHealthcare UnitedHealthcare Assisted Living Plan (HMO-POS I-SNP)
H5253-064-0 		HMOPOS $375 per Quarter Yes $1,500 Yes $2,000 Yes No Yes Yes No 70
Dean Advantage Prevea360 Essential (HMO-POS)
H9096-006-0 		HMOPOS $50 per Quarter No $200 Yes $750 No No No No No 67
Network Health Medicare Advantage Plans NetworkPrime (MSA)
H1181-001-0 		MSA No $0 No 61
Wellcare by Allwell Wellcare Dual Access (HMO D-SNP)
H8189-001-0 		HMO $220 per Month Yes $0 Yes $5,000 No No Yes Yes No 59
Quartz Medicare Advantage Aurora Health Quartz Med Advantage Elite D (w/Rx) (HMO)
H5262-024-0 		HMO $75 per Quarter No $300 Yes $2,500 Yes No No No No 51
Quartz Medicare Advantage Aurora Health Quartz Med Advantage Value D (w/Rx) (HMO)
H5262-011-0 		HMO $75 per Quarter No $300 Yes $2,000 Yes No No No No 47
UnitedHealthcare AARP Medicare Advantage Open Plan 1 (PPO)
H0294-004-0 		Local PPO No $0 Yes Yes No Yes Yes No 45
Humana Humana Medicare Employer (PPO)
H5216-806-0 		Local PPO No $0 No 42
Network Health Medicare Advantage Plans Network PlatinumPlus (PPO)
H5215-001-0 		Local PPO $225 per Quarter No $900 Yes No No Yes No No 41
Network Health Medicare Advantage Plans Network PlatinumPremier Pharmacy (PPO)
H5215-005-0 		Local PPO $225 per Quarter No $900 Yes $75 No No Yes No No 39
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-837-0 		Local PPO No $0 No 38
Humana Humana Medicare Employer (PPO)
H7617-801-0 		Local PPO No $0 No 36
Anthem Blue Cross and Blue Shield Anthem MediBlue Service (PPO)
H4036-024-0 		Local PPO $75 per Quarter Yes $300 Yes $2,000 Yes No Yes Yes No 34
Humana Humana Honor (Regional PPO)
R5361-001-0 		Regional PPO $50 per Quarter Yes $200 Yes No No Yes No No 32
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-870-0 		Local PPO No $0 No 30
Aetna Medicare Aetna Medicare Eagle (PPO)
H5521-286-0 		Local PPO $120 per Quarter No $480 Yes $3,000 No No Yes No No 28
Aetna Medicare Aetna Medicare Plan w/Rx (PPO)
H5521-802-0 		Local PPO No $0 No 28
Humana Humana Honor (PPO)
H5216-258-0 		Local PPO $100 per Quarter Yes $400 Yes No No Yes No No 18
Anthem Blue Cross and Blue Shield Anthem Medicare Preferred (PPO)
H4036-801-0 		Local PPO No $0 No 17
Network Health Medicare Advantage Plans Network Health Armor (PPO)
H5215-013-0 		Local PPO $100 per Quarter No $400 Yes No No Yes No No 16
Aetna Medicare Aetna Medicare Plan w/Rx $75 Buy-Down (PPO)
H5521-812-0 		Local PPO No $0 No 15
Blue Cross Blue Shield of Michigan Medicare Plus Blue PPO Employer CY (PPO)
H9572-802-0 		Local PPO No $0 No 15
Humana Humana Gold Choice H8145-006 (PFFS)
H8145-006-0 		PFFS $175 per Quarter Yes $700 Yes No No Yes No No 15
Humana Humana Honor (PPO)
H5216-355-0 		Local PPO $60 per Quarter Yes $240 Yes No No Yes No No 15
UnitedHealthcare UnitedHealthcare Dual Complete Choice (PPO D-SNP)
H0294-027-0 		Local PPO $164 per Month No $0 Yes $2,500 Yes No Yes Yes No 14
Humana Humana Value Plus H5216-173 (PPO)
H5216-173-0 		Local PPO $50 per Quarter Yes $200 Yes No No Yes No No 13
Quartz Medicare Advantage Aurora Health Quartz Med Advantage Value (HMO)
H5262-013-0 		HMO $75 per Quarter No $300 Yes $2,000 Yes No No No No 12
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