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Guide to Medicare Advantage Plans in Washington County, WI for 2025

There are 33 Medicare Advantage plans available in Washington County, WI for the 2025 plan year, including 22 plans with $0 premiums. Most plans include prescription drug coverage. These counts exclude Special Needs Plans.

Not in Washington County? Enter your ZIP code to see plans in your area.

Washington County, Wisconsin Medicare Advantage Plans

Plan Name Type Premium MOOP Rx Ded. Rating
Network Health Anywhere* PPO $0 $3,800 $300
☆☆☆☆☆
Network Health Bravo* PPO $0 $4,500 N/A
☆☆☆☆☆
Network Health Go* PPO $0 $3,900 $320
☆☆☆☆☆
Aetna Medicare Eagle* PPO $0 $4,900 N/A
☆☆☆☆☆
Aetna Medicare Enhanced Select* PPO $166 $1,500 $590
☆☆☆☆☆
Aetna Medicare Gold* PPO $57 $5,500 $590
☆☆☆☆☆
Aetna Medicare Premier* PPO $16 $4,500 $0
☆☆☆☆☆
Aetna Medicare SmartFit* PPO $0 $4,700 $590
☆☆☆☆☆
Aetna Medicare Value* PPO $0 $4,500 $590
☆☆☆☆☆
Aetna Medicare Value Plus* PPO $29 $5,500 $590
☆☆☆☆☆
AARP Medicare Advantage CareFlex from UHC WI-18 HMO-POS $0 $6,700 $495
☆☆☆☆☆
AARP Medicare Advantage from UHC WI-0010 HMO-POS $34 $3,800 $340
☆☆☆☆☆
AARP Medicare Advantage from UHC WI-0013 HMO-POS $0 $4,900 $340
☆☆☆☆☆
AARP Medicare Advantage Patriot No Rx WI-MA02 HMO-POS $0 $6,700 N/A
☆☆☆☆☆
Anthem Medicare Advantage PPO $0 $4,700 $195
☆☆☆☆☆
Anthem Medicare Advantage 3 PPO $39 $4,500 $120
☆☆☆☆☆
Anthem Veteran PPO $0 $6,751 N/A
☆☆☆☆☆
Humana Gold Choice H8145-006 PFFS $38 $7,000 $590
☆☆☆☆☆
Anthem Medicare Advantage HMO-POS $0 $4,300 $150
☆☆☆☆☆
Humana Full Access H5216-410 PPO $0 $5,000 $350
☆☆☆☆☆
Humana Gold Plus H6622-001 HMO $0 $4,150 $250
☆☆☆☆☆
Humana USAA Honor Giveback PPO $0 $5,500 N/A
☆☆☆☆☆
Humana USAA Honor Giveback PPO $0 $5,500 N/A
☆☆☆☆☆
Humana USAA Honor Giveback Regional PPO $0 $6,750 N/A
☆☆☆☆☆
Humana USAA Honor Giveback with Rx PPO $0 $5,500 $250
☆☆☆☆☆
Humana Value Plus H5216-173 PPO $39 $9,350 $590
☆☆☆☆☆
HumanaChoice H5216-001 PPO $82 $4,150 $590
☆☆☆☆☆
HumanaChoice H5216-253 PPO $0 $4,200 $250
☆☆☆☆☆
HumanaChoice R5361-002 Regional PPO $104 $7,200 $590
☆☆☆☆☆
AARP Medicare Advantage from UHC WI-0002 PPO $55 $6,700 $495
☆☆☆☆☆
AARP Medicare Advantage from UHC WI-0009 PPO $0 $6,700 $420
☆☆☆☆☆
Aetna Medicare Premier HMO-POS $0 $4,900 $590
☆☆☆☆☆
Network Health Prime MSA $0 $Not Applicable N/A
☆☆☆☆☆
**Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages.
📊 At a Glance: Medicare Advantage in Washington County
Average Monthly Premium
$19.97
Plans with $0 Premium
22
Average MOOP Limit
$5,258 ($9,350 max. in 2025)
Average Rx Deductible
$407.00
Plans Without Drug Coverage
4 (standalone Wisconsin Part D plans)
Plans with 5-Star Ratings
There are 3 5-star plans.
Stars  Ratings (Plan Mix)
4+ Stars: 54% · 3 Stars: 46% · Below 3: 0%
Plans Available
33 (excluding Washington County SNP plans)
Plan Type Breakdown
22 PPO · 6 HMO-POS · 1 PFFS · 1 HMO · 2 REGIONAL PPO · 1 MSA
Countywide Enrollments
16,824 (excluding SNP plans)
Top 3 Plans by Enrollment
1. AARP Medicare Advantage from UHC WI-0010 (HMO-POS) — 6,833 enrollees
2. AARP Medicare Advantage from UHC WI-0013 (HMO-POS) — 2,518 enrollees
3. Network Health Go (PPO) — 1,635 enrollees

Data Sources: CY2025 Landscape, PBP Benefits, Star Ratings Data, Monthly Enrollment by CPSC, and SimpleMaps U.S. Counties. Enrollment data last updated . County demographic data last updated .

Understanding Your Medicare Advantage Options

Medicare Advantage Plans, also known as Medicare Part C, are private health plans that provide all-in-one coverage, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). On top of the core benefits, many of the plans in Washington County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Washington County looking for something more than Original Medicare.

🏥 Health Maintenance Organization (HMO) Plans

HMO plan members must use the plan's network of doctors and hospitals in Washington County, and typically need a referral to see a specialist. Some Medicare Advantage HMO Plans may have lower costs but offer less flexibility in choosing healthcare providers. There are 942 residents enrolled in HMO plans in this county. The most popular plan is Humana Gold Plus H6622-001 .

🔓 Preferred Provider Organization (PPO)

A PPO allows more flexibility in choosing healthcare providers, with the option to see specialists without referrals, though often at a higher cost. Medicare Advantage PPOs usually have higher premiums and out-of-pocket expenses. There are 5,330 Washington County residents enrolled in PPO plans. The most popular of these plans by enrollments is Network Health Go .

🪟 Private Fee-for-Service (PFFS)

Allows members to visit any Medicare-approved doctor or hospital in their area that accepts the plan's payment terms. Medicare PFFS plans offer more flexibility but may result in higher costs. There are 49 Washington County residents enrolled in PFFS plans. The most popular of these plans by enrollments is Humana Gold Choice H8145-006 .

🔀 Health Maintenance Organization Point of Sale (HMO-POS)

Medicare HMO-POS plans are a type of HMO that offers a little more flexibility. Like a regular HMO, you typically use the plan's network of doctors and hospitals for care, usually requiring a referral to see specialists. However, an HMO-POS plan lets you receive certain healthcare services outside of the network at a higher cost. There are 10,462 residents enrolled in HMO-POS plans in this Washington County. The most popular plan by enrollments is AARP Medicare Advantage from UHC WI-0010 .

  • Medicare Savings Account (MSA): This plan pairs a high-deductible Medicare Advantage plan with a savings account that the plan funds. You can use the money in the savings account to pay for healthcare expenses before meeting your deductible. Any unused funds roll over year to year, offering a way to manage healthcare costs with greater flexibility.

    • Advantages of Enrolling in Medicare Advantage

    Many Medicare Advantage Plans offer extra benefits that go beyond Original Medicare, making them an attractive option for some people. These plans provide comprehensive coverage, often including additional services like prescription drug coverage, dental, vision, and wellness programs, all bundled into one plan. By choosing a Medicare Advantage Plan, you can simplify your healthcare and potentially save on costs.

    Take a look at the main benefits provided by Medicare Advantage Plans in Washington County:

    🧑‍⚕️Coordinated Care

    Plans often include care coordination services, which help you manage your healthcare across different providers and services.

    💸 Cost Savings

    Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.

    🧾 Comprehensive Coverage

    Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.

    🧘 Wellness Programs

    Many Yavapai County plans offer free gym memberships, wellness programs, and preventive care services. You need to stay healthy, right?

    Tips for Selecting a Medicare Advantage Plan

    When it comes to selecting from the 33 Medicare Advantage Plans available in Washington County, it’s important to focus on these critical factors:

    🏥1. Provider Network

    Confirm that your doctors and preferred healthcare facilities are in the plan's network to avoid out-of-network charges.

    💊 2. Prescription Drug Coverage

    Review the plan's drug coverage to ensure it meets your needs, particularly for any specialty medications.

    💰 3. Costs

    Compare the overall costs, including premiums, copayments, and maximum out-of-pocket expenses, to find a plan that fits within your budget.

    🎁 4. Additional Benefits

    Determine which additional benefits are offered and how they align with your personal health and wellness needs.

    ⭐ 5. Plan Ratings

    Research the plan’s star ratings to understand its effectiveness, quality of care, and member satisfaction.

    Find out how to effectively compare Medicare Advantage Plans and make an informed choice.

    Medicare Advantage Enrollment Periods

    Making sense of Medicare Advantage enrollment periods can seem overwhelming, but it's worth the effort for better health coverage. Missing these key dates could delay your coverage or limit your plan choices for 2025 in Washington County.

    📅 Initial Enrollment Period (IEP)

    This is your first opportunity to enroll in a Medicare Advantage Plan when you first become eligible for Medicare. Your Initial Enrollment Period lasts for seven months, starting three months before your 65th birthday.

    🗓️ Annual Enrollment Period (AEP)

    Occurs every year from October 15 to December 7. During the Annual Enrollment Period, you can switch, drop, or join a Medicare Advantage Plan.

    🔁 Open Enrollment Period (OEP)

    From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare if you’re already enrolled in a Medicare Advantage Plan.

    For more detailed information on the enrollment periods and how to enroll, visit our comprehensive guide on Medicare Advantage Plan Enrollment.

    Frequently Asked Questions

    What are the most popular Medicare Advantage plan types in Washington County?

    Based on the 2025 plan data, PPO plans are the most common in Washington County. The full breakdown of plan types is: 22 PPO · 6 HMO-POS · 1 PFFS · 1 HMO · 2 REGIONAL PPO · 1 MSA.

    How much can I expect to pay out of pocket for Medicare Advantage plans?

    The average maximum out-of-pocket limit (MOOP) in Washington County is $5,258 for 2025.

    Do any Medicare Advantage plans in Washington County have 5-star ratings?

    There are 3 5-star rated Medicare Advantage plans in Washington County, and 54% of all plans have a rating of 4 stars or higher.

    What is the average monthly premium for Medicare Advantage plans in Washington County?

    The average monthly premium for Medicare Advantage plans in Washington County is $19.97. A total of 22 offer $0 premiums, though costs vary by plan type and benefits.

    More About These Plans

    Carrier Plans Offered

    Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

    Master Plan Pages by Plan ID

    The plan pages listed in the table above have been modified for localization to help consumers identify plans available in their area. Most plans are available in multiple areas. The following list of plan IDs link to each plan's master page.

    Plan Availability

    The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Allenton, Colgate, Germantown, Hartford, Hubertus, Jackson, Kewaskum, Richfield, Slinger, West Bend, and all other areas of Washington County, Wisconsin, including the following zip codes: 53002, 53010, 53012, 53017, 53021, 53022, 53027, 53029, 53033, 53037, 53040, 53060, 53066, 53075, 53076, 53086, 53090, 53091, 53095.

    Citations & References