Security Health Plan of Wisconsin, Inc. Spirit (HMO-POS) Medicare Advantage Plan H5211-001 • 2026 • Brown County, WI

Security Health Plan of Wisconsin, Inc. Spirit Overview

Plan Overview for Security Health Plan of Wisconsin, Inc. Spirit

This Medicare Advantage HMO-POS plan provides Medicare Part A and Part B coverage through a network of participating providers, with limited coverage available for out-of-network services in certain situations. The monthly premium is $0.00, and costs are generally lower when services are received from in-network providers.

Primary care visits have a $0 copay | Out-of-network: $0 copay, 0% coinsurance, specialist visits come with a $25 copay | Out-of-network: $25 copay, urgent care services carry a $0-$25 copay, and ambulance transportation is $175 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $1500.00. After this limit is reached, in-network services are fully covered for the remainder of the year.

This plan is registered with CMS under Plan ID H5211-001. Cost-sharing details for key services are provided below.

Cost-Sharing Overview

Security Health Plan of Wisconsin, Inc. Spirit includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The table below outlines the most common in-network out-of-pocket costs associated with plan H5211-001.

Certain preventive services are covered 100% by Security Health Plan of Wisconsin, Inc. Spirit as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS Star Ratings

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.