2026 Medicare Advantage Plans in Eau Claire County, WI
Last update: . Enrollment data updated: June 13, 2026
For 2026, Eau Claire County, WI includes 16 Medicare Advantage plans. Enrollment across these plans totals approximately 6,106, with 11 $0 premium options and 64% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Eau Claire County, WI are summarized separately. Visit Medicare Options in Eau Claire County, WI to see more options.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in how members access care.
- Total PPO Plans
- 6
- Average Monthly Premium
- $25.00/mo
- Total PPO Enrollment
- 408
- $0 Premium PPO Plans
- 4
- Average MOOP
- $6,983
- Top PPO by Enrollment
- Humana USAA Honor Giveback (PPO) — 128 enrollees
- PPO Plans Without Drug Coverage
- 4
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Humana USAA Honor Giveback | $0 | $6,000 | N/A | H7617-022-0 | |
| HumanaChoice H7617-007 | $47 | $9,250 | $615 | H7617-007-0 | |
| AARP Medicare Advantage Patriot No Rx WI-MA01 | $0 | $6,700 | N/A | H0294-014-0 | |
| Humana USAA Honor Giveback | $0 | $6,000 | N/A | H5216-355-0 | |
| Humana USAA Honor Giveback | $0 | $6,750 | N/A | R5361-001-0 | |
| HumanaChoice R5361-002 | $103 | $7,200 | $615 | R5361-002-0 |
- What is the average monthly premium for PPO plans in Eau Claire?
- PPO plans in Eau Claire cost $25.00 per month on average.
- Which PPO plan has the highest enrollment in Eau Claire?
- The most popular PPO plan in Eau Claire is Humana USAA Honor Giveback (PPO), with 128 enrollees.
- How many PPO plans in Eau Claire do not include prescription drug coverage?
- 4 PPO plans in Eau Claire do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans are built around a defined network of doctors and hospitals. Care is generally covered only within the network, except in emergencies, but this structure often results in lower premiums and out-of-pocket costs.
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Cooperative Medicare Advantage | $0 | $6,000 | $275 | H7598-004-0 |
What is the total number of HMO plans offered in Eau Claire?
There are 1 HMO plans in 2026, covering 18 enrollees.
How much do HMO plans cost in Eau Claire?
The average HMO premium in Eau Claire is $0.00 per month, with 1 plans offering $0 premiums.
What is the top HMO by enrollment in Eau Claire?
Cooperative Medicare Advantage (HMO) is the top HMO in Eau Claire, with 18 enrollees.
What is the number of HMO plans without Part D coverage in Eau Claire?
0 HMO plans in Eau Claire do not include prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, while allowing limited out-of-network access at higher cost. This provides added flexibility compared with standard HMO plans.
- Total HMO-POS Plans
- 7
- Average Monthly Premium
- $50.86/mo
- Total HMO-POS Enrollment
- 5,387
- $0 Premium HMO-POS Plans
- 5
- Average MOOP
- $4,186
- Top HMO-POS by Enrollment
- Esteem Rx (HMO-POS) — 2,346 enrollees
- HMO-POS Plans Without Drug Coverage
- 3
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Security Health Plan of Wisconsin, Inc. Compass | $0 | $3,400 | N/A | H5211-003-0 | |
| Essence Rx | $87 | $3,800 | $330 | H5211-002-0 | |
| Esteem Rx | $0 | $5,000 | $250 | H5211-012-0 | |
| Legacy Rx | $269 | $2,200 | $0 | H5211-004-0 | |
| Security Health Plan of Wisconsin, Inc. Spirit | $0 | $1,500 | N/A | H5211-001-0 | |
| AARP Medicare Advantage from UHC WI-0015 | $0 | $6,700 | $520 | H5253-072-0 | |
| AARP Medicare Advantage Patriot No Rx WI-MA02 | $0 | $6,700 | N/A | H5253-021-0 |
What is the average monthly premium for HMO-POS plans?
HMO-POS plans in Eau Claire cost $50.86 per month on average.
Which HMO-POS plan is most popular in Eau Claire?
The most popular HMO-POS plan in Eau Claire is Esteem Rx (HMO-POS), with 2,346 enrollees.
How many HMO-POS plans in Eau Claire do not include drug coverage?
There are 3 HMO-POS plans in Eau Claire without prescription drug coverage.
Medicare Advantage PFFS Plans
Private Fee-for-Service (PFFS) plans allow members to visit any Medicare-approved provider that accepts the plan’s payment terms. This provides flexibility in choosing doctors and hospitals, but provider acceptance should be confirmed before receiving care.
- Total PFFS Plans 1
- Average Monthly Premium $37.00/mo
- Total PFFS Enrollment 278
- $0 Premium PFFS Plans 0
- Average MOOP $6,800
- Top PFFS by Enrollment Humana Gold Choice H8145-006 (PFFS) — 278 enrollees
- PFFS Plans Without Drug Coverage 0
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-006 | $37 | $6,800 | $615 | H8145-006-0 |
What is the top PFFS plan in Eau Claire?
Humana Gold Choice H8145-006 (PFFS) is the top PFFS in Eau Claire, with 278 enrollees.
What is the number of PFFS plans without Part D coverage in Eau Claire?
0 PFFS plans in Eau Claire do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Eau Claire County, WI (2026) are summarized below.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 9 | 64% |
| 3 Stars | 5 | 36% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 2 | 13% |
| Average Rating | 4 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
- CMS.gov, Medicare Advantage Landscape Source Files — Last accessed June 13, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed June 13, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed June 13, 2026
All plan counts, enrollment totals, averages, and percentage distributions are calculated at the county level using CMS data and include standard Medicare Advantage (MA/MAPD) plans only, based on a consistent aggregation methodology.
Data sources and methodology documentation .
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
MedicarePlans.com is an independent informational resource and has no affiliation with, or endorsement from, the U.S. Government or the federal Medicare program.
Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard .
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.