2026 Medicare Advantage Plans in Outagamie County, WI
Last update: . Enrollment data updated: May 2, 2026
Outagamie County, WI has 40 Medicare Advantage plans available in 2026. These include 26 plans with no monthly premium, and roughly 61% are rated at least 4 stars based on CMS data.
Medicare Advantage Special Needs Plans (SNPs) are not included in the figures shown above. View Special Needs Plans in Outagamie County, WI. Or explore all Medicare Options available in Outagamie County, WI.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow access to both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in choosing doctors and hospitals.
- Total PPO Plans 26
- Average Monthly Premium $27.58/mo
- Total PPO Enrollment 20,333
- $0 Premium PPO Plans 18
- Average MOOP $5,366
- Top PPO by Enrollment Network Health Select (PPO) — 6,760 enrollees
- PPO Plans Without Drug Coverage 7
What is the most popular PPO plan in Outagamie?
Network Health Select (PPO) is the top PPO in Outagamie, with 6,760 enrollees.
What is the number of PPO plans without Part D coverage in Outagamie?
There are 7 PPO plans in Outagamie without prescription drug coverage.
Medicare Advantage HMO Plans
HMO plans typically require members to use in-network providers and facilities, except in emergencies. In return, HMOs often offer lower monthly premiums and reduced cost-sharing.
- Total HMO Plans
- 1
- Average Monthly Premium
- $0.00/mo
- Total HMO Enrollment
- 1,883
- $0 Premium HMO Plans
- 1
- Average MOOP
- $4,200
- Top HMO by Enrollment
- Humana Gold Plus H6622-001 (HMO) — 1,883 enrollees
- HMO Plans Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Humana Gold Plus H6622-001 | $0 | $4,200 | $615 | H6622-001-0 |
What is the typical premium for HMO plans in Outagamie?
HMO plans in Outagamie cost $0.00 per month on average.
Which HMO plan do most beneficiaries choose in Outagamie?
The most popular HMO plan in Outagamie is Humana Gold Plus H6622-001 (HMO), with 1,883 enrollees.
How many HMO options are offered without prescription drug coverage in Outagamie?
There are 0 HMO plans in Outagamie without prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine HMO network requirements with limited out-of-network access. Care outside the network typically costs more, but HMO-POS plans provide added flexibility compared with standard HMOs.
- Total HMO-POS Plans 10
- Average Monthly Premium $45.40/mo
- Total HMO-POS Enrollment 3,502
- $0 Premium HMO-POS Plans 6
- Average MOOP $4,310
- Top HMO-POS by Enrollment AARP Medicare Advantage from UHC WI-0014 (HMO-POS) — 1,340 enrollees
- HMO-POS Plans Without Drug Coverage 3
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan 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 CareFlex from UHC WI-18 | $0 | $6,700 | $600 | H5253-198-0 | |
| AARP Medicare Advantage from UHC WI-0011 | $59 | $4,100 | $440 | H5253-011-0 | |
| AARP Medicare Advantage from UHC WI-0014 | $0 | $5,400 | $520 | H5253-034-0 | |
| AARP Medicare Advantage Patriot No Rx WI-MA02 | $0 | $6,700 | N/A | H5253-021-0 | |
| Anthem Medicare Advantage | $39 | $4,300 | $350 | H9525-006-0 |
What is the total number of HMO-POS plans in Outagamie?
In 2026, Outagamie has 10 HMO-POS plans with 3,502 enrollees.
How much do HMO-POS plans cost in Outagamie?
The typical HMO-POS premium in Outagamie is $45.40, and 6 plans have no monthly premium.
Medicare Advantage PFFS Plans
PFFS plans allow members to visit any Medicare-approved provider who accepts the plan’s payment terms. This offers broader choice than network-based plans, but coverage depends on provider participation, so acceptance should be confirmed in advance.
- Total PFFS Plans
- 1
- Average Monthly Premium
- $37.00/mo
- Total PFFS Enrollment
- 47
- $0 Premium PFFS Plans
- 0
- Average MOOP
- $6,800
- Top PFFS by Enrollment
- Humana Gold Choice H8145-006 (PFFS) — 47 enrollees
- PFFS Plans Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-006 | $37 | $6,800 | $615 | H8145-006-0 |
- What is the average monthly premium for PFFS plans?
- PFFS plans in Outagamie cost $37.00 per month on average.
- Which PFFS plan is most popular in Outagamie?
- The most popular PFFS plan in Outagamie is Humana Gold Choice H8145-006 (PFFS), with 47 enrollees.
- How many PFFS plans in Outagamie do not include drug coverage?
- There are 0 PFFS plans in Outagamie without prescription drug coverage.
Below is a breakdown of CMS star ratings for Medicare Advantage plans available in Outagamie County, WI for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 22 | 61% |
| 3 Stars | 14 | 39% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 3 | 8% |
| Average Rating | 4 | |
* Medicare Advantage star ratings are determined by CMS each year using a standardized 5-star rating system.
- CMS.gov, Medicare Advantage Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed May 2, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed May 2, 2026
County-level figures shown on this page, including plan counts, enrollment totals, averages, and percentage distributions, reflect standard Medicare Advantage (MA/MAPD) plans only and are derived from CMS datasets using a standardized aggregation methodology.
Data sources and methodology documentation .
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 25 May, 2025
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Data provenance documentation is maintained in alignment 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.