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2027 Medicare Advantage Plans in Waukesha County, WI

Last update: .

For 2027, Waukesha County, WI includes 33 Medicare Advantage plans. Enrollment across these plans totals approximately 48,556, with 23 $0 premium options and 83% rated 4 stars or higher.

At a Glance

This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Waukesha County, WI are summarized separately. Visit Medicare Options in Waukesha County, WI to see more options. For a broader perspective, explore Wisconsin Medicare Advantage plans, including statewide premiums, out-of-pocket costs, CMS ratings, and enrollment comparisons.

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
22
Average Monthly Premium
$18.65/mo
Total PPO Enrollment
17,516
$0 Premium PPO Plans
16
Average MOOP
$5,934
Top PPO by Enrollment
Network Health Anywhere (PPO) — 7,005 enrollees
PPO Plans Without Drug Coverage
6

2027 PPO Medicare Advantage plans in Waukesha County, Wisconsin (comparison chart)
PPO Plan Name Rating* Premium MOOP Rx Ded. Plan-ID
Anthem Medicare Advantage 3
☆☆☆☆☆
 $84 $7,150 $595 H4036-008-0
Anthem Veteran
☆☆☆☆☆
 $0 $6,751 N/A H4036-024-0
Humana Essentials Plus Giveback
☆☆☆☆☆
 $0 $5,250 $700 H7617-011-0
Humana Full Access
☆☆☆☆☆
 $0 $6,100 $700 H7617-020-0
Humana USAA Honor Giveback
☆☆☆☆☆
 $0 $6,000 N/A H7617-022-0
Aetna Medicare Eagle
☆☆☆☆☆
 $0 $5,200 N/A H5521-286-0
Aetna Medicare Enhanced
☆☆☆☆☆
 $40 $5,000 $700 H5521-150-0
Aetna Medicare Signature
☆☆☆☆☆
 $0 $5,500 $700 H5521-195-0
Aetna Medicare Signature Extra
☆☆☆☆☆
 $0 $5,500 $500 H5521-403-0
Aetna Medicare Value Care
☆☆☆☆☆
 $0 $6,350 $400 H5521-400-0
Humana Full Access
☆☆☆☆☆
 $0 $6,400 $700 H5216-410-0
Humana USAA Honor Giveback
☆☆☆☆☆
 $0 $6,000 N/A H5216-355-0
Humana Value Choice
☆☆☆☆☆
 $0 $4,450 $700 H5216-253-0
Humana Value Plus H5216-173
☆☆☆☆☆
 $6 $9,850 $700 H5216-173-0
HumanaChoice Giveback H5216-252
☆☆☆☆☆
 $0 $5,250 $700 H5216-252-0
HumanaChoice H5216-001
☆☆☆☆☆
 $94 $4,200 $700 H5216-001-0
Network Health Anywhere
☆☆☆☆☆
 $0 $4,500 $320 H5215-010-0
Network Health Bravo
☆☆☆☆☆
 $0 $4,500 N/A H5215-014-0
Network Health Go
☆☆☆☆☆
 $0 $5,000 $340 H5215-009-0
Humana USAA Honor Giveback
☆☆☆☆☆
 $0 $6,750 N/A R5361-001-0
HumanaChoice R5361-002
☆☆☆☆☆
 $87 $7,700 $700 R5361-002-0
AARP Medicare Advantage from UHC WI-0002
☆☆☆☆☆
 $99 $7,150 $685 H0294-004-0

What is the average monthly premium for PPO plans in Waukesha?

PPO plans in Waukesha cost $18.65 per month on average.

Which PPO plan has the highest enrollment in Waukesha?

The most popular PPO plan in Waukesha is Network Health Anywhere (PPO), with 7,005 enrollees.

How many PPO plans in Waukesha do not include prescription drug coverage?

6 PPO plans in Waukesha do not include prescription drug coverage.

Medicare Advantage HMO Plans

Health Maintenance Organization (HMO) plans generally require members to use in-network doctors, hospitals, and other providers, except in emergencies. Because of this structure, HMOs often have lower premiums and out-of-pocket costs than other plan types.

  • Total HMO Plans 1
  • Average Monthly Premium $0.00/mo
  • Total HMO Enrollment 2,471
  • $0 Premium HMO Plans 1
  • Average MOOP $4,200
  • Top HMO by Enrollment Humana Total Complete (HMO) — 2,471 enrollees
  • HMO Plans Without Drug Coverage 0

2027 HMO Medicare Advantage plans in Waukesha County, Wisconsin (comparison chart)
Plan Name Rating* Premium MOOP Rx Ded. Plan-ID
Humana Total Complete
☆☆☆☆☆
 $0 $4,200 $500 H6622-001-0
What is the top HMO by enrollment in Waukesha?

Humana Total Complete (HMO) is the top HMO in Waukesha, with 2,471 enrollees.

What is the number of HMO plans without Part D coverage in Waukesha?

0 HMO plans in Waukesha 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
6
Average Monthly Premium
$9.50/mo
Total HMO-POS Enrollment
28,340
$0 Premium HMO-POS Plans
5
Average MOOP
$5,825
Top HMO-POS by Enrollment
AARP Medicare Advantage from UHC WI-0010 (HMO-POS) — 18,530 enrollees
HMO-POS Plans Without Drug Coverage
1

2027 HMO-POS Medicare Advantage plans in Waukesha County, Wisconsin (comparison chart)
Plan Name Rating* Premium MOOP Rx Ded. Plan-ID
AARP Medicare Advantage Essentials from UHC WI-13
☆☆☆☆☆
 $0 $5,400 $685 H5253-033-0
AARP Medicare Advantage Extras from UHC WI-19
☆☆☆☆☆
 $0 $7,150 $685 H5253-199-0
AARP Medicare Advantage from UHC WI-0010
☆☆☆☆☆
 $57 $4,450 $685 H5253-004-0
AARP Medicare Advantage Patriot No Rx WI-MA02
☆☆☆☆☆
 $0 $7,150 N/A H5253-021-0
Aetna Medicare Signature
☆☆☆☆☆
 $0 $5,900 $400 H1206-002-0
Anthem Medicare Advantage
☆☆☆☆☆
 $0 $4,900 $450 H9525-004-0

What is the typical premium for HMO-POS plans in Waukesha?

HMO-POS plans in Waukesha cost $9.50 per month on average.

Which HMO-POS plan has the most members in Waukesha?

The most popular HMO-POS plan in Waukesha is AARP Medicare Advantage from UHC WI-0010 (HMO-POS), with 18,530 enrollees.

How many HMO-POS options are offered without prescription drug coverage in Waukesha?

There are 1 HMO-POS plans in Waukesha without prescription drug coverage.

Medicare Advantage PFFS Plans

PFFS, or Private Fee-for-Service plans, allow access to any Medicare-approved doctor or hospital that accepts the plan’s terms. They provide wide flexibility in choosing providers, but it’s essential to verify that your preferred healthcare professionals agree to the plan’s payment rules before scheduling care.

Total PFFS Plans
1
Average Monthly Premium
$60.00/mo
Beneficiaries Enrolled
164
$0 Premium PFFS
0
Average MOOP
$7,800
PFFS with the Highest Enrollment
Humana Gold Choice H8145-006 (PFFS) with 164 enrollees
PFFS Without Drug Coverage
0

2027 PFFS Medicare Advantage plans in Waukesha County, Wisconsin (comparison chart)
Plan Name Rating* Premium MOOP Rx Ded. Plan-ID
Humana Gold Choice H8145-006
☆☆☆☆☆
 $60 $7,800 $700 H8145-006-0
What is the total number of PFFS plans in Waukesha?

In 2027, Waukesha has 1 PFFS plans with 164 enrollees.

How much do PFFS plans cost in Waukesha?

The typical PFFS premium in Waukesha is $60.00, and 0 plans have no monthly premium.

CMS quality ratings for Medicare Advantage plans in Waukesha County, WI (2027) are summarized below.

Medicare Advantage Plan Ratings in Waukesha County, WI (2027)
Rating Category Number of Plans Percent of Plans
5 Stars No 5-star plans available. 0%
4 Stars (includes 5 Stars) 25 83%
3 Stars 5 17%
Below 3 Stars 0 0%
Not Rated 1 3%
Average Rating 3.98

* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.

Medicare Advantage plans listed on this page are available to eligible beneficiaries residing in Waukesha County, Wisconsin, including communities such as Brookfield, Butler, Delafield, Hartland, Menomonee Falls, Nashotah, Oconomowoc, Pewaukee, Sussex, Big Bend, Dousman, Eagle, Elm Grove, New Berlin, Mukwonago, Muskego, North Prairie, Wales, Waukesha, and other areas throughout the county. Plan availability is determined by county of residence, not by city.

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 .

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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard .