2026 Medicare Advantage Plans in Waukesha County, WI
Last update: . Enrollment data updated: May 2, 2026
For 2026, Waukesha County, WI includes 39 Medicare Advantage plans. Enrollment across these plans totals approximately 48,299, with 27 $0 premium options and 64% rated 4 stars or higher.
Totals on this page exclude Medicare Advantage Special Needs Plans (SNPs). SNP plans for Waukesha County, WI are provided separately. Or you can discover all Medicare Options in Waukesha County, WI.
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
- 23
- Average Monthly Premium
- $18.23/mo
- Total PPO Enrollment
- 16,792
- $0 Premium PPO Plans
- 16
- Average MOOP
- $5,546
- Top PPO by Enrollment
- Network Health Anywhere (PPO) — 6,410 enrollees
- PPO Plans Without Drug Coverage
- 7
What is the typical premium for PPO plans available in Waukesha?
PPO plans in Waukesha cost $18.23 per month on average.
Which PPO plan do most beneficiaries choose in Waukesha?
The most popular PPO plan in Waukesha is Network Health Anywhere (PPO), with 6,410 enrollees.
How many PPO options are offered without drug coverage in Waukesha?
7 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 2,510
- $0 Premium HMO Plans 1
- Average MOOP $4,200
- Top HMO by Enrollment Humana Gold Plus H6622-001 (HMO) — 2,510 enrollees
- HMO Plans Without Drug Coverage 0
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Humana Gold Plus H6622-001 | $0 | $4,200 | $615 | H6622-001-0 |
What is the total number of HMO plans offered in Waukesha?
In 2026, Waukesha County has 1 HMO plans with 2,510 enrollees.
How much do HMO plans cost in Waukesha?
The typical HMO premium in Waukesha is $0.00, and 1 plans have no monthly premium.
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
- 12
- Average Monthly Premium
- $33.33/mo
- Total HMO-POS Enrollment
- 28,764
- $0 Premium HMO-POS Plans
- 9
- Average MOOP
- $4,583
- Top HMO-POS by Enrollment
- AARP Medicare Advantage from UHC WI-0010 (HMO-POS) — 18,801 enrollees
- HMO-POS Plans Without Drug Coverage
- 3
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 Essentials from UHC WI-13 | $0 | $4,900 | $520 | H5253-033-0 | |
| AARP Medicare Advantage Extras from UHC WI-19 | $0 | $6,700 | $600 | H5253-199-0 | |
| AARP Medicare Advantage from UHC WI-0010 | $44 | $3,800 | $440 | H5253-004-0 | |
| AARP Medicare Advantage Patriot No Rx WI-MA02 | $0 | $6,700 | N/A | H5253-021-0 | |
| Anthem Medicare Advantage | $0 | $4,400 | $315 | H9525-004-0 | |
| Aetna Medicare Signature | $0 | $5,900 | $615 | H1206-002-0 |
- What is the average monthly premium for HMO-POS plans?
- HMO-POS plans in Waukesha cost $33.33 per month on average.
- Which HMO-POS plan is most popular in Waukesha?
- The most popular HMO-POS plan in Waukesha is AARP Medicare Advantage from UHC WI-0010 (HMO-POS), with 18,801 enrollees.
- How many HMO-POS plans in Waukesha do not include drug coverage?
- There are 3 HMO-POS plans in Waukesha 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 166
- $0 Premium PFFS Plans 0
- Average MOOP $6,800
- Top PFFS by Enrollment Humana Gold Choice H8145-006 (PFFS) — 166 enrollees
- PFFS Plans Without Drug Coverage 0
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-006 | $37 | $6,800 | $615 | H8145-006-0 |
What is the total number of PFFS plans in Waukesha?
There are 1 PFFS plans in 2026, covering 166 enrollees.
How much do PFFS plans cost in Waukesha?
The average PFFS premium in Waukesha is $37.00 per month, with 0 plans offering $0 premiums.
What is the top PFFS plan in Waukesha?
Humana Gold Choice H8145-006 (PFFS) is the top PFFS in Waukesha, with 166 enrollees.
What is the number of PFFS plans without Part D coverage in Waukesha?
0 PFFS plans in Waukesha do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Waukesha 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) | 23 | 64% |
| 3 Stars | 13 | 36% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 2 | 5% |
| Average Rating | 4.01 | |
* Star ratings are based on CMS quality measures and reflect plan performance for the 2026 rating period.
- 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
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, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
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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.