- Entity
- county:wisconsin-waupaca-55135
- Digest
- 2026-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/wisconsin/waupaca/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 38
- PPO Plans
- 25
- HMO Plans
- 2
- HMO-POS Plans
- 9
- PFFS Plans
- 1
- Average Monthly Premium
- 30.77
- Average MOOP
- 5058.38
- Average Part D Deductible
- 435.71
- $0 Premium Plans
- 26
- Plans Without Part D Coverage
- 10
- Average CMS Star Rating
- 3.96
- $0 Premium Plan Share
- 68.42
- 5-Star Plan Share
- 0
- 4+ Star Plan Share
- 56
- 3-Star Plan Share
- 44
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 11
- PPO Average Monthly Premium
- 28.68
- PPO Average MOOP
- 5254.4
- PPO Enrollment
- 6625
- PPO $0 Premium Plans
- 17
- PPO Plans Without Part D Coverage
- 6
- HMO Average Monthly Premium
- 0
- HMO Average MOOP
- 5100
- HMO Enrollment
- 699
- HMO $0 Premium Plans
- 2
- HMO Plans Without Part D Coverage
- 0
- HMO-POS Average Monthly Premium
- 46.11
- HMO-POS Average MOOP
- 4311.11
- HMO-POS Enrollment
- 1502
- HMO-POS $0 Premium Plans
- 6
- HMO-POS Plans Without Part D Coverage
- 3
- PFFS Average Monthly Premium
- 37
- PFFS Average MOOP
- 6800
- PFFS Enrollment
- 22
- PFFS $0 Premium Plans
- 0
- PFFS Plans Without Part D Coverage
- 0
- Entity
- county:wisconsin-waupaca-55135
- Digest
- 2026-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/wisconsin/waupaca/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-wisconsin-waupaca-55135-landscape-stats
- Plans Indexed
- 38
- Standard Medicare Advantage Plans
-
-
Compass
H5211-003-0 -
Essence Rx
H5211-002-0 -
Esteem Rx
H5211-012-0 -
Humana Full Access H7617-020
H7617-020-0 -
Humana USAA Honor Giveback
H7617-022-0 -
HumanaChoice Giveback H7617-011
H7617-011-0 -
Legacy Rx
H5211-004-0 -
Network Health Armor
H5215-013-0 -
Network Health Choice
H5215-011-0 -
Network Health PlusRx
H5215-002-0 -
Network Health PremierRx
H5215-005-0 -
Network Health Select
H5215-008-0 -
Network Health Zero
H5215-012-0 -
Spirit
H5211-001-0 -
AARP Medicare Advantage CareFlex from UHC WI-18
H5253-198-0 -
AARP Medicare Advantage from UHC WI-0011
H5253-011-0 -
AARP Medicare Advantage from UHC WI-0014
H5253-034-0 -
AARP Medicare Advantage Patriot No Rx WI-MA02
H5253-021-0 -
Anthem Medicare Advantage 3
H4036-008-0 -
AARP Medicare Advantage from UHC WI-0002
H0294-004-0 -
AARP Medicare Advantage from UHC WI-6
H0294-015-0 -
Aspirus Health Plan Elite
H6874-003-0 -
Aspirus Health Plan Essential Rx
H6874-001-0 -
Humana Full Access H5216-410
H5216-410-0 -
Humana Gold Choice H8145-006
H8145-006-0 -
Humana Gold Plus H6622-001
H6622-001-0 -
Humana USAA Honor Giveback
H5216-355-0 -
Humana USAA Honor Giveback
H5216-258-0 -
Humana Value Plus H5216-173
H5216-173-0 -
HumanaChoice Giveback H5216-252
H5216-252-0 -
HumanaChoice H5216-001
H5216-001-0 -
HumanaChoice H5216-253
H5216-253-0 -
Humana USAA Honor Giveback
R5361-001-0 -
HumanaChoice R5361-002
R5361-002-0 -
Cooperative Medicare Advantage
H7598-004-0 -
HealthPartners Birch
H6309-001-0 -
HealthPartners Cedar
H6309-002-0 -
Network Health Prime
H1181-001-0
-
Compass
- Total Standard Medicare Advantage Enrollment
- 8874
2026 Medicare Advantage Plans in Waupaca County, WI
Last update: .
For 2026, Waupaca County, WI includes 38 Medicare Advantage plans. Enrollment across these plans totals approximately 8,874, with 26 $0 premium options and 56% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Waupaca County, WI are summarized separately. Visit Medicare Options in Waupaca 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
- 25
- Average Monthly Premium
- $28.68/mo
- Total PPO Enrollment
- 6,625
- $0 Premium PPO Plans
- 17
- Average MOOP
- $5,254
- Top PPO by Enrollment
- Network Health Select (PPO) — 2,569 enrollees
- PPO Plans Without Drug Coverage
- 6
- What is the average monthly premium for PPO plans in Waupaca?
- PPO plans in Waupaca cost $28.68 per month on average.
- Which PPO plan has the highest enrollment in Waupaca?
- The most popular PPO plan in Waupaca is Network Health Select (PPO), with 2,569 enrollees.
- How many PPO plans in Waupaca do not include prescription drug coverage?
- 6 PPO plans in Waupaca 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 |
|---|---|---|---|---|---|
| Humana Gold Plus H6622-001 | $0 | $4,200 | $615 | H6622-001-0 | |
| Cooperative Medicare Advantage | $0 | $6,000 | $275 | H7598-004-0 |
What is the total number of HMO plans offered in Waupaca?
There are 2 HMO plans in 2026, covering 699 enrollees.
How much do HMO plans cost in Waupaca?
The average HMO premium in Waupaca is $0.00 per month, with 2 plans offering $0 premiums.
What is the top HMO by enrollment in Waupaca?
Humana Gold Plus H6622-001 (HMO) is the top HMO in Waupaca, with 699 enrollees.
What is the number of HMO plans without Part D coverage in Waupaca?
0 HMO plans in Waupaca 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
- 9
- Average Monthly Premium
- $46.11/mo
- Total HMO-POS Enrollment
- 1,502
- $0 Premium HMO-POS Plans
- 6
- Average MOOP
- $4,311
- Top HMO-POS by Enrollment
- AARP Medicare Advantage from UHC WI-0014 (HMO-POS) — 508 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 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 |
What is the average monthly premium for HMO-POS plans?
HMO-POS plans in Waupaca cost $46.11 per month on average.
Which HMO-POS plan is most popular in Waupaca?
The most popular HMO-POS plan in Waupaca is AARP Medicare Advantage from UHC WI-0014 (HMO-POS), with 508 enrollees.
How many HMO-POS plans in Waupaca do not include drug coverage?
There are 3 HMO-POS plans in Waupaca 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 22
- $0 Premium PFFS Plans 0
- Average MOOP $6,800
- Top PFFS by Enrollment Humana Gold Choice H8145-006 (PFFS) — 22 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 Waupaca?
Humana Gold Choice H8145-006 (PFFS) is the top PFFS in Waupaca, with 22 enrollees.
What is the number of PFFS plans without Part D coverage in Waupaca?
0 PFFS plans in Waupaca do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Waupaca 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) | 19 | 56% |
| 3 Stars | 15 | 44% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 4 | 11% |
| Average Rating | 3.96 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
- CMS.gov, Medicare Advantage & Special Needs Plan Landscape Source Files — Version: 202608
- CMS.gov, Medicare Part C & D Performance Data — Version: 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Version: 2026-08
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.