Medicare Advantage

Before you pick a Medicare Advantage plan in Milwaukee: the 7 carriers and how HMO, PPO and PFFS differ

People in Milwaukee can choose from 52 Medicare Advantage plans for 2027, against 52 this year. Six of this year’s plans are gone, 6 are new to Milwaukee County, and 31 that continue have changed their premium, deductible, plan type or name, 12 of them under a new name.

Medicare AdvantageMilwaukee, WI

Shopping for a Medicare Advantage plan in Milwaukee for 2027 comes down to two questions before you look at any single plan: who is selling coverage in your area, and what kind of plan structure fits how you like to get care. Milwaukee sits in Milwaukee County, where seven carriers are offering Medicare Advantage plans with drug coverage for the 2027 plan year, and those plans come in several different shapes — HMO, HMO-POS, PPO, PFFS, MSA, and Special Needs Plans built for specific situations.

This guide walks through who the carriers are and what each plan type actually means, so the full plan list makes more sense when you sit down with it.

The 7 carriers offering Medicare Advantage in Milwaukee County

For 2027, these carriers offer Medicare Advantage plans in the county (listed alphabetically):

• Aetna (CVS Health) — 6 plans (HMO-POS, PPO)
• Centene (WellCare) — 3 plans (HMO-POS; 2 Special Needs)
• Elevance Health (Anthem) — 5 plans (HMO, HMO-POS, PPO; 2 Special Needs)
• Humana — 16 plans (HMO, PFFS, PPO; 2 Special Needs)
• Molina Healthcare of Wisconsin — 2 plans (HMO; 2 Special Needs)
• Network Health Medicare Advantage Plans — 5 plans (MSA, PPO; 1 Special Needs)
• UnitedHealthcare — 15 plans (HMO-POS, PPO; 9 Special Needs)

The table below lists every plan by carrier. Instead of thinking "which carrier is biggest," think "which plan type do I want, and which carriers offer it here?"

HMO and HMO-POS: the network-first choices

An HMO (Health Maintenance Organization) plan asks you to pick doctors and hospitals inside its network, and usually to get a referral from a primary care doctor before you see a specialist. If you go outside the network for non-emergency care, the plan generally won't pay.

An HMO-POS ("point of service") plan works the same way most of the time, but adds a limited option to see certain out-of-network providers for specific services, usually at a higher cost.

In Milwaukee County, 6 of the 52 plans are HMOs and 17 are HMO-POS plans. Carriers with HMO or HMO-POS options in the county include Aetna, Centene, Elevance Health, Humana, Molina Healthcare of Wisconsin and UnitedHealthcare.

PPO: more flexibility, usually more cost outside the network

A PPO (Preferred Provider Organization) plan also has a network, but you can see out-of-network doctors and generally don't need referrals. You pay less when you stay in-network and more when you go out. If you split time between homes, travel a lot, or want to keep a specialist who may not be in every network, a PPO structure tends to be worth a look.

PPO plans remain a common shape in the county's 2027 lineup. Carriers offering PPO plans in Milwaukee County include Aetna, Elevance Health, Humana, Network Health and UnitedHealthcare.

PFFS and MSA: the less common structures

A PFFS (Private Fee-for-Service) plan lets you see any Medicare-approved provider who agrees to the plan's payment terms. There is no network in the traditional sense, but a provider can decide, visit by visit, whether to accept the plan. That flexibility comes with the responsibility to confirm acceptance before each appointment.

Milwaukee County has one PFFS plan for 2027, offered by Humana (Humana Gold Choice H8145-006).

An MSA (Medical Savings Account) plan pairs a high-deductible Medicare Advantage plan with a bank account the plan deposits money into, which you can use for care. MSAs don't include drug coverage on their own, so you'd add a stand-alone Part D plan — though note that in this county's data, all 40 MA plans on the 2027 landscape are shown with drug coverage. There is one MSA plan available in Milwaukee County for 2027, from Network Health (Network Health Prime).

Special Needs Plans: only if you qualify

Special Needs Plans (SNPs) are Medicare Advantage plans built for a specific group of people. There are three kinds:

• D-SNP (Dual Eligible): for people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition): for people with certain qualifying chronic conditions.
• I-SNP (Institutional): for people who live in a nursing home or need a similar level of care.

You can only enroll in a SNP if you meet its eligibility rules. Milwaukee County SNPs for 2027 are offered by Centene, Elevance Health, Humana, Molina Healthcare of Wisconsin, Network Health and UnitedHealthcare. UnitedHealthcare's lineup includes both C-SNP and I-SNP options in the county in addition to D-SNPs. Two smaller organizations, iCare and My Choice Wisconsin, also serve dual-eligible members through partnership-style D-SNP plans that appear in the roster.

If you don't qualify for a SNP, focus on the standard HMO, HMO-POS, PPO, PFFS or MSA plans instead.

How to narrow it down

A useful order of operations:

1. Rule out or rule in a SNP. If you have Medicaid, a qualifying chronic condition, or live in a nursing facility, a SNP may fit. If not, skip them. 2. Pick a plan type. Do you want a set network with a primary care doctor coordinating things (HMO / HMO-POS), or more freedom to go out-of-network (PPO, PFFS, MSA)? 3. Check that your doctors and hospitals are in the plan's network. This is the single most common source of surprise. Call the plan or use its provider search. 4. Check that your prescriptions are on the plan's formulary. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. The Part D maximum deductible is $615 in 2026 and $700 in 2027. The old coverage gap ("donut hole") is gone. The Medicare Prescription Payment Plan can spread your drug costs across the year if you'd like. 5. Compare total costs, not just premium. Add up premium, deductibles, expected copays, and out-of-pocket maximums for the way you actually use care.

Also worth knowing: if your income is above $109,000 as a single filer in 2026, an IRMAA surcharge is added to your Part B and Part D premiums.

Enrollment dates to circle

• October 15 – December 7: Medicare Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan. Coverage starts January 1.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you can switch to a different one or return to Original Medicare (and add a stand-alone Part D plan).