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My Choice Wisconsin Partnership Plan (HMO D-SNP)

Benefits Summary and Overview

This page is a benefits summary and overview of key plan information for My Choice Wisconsin Partnership Plan (HMO D-SNP). The information on this page is a summary only.

For a complete listing of all available benefits and cost information on My Choice Wisconsin Partnership Plan (HMO D-SNP) in 2026, please refer to our full plan details page.

My Choice Wisconsin Partnership Plan (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Select counties in WI. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that My Choice Wisconsin Partnership Plan (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Important:

My Choice Wisconsin Partnership Plan (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about My Choice Wisconsin Partnership Plan (HMO D-SNP).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

  • First, the monthly premium — the amount you pay every month.
  • Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
  • Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
  • Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

For My Choice Wisconsin Partnership Plan (HMO D-SNP), the main costs are as follows:

Monthly Premium

The Monthly Premium for this plan is $13.30. This is the amount you must pay every month.

This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.

Deductibles

This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.

This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.

Out-of-Pocket Maximums

This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Doctor Visits:

Regular visits to your primary care doctor are covered and will have a copay of and coinsurance of 30%.

Specialist Visits:

Visits to specialists are covered and will have a copay of and coinsurance of 30%. Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of and coinsurance of 30%. Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care arecovered and will have a copay of and coinsurance of 30%. Coverage may vary for in-network and out-of-network hospitals.

Sign up for My Choice Wisconsin Partnership Plan (HMO D-SNP)

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Drug Coverage IconDrug Coverage

The My Choice Wisconsin Partnership Plan (HMO D-SNP) has an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 (Preferred Generic) and Tier 6 (Select Care Drugs) medications for up to a three-month supply at standard pharmacies and standard mail order. This makes managing common and select care prescriptions highly affordable. For other medication tiers, costs are structured as coinsurance at standard pharmacies and standard mail order. Tier 2 (Generic) and Tier 3 (Preferred Brand) drugs require a 20% coinsurance, while Tier 4 (Non-Preferred Drug) medications carry a 30% coinsurance. Specialty Tier (Tier 5) drugs are covered with a 25% coinsurance for a one-month supply.

Additional Benefits IconAdditional Benefits

The My Choice Wisconsin Partnership Plan (HMO D-SNP) offers comprehensive healthcare coverage featuring no copays for many essential services, including inpatient hospital stays, skilled nursing facility care, and home health services. For outpatient care, primary care visits, and specialist consultations, members generally face no copay but will pay a coinsurance ranging from 20% to 30%. Emergency and urgent care are also covered with no copay and a 30% coinsurance, while worldwide emergency services are fully covered with no copay and no coinsurance up to a $10,000 limit. In addition to medical care, this plan provides valuable supplemental benefits with no copay and no coinsurance, including preventive dental care, over-the-counter items, meal benefits, and unlimited one-way transportation to approved locations. Routine hearing and vision exams are covered with no copay and a 20% coinsurance, alongside allowances for hearing aids and eyewear to help reduce your out-of-pocket costs. Diagnostic tests, medical equipment, and dialysis services are also accessible with no copay and a standard 20% coinsurance.

Inpatient Hospital See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) partially covers inpatient hospital care, providing acute and psychiatric stays with no copay, no coinsurance, and requiring prior authorization. Additional days, upgrades, and non-Medicare-covered stays are not covered.

Outpatient Services See details

Outpatient services are covered by the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay, though a 20% coinsurance and prior authorization requirements apply to outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services are also covered with no copay, a 20% coinsurance, and no deductible.

Partial Hospitalization See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to receive this benefit.

Ambulance and Transportation Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers ambulance services with a 20% coinsurance and no copay, while transportation services are partially covered. Unlimited one-way transportation to plan-approved locations is available with no copay and no coinsurance, but transportation to any health-related location is not covered.

Emergency Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers emergency services with a 30% coinsurance and no copay, up to $115 per visit, with the coinsurance waived if admitted to the hospital within 24 hours. Urgently needed services require a 30% coinsurance and no copay up to $40 per visit, while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance up to a $10,000 maximum benefit limit.

Primary Care See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers primary care, specialist, and mental health services with no copay and a 30% coinsurance, though prior authorization is required for some benefits. While routine chiropractic care is covered for up to 20 visits per year, other chiropractic and podiatry services are not covered.

Preventive Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) offers partially covered preventive services, including annual physical exams and select health benefits with no copay and no coinsurance. Kidney disease education and other specific screenings are covered with no copay and a 20% coinsurance, while several sub-services like fitness benefits and in-home support are not covered.

Hearing Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers hearing services with no deductibles, offering routine hearing exams with no copay and 20% coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance for up to two devices every two years, excluding inner ear, outer ear, and over-the-ear types. Over-the-counter (OTC) hearing aids are also covered with no copay and no coinsurance.

Vision Services See details

Vision services are partially covered by the My Choice Wisconsin Partnership Plan (HMO D-SNP), which offers one routine eye exam per year with no copay and a 20% coinsurance, while other eye exam services are not covered. Eyewear is also covered with no copay, a 20% coinsurance for contact lenses, and a $300 combined annual limit for contacts, glasses, and upgrades.

Dental Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance for preventive and comprehensive care, while Medicare-covered dental services have a 20% coinsurance and no copay. Sub-services that are not covered under this plan include other diagnostic services, other preventive services, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics.

Home Infusion bundled Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers home infusion bundled services with no copay and no coinsurance, although prior authorization is required. Associated Medicare Part B chemotherapy and other drugs incur a 0% to 20% coinsurance with no copay, while Part B insulin has a $35 copay and 0% to 20% coinsurance.

Dialysis Services See details

Dialysis services are covered under the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay and a 20% coinsurance.

Medical Equipment See details

Medical equipment is covered by the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for these services, and coverage for certain items may be limited to preferred vendors or specified manufacturers.

Diagnostic and Radiological Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) covers diagnostic and radiological services, including lab tests, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization is required for all of these covered diagnostic and radiological services.

Home Health Services See details

Home health services are covered under the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.

Cardiac Rehabilitation Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) offers Cardiac Rehabilitation Services where some services are covered with no copay and prior authorization required. However, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry a 30% coinsurance.

Skilled Nursing Facility (SNF) See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) services with no copayment and no coinsurance, though prior authorization is required. This benefit allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.

Other Services See details

My Choice Wisconsin Partnership Plan (HMO D-SNP) partially covers other services, providing over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.

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