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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.
Key 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:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The My Choice Wisconsin Partnership Plan (HMO D-SNP) has a yearly prescription drug deductible of $615. Plan members enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs filled through standard pharmacies or standard mail order. This ensures that many common and essential medications are available at no cost to you. For other drug categories, your costs are determined by a percentage of the drug price. You will pay a 20% coinsurance for Tier 2 generic and Tier 3 preferred brand drugs, and a 30% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs carry a 25% coinsurance and are restricted to a one-month supply.
Additional Benefits
The My Choice Wisconsin Partnership Plan (HMO D-SNP) offers comprehensive coverage with many essential services requiring no copay, though coinsurance typically applies. For outpatient care, primary care visits, diagnostics, and medical equipment, members will pay no copay and a coinsurance ranging from 20% to 30%. Additionally, emergency care and ambulance services are covered with no copay and a 20% to 30% coinsurance, while worldwide emergency coverage is available up to a $10,000 limit. Members benefit from several services with no copay and no coinsurance, including preventive annual physicals, skilled nursing facility stays, home health care, and unlimited one-way trips to plan-approved medical sites. Routine dental and vision services are highly covered, featuring no copay or coinsurance up to a $4,000 annual limit for dental and a $300 annual limit for eyewear. Prescription and over-the-counter hearing aids, as well as general over-the-counter items, are also covered with no copay and no coinsurance.
Inpatient Hospital See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) partially covers inpatient acute and psychiatric hospital services with no coinsurance and Medicare-defined cost-sharing, though prior authorization is required. Additional hospital days, non-Medicare-covered stays, and room upgrades are not covered under this benefit.
Outpatient Services See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, ambulatory surgical center, and substance abuse services.
Partial Hospitalization See details
Partial hospitalization is covered under the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay and a 30% coinsurance. Prior authorization is required for these services.
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 trips to plan-approved health-related locations are offered 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 and urgently needed services with a 30% coinsurance and no copay, with the emergency coinsurance waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered up to a $10,000 maximum limit with no copay and no coinsurance.
Primary Care See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) partially covers primary care services with no copays and coinsurance ranging from 20% to 30%. Covered benefits include primary care physician visits, therapy services, and telehealth, while podiatry services and other chiropractic services are not covered.
Preventive Services See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, and no copay with a 20% coinsurance for kidney disease education and specific screenings. Several additional services are not covered, including fitness benefits, counseling, telemonitoring, home safety devices, PERS, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, palliative care, caregiver support, in-home support, medication reconciliation, re-admission prevention, wigs, and enhanced disease management.
Hearing Services See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) covers hearing exams and fitting evaluations with no copay, though routine exams carry a 20% coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance, but inner ear, outer ear, and over the ear types are not covered. 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 does not cover other eye exam services. Covered routine eye exams and contact lenses require no copay and a 20% coinsurance, while other covered eyewear has no copay and no coinsurance, featuring no deductible and a $300 combined annual limit.
Dental Services See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance, and preventive and comprehensive dental benefits with no copay and no coinsurance up to a $4,000 annual limit. However, other diagnostic services, other preventive services, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, carry a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis services are covered by the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
My Choice Wisconsin Partnership Plan (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and 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 with no copay and a 20% coinsurance, though prior authorization is required. This coverage includes diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home health services are covered by 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) covers some cardiac rehabilitation services with no copay and prior authorization required. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by the My Choice Wisconsin Partnership Plan (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required. The plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond those covered by Medicare are not covered.
Other Services See details
Other services are partially covered by the My Choice Wisconsin Partnership Plan (HMO D-SNP), which offers over-the-counter (OTC) items and a meal benefit with no copay and no coinsurance, though prior authorization is required for meals. Acupuncture is not covered under this plan.
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