Understanding Humana Medicare Advantage Plans in Wisconsin

Humana offers an extensive array of Medicare Advantage plans to Wisconsin residents, broadening the spectrum of healthcare possibilities. From traditional Health Maintenance Organization (HMO) plans to Preferred Provider Organization (PPO) and Private Fee-for-Service (PFFS) plans, Humana is dedicated to catering to the unique needs of every beneficiary.
In 2025, Humana is expanding its HMO offerings into 140 Wisconsin counties and Medicare LPPO plans into 80 counties, underscoring its commitment to providing a comprehensive range of healthcare solutions.
Medicare Advantage HMO Plans
Among Humana’s offerings are Medicare Advantage HMO plans. These plans are characterized by their requirement for enrollees to use network providers, ensuring cost-effective healthcare solutions.
As part of their HMO plan, enrollees must select a primary care physician, fostering a consistent and personal relationship between doctor and patient.
However, this type of plan typically requires referrals for specialist care, emphasizing the role of the primary care physician as a gatekeeper of healthcare services.
Medicare Advantage PPO Plans
For those seeking more flexibility in their healthcare choices, Humana’s Medicare Advantage PPO plans, as well as Medicare Advantage HMO PPO options, are viable alternatives. These plans offer the freedom to see any provider, whether in-network or out-of-network, without the need for a referral.
While PPO plans may come with higher premiums than HMO plans, they provide members with a more comprehensive range of provider options, giving them the freedom to choose their healthcare path.
Medicare Advantage PFFS Plans
Humana’s Medicare Advantage PFFS plans offer even greater flexibility than its HMO and PPO counterparts. Members of PFFS plans:
- are not required to choose a primary care physician
- do not require specialist referrals
- You can see any Medicare-approved doctor or provider who agrees to the PFFS plan’s payment terms and conditions.
Enrollees are required to pay the Medicare Part B premium, along with their PFFS plan premium and any Optional Supplemental Benefit premium. This is an important point to keep in mind.
Lower Cost Preferred Pharmacies and Urban Areas
Access to lower-cost preferred pharmacies is another benefit of Humana Medicare Advantage plans. Nonetheless, one should take into account that the accessibility of these pharmacies may fluctuate based on location, especially in Wisconsin’s urban areas.
Therefore, plan members may experience variations in the availability of these pharmacies based on their specific urban, suburban, or rural areas.
For example, in Milwaukee, Humana Medicare Advantage plan members can access lower-cost preferred pharmacies. However, the specific locations and availability may vary.
Therefore, members are encouraged to check for up-to-date information regarding the locations of preferred pharmacies in their area.