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Wisconsin Plan Benefit Comparison 

Find the plan that's right for you. We offer three flexible levels of coverage to fit a variety of needs. Take a moment to compare the different plans below and learn what nearly 100,000 members across Minnesota and western Wisconsin already know. UCare for Seniors gives you more from your Medicare plan. 
Value Plus​
Essentials Rx 
Value​
Monthly premium† ​
$106 ​
$48
$25​
Primary care doctor office visits​
$0
$15
$0​
Specialist office visits​
$30​
$40
$30​
Inpatient hospital care ​
$400 per admission​
$300 per day (days 1-5)​
$400 per admission​
Worldwide emergency care
$65 co-pay

$65 co-pay

$65 co-pay

 
 
 
Not covered​
Vision coverage ​
$0 co-pay for annual routine eye exam.

$30 co-pay for diagnostic eye exams.​
$0 co-pay for annual routine eye exam.
 
$40 co-pay for diagnostic eye exams.
$0 co-pay for annual routine eye exam.
 
$30 co-pay for diagnostic eye exams.​
Hearing device discounts​

$0 co-pay for annual routine hearing test.

$30 co-pay for diagnostic hearing exams.​

$0 co-pay for annual routine hearing test. 

$40 co-pay for diagnostic hearing exams.​

$0 co-pay for annual routine hearing test.​

$30 co-pay for diagnostic hearing exams.

Fitness Programs - choose one:
SilverSneakers® OR
Health Club Savings
Out-of-pocket maximum ($3,400 per year)††​
 
For more plan comparison information, check out A Guide to Comparing Your Options - Wisconsin (PDF).
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January of each year.
Limitations, co-payments, and restrictions may apply.
†You must continue to pay your Medicare Part B premium.
††Out-of-pocket maximum refers to the out-of-pocket limit for in-network, Medicare-covered services.