Form Number: et-2158prm

Medicare 1 = Family coverage with at least one insured family member enrolled in Medicare Parts A, B and D.
Medicare 2 = Family coverage with all insured family members enrolled in Medicare Parts A, B and D.

Health Plan Medicare Single Medicare 1 Medicare 2
Dean Health Insurance $443.86 $1,047.00 $867.16
Dean Health Insurance-Prevea360 $445.26 $1,051.34 $869.96
Group Health Cooperative of Eau Claire $437.66 $1,174.94 $854.76
Group Health Cooperative of South Central Wisconsin $450.76 $1,055.10 $880.96
HealthPartners Health Plan $544.56 $1,416.52 $1,068.56
Medical Associates Health Plan $336.86 $872.94 $653.16
Medicare Advantage by UnitedHealthCare $288.98 Not available $557.40
Medicare Plus by WEA Trust $364.46 $1,519.16 $708.36
MercyCare Health Plan $461.72 $1,136.00 $902.88
Network Health $510.56 $1,234.40 $1,000.56
Quartz - Community $440.88 $1,137.62 $861.20
Quartz - UW Health $393.34 $974.12 $766.12
Robin with HealthPartners Health Plan $544.56 $1,416.52 $1,068.56
Security Health Plan - Central $531.66 $1,567.22 $1,042.76
Security Health Plan - Valley $530.32 $1,562.16 $1,040.08
State Maintenance Plan (SMP)1 by WEA Trust $364.46 $1,122.04 $708.36
WEA Trust - East $431.26 $1,207.36 $841.96
WEA Trust West - Chippewa Valley $500.26 $1,448.58 $979.96
 WEA Trust West - Mayo Clinic Health System $478.56 $1,366.80 $936.56

1Members with Local Access Plan or SMP coverage who enroll in Medicare Parts A and B will automatically be moved to the IYC Medicare Plus plan. All other non-Medicare family members remain covered under the Local Access Plan or SMP.

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