Company vs company · La Crosse County, WI · 2027 plan year

Aetna Medicare vs Quartz Medicare Advantage (HMO) Medicare Advantage plans

Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.

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In most states, including Wisconsin, you cannot count on getting Medigap later

You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in Wisconsin can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later.

One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.

Read about Medigap rights on Medicare.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Wisconsin sets its own Medigap plans: a basic plan with optional riders, two cost-sharing plans, and a high-deductible plan. These plans are not the plans with letters, such as Plan G and Plan N. We have no prices for these plans, so the totals show Original Medicare without Medigap. Without Medigap you pay 20% of most costs, with no yearly limit. Check Medigap plans and prices for ZIP 54636 on Medicare.gov

Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov

Original Medicare

With no Medigap and AARP Medicare Rx Saver from UHC (PDP)

$6,133 a year

Premiums
$2,638
Medical costs
$1,616
Drugs
$1,880

No yearly limit on what you pay for medical care.

Aetna Medicare Signature (PPO)

PPO from Aetna Medicare

$5,962 a year

Premiums
$2,514
Medical costs
$1,745
Drugs
$1,703

Most you can pay in a bad year, before drugs: $8,414.

Gundersen Quartz Med Advantage Core D (w/Rx) (HMO)

HMO from Quartz Medicare Advantage (HMO)

$6,424 a year

Premiums
$3,018
Medical costs
$1,870
Drugs
$1,536

Most you can pay in a bad year, before drugs: $8,918.

With these settings, Aetna Medicare Signature (PPO) costs about $171 less a year than Original Medicare.

These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.

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What you pay each time you get care

In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: no Medigap.

Primary doctor visit

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $0

  • Aetna Medicare Signature (PPO)

    $0

  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $15

  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $10

Specialist visit

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $40

  • Aetna Medicare Signature (PPO)

    $50

  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $50

  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $45

Lab tests

  • Original Medicare, no Medigap

    $0

    most Medicare-covered tests

  • Aetna Medicare Eagle (PPO)

    $0

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $0-$10

    Prior authorization
  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $15

    Prior authorization
  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $10

    Prior authorization

MRI or CT scan

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $0-$250

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $0-$300

    Prior authorization
  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $160

  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $75

Emergency room

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $130

  • Aetna Medicare Signature (PPO)

    $130

  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $130

  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $150

Urgent care

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $45

  • Aetna Medicare Signature (PPO)

    $50

  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $50

  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $50

Outpatient surgery

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $0-$250

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $0-$385

    Prior authorization
  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $0-$200

  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $0-$150

Ground ambulance

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Aetna Medicare Eagle (PPO)

    $290

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $295

    Prior authorization
  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $300

    Prior authorization
  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $300

    Prior authorization

Hospital stay, 5 days

  • Original Medicare, no Medigap

    $1,788

    Part A deductible each benefit period; $447 a day for days 61-90

  • Aetna Medicare Eagle (PPO)

    $1,500

    for a 5-day stay

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $2,175

    for a 5-day stay

    Prior authorization
  • Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

    $1,375

    for a 5-day stay

    Prior authorization
  • Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

    $300

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare, no MedigapAetna Medicare Eagle (PPO)Aetna Medicare Signature (PPO)Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)
Monthly premiumPart B $209.50 + drug plan $10.30$0 (pays back $70 a month of your Part B premium) + Part B $209.50$0 + Part B $209.50$97 + Part B $209.50$202 + Part B $209.50
Yearly limit on what you payNo yearly limit$5,200 in network; $10,750 in and out of network$5,900 in network; $10,750 in and out of network$4,900 in network$4,000 in network
Medical deductible$292 Part B; $1,788 Part A each benefit period$0$0$0$0
Primary doctor visit20%, after the $292 yearly Part B deductible$0 copay$0 copay$15 copay$10 copay
Specialist visit20%, after the $292 yearly Part B deductible$40 copay$50 copay$50 copay$45 copay
Lab tests$0, most Medicare-covered tests$0 copayPrior authorization$0-$10 copayPrior authorization$15 copayPrior authorization$10 copayPrior authorization
MRI or CT scan20%, after the $292 yearly Part B deductible$0-$250 copayPrior authorization$0-$300 copayPrior authorization$160 copay$75 copay
X-rays20%, after the $292 yearly Part B deductible$20 copayPrior authorization$20 copayPrior authorization$15 copay$10 copay
Emergency room20%, after the $292 yearly Part B deductible$130 copay$130 copay$130 copay$150 copay
Urgent care20%, after the $292 yearly Part B deductible$45 copay$50 copay$50 copay$50 copay
Outpatient hospital20%, after the $292 yearly Part B deductible$0-$300 copayPrior authorization$0-$435 copayPrior authorization$0-$200 copayPrior authorization$0-$150 copayPrior authorization
Surgery center20%, after the $292 yearly Part B deductible$0-$250 copayPrior authorization$0-$385 copayPrior authorization$0-$200 copay$0-$150 copay
Ground ambulance20%, after the $292 yearly Part B deductible$290 copayPrior authorization$295 copayPrior authorization$300 copayPrior authorization$300 copayPrior authorization
Hospital stay$1,788, Part A deductible each benefit period; $447 a day for days 61-90$300 per day for days 1-6; $0 per day for days 7-90Prior authorization$435 per day for days 1-6; $0 per day for days 7-90Prior authorization$275 per day for days 1-6; $0 per day for days 7-90Prior authorization$300 per stayPrior authorization
Skilled nursing facility$0, days 1-20, then $223.50 a day for days 21-100$10 per day for days 1-20; $221 per day for days 21-100Prior authorization$10 per day for days 1-20; $221 per day for days 21-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-100Prior authorization
Mental health visit20%, after the $292 yearly Part B deductible$0 copayPrior authorization$40 copayPrior authorization$40 copay$35 copay
Physical therapy20%, after the $292 yearly Part B deductible$40 copay$50 copay$40 copayPrior authorization$30 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization
Medical equipment20%, after the $292 yearly Part B deductible20% coinsurancePrior authorization20% coinsurancePrior authorization20% coinsurancePrior authorization20% coinsurancePrior authorization
Part B drugs20% after the $292 Part B deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
Drug deductible (Part D)$700 with AARP Medicare Rx Saver from UHC (PDP)No drug coverage$700$225$200
Drug tiers (one month, retail)Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 25% coinsuranceNo drug coveragePreferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 28% coinsuranceSpecialty Tier: 25% coinsurancePreferred Generic: $0 copayGeneric: $10 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 35% coinsuranceSpecialty Tier: 30% coinsuranceSelect Care Drugs: $0 copayPreferred Generic: $0 copayGeneric: $10 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 35% coinsuranceSpecialty Tier: 31% coinsuranceSelect Care Drugs: $0 copay

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A higher drug plan premium is not, by itself, a reason to switch

With Original Medicare, you buy a separate drug plan. In Wisconsin, 8 drug plans are for sale for 2027, from $5.30 to $189.10 a month. Half of them cost $10.85 a month or less.

  • Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
  • The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
  • A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
  • If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov

The two companies in La Crosse County

Aetna Medicare

  • 3 plans for 2027 (not counting special needs plans)
  • 2 with a $0 premium; 1 pay back part of your Part B premium
  • Yearly limits from $5,200 to $5,900
  • Star ratings 4 to 4

Quartz Medicare Advantage (HMO)

  • 6 plans for 2027 (not counting special needs plans)
  • 2 with a $0 premium; 0 pay back part of your Part B premium
  • Yearly limits from $4,000 to $7,150
  • Star ratings 4 to 4

Doctors, referrals, and prior authorization

Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.

Original Medicare

  • Any doctor or hospital in the U.S. that takes Medicare
  • No referrals
  • Prior authorization only for a short list of services

Aetna Medicare Eagle (PPO)

PPO

  • The plan has a network. You can go outside it, but you pay more.
  • No referral needed to see a specialist.

Prior authorization for 19 services

Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Aetna Medicare Signature (PPO)

PPO

  • The plan has a network. You can go outside it, but you pay more.
  • No referral needed to see a specialist.

Prior authorization for 19 services

Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • No referral needed to see a specialist.

Prior authorization for 12 services

Diagnostic tests, Outpatient hospital, Ambulance, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Medical equipment, Prosthetics, Hospital stay, Skilled nursing, Part B drugs

Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • No referral needed to see a specialist.

Prior authorization for 12 services

Diagnostic tests, Outpatient hospital, Ambulance, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Medical equipment, Prosthetics, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareAetna Medicare Eagle (PPO)Aetna Medicare Signature (PPO)Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)
DentalNoComprehensive, up to $3,750 a yearPreventive onlyComprehensive, up to $375 a yearComprehensive, up to $550 a year
Eye examNoYesYesYesYes
Glasses or contactsNoYes, $300 allowanceYes, $100 allowanceYes, $175 allowanceYes, $250 allowance
Hearing aidsNoYes, up to $1,250Yes, up to $500Yes, up to $1,250Yes, up to $1,500
Over-the-counter allowanceNo$400 a yearNoNoNo
Fitness benefitNoYesYesNoNo
Rides to careNoNoNoNoNo
Meals after a hospital stayNoYesNoNoNo
Emergency care abroadNo, unless your Medigap plan pays for itYesYesYesYes
Part B premium givebackNo$70 a monthNoNoNo

What changed for 2027

Aetna Medicare Eagle (PPO)

Renewal Plan with SAR · 2026 plan H5521-286-0

  • In-network out-of-pocket maximum up from $4,900 to $5,200
  • Specialist visit: $30 copay to $40 copay
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $10 per day for days 1-20; $221 per day for days 21-100
  • Hearing aid allowance down from $1,500 to $1,250
  • Overall star rating down from 4.5 to 4

Aetna Medicare Signature (PPO)

Renewal Plan · 2026 plan H5521-289-0

  • Drug deductible up from $615 to $700
  • Specialist visit: $45 copay to $50 copay
  • Urgent care: $40 copay to $50 copay
  • Outpatient hospital: $0-$410 copay to $0-$435 copay
  • Inpatient hospital: $410 per day for days 1-6; $0 per day for days 7-90 to $435 per day for days 1-6; $0 per day for days 7-90
  • Skilled nursing facility: $10 per day for days 1-20; $218 per day for days 21-100 to $10 per day for days 1-20; $221 per day for days 21-100
  • Comprehensive dental removed
  • Overall star rating down from 4.5 to 4

Gundersen Quartz Med Advantage Value D (w/Rx) (HMO)

Renewal Plan · 2026 plan H5262-003-0

  • Monthly premium up from $90 to $97
  • In-network out-of-pocket maximum up from $4,200 to $4,900
  • Emergency care: $150 copay to $130 copay
  • Urgent care: $60 copay to $50 copay
  • Diagnostic radiology (MRI, CT): $100 copay to $160 copay
  • Inpatient hospital: $250 per day for days 1-6; $0 per day for days 7-90 to $275 per day for days 1-6; $0 per day for days 7-90
  • Skilled nursing facility: $0 per day for days 1-20; $215 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Dental maximum down from $425 to $375
  • Eyewear allowance down from $225 to $175

Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO)

Renewal Plan · 2026 plan H5262-001-0

  • Monthly premium up from $196 to $202
  • In-network out-of-pocket maximum up from $3,500 to $4,000
  • Skilled nursing facility: $0 per day for days 1-20; $200 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Dental maximum down from $600 to $550
  • Eyewear allowance down from $300 to $250

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Sources and method

Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Wisconsin sets its own Medigap plans: a basic plan with optional riders, two cost-sharing plans, and a high-deductible plan. These plans are not the plans with letters, such as Plan G and Plan N. We have no prices or cost model for these plans, so the totals show Original Medicare without Medigap. You can look up Medigap plans and prices for ZIP 54636 on Medicare.gov. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.

Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

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