Company vs company · Oconto County, WI · 2027 plan year

Network Health Medicare Advantage Plans vs Aetna Medicare 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 54149 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.

Network Health Select (PPO)

PPO from Network Health Medicare Advantage Plans

$5,967 a year

Premiums
$2,514
Medical costs
$1,833
Drugs
$1,620

Most you can pay in a bad year, before drugs: $6,964.

Aetna Medicare Signature (PPO)

PPO from Aetna Medicare

$5,662 a year

Premiums
$2,514
Medical costs
$1,445
Drugs
$1,703

Most you can pay in a bad year, before drugs: $8,014.

With these settings, Aetna Medicare Signature (PPO) costs about $305 less a year than Network Health Select (PPO).

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

  • Network Health Select (PPO)

    $0 copay

  • Network Health Choice (PPO)

    $0

  • Aetna Medicare Eagle (PPO)

    $0

  • Aetna Medicare Signature (PPO)

    $0

Specialist visit

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Network Health Select (PPO)

    $60

    Prior authorization
  • Network Health Choice (PPO)

    $50

    Prior authorization
  • Aetna Medicare Eagle (PPO)

    $40

  • Aetna Medicare Signature (PPO)

    $40

Lab tests

  • Original Medicare, no Medigap

    $0

    most Medicare-covered tests

  • Network Health Select (PPO)

    $0-$20

    Prior authorization
  • Network Health Choice (PPO)

    $0-$40

    Prior authorization
  • Aetna Medicare Eagle (PPO)

    $0

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $0

    Prior authorization

MRI or CT scan

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Network Health Select (PPO)

    $0-$300

    Prior authorization
  • Network Health Choice (PPO)

    $0-$295

    Prior authorization
  • Aetna Medicare Eagle (PPO)

    $0-$250

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $0-$200

    Prior authorization

Emergency room

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Network Health Select (PPO)

    $130

  • Network Health Choice (PPO)

    $130

  • Aetna Medicare Eagle (PPO)

    $130

  • Aetna Medicare Signature (PPO)

    $130

Urgent care

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Network Health Select (PPO)

    $60

  • Network Health Choice (PPO)

    $50

  • Aetna Medicare Eagle (PPO)

    $45

  • Aetna Medicare Signature (PPO)

    $45

Outpatient surgery

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Network Health Select (PPO)

    $250

    Prior authorization
  • Network Health Choice (PPO)

    $0-$200

    Prior authorization
  • Aetna Medicare Eagle (PPO)

    $0-$250

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $0-$315

    Prior authorization

Ground ambulance

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Network Health Select (PPO)

    $300

    Prior authorization
  • Network Health Choice (PPO)

    $275

    Prior authorization
  • Aetna Medicare Eagle (PPO)

    $290

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $280

    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

  • Network Health Select (PPO)

    $1,700

    for a 5-day stay

    Prior authorization
  • Network Health Choice (PPO)

    $1,700

    for a 5-day stay

    Prior authorization
  • Aetna Medicare Eagle (PPO)

    $1,500

    for a 5-day stay

    Prior authorization
  • Aetna Medicare Signature (PPO)

    $1,825

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare, no MedigapNetwork Health Select (PPO)Network Health Choice (PPO)Aetna Medicare Eagle (PPO)Aetna Medicare Signature (PPO)
Monthly premiumPart B $209.50 + drug plan $10.30$0 + Part B $209.50$0 + Part B $209.50$0 (pays back $70 a month of your Part B premium) + Part B $209.50$0 + Part B $209.50
Yearly limit on what you payNo yearly limit$4,450 in network; $4,450 in and out of network$5,100 in network; $5,100 in and out of network$5,200 in network; $10,750 in and out of network$5,500 in network; $10,750 in and out of network
Medical deductible$292 Part B; $1,788 Part A each benefit period$200$500$0$0
Primary doctor visit20%, after the $292 yearly Part B deductible$0 copay$0 copay$0 copay$0 copay
Specialist visit20%, after the $292 yearly Part B deductible$60 copayPrior authorization$50 copayPrior authorization$40 copay$40 copay
Lab tests$0, most Medicare-covered tests$0-$20 copayPrior authorization$0-$40 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization
MRI or CT scan20%, after the $292 yearly Part B deductible$0-$300 copayPrior authorization$0-$295 copayPrior authorization$0-$250 copayPrior authorization$0-$200 copayPrior authorization
X-rays20%, after the $292 yearly Part B deductible$40 copayPrior authorization$90 copayPrior authorization$20 copayPrior authorization$20 copayPrior authorization
Emergency room20%, after the $292 yearly Part B deductible$130 copay$130 copay$130 copay$130 copay
Urgent care20%, after the $292 yearly Part B deductible$60 copay$50 copay$45 copay$45 copay
Outpatient hospital20%, after the $292 yearly Part B deductible$300 copayPrior authorization$0-$300 copayPrior authorization$0-$300 copayPrior authorization$0-$365 copayPrior authorization
Surgery center20%, after the $292 yearly Part B deductible$250 copayPrior authorization$0-$200 copayPrior authorization$0-$250 copayPrior authorization$0-$315 copayPrior authorization
Ground ambulance20%, after the $292 yearly Part B deductible$300 copayPrior authorization$275 copayPrior authorization$290 copayPrior authorization$280 copayPrior authorization
Hospital stay$1,788, Part A deductible each benefit period; $447 a day for days 61-90$340 per day for days 1-6; $0 per day for days 7-90Prior authorization$340 per day for days 1-7; $0 per day for days 8-90Prior authorization$300 per day for days 1-6; $0 per day for days 7-90Prior authorization$365 per day for days 1-7; $0 per day for days 8-90Prior authorization
Skilled nursing facility$0, days 1-20, then $223.50 a day for days 21-100$0 per day for days 1-20; $221 per day for days 21-45; $0 per day for days 46-100Prior authorization$0 per day for days 1-20; $221 per day for days 21-45; $0 per day for days 46-100Prior authorization$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
Mental health visit20%, after the $292 yearly Part B deductible$40 copayPrior authorization$50 copayPrior authorization$0 copayPrior authorization$40 copayPrior authorization
Physical therapy20%, after the $292 yearly Part B deductible$55 copayPrior authorization$50 copayPrior authorization$40 copay$45 copay
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 deductible0%-20% coinsurancePrior authorization0%-20% 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)$330$300No drug coverage$700
Drug tiers (one month, retail)Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 25% coinsurancePreferred Generic: $1 copayGeneric: $8 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 37% coinsuranceSpecialty Tier: 29% coinsurancePreferred Generic: $1 copayGeneric: $8 copayPreferred Brand: 22% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 30% coinsuranceNo drug coveragePreferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 28% coinsuranceSpecialty Tier: 25% coinsurance

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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 Oconto County

Network Health Medicare Advantage Plans

  • 5 plans for 2027 (not counting special needs plans)
  • 3 with a $0 premium; 1 pay back part of your Part B premium
  • Yearly limits from $3,400 to $5,100
  • Star ratings 4 to 4

Aetna Medicare

  • 2 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 $5,500
  • 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

Network Health Select (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 21 services

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

Network Health Choice (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 21 services

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

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

Extra benefits

Extra benefitOriginal MedicareNetwork Health Select (PPO)Network Health Choice (PPO)Aetna Medicare Eagle (PPO)Aetna Medicare Signature (PPO)
DentalNoComprehensive, up to $400 a yearComprehensive, up to $1,000 a yearComprehensive, up to $3,750 a yearComprehensive, up to $2,000 a year
Eye examNoYesYesYesYes
Glasses or contactsNoYesNoYes, $300 allowanceYes, $150 allowance
Hearing aidsNoYes, up to $75Yes, up to $75Yes, up to $1,250Yes, up to $500
Over-the-counter allowanceNo$400 a yearNo$400 a yearNo
Fitness benefitNoYesYesYesYes
Rides to careNoYesNoNoNo
Meals after a hospital stayNoNoNoYesNo
Emergency care abroadNo, unless your Medigap plan pays for itYesYesYesYes
Part B premium givebackNoNoNo$70 a monthNo

What changed for 2027

Network Health Select (PPO)

Consolidated Renewal Plan · 2026 plan H5215-008-0

  • In-network out-of-pocket maximum up from $3,900 to $4,450
  • Medical deductible up from $0 to $200
  • Part B giveback down from $3 to $0
  • Diagnostic radiology (MRI, CT): $40-$300 copay to $0-$300 copay
  • Inpatient hospital: $275 per day for days 1-6; $0 per day for days 7-90 to $340 per day for days 1-6; $0 per day for days 7-90
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-45; $0 per day for days 46-100 to $0 per day for days 1-20; $221 per day for days 21-45; $0 per day for days 46-100
  • Dental maximum down from $460 to $400
  • Yearly OTC allowance down from $550 to $400
  • Meals after a hospital stay removed
  • Overall star rating down from 4.5 to 4

Network Health Choice (PPO)

Renewal Plan · 2026 plan H5215-011-0

  • In-network out-of-pocket maximum up from $4,700 to $5,100
  • Medical deductible up from $0 to $500
  • Part B giveback down from $24 to $0
  • Diagnostic radiology (MRI, CT): $90-$295 copay to $0-$295 copay
  • Outpatient hospital: $300 copay to $0-$300 copay
  • Inpatient hospital: $315 per day for days 1-7; $0 per day for days 8-90 to $340 per day for days 1-7; $0 per day for days 8-90
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-45; $0 per day for days 46-100 to $0 per day for days 1-20; $221 per day for days 21-45; $0 per day for days 46-100
  • Dental maximum down from $1,500 to $1,000
  • Eyewear removed
  • OTC allowance removed
  • Overall star rating down from 4.5 to 4

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 H5521-195-0

  • In-network out-of-pocket maximum up from $5,200 to $5,500
  • Drug deductible up from $615 to $700
  • Specialist visit: $0-$40 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
  • Dental maximum up from $1,250 to $2,000
  • Eyewear allowance up from $100 to $150
  • Overall star rating down from 4.5 to 4

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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 54149 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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