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

Security Health Plan of Wisconsin, Inc. vs Humana 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 54755 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.

Esteem Rx (HMO)

HMO from Security Health Plan of Wisconsin, Inc.

$6,257 a year

Premiums
$2,754
Medical costs
$1,440
Drugs
$2,063

Most you can pay in a bad year, before drugs: $9,904.

HumanaChoice H7617-007 (PPO)

PPO from Humana

$6,468 a year

Premiums
$3,234
Medical costs
$1,531
Drugs
$1,703

Most you can pay in a bad year, before drugs: $12,484.

With these settings, Original Medicare costs about $123 less a year than Esteem Rx (HMO).

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

  • Esteem Rx (HMO)

    $0 copay

  • Compass (HMO)

    $0 copay

  • Humana USAA Honor Giveback (PPO)

    $0

  • Humana USAA Honor Giveback (PPO)

    $0

Specialist visit

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Esteem Rx (HMO)

    $50

  • Compass (HMO)

    $50

  • Humana USAA Honor Giveback (PPO)

    $45

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $45

    Prior authorization

Lab tests

  • Original Medicare, no Medigap

    $0

    most Medicare-covered tests

  • Esteem Rx (HMO)

    $10

    Prior authorization
  • Compass (HMO)

    $0 copay

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $0

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $0

    Prior authorization

MRI or CT scan

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Esteem Rx (HMO)

    $0-$250

    Prior authorization
  • Compass (HMO)

    $0-$200

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $0-$345

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $0-$345

    Prior authorization

Emergency room

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Esteem Rx (HMO)

    $130

  • Compass (HMO)

    $130

  • Humana USAA Honor Giveback (PPO)

    $130

  • Humana USAA Honor Giveback (PPO)

    $130

Urgent care

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Esteem Rx (HMO)

    $0-$50

  • Compass (HMO)

    $0-$50

  • Humana USAA Honor Giveback (PPO)

    $50

  • Humana USAA Honor Giveback (PPO)

    $50

Outpatient surgery

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Esteem Rx (HMO)

    $0-$300

    Prior authorization
  • Compass (HMO)

    $0-$300

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $0-$300

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $0-$300

    Prior authorization

Ground ambulance

  • Original Medicare, no Medigap

    20%

    after the $292 yearly Part B deductible

  • Esteem Rx (HMO)

    $295

    Prior authorization
  • Compass (HMO)

    $275

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $325

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $325

    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

  • Esteem Rx (HMO)

    $1,600

    for a 5-day stay

    Prior authorization
  • Compass (HMO)

    $1,600

    for a 5-day stay

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $1,475

    for a 5-day stay

    Prior authorization
  • Humana USAA Honor Giveback (PPO)

    $1,475

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare, no MedigapEsteem Rx (HMO)Compass (HMO)Humana USAA Honor Giveback (PPO)Humana USAA Honor Giveback (PPO)
Monthly premiumPart B $209.50 + drug plan $10.30$20 + Part B $209.50$0 + Part B $209.50$0 (pays back $150 a month of your Part B premium) + Part B $209.50$0 (pays back $150 a month of your Part B premium) + Part B $209.50
Yearly limit on what you payNo yearly limit$7,150 in network$5,000 in network$6,000 in network; $10,100 in and out of network$6,000 in network; $10,100 in and out of network
Medical deductible$292 Part B; $1,788 Part A each benefit period$0$0$100$100
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$50 copay$50 copay$45 copayPrior authorization$45 copayPrior authorization
Lab tests$0, most Medicare-covered tests$10 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization
MRI or CT scan20%, after the $292 yearly Part B deductible$0-$250 copayPrior authorization$0-$200 copayPrior authorization$0-$345 copayPrior authorization$0-$345 copayPrior authorization
X-rays20%, after the $292 yearly Part B deductible$20 copayPrior authorization$20 copayPrior authorization$0-$145 copayPrior authorization$0-$145 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$0-$50 copay$0-$50 copay$50 copay$50 copay
Outpatient hospital20%, after the $292 yearly Part B deductible$0-$300 copayPrior authorization$0-$300 copayPrior authorization$0-$400 copayPrior authorization$0-$400 copayPrior authorization
Surgery center20%, after the $292 yearly Part B deductible$0-$300 copayPrior authorization$0-$300 copayPrior authorization$0-$300 copayPrior authorization$0-$300 copayPrior authorization
Ground ambulance20%, after the $292 yearly Part B deductible$295 copayPrior authorization$275 copayPrior authorization$325 copayPrior authorization$325 copayPrior authorization
Hospital stay$1,788, Part A deductible each benefit period; $447 a day for days 61-90$400 per day for days 1-4; $0 per day for days 5-90Prior authorization$400 per day for days 1-4; $0 per day for days 5-90Prior authorization$295 per day for days 1-6; $0 per day for days 7-90Prior authorization$295 per day for days 1-6; $0 per day for days 7-90Prior 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 21-100Prior authorization$0 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$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$50 copay$50 copay$0 copayPrior authorization$0 copayPrior authorization
Physical therapy20%, after the $292 yearly Part B deductible$40 copay$20 copay$40 copayPrior authorization$40 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 deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization18% coinsurancePrior authorization18% 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)$550No drug coverageNo drug coverageNo drug coverage
Drug tiers (one month, retail)Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 25% coinsurancePreferred Generic: $0 copayGeneric: $8 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 30% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copayNo drug coverageNo drug coverageNo drug coverage

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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 Buffalo County

Security Health Plan of Wisconsin, Inc.

  • 5 plans for 2027 (not counting special needs plans)
  • 1 with a $0 premium; 0 pay back part of your Part B premium
  • Yearly limits from $3,000 to $7,150
  • Star ratings 4 to 4

Humana

  • 5 plans for 2027 (not counting special needs plans)
  • 3 with a $0 premium; 3 pay back part of your Part B premium
  • Yearly limits from $6,000 to $9,250
  • Star ratings 3.5 to 4.5

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

Esteem 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 13 services

Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Home health, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs

Compass (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 13 services

Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Home health, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs

Humana USAA Honor Giveback (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 24 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, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Humana USAA Honor Giveback (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 24 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, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareEsteem Rx (HMO)Compass (HMO)Humana USAA Honor Giveback (PPO)Humana USAA Honor Giveback (PPO)
DentalNoPreventive onlyPreventive onlyComprehensive, up to $1,000 a yearComprehensive, up to $1,000 a year
Eye examNoYesYesYesYes
Glasses or contactsNoYes, $175 allowanceYes, $175 allowanceYes, $200 allowanceYes, $200 allowance
Hearing aidsNoYes, copays from $499Yes, copays from $499Yes, copays from $575Yes, copays from $575
Over-the-counter allowanceNo$180 a year$160 a year$400 a year$400 a year
Fitness benefitNoYesYesYesYes
Rides to careNoNoNoNoNo
Meals after a hospital stayNoNoNoYesYes
Emergency care abroadNo, unless your Medigap plan pays for itNoNoYesYes
Part B premium givebackNoNoNo$150 a month$150 a month

What changed for 2027

Esteem Rx (HMO)

Renewal Plan with SAR · 2026 plan H5211-012-0

  • Monthly premium up from $0 to $20
  • In-network out-of-pocket maximum up from $5,000 to $7,150
  • Drug deductible up from $250 to $550
  • Diagnostic radiology (MRI, CT): $250 copay to $0-$250 copay
  • Inpatient hospital: $335 per day for days 1-4; $0 per day for days 5-90 to $400 per day for days 1-4; $0 per day for days 5-90
  • Skilled nursing facility: $0 per day for days 1-20; $178 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Comprehensive dental removed
  • Worldwide emergency coverage removed
  • Overall star rating down from 4.5 to 4

Compass (HMO)

Consolidated Renewal Plan · 2026 plan H5211-003-0

  • In-network out-of-pocket maximum up from $3,400 to $5,000
  • Emergency care: $150 copay to $130 copay
  • Diagnostic radiology (MRI, CT): $200 copay to $0-$200 copay
  • Outpatient hospital: $0-$200 copay to $0-$300 copay
  • Ground ambulance: $225 copay to $275 copay
  • Inpatient hospital: $300 per day for days 1-5; $0 per day for days 6-90 to $400 per day for days 1-4; $0 per day for days 5-90
  • Skilled nursing facility: $0 per day for days 1-6; $20 per day for days 7-45; $0 per day for days 46-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Yearly OTC allowance up from $120 to $160
  • Worldwide emergency coverage removed
  • Overall star rating down from 4.5 to 4

Humana USAA Honor Giveback (PPO)

Consolidated Renewal Plan · 2026 plan H5216-355-0

  • Part B giveback up from $145 to $150
  • Diagnostic radiology (MRI, CT): $0-$335 copay to $0-$345 copay
  • Outpatient hospital: $0-$350 copay to $0-$400 copay
  • Ground ambulance: $335 copay to $325 copay
  • 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
  • Overall star rating up from 3.5 to 4

Humana USAA Honor Giveback (PPO)

Renewal Plan · 2026 plan H7617-022-0

  • Part B giveback up from $145 to $150
  • Diagnostic radiology (MRI, CT): $0-$335 copay to $0-$345 copay
  • Outpatient hospital: $0-$350 copay to $0-$400 copay
  • Ground ambulance: $335 copay to $325 copay
  • 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

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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 54755 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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