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Esteem Rx Gold (HMO-POS) (2027)

Medicare Advantage plan with drug coverage from Security Health Plan of Wisconsin, Inc., plan ID H5211-015-000. Sold in 33 counties in Wisconsin.

★★★★★4.0

2027 costs

Monthly premium$125 ($50.20 of it for drug coverage)
Drug deductible$300
Medical deductible$0
Out-of-pocket maximum (in network)$5,000
Plan typeMedicare Advantage plan with drug coverage, HMO-POS
Referral needed to see a specialistYes
Plan IDH5211-015-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium.

What this plan would cost for your prescriptions

Add your prescriptions to see this plan's estimated yearly cost for them, which of them are on its drug list, and how each compares with Cost Plus Drugs prices.

See this plan with my prescriptions

What you pay for medical care

Primary care visit$0
Specialist visit$40
Preventive care$0
Urgent care$0–$40
Emergency room$130
Hospital stay$350/day
Outpatient surgery$0–$250
Lab tests$20
X-rays and scans$0
Mental health visit$40
Physical therapy$30
Medical equipment$0
TelehealthCovered

In-network amounts. A range means it depends on the service or provider.

Extra benefits

DentalCovered — up to $500/yr allowance
VisionCovered — up to $250/yr allowance
HearingCovered — $499–$999 copay per aid
Over-the-counter itemsCovered — up to $55/quarter allowance
FitnessCovered
Rides to appointmentsNot covered

Drug costs by tier

Tier30 days, standard pharmacy30 days, preferred pharmacy90 days by mail
1 Preferred Generic$0$0$0
2 Generic$8$8$24
3 Preferred Brand25%25%25%
4 Non-Preferred Drug30%30%30%
5 Specialty Tier30%30%N/A
6 Select Care Drugs$0$0$0

A percentage is coinsurance: your share of the drug's price. The drug deductible may apply first, depending on the tier. Your Part D out-of-pocket costs are capped at $2,400 for 2027.

Where it's sold

Wisconsin (33 counties)

Other 2027 Security Health Plan of Wisconsin, Inc. plans in Wisconsin

Plan costs and benefits are from CMS's 2027 Medicare plan data (data as of October 27, 2026). Star ratings are CMS's 2027 Star Ratings. Every year, Medicare evaluates plans based on a 5-star rating system. Benefits, premiums and copays can change from year to year; check the plan's Evidence of Coverage, call the plan, or use Medicare.gov before you enroll.