Network Health Choice (PPO)
Available to residents of Calumet County, WI for 2026. Contract H5215, plan 011, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $300.00Tier 1 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H5215-011-0 |
| Offered by | Network Health Medicare Advantage Plans |
| Parent organization | Network Health, Inc. |
| Formulary drugs | 3,928 |
CMS star ratings
- Overall
- 4.5 out of 5 stars for Overall
- Health plan (Part C)
- 4.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5215 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $1.00 |
| Tier 2 | $8.00 |
| Tier 3 | 23% |
| Tier 4 | 28% |
| Tier 5 | 29% |
Also available in 20 other WI counties
Plan facts come from the CMS quarterly prescription drug plan public use files.