My Choice Wisconsin Medicare Dual Advantage Plan (HMO D-SNP)
Available to residents of Green County, WI for 2026. Contract H5209, plan 006, segment 2.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $615.00Tier 1 and 6 exempt |
| Plan type | Dual-eligible SNP |
| Special needs plan | Dual-eligible SNP |
| Contract / plan | H5209-006-2 |
| Offered by | My Choice Wisconsin |
| Parent organization | Molina Healthcare, Inc. |
| Formulary drugs | 3,522 |
CMS star ratings
- Overall
- 3 out of 5 stars for Overall
- Health plan (Part C)
- 3 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 3.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5209 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | 15% |
| Tier 3 | 20% |
| Tier 4 | 30% |
| Tier 5 | 25% |
| Tier 6 | $0.00 |
Also available in 34 other WI counties
Plan facts come from the CMS quarterly prescription drug plan public use files.