Esteem Rx (HMO-POS)
Available to residents of Waupaca County, WI for 2026. Contract H5211, plan 012, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $250.00Tier 1, 2 and 6 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H5211-012-0 |
| Offered by | Security Health Plan of Wisconsin, Inc. |
| Parent organization | Marshfield Clinic Health System, Inc. |
| Formulary drugs | 3,478 |
CMS star ratings
- Overall
- 4.5 out of 5 stars for Overall
- Health plan (Part C)
- 4 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5211 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $16.00 |
| Tier 3 | $47.00 |
| Tier 4 | 40% |
| Tier 5 | 30% |
| Tier 6 | $0.00 |
Also available in 53 other WI counties
- Adams
- Ashland
- Barron
- Bayfield
- Brown
- Buffalo
- Burnett
- Chippewa
- Clark
- Columbia
- Crawford
- Dane
- Door
- Douglas
- Dunn
- Eau Claire
- Florence
- Forest
- Green Lake
- Iowa
- Iron
- Jackson
- Juneau
- Kewaunee
- La Crosse
- Langlade
- Lincoln
- Marathon
- Marinette
- Marquette
- Monroe
- Oconto
- Oneida
- Outagamie
- Pepin
- Pierce
- Polk
- Portage
- Price
- Richland
- Rusk
- Sauk
- Sawyer
- Shawano
- Taylor
- Trempealeau
- Vernon
- Vilas
- Washburn
- Waukesha
- Waushara
- Winnebago
- Wood
Plan facts come from the CMS quarterly prescription drug plan public use files.