Cooperative Advantage (HMO D-SNP)
Available to residents of Washburn County, WI for 2027. Contract H7598, plan 003, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
Renewed for 2027. CMS carries this plan forward from 2026.
Plan details
| Monthly premium (Part C + D) | $0.00 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $0.00 |
| In-network out-of-pocket maximum | $9,850.00 |
| Drug deductible | $700.00Tier 1 and 2 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO D-SNP |
| Special needs plan | Dual-eligible SNP |
| D-SNP integration status | Highly Integrated (HIDE) |
| Zero-dollar cost sharing D-SNP | Yes |
| Contract / plan | H7598-003-0 |
| Offered by | Group Health Cooperative of Eau Claire |
| Parent organization | Group Health Cooperative of Eau Claire |
| Formulary tiers | 5 |
| Member services | (800)460-4641TTY (800)716-3231 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H7598 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Preferred Generic | $0.00 |
| Tier 2 · Generic | 25% |
| Tier 3 · Preferred Brand | 25% |
| Tier 4 · Non-Preferred Drug | 25% |
| Tier 5 · Specialty Tier | 25% |
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Managing Chronic (Long Term) Conditions | ||
| Special Needs Plan (SNP) Care Management · C07 | 3 out of 5 stars for Special Needs Plan (SNP) Care Management | 5 out of 5 stars for Special Needs Plan (SNP) Care Management |
| Care for Older Adults – Medication Review · C08 | 3 out of 5 stars for Care for Older Adults – Medication Review | not enough data |
| Care for Older Adults - Functional Status Assessment · C09 | 1 out of 5 stars for Care for Older Adults - Functional Status Assessment | new measure |
| Health Plan Customer Service | ||
| Plan Makes Timely Decisions about Appeals · C30 | 3 out of 5 stars for Plan Makes Timely Decisions about Appeals | not enough data |
| Reviewing Appeals Decisions · C31 | 1 out of 5 stars for Reviewing Appeals Decisions | not enough data |
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 3 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 2 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 2 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 4 out of 5 stars for MPF Price Accuracy | 5 out of 5 stars for MPF Price Accuracy |
| Medication Adherence for Hypertension (RAS antagonists) · D09 | 4 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) | 3 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) |
| Medication Adherence for Cholesterol (Statins) · D10 | 3 out of 5 stars for Medication Adherence for Cholesterol (Statins) | 4 out of 5 stars for Medication Adherence for Cholesterol (Statins) |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H7598 shares it.
Also available in 49 other WI counties
- Adams
- Ashland
- Barron
- Bayfield
- Buffalo
- Burnett
- Chippewa
- Clark
- Columbia
- Crawford
- Douglas
- Dunn
- Eau Claire
- Florence
- Forest
- Grant
- Green
- Iowa
- Iron
- Jackson
- Juneau
- La Crosse
- Lafayette
- Langlade
- Lincoln
- Marathon
- Marquette
- Menominee
- Monroe
- Oconto
- Oneida
- Pepin
- Pierce
- Polk
- Portage
- Price
- Richland
- Rusk
- St. Croix
- Sauk
- Sawyer
- Shawano
- Taylor
- Trempealeau
- Vernon
- Vilas
- Waupaca
- Waushara
- Wood
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.