Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
UHC Complete Care WI-20, 2027
H5253Contract202Plan
HMO-POS C-SNP · special needs plan, chronic or disabling condition · 32 counties in Wisconsin
Run by UnitedHealthcare of Wisconsin, Inc. (contract H5253), sold as UnitedHealthcare, owned by UnitedHealth Group, Inc.
UHC Complete Care WI-20 (H5253-202) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $5,900 ($5,400 in 2026). It leaves 6 counties it served in 2026, where 766 of its members lived; they choose another plan for 2027 (the counties are listed below).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| In-network out-of-pocket limit | $5,400 | $5,900 | ▲up $500 |
| Drug deductible | $520 | $595 | ▲up $75 |
| Hospital stay, in network | $495 a day for days 1–5, then $0 a day for days 6–90 | $550 a day for days 1–5, then $0 a day for days 6–90 | ▲up $275for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Ground ambulance, in network | $275 copay | $350 copay | ▲up $75 |
| Hearing aids, yearly limit for both ears | not offered | $1,000 a year | ▲added |
| Counties served | 38 | 32 | ▼down 6 |
| Drug tier 2, generic | $10 | $6 | ▼down $4 |
| Drug tier 3, preferred brand | 18% of the cost | 22% of the cost | ▲up 4 points |
| Drug tier 4, non-preferred drug | 42% of the cost | 29% of the cost | ▼down 13 points |
| 11 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $0 copay | $0 copay | no change |
| Emergency room | $130 copay | $130 copay | no change |
| Medical deductible, in network | none | none | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Eyewear, yearly limit | $100 a year | $100 a year | no change |
| Over-the-counter items, yearly | not offered | not offered | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 5, specialty tier | 27% of the cost | 27% of the cost | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $10 | $6 |
| Tier 3 | Preferred Brand | 18% of the cost | 22% of the cost |
| Tier 4 | Non-Preferred Drug | 42% of the cost | 29% of the cost |
| Tier 5 | Specialty Tier | 27% of the cost | 27% of the cost |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 4 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 2 plans have a lower out-of-pocket limit, 1 a higher one. On the premium, 3 the same.
Out-of-pocket limits of the 4 chronic or disabling condition special needs plans
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
It stops serving 6 counties it served in 2026 (listed in the next section).
The premium and the out-of-pocket limit are the same in all 32 counties: $0 a month and $5,900.
Wisconsin
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
What if you live in a county it leaves?
Its 2026 members in the 6 counties listed below cannot stay in it for 2027; each county page lists the 2027 plans sold there.
- Your coverage
- This plan ends for you on December 31, 2026, because it is no longer sold where you live.
- October 15 to December 7, 2026
- Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
- December 8, 2026 to the end of February 2027
- A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
- If you do nothing
- You are enrolled in Original Medicare when the plan ends, without a drug plan unless you join one (with Extra Help or full Medicaid, Medicare enrolls you in one).
- Without a drug plan
- Going 63 days or more in a row without drug coverage can mean a late enrollment penalty if you join a drug plan later; joining by the end of February keeps a January and February gap under 63 days, waiting longer does not.
- If you choose Original Medicare
- You have a guaranteed right to buy Medigap Plan A, B, C, D, F, G, K or L sold in your state by any insurance company; if you were new to Medicare on or after January 1, 2020, Plans D and G take the place of C and F. Apply from 60 days before to 63 days after the plan ends; the policy starts once your Medicare Advantage coverage ends. Other Medigap plans are not covered by this right.
| County | Members, Sept. 2026 |
|---|---|
| Kenosha, WI | 298 |
| Dodge, WI | 237 |
| Langlade, WI | 82 |
| Waushara, WI | 70 |
| Green Lake, WI | 54 |
| Door, WI | 25 |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); Medicare.gov, “Special enrollment periods” and “When can I buy Medigap?” (read Oct. 7, 2026).
Who runs this plan?
- Plan ID
- H5253-202
- Legal name of the contract
- UnitedHealthcare of Wisconsin, Inc.
- Sold as
- UnitedHealthcare
- Parent company
- UnitedHealth Group, Inc.
- Plan type
- HMO-POS C-SNP
- 2026 star rating of the contract
- 4 of 5 overall; health plan 4 of 5, drug plan 4 of 5
- Members, September 2026
- 8,696
- Plan website, as filed with CMS
- UHC.com/Medicare
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Milwaukee, WIWhere most of its members live; premiums and limits side by side
- Every UnitedHealthcare plan for 2027Its contracts, counties and plans that end
- The other 125 plans of contract H5253Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.