Medicare Counseling: Dual Eligible Special Need Plans (D-SNP) Plan – My Choice Wisconsin Medicare Dual Advantage
Check what other D-SNPs are available in your county and what Medicaid plans they accept. (Excel)
My Choice Wisconsin Medicare Dual Advantage (HMO D-SNP, H5209)
For calendar year 2023
Contact information
Phone: 800-963-0035
TTY: 711
Website: https://mychoicewi.org/medicare-dual-advantage/
Eligibility
Who can get this plan
People with full benefit Medicaid
Service area
- Adams
- Brown
- Calumet
- Columbia
- Dane
- Dodge
- Door
- Florence
- Fond du Lac
- Green
- Green Lake
- Iowa
- Jefferson
- Kewaunee
- Manitowoc
- Marinette
- Marquette
- Milwaukee
- Oconto
- Outagamie
- Ozaukee
- Racine
- Rock
- Sauk
- Sheboygan
- Shawano
- Walworth
- Washington
- Waukesha
- Waupaca
- Waushara
- Winnebago
Star rating
4 out of 5 stars
Coverage
Check if your doctors are in-network: Provider search
Check if your prescription drugs are covered: Drug coverage information
Costs
Doctor visit: No cost
Hospitalization: No cost
Skilled nursing facility: No cost
Emergency department: No cost
Extra benefits
Details: Summary of Benefits
Basic dental:
- Two diagnostic visits per year
- Exams, cleanings, and x-rays
The plan will cover up to $2,500 in basic and extra dental services each year.
Extra dental:
- Restorative services (crowns, fillings) up to one restoration per tooth, per year
- Dentures
- Non-surgical extractions
Prior authorizations are required. The plan will cover up to $2,500 in basic and extra dental services each year.
Vision: Up to $150 per year for eyeglass lenses, eyeglass frames, eyewear upgrades, and/or contact lenses. Prior authorization required.
Hearing:
- Hearing exams to diagnose and treat hearing and balance issues
- Hearing aid batteries
Wellness programs: None
Other:
- Over-the-counter (OTC) benefit of $155 per month with rollover
- Meals following a discharge from a hospital or nursing facility stay
- Personal emergency response button
- Home and bath safety items and modifications
How to enroll
You can only enroll during a Medicare enrollment period; learn more at Medicare.gov.
Enrollment into this plan will automatically disenroll you from your current Medicare Advantage or Part D plan.
There are multiple ways to enroll:
- Call My Choice Wisconsin Medicare Dual Advantage: 1-800-963-0035
- Medicare.gov
- 1-800-MEDICARE
- Contact the State Health Insurance Assistance Program (SHIP)