Security Health Plan of Wisconsin, Inc. Spirit (HMO-POS) 2026 Plan Details for Richland County, Wisconsin Residents
Security Health Plan of Wisconsin, Inc. Spirit (HMO-POS) 2026 Plan Details for Richland County, Wisconsin Residents
When selecting a Medicare Advantage plan in Richland County for 2026, it's important to compare all your options. Security Health Plan of Wisconsin, Inc. Spirit (HMO-POS) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
Based on the most recent CMS data, plan enrollments topped 1,918 members, with 0 in Richland County, Wisconsin.
Security Health Plan of Wisconsin, Inc. Spirit Overview
| Plan ID H5211-001-0 Overview | |
|---|---|
| Health Plan ID: | H5211-001-0 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $1500.00 (In-Network) |
| Part B Give Back: | Not offered |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Richland County, WI |
| Insured By: | Security Health Plan of Wisconsin, Inc. |
Why Choose Security Health Plan of Wisconsin, Inc. Spirit?
This Medicare Advantage HMO-POS plan gives you structured benefits with added flexibility. With a monthly premium of $0.00, Security Health Plan of Wisconsin, Inc. Spirit covers all the essentials of Medicare Part A and Part B, while giving you the option to see out-of-network providers in certain situations. You’ll typically pay less when staying in-network, but have the freedom to go outside when needed — a nice middle ground for those who want more control over their care.
Primary care visits have a $0 copay | Out-of-network: $0 copay, 0% coinsurance, specialist visits come with a $25 copay | Out-of-network: $25 copay, urgent care services carry a $0-$25 copay, and ambulance transportation is $175 copay. These costs all apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $1500.00. Once you reach that cap, your in-network services are covered at 100% for the rest of the year. It’s a dependable option if you’re looking for predictable costs and the flexibility to step outside the network when needed.
This plan is registered with CMS under ID H5211-001-0. You’ll find a summary of its cost sharing below, including what you can expect to pay for primary care, specialists, urgent care, and more. Still have questions? Check the FAQ section for more details.
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Cost-Sharing Overview
Security Health Plan of Wisconsin, Inc. Spirit includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H5211-001-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Specialist: | In-network: $25 copay | Out-of-network: $25 copay |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$175 copay |
| Routine chiropractic: | In-network: $20 copay | Out-of-network: $20 copay |
| Fitness benefits: | In-network: $0 copay |
| Health education: | In-network: $0 copay |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $140 copay |
| Wordwide emergency care: | $140 copay |
| Urgent care: | $0-$25 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $250 per stay | Out-of-network: | $250 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-6 | $20 per day for days 7-20 | $0 per day for days 21-100 | Out-of-network: | $0 per day for days 1-6 | $20 per day for days 7-20 | $0 per day for days 21-100 | $0 per stay |
| Ground ambulance: | In-network: $175 copay |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $25 copay | Out-of-network: $25 copay |
| Outpatient group therapy: | In-network: $25 copay | Out-of-network: $25 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $250 per stay | Out-of-network: | $250 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $20 copay | Out-of-network: $20 copay |
| Occupational therapy: | In-network: $20 copay | Out-of-network: $20 copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: $0 copay |
| Durable medical equipment: | In-network: 0%-20% coinsurance |
| Prosthetics: | In-network: 20% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $150 copay | Out-of-network: $150 copay |
| Lab services: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Outpatient x-rays: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Diagnostic tests and procedures: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-20% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay |
| Dental x-rays: | In-network: $0 copay |
| Cleaning: | In-network: $0 copay |
| Periodontics: | Not covered |
| Endodontics: | Not covered |
| Restorative services: | Not covered |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | Not covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $25 copay | Out-of-network: $25 copay |
| Fitting/evaluation: | In-network: $25 copay | Out-of-network: $25 copay |
| Prescription hearing aids: | In-network: $500 copay |
| OTC hearing aids: | Not covered |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $0-$25 copay |
| Contact lenses: | Not covered |
| Eyeglass frames only: | Not covered |
| Eyeglass lenses only: | Not covered |
| Eyeglasses (frames & lenses): | In-network: $0 copay |
| Upgrades: | Not covered |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | In-network: 20% coinsurance |
Certain preventive services are covered 100% by Security Health Plan of Wisconsin, Inc. Spirit as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Eligibility Requirements for Security Health Plan of Wisconsin, Inc. Spirit
To enroll in Security Health Plan of Wisconsin, Inc. Spirit, you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in Security Health Plan of Wisconsin, Inc. Spirit and benefit from its comprehensive coverage options.
When Can I Enroll in Security Health Plan of Wisconsin, Inc. Spirit?
Understanding the right time to enroll in Security Health Plan of Wisconsin, Inc. Spirit is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
How to Enroll in Security Health Plan of Wisconsin, Inc. Spirit
Joining Security Health Plan of Wisconsin, Inc. Spirit is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Security Health Plan of Wisconsin, Inc. Spirit.
- Direct Enrollment: You can also choose to enroll directly with Security Health Plan of Wisconsin, Inc. Spirit. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H5211-001-0:
How much does H5211-001-0 cost per month?
The 2026 premium is $0.00 each month, and you must continue to pay your Part B premium.
How high can my costs go in a worst-case year?
For 2026, the maximum you’d spend out-of-pocket in-network is $1500.00.
What’s the CMS star score for Security Health Plan of Wisconsin, Inc. Spirit?
CMS rates it ★4.5 out of 5 stars for 2026.
Is Security Health Plan of Wisconsin, Inc. Spirit popular?
As of last month, about 1,918 beneficiaries are enrolled.
Contact Security Health Plan of Wisconsin, Inc.
| Contact Type | Details |
|---|---|
| Website: | Security Health Plan of Wisconsin, Inc. Plan Page |
| New Members: | 1-877-998-0998 |
| Existing Members: | 1-877-998-0998 |
| Plan Address: | 1515 North Saint Joseph Avenue | PO Box 8000 | Marshfield, WI 54449 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Security Health Plan of Wisconsin, Inc., http://www.securityhealth.org/medicareadvantage — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
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