If you want a Wisconsin Medicare Advantage plan that has comprehensive coverage and budget-friendly benefits, the Birch plan may be the answer. In addition to medical and prescription drug coverage, this plan includes dental coverage, an allowance for non-Medicare prescription eyewear, $0 monthly premiums and lower out-of-pocket maximums than our Cedar plan.
Wondering if the Birch plan is right for you? Let’s dig into the details.
Living in northeast Wisconsin? From Manitowoc to Marinette, Green Bay to Baileys Harbor, Oshkosh to Appleton and more, the Birch plan has you covered.
Our Birch plan is available in these Wisconsin counties:
- Brown
- Calumet
- Door
- Kewaunee
- Manitowoc
- Marinette
- Menominee
- Oconto
- Outagamie
- Shawano
- Waupaca
- Winnebago
Our Wisconsin Medicare Advantage network includes over 90,000 in-network care providers, including Emplify Health, ThedaCare, Holy Family Memorial, Aurora Health Care, UW Health, Froedtert & the Medical College of Wisconsin, and more. You can also see out-of-network providers who accept Medicare and are willing to see you – you’ll pay the same costs as if they were in network
Part D prescription drug coverage is included with the Birch plan.
- Part D prescription drug coverage, starting at $0 copays for covered generic drugs
- Pay in-network costs at out-of-network providers who accept Medicare and are willing to see you
- $0 copays for preventive care, $0 copays for primary care visits and $55 copays for specialty care visits
- Outpatient care (for example: $75 for diagnostic procedures and tests, 10% coinsurance for lab work and $100 for X-rays)
- Out-of-pocket maximum: $6,750 in-network / $10,000 combined in and out of network
- $150 allowance for non-Medicare-covered prescription eyewear
- Partial dental coverage for certain preventive care and certain comprehensive care, like one annual routine exam and cleaning
- In-network cost sharing for up to nine months of domestic travel
- Worldwide emergency and urgent care coverage
- SilverSneakers® fitness programs
- $0 copays for routine vision and hearing exams
- 24/7 CareLine℠ nurse support
- Condition management support services
Please note: We are limiting the number of Medicare Advantage members we can accept for 2027. For more information, get the latest updates about our 2027 Medicare Advantage plans.
If the Birch plan isn’t a good match for you, we also offer the Cedar Medicare Advantage plan. Or you can get one-on-one help from our Medicare experts.
For more information about all your Medicare plan options, visit medicare.gov.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
SilverSneakers® is a registered trademark of Tivity Health, Inc. © 2026 Tivity Health, Inc. All rights reserved.
Last updated October 2026
Y0095_005698_M Accepted 09/26/26
H2422_005698_M Accepted 09/26/26
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