Wisconsin health plan · 2026

Partners HMO Bronze 6000 Ded/10600 MOOP HSA · 94529WI0240027

Group Health of South Central Wisconsin offers this marketplace health insurance plan (Plan ID 94529WI0240027) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Bronze Plan type: HMO CSR: Limited Cost Sharing Plan Variation Issuer: Group Health of South Central Wisconsin
Telehealth Data pending HSA eligible Yes Dental Not listed Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 58.62% (41.38% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$284 – $1114

Before subsidies

Estimate after subsidies

Deductible

$6,000

$12000 per group

See deductible details

Max out-of-pocket

$10,600

$21200 per group

Review MOOP rules

Office visits

Primary care $125.00
Specialist $200.00
HSA Eligible

Drug tiers

Generic $30.00
Preferred brand $250.00

View formulary tiers

$389 / mo before subsidies

≈ $4668 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1233 / mo before subsidies

≈ $14794 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1493 / mo before subsidies

≈ $17916 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$949 / mo before subsidies

≈ $11386 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

50.00% Coinsurance after deductible

Durable Medical Equipment

20.00%

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Wisconsin). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

50.00% Coinsurance after deductible

Durable Medical Equipment

20.00%

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 94529WI0240027
Coverage year 2026
State Wisconsin
Issuer Group Health of South Central Wisconsin
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 94529WI0240027-03
Available variants

Standard Off Exchange Plan · 94529WI0240027-00

Standard On Exchange Plan · 94529WI0240027-01

Open to Indians below 300% FPL · 94529WI0240027-02

Open to Indians above 300% FPL · 94529WI0240027-03
Last plan update Wed, 15 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Wisconsin 1907
PCPs in Wisconsin 529
Telehealth support Data pending
Nationwide providers 2091
1,907 doctors statewide 529 PCPs 8 OB/GYN

Provider network(s)

Providers Wisconsin All US states
All 1907 2091
PCP 529 563
Allergy 1 1
OB/GYN 8 8
Dentists 3 8

Drug coverage overview

4,290 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
NON-PREFERRED-GENERIC 2,564
NON-PREFERRED-BRAND 924
SPECIALTY-DRUGS 651
MEDICAL-SERVICE-DRUGS 351
Prior authorization Drugs
Required 860
Not Required 3,430
Step therapy Drugs
Required 87
Not Required 4,203
Quantity limits Drugs
Has Limit 987
No Limit 3,303

Customer highlights

What stands out for members

  • Issuer: Group Health of South Central Wisconsin · Plan ID 94529WI0240027 · 2026 filing.
  • Disease management programs available: Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 94529WI0240027-03 (Open to Indians above 300% FPL) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

$125.00
Tier 1 in-network $125.00
Out-of-network 100.00%

Rehabilitative services must be short term. Visit limits do not apply to Manipulative Therapy.

Diabetes Education

$0.00
Tier 1 in-network $0.00
Out-of-network 100.00%

Home Health Care Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Year

Services must be provided fewer than seven days each week and fewer than eight hours each day for periods of 21 days or less.

Laboratory Outpatient and Professional Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Other Practitioner Office Visit (Nurse, Physician Assistant)

$125.00
Tier 1 in-network $125.00
Out-of-network 100.00%

Preventive Care/Screening/Immunization

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Primary Care Visit to Treat an Injury or Illness

$125.00
Tier 1 in-network $125.00
Out-of-network 100.00%

Rehabilitative Occupational and Rehabilitative Physical Therapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 40.0 Visit(s) per Year

PT/OT Rehabilitative Therapies have a combined limit of 40 Visits per year.

Rehabilitative Speech Therapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Year

Rehabilitative services must be short term.

Specialist Visit

$200.00
Tier 1 in-network $200.00
Out-of-network 100.00%

Urgent Care Centers or Facilities

$185.00
Tier 1 in-network $185.00
Out-of-network $185.00

X-rays and Diagnostic Imaging

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Intravenous chemotherapy is covered.

Delivery and All Inpatient Services for Maternity Care

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Dialysis

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Durable Medical Equipment

20.00%
Tier 1 in-network 20.00%
Out-of-network 100.00%

Emergency Room Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Copay waived if admitted as a hospital inpatient.

Emergency Transportation/Ambulance

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Hospice Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Inpatient Hospital Services (e.g., Hospital Stay)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Inpatient Physician and Surgical Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Mental/Behavioral Health Inpatient Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Mental/Behavioral Health Outpatient Services

$125.00
Tier 1 in-network $125.00
Out-of-network 100.00%

The cost sharing that displays applies to outpatient office visits only. Other outpatient services (e.g. Transitional MH/SUD Treatment Services) may be subject to additional cost sharing. Please refer to the plan policy documents for detailed information. For CMS Standardized Plan Options, for in-network outpatient MH/SUD services other than MH/SUD office vsitis, the plan's coinsurance rate and deductible applies.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Outpatient Rehabilitation Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Year

Rehabilitative services must be short term. PT/OT Rehabilitative Therapies have a combined limit of 40 Visits per year. Rehabilitative Speech Therapy, Pulmonary Rehabilition, and Cognitive Therapy have a limit of 20 Visits per therapy per year. Cardiac Rehabilitation Therapy has a limit of 36 Visits per year. Post-Cochlear Implant Aural Rehabilitation Therapy has a limit of 30 Visits per year.

Outpatient Surgery Physician/Surgical Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Radiation

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Skilled Nursing Facility

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Days per Stay

Substance Abuse Disorder Inpatient Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Substance Abuse Disorder Outpatient Services

$125.00
Tier 1 in-network $125.00
Out-of-network 100.00%

The cost sharing that displays applies to outpatient office visits only. Other outpatient services (e.g. Transitional MH/SUD Treatment Services) may be subject to additional cost sharing. Please refer to the plan policy documents for detailed information. For CMS Standardized Plan Options, for in-network outpatient MH/SUD services other than MH/SUD office vsitis, the plan's coinsurance rate and deductible applies.

Transplant

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

20.00%
Tier 1 in-network 20.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per 3 Years

1 Hearing Aid per ear per 36 months.

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Routine Eye Exam for Children

$0.00
Tier 1 in-network $0.00
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Year

Well Baby Visits and Care

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$30.00
Tier 1 in-network $30.00
Out-of-network 100.00%

Non-Preferred Brand Drugs

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Preferred Brand Drugs

$250.00
Tier 1 in-network $250.00
Out-of-network 100.00%

Specialty Drugs

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Post-Cochlear Implant Aural Rehabilitation Therapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 30.0 Visit(s) per Year

Prosthetic Devices

20.00%
Tier 1 in-network 20.00%
Out-of-network 100.00%

Pulmonary Rehabilitation Therapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Year

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Cardiac Rehabilitation

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 36.0 Visit(s) per Year

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Eye Glasses for Children

$0.00
Tier 1 in-network $0.00
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Gender Affirming Care

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Medically Necessary Gender Affirming Care is covered as allowed by law. GHC-SCW does not discriminate on the basis of sexual orientation or gender identity.

Habilitation Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Year

Supplementing with the federal definition of habilitative services: Health care services that help a person keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who is not walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings. PT/OT Habilitative Therapies have a combined limit of 40 Visits per year. Habilitative Speech Therapy and Cognitive Therapy have a limit of 20 Visits per therapy per year.

Imaging (CT/PET Scans, MRIs)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Treatment for Temporomandibular Joint Disorders

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Variant attributes

Partners HMO Bronze 6000 Ded/10600 MOOP HSA · Variant 94529WI0240027-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

94529WI024

Metal Level

Bronze

Plan ID (Standard Component ID with Variant)

94529WI0240027-03

Plan Marketing Name

Partners HMO Bronze 6000 Ded/10600 MOOP HSA

Plan Variant Marketing Name

Partners HMO Bronze 6000 Ded/10600 MOOP HSA Limited Cost Sharing

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

94529

Issuer Marketplace Marketing Name

Group Health Cooperative-SCW

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

WIN001

Out of Country Coverage

No

Out of Service Area Coverage

No

Service Area ID

WIS001

State Code

WI

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.586201852

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$1,300

SBC Scenario, Having a Baby, Copayment

$90

SBC Scenario, Having a Baby, Deductible

$6,000

SBC Scenario, Having Diabetes, Coinsurance

$620

SBC Scenario, Having Diabetes, Copayment

$1,600

SBC Scenario, Having Diabetes, Deductible

$110

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$60

SBC Scenario, Treatment of a Simple Fracture, Copayment

$130

SBC Scenario, Treatment of a Simple Fracture, Deductible

$1,800

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$21200 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$10600 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$10,600

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

WIF004

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$50

SBC Scenario, Having Diabetes, Limit

$20

SBC Scenario, Treatment of a Simple Fracture, Limit

$10

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy

EHB Percent of Total Premium

0.999999

First Tier Utilization

100%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

Yes

New/Existing Plan

Existing

Notice Required for Pregnancy

Yes

Is a Referral Required for Specialist?

Yes

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Level Exclusions

Prior Authorization, Medically Necessary/Medical Necessity, Act of War, Ongoing Medical Necessity, Experimental/ Investigational Treatment, Service Before Effective Date, Service After Termination Date, Services While Incarcerated, Any Charge for an Appointment a Member does not Attend, Services for Injuries Incurred During the Commission of a Crime

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Specialist Requiring a Referral

Allergy, Asthma, Audiology, Cardiovascular, Dermatology, ENT/Otolaryngology, Endocrinology, Gastroenterology, General Surgery, Geriatrics, Hematology, Immunology, Infectious Diseases, Nephrology, Neurology , Neurosurgery, Medical Oncology, Ophthalmology, Orthopedics, Pain Management, Peripheral Vascular, Perinatology, Plastic Surgery, Pulmonology, Radiation Oncology, Rheumatology, Speech Therapy, Spine Medicine, Sports Medicine, Transplant Surgery/Medicine, Urology, Vascular Surgery, All out of area specialty care

Plan ID

94529WI0240027

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$12000 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$6000 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$6,000

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Individual

Not Applicable

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Wisconsin?

Partners HMO Bronze 6000 Ded/10600 MOOP HSA (94529WI0240027) is a Bronze HMO from Group Health of South Central Wisconsin in Wisconsin for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Partners HMO Bronze 6000 Ded/10600 MOOP HSA support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Partners HMO Bronze 6000 Ded/10600 MOOP HSA HSA-eligible and does it include dental or vision coverage?

It is HSA-eligible, so you can pair it with a Health Savings Account to lower taxes.

Dental coverage is not listed for this plan.

Vision add-ons: Child.

Does Partners HMO Bronze 6000 Ded/10600 MOOP HSA support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with Partners HMO Bronze 6000 Ded/10600 MOOP HSA?

The issuer lists disease management resources for: Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy.

Is there out-of-country coverage for Partners HMO Bronze 6000 Ded/10600 MOOP HSA?

No, out-of-country services are not covered for this plan.

Does Partners HMO Bronze 6000 Ded/10600 MOOP HSA cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies.

How do I enroll in or manage payments for Partners HMO Bronze 6000 Ded/10600 MOOP HSA?

Use the issuer portal https://quote.ghcscw.com/MarketPlaceWelcome to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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