Medicare Advantage · HMOPOS
Security Health Plan of Wisconsin, Inc.
Plan year 2026

Legacy Rx (HMO-POS) H5211-004

4.5 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$269
+ your Part B premium
Max out-of-pocket
$2,200
in-network annual cap
Primary care
$0
per visit copay
Specialist
$25
per visit

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$0
Inpatient hospital
$350
per stay
no limit on covered hospital days
Inpatient mental health
$350
per stay
Outpatient surgery
$100
Emergency room
$140
Urgent care
$25

What's included, and what it's actually worth4 benefits included. Tap any card for the detail

Hearing

$500copay per hearing aid
Details$500 copay per hearing aid
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$175/yr eyewear allowance
Eyewear allowance$175/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

OTC allowance

$30/quarter OTC allowance
Prepaid card$30/quarter OTC allowance
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$25 copay
In-network$25 copay per visit
Inpatient Hospital$350 per stay
In-network$350 per stay
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$100 copay
In-network$100 copay per procedure
Mental Health$350 per stay
Inpatient psychiatric$350 per stay
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic
Tier 2
$20
Generic
Tier 3
$47
Preferred Brand
Tier 4
40%
Non-Pref Brand
Tier 5
33%
Specialty
Tier 6
$0
Tier 6

Our take

Where this plan shines

This plan’s out-of-pocket maximum ($2,200) is among the lowest available.
See your primary doctor for $0.
The specialist copay ($25) is among the more affordable options.
No separate drug deductible.
Highly rated by CMS (4.5 stars).

Things to know before you enroll

Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Legacy Rx (HMO-POS) (HMOPOS)

What does Legacy Rx (HMO-POS) (HMOPOS) cover?

Legacy Rx (HMO-POS) (HMOPOS) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include vision ($175/yr eyewear allowance), hearing ($500 copay per hearing aid), over-the-counter (OTC) ($30/quarter OTC allowance), and meals (Meal benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Legacy Rx (HMO-POS) (HMOPOS) cost in 2026?

The published 2026 monthly plan premium for Legacy Rx (HMO-POS) (HMOPOS) is $269. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $2,200; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $25. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Legacy Rx (HMO-POS) (HMOPOS)?

CMS lists Legacy Rx (HMO-POS) (HMOPOS) as a HMOPOS plan. The record also identifies point-of-service flexibility, but exact out-of-network rules can vary. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Does Legacy Rx (HMO-POS) (HMOPOS) cover my prescriptions?

Legacy Rx (HMO-POS) (HMOPOS) has 6 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $20, Tier 3 at $47, Tier 4 at 40%, and Tier 5 at 33%. The listed Part D deductible is $0. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does Legacy Rx (HMO-POS) (HMOPOS) include?

The current plan record for Legacy Rx (HMO-POS) (HMOPOS) lists vision ($175/yr eyewear allowance) and hearing ($500 copay per hearing aid). It also lists over-the-counter (OTC) ($30/quarter OTC allowance). The current data does not list dental as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in Legacy Rx (HMO-POS) (HMOPOS)?

Legacy Rx (HMO-POS) (HMOPOS) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Medicare Advantage with drug coverage directory. This plan is offered in Wisconsin. Plan availability can vary by county.

Helpful next steps