How Do Medicare Supplement Insurance Plans in Wisconsin Work?
Wisconsin is one of three waivered states when it comes to Medicare Supplement Insurance for residents age 65 and older. In Wisconsin, a Medicare Supplement Insurance plan, also called Medigap, is designed to work with Medicare Parts A and B (Original Medicare) and provides coverage for things like copayments, coinsurance and deductibles that are not covered by Original Medicare.
In Wisconsin, Medigap policies are standardized in a different way as compared to most of the other states. For most states, there are 8 Medigap plans available to those eligible for Medicare and the Plan names are labeled A-N. However in Minnesota, Medicare Supplement Insurance plans cover “basic benefits” and residents have the option to enroll in a Basic Plan, add on “riders” to their Medigap coverage and/or enroll in a Medigap plan that helps with your Original Medicare costs on a 25% or 50% cost-sharing level. These plans are similar to Medigap Plan K and Plan L available in other states.
Wisconsin residents looking for a Medicare Supplement Insurance plan should thoroughly evaluate all available plans and make a determination based on personal health needs and budget.
Most Popular Medicare Supplement Plans in Wisconsin
- Medicare Part A coinsurance for inpatient hospital care
- Medicare Part A hospice coinsurance or copayment
- Medical costs: covers the Part B coinsurance (generally 20% of the Medicare-approved amount)
- First three pints of blood used each year
A Wisconsin “Basic Plan,” for Medigap covers the following, in addition to the basic benefits outlined above:
- Medicare Part A skilled nursing facility coinsurance
- 175 days of inpatient mental health coverage per lifetime, in addition to what Medicare covers
- An additional 40 home health care visits, on top of what Medicare pays for
- State-mandated benefits, such as preventive services
Last but not least, Wisconsin also offers two Medigap plans that help with your Original Medicare costs on a 25% or 50% cost-sharing level. These plans are similar to Medigap Plan K and Plan L available in other states. These are known as “50% and 25% Cost-sharing Plans.”
As reported by AHIP, 308,713 Wisconsin beneficiaries enrolled in a Medigap policy in 2019. Below is the breakdown of the number of Wisconsin enrollees by Medigap plan type.
| Plan | A | B | C | D | E | F | G | H | I | J | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Enrollment # | 3,846 | 7,135 | 473 | 121 | 19 | 1,798 | 78 | 4 | 45 | 362 | 28 | 27 | 0 | 360 |
Source: AHIP. Reflects data through December, 2019.
| Plan | Enrollment # | |
|---|---|---|
| A | 3,846 | |
| B | 7,135 | |
| C | 473 | |
| D | 121 | |
| E | 19 | |
| F | 1,798 | |
| G | 78 | |
| H | 4 | |
| I | 45 | |
| J | 362 | |
| K | 28 | |
| L | 27 | |
| M | 0 | |
| N | 360 |
Source: AHIP. Reflects data through December, 2019.
While a Medigap policy will help pay for things like copayments, coinsurance and deductibles not covered by Medicare Parts A and B, it is important to note that your Wisconsin Medicare Supplement Insurance plan does not include benefits for prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to help with prescription drug costs. Or you may want to consider a Medicare Advantage plan, which typically includes prescription drug coverage and may also include other benefits, such as dental, vision, hearing and gym memberships.
To learn more about your Medicare Supplement Insurance plan options in Wisconsin, you can work with a SelectQuote licensed sales agent. Acting as your advocate, our licensed sales agents can guide you through the Medicare maze to better understand Medigap plan options and answer any questions you may have throughout the process. SelectQuote individually shops more than 20 national insurance companies to help you compare Medicare plans in Wisconsin.
Wisconsin residents cannot be enrolled in a Medicare Supplement (Medigap) Insurance plan and a Medicare Advantage plan at the same time. A Medigap plan can also not be used to pay for any expenses for a Medicare Advantage plan.
When is the Wisconsin Medicare Supplement Plan Enrollment Period?
Initial enrollment timeframes are very important. Enrollment for Wisconsin Medicare Supplement Insurance plans begins the first day of the month you turn 65 years old. You also must be enrolled in both Medicare Parts A and B in order to get a Medigap plan..
Wisconsin residents have a six-month period surrounding their birth month to buy a Medicare Supplement Insurance plan. Those under the age of 65 can check with the Social Security Administration office for additional enrollment periods.
The best time to enroll in a Medicare Supplement Insurance plan is during the initial 6 months you are eligible for Medicare. You might be surprised to hear that enrollment can begin as early as 64 and 6 months. During this important six-month period, companies that offer Medicare Supplement Insurance plans cannot use underwriting. If you apply for Medicare Supplement Insurance outside of this window of time, you will be subject to a physical exam. If you apply for Medigap coverage after the first six months of eligibility, a company can refuse to sell you a plan or premiums may also adjust depending on current health status and pre-existing health conditions.
How Do I Find the Right Wisconsin Medicare Supplement Insurance Plan?
When you’re ready to learn more about Medicare Supplement Insurance in Wisconsin, it’s a good idea to talk to a Medicare Insurance specialist at SelectQuote. We can help you understand the ins and outs of these plans and ensure you receive all of the available Medicare benefits you deserve. As a trusted independent third-party company, SelectQuote is here to help you find the right Wisconsin Medicare plan to meet your needs and budget.
To ensure you are getting all the benefits you are entitled to receive, call or complete your online form today. Let SelectQuote’s personal licensed sales agents simplify the Medicare maze by comparing rates and independently shopping insurance companies to help you find an affordable option that meets your unique needs.
