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Medicare Wisconsin 2021

Are you a Wisconsin resident soon-to-be celebrating your 65th birthday? If the answer is yes, it’s the perfect time to start thinking about your Medicare options.

When you reach 65-years-old, you enter the privileged position of Medicare eligibility; the health insurance program that helps senior Americans cover the increasing healthcare costs.

The switch to a new healthcare program can be intimidating, but you’re certainly not going through the process alone; Medicare is the nation’s largest health insurance program, covering over 40 million Americans. Ten thousand citizens become eligible every day!

Although enrollment is simple, there are many components for you to consider, and getting to grips with all the different possibilities can take time, but believe us, putting time into your research ensures you get the best package for your budget.

The sooner you pick a plan, the sooner you can enjoy all of the benefits Medicare offers. Remember, you’ve been paying into your Medicare fund your entire working life – it’s time for you to reap the rewards.

Read on as our experts explore Medicare Supplement Insurance and Medicare Advantage plans in Wisconsin.

Overview of Medicare in Wisconsin

Medicare Supplement Insurance in Wisconsin

Original Medicare (Part A and Part B) comes with out-of-pocket costs the plan holder is responsible for, including deductibles, copayments, and coinsurance. Medicare supplement plans (also known as Medigap plans) fill in these gaps by covering a portion of the expenses.

Medicare supplement plans in Wisconsin differ from those in other states. Wisconsin does not offer the standard 10 Medigap plans you commonly find elsewhere. Instead, the Wisconsin Basic Plan offers a set of benefits outlined by the state.

The Wisconsin Medigap Basic Plan covers:

  • Part A coinsurance – the daily hospital copays that you incur after 60 days in the hospital.
  • Part B coinsurance – the 20% that Medicare does not cover for outpatient services.
  • Blood as needed for Medicare-approved surgeries and other procedures.
  • Hospice and Skilled Nursing Facility copayments.
  • 175 extra days of inpatient mental health care.
  • 40 extra home health care visits beyond what Medicare already covers.

If the Wisconsin Basic Plan does not meet your needs, explore the possibilities of Medigap Plan K and Plan L, which are now offered in the state.

Wisconsin Medigap – Mandated Benefits

Alongside the coverage listed above, Medicare Supplement policies in Wisconsin must contain certain mandated benefits:

  • Skilled Nursing – 30 days of skilled nursing care in a skilled nursing facility (SNF).
  • Home Health Care – Up to 40 home care visits each year beyond those provided by Medicare.
  • Kidney Disease – Inpatient and outpatient expenses for dialysis, transplants, and donor-related services.
  • Diabetes – Customary costs for installation and use of an insulin infusion pump or other equipment and supplies for diabetes treatment.
  • Other Mandates – Chiropractic care, surgery center care, breast reconstruction, colorectal cancer screening, and certain costs in trials for cancer.

Wisconsin Medicare Supplement Riders

Riders can be added to the Wisconsin Medigap Basic plan to extend the coverage further. Wisconsin has five optional riders available that are purchased directly through your chosen insurance carrier.

Part A Deductible Rider

One of the most popular purchased riders in Wisconsin. This rider pays for your Part A deductible of $1,364 per benefit period. A Medicare hospital benefit period is 60 days, and there are up to four benefit periods in a year.

Part B Deductible Rider

The Part B Deductible rider pays your Part B deductible of $185. If you do not have this rider, you will have to pay all medical costs for Part B until you meet your deductible

Part B Copayment/Coinsurance Rider

An alternative to the Part B Deductible Rider. You will be responsible for the Part B deductible, and in addition to you will pay up to $20 copay for a doctor’s office visit or up to $50 for an emergency room visit. Adding this rider often lowers your premium.

Medicare Part B Excess Charges

If a doctor doesn’t accept Medicare Assignment, they can charge up to 15% more than what Medicare will approve and pay. This rider will cover the difference.

Additional Home Health Care Rider

Extends the basic plan coverage of 40 home health care visits per year to 365 days.

Foreign Travel Emergency Rider

Up to $50,000 coverage for Medicare-approved medical expenses incurred outside the country, after meeting a $250 deductible.

Selecting Medigap Plan in Wisconsin

If you are looking to enroll in a Medicare Supplement plan, the best time to do so is during your Open Enrollment Period – a six-month period that starts once your Medicare Part B is activated. Insurance companies can’t deny you coverage or charge higher premiums based on pre-existing conditions in this period.

When searching for a plan, it’s advised to compare all the different providers available. In Wisconsin, Medicare Supplement insurance plans indeed offer the same benefits, but the cost varies by insurance company and location.

Remember to consider the plan’s full cost, not just the monthly premium; a plan with low premiums can cost you more in out-of-pocket costs. Start comparing the Medigap plans options available in your area today.

Medicare Advantage Plans Wisconsin

Medicare Advantage combines the benefits of Original Medicare and supplemental plans into a single plan. Medicare Advantage plans have at least the same coverage as Original Medicare, plus Part D and other healthcare services, such as dental and vision.

Unlike Original Medicare, Medicare Advantage plans are provided by private insurance companies. In Wisconsin, there are dozens of different plans and providers to choose from.

Wisconsin Medicare Advantage Plans with Prescription Drug Plans

Medicare Advantage plans in Wisconsin offer excellent benefits, and most include Part D prescription drug coverage! For those who like the convenience of managing benefits under a single plan, this is a big plus.

Before enrolling, check that your prescription is covered; prescription medication included varies from plan to plan.

Tip: Medicare Advantage holders should get prescription drug coverage through a Medicare Advantage plan instead of a stand-alone Medicare Prescription Drug Plan (Part D). If you join a Part D plan while enrolled in a Medicare Advantage plan, you’ll be disenrolled and returned to Original Medicare.

Comparing Medicare Advantage Plans in Wisconsin

To be eligible for Medicare Advantage, you must be enrolled in Original Medicare (Part A and Part B), live in the carrier’s service area, and not have end-stage renal disease (ESRD).

Depending on the Wisconsin county you live in, you will have between 9 and 47 plans available. Costs like premiums, copayments, coinsurance, and deductibles can vary dramatically from plan to plan, so it’s important to research all the plans in your area.

Start comparing the Medicare Advantage plans in your zip code today.

Wisconsin Medicare FAQ

How Much are Medicare Supplement Plans in Wisconsin?

Medigap plan premiums are based on factors such as age, gender, zip code, and riders. The personalized aspect of the pricing makes it difficult to provide an accurate estimate of the cost. That being said, Wisconsin has some of the cheapest rates in the country.

To get an accurate estimate of the rates in your area, compare today.

Which Medigap Plans are Available in Wisconsin?

The Medigap plans in Wisconsin are unconventional. Unlike other states that offer ten standardized letter plans, Wisconsin has state-mandated benefits that are the same regardless of provider. Enrollees can then add riders to extend coverage and customize the plan.

If you have any questions about your Wisconsin Medicare options, speak to one of our licensed agents. Our dedicated team will help find a Medicare plan that works for you. Call us today at 1-844-236-0228.

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