Benefits of Medicare | Medicare in Wisconsin

Benefits of Medicare in Wisconsin

Medicare is health insurance aimed at persons aged 65 or over, persons with certain disabilities, and persons of all ages suffering from End-Stage Renal Disease (ESRD), a permanent kidney failure requiring kidney transplant. In the year 2015, Medicare provided health insurance for over 55 million people. Benefits of Medicare in Wisconsin are no different, but the Medicare Supplement Plans sure are.  Keep read for a comprehensive explanation of the Benefits of Medicare or feel free to call us anytime for a personal explanation 920-545-4884

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Basically, Medicare offers health insurance plans to people who have historically been unable to acquire affordable health care coverage. Illnesses often come upon us when we least expect and are least equipped to handle them. Medicare, on the other hand, allows us to enter retirement prepared to take on whatever health issues life may throw at us.

When you first enroll in Medicare, Original Medicare is your default plan. On average, Medicare covers about half of the healthcare charges for those involved. The enrollees are left to cover the remaining costs either with supplemental insurance or out of their own pockets.

However, there are a variety of other options that add on to Original Medicare in order to extend your coverage. This article will detail the major benefits of your different options.

How Does Medicare Work?

There are four Medicare parts. Parts A and B are collectively known as Original Medicare, and make up the standard Medicare package that most people receive. Part A covers hospital and hospice services while Part B covers outpatient services. Parts D covers self-administered prescriptions. Part C (also known as a Medicare Advantage Plan) serves an alternative to all other parts.

In addition to these parts, those who are not on an Advantage Plan may also purchase separate Medicare Supplemental Insurance to reduce out-of-pocket costs.

Each part benefits you differently. This why seeking counsel prior to enrolling in any Medicare plan is important.

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 Benefits of Medicare

Although each individual part of Medicare has its own unique benefits, the following are some of the most common reasons that people sign up for Medicare rather than seeking other health insurance.

Low Costs

Enrolling in Medicare reduces the cost of virtually every major medical expense. For most people, it is a better deal than they could get from seeking private insurance outside of Medicare. Most recipients pay no premiums for Part A, for example, and with the right selection of supplement plans, you can reduce deductibles and premiums significantly.

Wide Coverage

 Medicare covers a wide range of illnesses and health conditions. For every medical cost possible, there is a plan to accommodate it.


If you enroll during your open enrollment period, you cannot be denied coverage despite health risks or pre-existing conditions. Furthermore, with the right additions to Original Medicare, you can even get prescriptions covered, as well as other special care, such as vision and dental exams.

Wide Acceptance

Surveys show that 9 out of ten doctors accept Medicare. This means that there is a low chance that the doctor you have in mind will refuse to treat you. And, since Medicare is widely accepted, accessing this medical care is not a problem if you travel throughout the United States.

Flexibility

With Medicare in Wisconsin, you have a lot of options to find the health care that works for you. Enrollees are faced with plans that can be edited to suit their history, their prescriptions, and their medical conditions.

For example, Medicare Advantage is typically considered an all-in-one program. One card will take care of medical, hospital, and drug prescription benefits. Medicare supplement plans, on the other hand, allow you to custom pick the coverage you need to keep your expenses at a minimum.

Benefits of Medicare Part A

When people think of health insurance, emergencies are one of the first things that come to mind. For many, health insurance is like a safety net: although no one ever plans to have a medical emergency, they want something in place to catch them if they do. That’s exactly how Medicare Part A will benefit you.

 Part A is your “hospital insurance”. Not only does it have you covered for in-patient services when you need to be admitted to a hospital, but the benefits also extend to stays at Skilled Nursing Facilities. Part A even applies to home and hospice care. So if you ever do need extended care, know that Part A has got you covered.

Benefits of Medicare Part B

The other most common benefit people are looking for in health insurance is coverage for routine check ups, sick appointments, and similar non-emergency medical care.

Health insurance offers the peace of mind that you won’t have to neglect preventative care or getting a nasty cold checked out simply due to costs. And that’s what Medicare Part B is here to do.

 Part B, commonly referred to as “medical insurance” has a premium (see below), and helps you to pay for your regular health exams, sick appointments, an outpatient service. It also covers lab tests, x-rays, mental health care, and a variety of other routine health costs

Benefits of Medicare Part D

It can be truly intimidating when you step up to the counter at your pharmacy and hear the price of your prescription. In fact, due to the high cost of medications, more than 30% of prescriptions go unfilled.

The good news for Medicare recipients is that Part D extends the coverage of traditional Medicare in order to bring prescription costs down to a reasonable level.

While parts A and B are included in Original Medicare Part D must be purchased separately. So it’s especially important to add this to your benefits during open enrollment if you are on routine medications. Even if you aren’t, it is better to have the coverage available when you need it than to be hit with a hefty charge when it comes time to fill a prescription.

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Benefits of Medicare Part C

Medicare Part C involves getting your Medicare service from a Medicare Advantage Plan offered by a private insurance company and not really a true Benefits of Medicare. An Advantage Plan isn’t for everyone, but those who choose Part C do so for a variety of reasons.

 First, Advantage Plans function very similar to traditional employer health plans, so if you are leaving the workforce, the transition may feel easier than learning the new systems involved in Original Medicare. 


Additionally, Part C plans include a maximum out-of-pocket expense cap, which means that you always know the absolute highest possible cost you’ll pay for healthcare in any given year. Finally, Advantage Plans often offer coverage for services that are not covered at all under traditional Medicare Benefits, such as dental and vision care

Benefits of Medicare Supplement Plans

You may have heard of the “gaps” in Medicare. These refer to out-of-pocket expenses for services that are often difficult to pay for people living on a fixed income. For example, Medicare Part A will only begin covering a hospital stay after you’ve paid the deductible ($1,340 in 2018). That can be quite the sum for someone who wasn’t expecting it.

Medicare supplemental insurance, frequently called Medigap, extends your traditional Medicare benefits by covering many of these “gaps” so that high costs don’t take you by surprise. While Medigap plans will increase your monthly premiums, many people choose them for the peace of mind they provide.

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Medicare Benefits | Five Things You Should Know

Signing Up Late Comes With a Cost

There are penalties for signing up late. Medicare filing errors can be costly. If you sign up or change plans outside of your open enrollment period, you do not have guaranteed rights. This means that you may be denied coverage or charged higher prices based on your health status. To avoid this headache, sign up during the 3 month period before and after your 65th birthday, and consult with an expert who can ensure that you choose the right plan the first time around.

Pay Your Taxes for Maximum Benefit

Medicare really pays those who have steadily paid taxes over the years: If you are up to ten years away from being 65 and you have not been a steady taxpayer, you should consider changing that as soon as possible. Premiums for Part A can cost as much as $422 per month, while those who have steadily paid taxes for ten years don’t pay anything for the Part A of their Medicare Benefits.

Income Affects Premiums

Medicare is primarily aimed at ensuring that people who cannot afford medical care still get it. Therefore, the more money you make, the higher your monthly premiums will be.

Prescriptions Aren’t Covered Automatically

As a Medicare beneficiary, you don’t automatically get Medicare Part D prescription drug coverage. This Medicare Part D coverage is based on choice, but can be valuable if you take medications. If you do not sign up for Medicare Part D Coverage when you are first eligible, you might have to face a late-enrollment penalty.

Choose Medigap or an Advantage Plan, Not Both

If you enroll in Part C, you are not eligible for Medicare supplement insurance. This is because Medigap is designed to fill the gaps left in traditional Medicare. Oftentimes, these holes are already taken into account for Advantage Plans. It can be tough to find the right plan for you, so be sure to consult with an expert who can take all of your needs into consideration.

Get The Medicare Coverage You Need

The benefits of Medicare are obvious: you’re covered in emergencies, you’re covered for preventative care, and with the right options you’re covered for prescriptions, dental care, eye exams, and more.

  • Deciding to enroll in Medicare is the easy part.
  • The hard part is finding just the right plan for you:
  • Do I need Part D even if I’m not on routine medications right now?
  • Should I take an Advantage Plan or Original Medicare?
  • What Medigap plans should I opt for?

If you’ve got questions like these holding you back from enrolling in Medicare, don’t hesitate to reach out to the the experts on the Medicare Solutions Team at (920) 545-4884 or contact us through our website at your convenience.

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