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Choosing a Medigap Policy in Wisconsin in 2019

Wisconsin Medicare Supplement Plans 2019

Choosing a Medigap Policy in Wisconsin:  If 2019 is your year to start receiving Original Medicare benefits, you need to know that although Original Medicare is a comprehensive health insurance program, because of several coverage gaps, your annual out-of-pocket expenses can quickly get out of hand.

Yes, there are changes to Medicare that happen every year, but in almost every case, the changes will typically never result in additional coverage. Because of these gaps in health care coverage, having a Medigap policy is almost a must for every Medicare beneficiary.

Original Medicare Coverage and Coverage Gaps

Beneficiaries (people in enrolled in Medicare) are eligible to begin receiving health insurance benefits from Original Medicare when they are 65.

Original Medicare is composed of two parts; Part A, which covers in-patient expenses (hospital care) and Part B, which covers outpatient expenses like physician treatments and medical supplies.

To be clear, Original Medicare is very affordable when compared to the average individual health insurance premium which is about $525 a month for a very healthy non-smoker.

If you are 63 or 64 years old and have preexisting conditions, your individual health insurance is likely closer to $1,000 which makes Original Medicare an incredible value.

 In fact, Part A (the hospital coverage) is typically free for most people and Part B (physician coverage) is only $134 a month for most people. The problem with Medicare, however, exists in the deductibles, coinsurance, and copayment, this is where Medigap insurance comes in.

Wisconsin Medigap Plans in 2019

Although most states have approved 10 Medigap plans for seniors, the state of Wisconsin has narrowed the selection for their residents significantly.

In Wisconsin, When Choosing a Medigap Policy in Wisconsin, Medicare beneficiaries can choose between two plans: the Basic Plan and the Cost Sharing Plans. These approved plans, however, are offered by many insurance companies licensed to do business in Wisconsin. Here is a breakdown of coverages that every plan must offer: 

  • The coinsurance charge for inpatient hospital care that Medicare Part A requires
  • The coinsurance or copayment required for hospice care that Medicare Part A requires
  • Coinsurance for outpatient services required under Medicare Part B
  • First three pints of blood used each year not paid for under Medicare Part A or Part B

Wisconsin Medicare Supplement Base Plan

Wisconsin seniors who choose the “Base” plan which basically only covers coinsurance and copayments that 20% Medicare will not cover will be left with many gaps in coverage and the resulting out-of-pocket expenses as a result. These expenses will include:

  • The $1,340.00 deductible for Medicare Part A (per benefit period – not per year)
  • The $185.00 annual deductible for Medicare Part B
  • Emergency expenses during foreign travel
  • Medicare Part B copayments and coinsurance
  • Extended Home Healthcare fees
  • Medicare Part B excess charges by physicians

Wisconsin Medicare Supplement Riders

Wisconsin residents are, however, allowed to choose insurance riders (optional coverages) that when added, make your Wisconsin Medigap plan more comprehensive and equal to the lettered traditional Medigap plans sold throughout the country:

  • The Medicare Part A deductible Rider
  • The Medicare Part B deductible Rider
  • The Medicare Foreign Travel Rider
  • The Medicare Home Healthcare Rider
  • The Medicare Part B Excess Charges Rider

 When the applicant adds the riders listed above to the coverages provided in the Wisconsin Base Plan, your Medicare supplement plan then matches up with the lettered plans that are available throughout the country.

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Choosing a Medigap Policy in Wisconsin in 2019

The primary from company to company when it comes to Medigap Plans in Wisconsin is the cost of the coverage which can vary based on the area of Wisconsin you reside.

For example, your cost for a Medigap policy in Clark County will likely be different than the cost for the same plan in Douglas County.

 It’s also important to note that the amount of the monthly payment is not the determining factor when considering your actual cost of the Medigap policy you choose in 2019. The bottom line for your annual cost is your out-of-pocket expenses so you should consult your independent agent for determining which plan will likely cost the least on an annual basis.

Choosing a Medigap Policy in Wisconsin | Here is what we Recommend

It’s important to remember that although you can purchase an inexpensive “bare bones” Medigap Policy in Wisconsin, your choice will likely end up costing you more in the long run because of your inevitable out-of-pocket expenses, especially if you have health issues that will require you to visit a physician or be in the hospital during the year.

When you take pricing and coverage into consideration, we believe that the following selections will deliver the most bang for the buck. We have listed the plan with the appropriate riders and the lettered plan equivalent.

Medigap Plan G Equivalent

Base + Following Riders

  • Medicare Part A Deductible
  • Medicare Part B Excess Charges
  • Emergency Foreign Travel 
  • Additional Home Health Care

The above group of Medigap coverages is equivalent to a Medicare supplement Plan G which is one of the top three Medicare supplement Policies when it comes to sales of all Medigap Plans nationally.

Medigap Plan N Equivalent

Base + Following Riders

  • Medicare Part A Deductible
  • Medicare Part B Coinsurance Rider
  • Emergency Foreign Travel 
  • Additional Home Health Care

           ****Medicare Part B Excess Charges rider can be added for a Hybrid Plan N

In our experience with policyholders in Wisconsin, we have found that there is really no perfect selection for which Medigap plan to purchase because most people cannot foresee their use of the plan they select. The Medigap Plan you select is the one that will best cover your health care needs and fit in your budget.

We do know that the national sales for Medigap plans rank Plan G and Medicare supplement Plan N at the very top since Plan F is being phased out in 2020. The best method for you to make an informed choice is to speak with an insurance professional who specializes in Medigap Insurance. There are no fees for getting advice from an experienced agent since the insurance company is responsible for paying them.

For a personalized and confidential quote with no obligation to buy, contact a professional on the Medicare Solutions Team at (920) 545-4884 during normal business hours or contact us by email using our contact form.