Wisconsin | Medicare Supplement Plans

Wisconsin Medicare Supplement Plans

Medicare Supplement Plans | Wisconsin

Wisconsin is not the same when it comes to Medicare Supplement Plans (Medigap).  They use a base and a series of riders to equal the benefits of the lettered plans that the rest of the country uses.  This confuses many people when they see all this talk about Plan G and then when the look for a Plan G for Wisconsin Medicare Supplement Plans, they see it doesn't exist.  

For help navigating the Medicare in Wisconsin and to get the details you need to know, give us a call 920-545-4884, we are a local Independent Medicare Supplement agency and we know Medicare in Wisconsin.  Please keep reading for more information on Wisconsin Medicare Supplemental Insurance.

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Medicare Supplement Plans Wisconsin

Medicare in Wisconsin is the same as the rest of the nation, it is the supplemental insurance that does not follow the same standardization.  The benefits can be matched it is just a different way of getting there.

Medicare Supplement Plans or Supplemental Insurance, also known as Medigap, is always sold by private insurance companies.

It is designed to help pay for some or all of the health care costs that Original Medicare will not cover, like deductibles, copayments, and coinsurance.

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Wisconsin Medicare Supplement Enrollment

Your Medicare Supplement open enrollment period  will be the six months of you turning 65 and starting Medicare Part B.  You can than enroll in any Medicare Supplement Plan in Wisconsin with no underwriting and it is guarantee issue.  You cannot be turned down.

After the open enrollment period, you may face serious challenges enrolling in a Medicare Supplement Plan. You no longer have guaranteed issue (except in some situations), so the insurance company will likely require you to go through an underwriting process.

Medical underwriting typically involves a review of your medical history—and possibly a physical examination—in order to determine if you are eligible to receive coverage. For example, you may be denied coverage from insurance companies due to pre-existing health conditions.

 If they do decide to offer you insurance, you may have to pay more for Medigap based on the status of your health. In essence, the insurance company reserves the right to charge you based on how much they predict your health care could cost them

The same underwriting process is required if you decide to change Wisconsin Medicare Supplement Plans after you have already chosen a plan. For these reasons, it’s imperative that you sign up for Medigap on time and choose the right plan from the start.

Is A Wisconsin Medicare Supplement Right for Me?

There are a lot of decisions to make and factors to consider when choosing your ideal health care plan. You may still not be sure if a Medigap plan is right for you. Use the following guidelines to help make your choice a little easier.

YES, Wisconsin Medicare Supplement Plans are right for you if…

  • You want to minimize surprise costs (like deductibles and copays).
  • You have already enrolled in Medicare Parts A and B.
  • You don’t want to worry about getting referrals.
  • You don’t want to worry about finding doctors in-network.
  • You plan to purchase vision or dental insurance separately.
  • You want to know that you can see any Medicare doctor when traveling (within the United States).

NO, Wisconsin Medicare Supplement Plans are not for you if…

  • You are enrolled in (or plan to enroll in) Medicare Part C, a Wisconsin Medicare Advantage Plan.
  • You do NOT receive Medicare Parts A and B.
  • You already receive health coverage from an employer that pays for costs not covered by Medicare.
  • You already receive health coverage from a union that pays for costs not covered by Medicare.

Medicare Supplements in Wisconsin

Medicare Supplement plans are standardized through out the United States by the letters A - N.  

Which in itself can be a little confusing, because each letter has a different set of benefits.  Now just to throw another little twist in, three (3) states do not follow that rule.

The Three Oddball States

  1. Wisconsin
  2. Minnesota
  3. Massachusetts

These states use different variations of a "base" offering that covers certain costs and series of "riders" that can be added to the base and they cover the other holes of Medicare.

Wisconsin Medicare Supplement Plans

Wisconsin Medicare Supplement Plans

Wisconsin has the "base" which only covers the 20% that Medicare does not cover.  Having a Wisconsin Medicare Supplement Plans that only covers the base would leave many gaps in your coverage, such as:

  1. ​The Part A Deductible ($1340.00 Per 90 day period)
  2. The Part B Deductible ($183.00 per year)
  3. Foreign Travel coverage
  4. Extended Home Healthcare
  5.  Part B Excess Charges
  6. Part B coinsurance and copays

Amounts above are for 2018

By combining the base with various riders, we can make the benefits match the lettered plans.  Adding the riders will also affect the cost of Medicare Supplemental insurance.

The chart below is from the Medicare & You handbook from CMS.  It shows the Medicare Supplement Plans for the majority of the U. S. and the benefits for each.  Plan F, G, and N are the most popular.

Medicare Supplement Comparison

Wisconsin Medigap Comparison

The chart below, illustrates how the base and riders can be put together with a Wisconsin Medicare Supplement Plan, to equal the benefits of the three most popular Medigap lettered plans, keep reading to see more on how the supplemental insurance plans in Wisconsin are standardized.

Wisconsin Medicare Supplement Plans

Medicare Supplement Riders

The riders for a Medicare Supplement in Wisconsin consist of the following:

  1. Part A Deductible Rider*
  2. Part B Deductible Rider *
  3. Part B Excess Rider*
  4. Foreign Travel Rider*
  5. Home Healthcare Rider*
  6. Part A 50% Deductible Rider**
  7. Medicare Part B Copayment/Coinsurance Rider**

*Most Commonly used

**Can be used to keep monthly premiums down​

Call 920-545-4884 Today for a FREE quote and Medicare Supplement Plan Comparison

Most Common Medicare Supplement Plans

The three most common Medicare Supplement Plans are Plan F, Plan G and Plan N.  The benefits of these plans are easily obtained with the base and a combination of the riders in Wisconsin.  

Which plan is the best greatly depends on your needs on your budget.  What we have found is that for most circumstances the Plan G offers the most comprehensive coverage with the lowest rate increases.  

This could vary by state and your budget, if you do not use many office visits, the Plan N would be the lowest cost.  If you use several office visits during the year the $20.00 copay could eliminate any possible savings.

You should carefully consider what Medicare Health Plan makes the most sense for you.  There are several factor that you should consider and you can read more about on our post, 6 Facts To Consider Before Choosing a Medicare Health Plan

Best Medicare Supplement

Medicare Supplement Plan G | Wisconsin

  • Part A Deductible Rider
  • Part B Excess Rider
  • Foreign Travel Rider
  • Home Health Care Rider

A Plan G would give you 100% coverage of Medicare approved charges after you pay the Part B deductible of $183.00 (in 2018).

A Plan G would give you 100% coverage of Medicare approved charges after you pay the Part B deductible of $183.00 (in 2018).

The Part B deductible is set by Medicare and can be changed at any time, but paying this small deductible out of pocket is the key to lower premiums and lower rate increases over time.

Medicare Supplement Plan F

Medicare Supplement Plan F | Wisconsin

  • Part A Deductible Rider
  • Part B Deductible Rider
  • Part B Excess Rider
  • Foreign Travel Rider
  • Home Health Care Rider

The riders to match the benefits of a Medicare Plan F are very similar to the Plan G, but as you can see in the table above the Part B deductible rider has been added.  If your friends are telling you that they never get a bill, this is the plan the have.

This might seem to be the best choice, I mean why would you want a deductible when you can go without one right?  I will give a few reasons why it makes sense for you to pay the Part B deductible out of pocket.

In most states the Plan F will cost you about $300.00 more per year than a Plan G

(that means you are paying the insurance company $300.00 to pay a $183.00 deductible for you, ya nuts, I know).​

The Wisconsin Plan F the price is actually about the same if you pay it or if the insurance company pays it.  The biggest problem is now that when you get a rate increase they are increasing the Part B deductible rider more than any part of the Medicare Supplemental Plan.

The main reason is that Medicare will be doing away with the Plan F and the Part B deductible rider​ in 2020 which means a Medicare Supplement Plan will no longer be able to cover the Part B deductible.

Lowest Cost Medicare Supplement

Medicare Supplement Plan N is the lowest cost of the three most popular plans, when it comes to monthly premium.  

Medicare Supplement Plan N | Wisconsin

  • Part A Deductible Rider
  • Part B Coinsurance or Copayment Rider**
  • Foreign Travel Rider
  • Home Health Care Rider

** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

If you do not use many visits to the doctor per year this Medicare Supplement plan could save you premium, but if you are going to the doctor 5-6 times per year, that savings will be eaten up by the $20.00 copays.

A plan N Medicare Supplement Plan does not cover the Part B Excess charges.  These charges in today's world are rare but can add extra out-of-pocket costs.  If you wish to go with a Plan N, check with your doctors that they are Assigned by Medicare and you should have no problems.

Wisconsin Medicare Supplement Plan N

If  you are new to Medicare and looking for information on Medicare Supplements in Wisconsin you are probably seeing a ton of information on Plans F, G, and N and very little on the Base plus the riders.

That is why it is important to work with a local Medicare Supplement Agency like Medicare Solutions team.  We are located here in Wisconsin and we understand the Wisconsin Medicare market.

​You can get an instant quote now by clicking the button below or call us anytime at 920-545-4884

​Medicare Supplemental Insurance

Medicare Supplement policies also provide coverage for various services that Original Medicare will not pay for, like medical care when you journey abroad.

If you have got Original Medicare and you purchase a Medicare Supplement insurance policy, Medicare will pay out its portion of the Medicare-approved amount for covered health care expenses, and then your Medicare Supplement insurance pays its share of the covered health care expenses....

What is the Difference between a Medicare Supplement and Medicare Advantage Plan?

While most people call anything they have with their Medicare, the fact is there are really two separate and distinctly different products.

A Medicare Supplement insurance policy is different from the Medicare Advantage Plan. Advantage plans are options to get Medicare benefits, while a Medicare Supplement policy only supplements (fills in coverage gaps) your Original Medicare health benefits.

You cannot have both products at the same time, so how do you decide which to choose? Here are a few of the most important comparisons between the two to help inform your decisions.

Premiums. Medigap typically costs $150 to $200 per month, while Medicare Advantage ranges from $0 to $100+ per month.

Deductible. Deductibles are low or non-existent for Medicap. The Advantage plans have high deductibles, starting around $3,400 of out-of-pocket expenses you would have to cover every year.

Choice of Doctor. With Medigap, you can go to any doctor who accepts Medicare. There are more restrictions with the Medicare Advantage Plans, which require you to either only see doctors within their network or pay higher prices to see doctors who are out-of-network.

Based on these comparisons, many Medicare recipients prefer to choose Wisconsin Medicare Supplement Plans (Medigap) because it provides predictable expenses and more freedom of healthcare options.

What You should know about Medicare Supplemental Insurance Plans

Any Medicare enrollee should understand the basic terms and conditions before purchasing Medicare Supplement insurance:

  • The applicant must already have Medicare Part A and Part B.
  • If you have purchased a Medicare Advantage Plan, you can easily apply for a Medicare Supplement policy, but make certain you can exit the Medicare Advantage Plan before your Medigap policy gets started.
  • You pay the Medicare Supplement insurance company a once a month premium for your Medigap insurance policy in addition to the month-to-month Part B premium that you spend to Medicare.
  • A Medicare Supplement insurance policy will only cover one person at a time. If you and your spouse both want Medicare Supplemental insurance, each of you will have to purchase separate policies.
  • You can buy a Medicare Supplement policy from any Medicare approved insurance company that's licensed in your state to sell one.
  • All standardized Medicare Supplement policies are guaranteed renewable even if you have health issues. This means the insurer cannot cancel your Medicare Supplement policy as long as you pay the monthly premium.
  • Some Medicare Supplement policies previously sold would pay for prescription drugs, but Medicare Supplement policies sold after January 1, 2006, aren't authorized to include prescription drug coverage. You will need prescription drug coverage, you can sign up for a Medicare Prescription Drug Plan (Part D).
Wisconsin Medicare Supplement
Medicare Supplement Insurance Doesn’t Cover Everything

Medicare Supplement insurance policies, in general, do not include:

  1. Long-Term Care
  2. Vision
  3. Dental
  4. Hearing Aids
  5. Eyeglasses
  6. Private Duty Nursing

Medicare Supplements in Wisconsin are not difficult to understand once you understand what each rider covers.  

Basically they cover exactly what the rider is named, such as the Part A deductible rider covers the "Part A deductible".  Here is a little more detail on some of the more common riders.

Part A Deductible Rider. This is typically considered to be the most important rider to add to your Medicare plan because it will cover your entire deductible for Medicare Part A ($1340 in 2018). This means that if you were admitted to a hospital, for example, and did not have the Part A Rider, you would have to pay the first $1340 of expenses out-of-pocket.

Part B Deductible Rider. Just like it sounds, this rider covers the $183 deductible (in 2018) for medical services and supplies that fall under Medicare Part B. We do NOT recommend that you take this rider because of important changes that are coming in 2020.

Wisconsin Foreign Travel Emergency Rider. This is an ideal rider if you tend to travel outside of the U.S. (such as on cruises). The Travel Rider will cover up to $50,000 in out-of-country medical expenses once you have met the $250 deductible.

Wisconsin Additional Home Health Care Rider. Original Medicare only covers 40 days of home health care. This rider covers the gap by extending the limit to 365 days for those who need care at home every single day of the year.

Wisconsin Medicare Supplement Pricing

As with anything in life, each added benefit adds cost to the Medicare Supplement.  The base which is the start of the pricing and the root of the coverage covers the 20% that Medicare does not cover and the base alone is the lowest priced Medicare Supplement in Wisconsin.  

I do not recommend going with only the base as this leaves you open to some serious out-of-pocket expenses.  

It’s also important to base your decisions on more than just the monthly premiums. Lower premiums typically mean higher deductibles, so the cheaper option is also the one that could lead to more surprise out-of-pocket fees.

As you compare your Medigap options, be sure to look at the big picture, weighing each choice against the others while also taking into account your expected health care needs.

Another important consideration is that your costs will change from one insurance company to the next, even by location. You might get one price in Sauk County, a higher one in Outagamie, and a lower one in Dane. Regardless of where or from whom you purchase your Wisconsin Medigap plan, however, they will all provide the same type of coverage.

There somethings that can lower your Medicare supplement price, such as household discounts, and spousal discounts.  While these might sound the same, they are very different.

  • Household Discount:  Is a discount for just living with someone, the age of the person you are living with varies from company to company, and the person does not need to have the same or any Medicare Supplement.
  • Spousal Discount:  You and your spouse must both have the same Medicare supplement plan.

Companies offer one of the above discounts, not both, it comes down to either or.  The amount of the discounts, if any, vary from 7% to 12% and again this is set by the Medicare Supplement Company or provider.

Another cost with a supplemental plan is an application fee.  This is a one time fee that is added to the first monthly payment.  It is normally in the twenty to twenty five dollar range and not all companies add this charge.

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