Wisconsin Medicare Supplement Plans
Wisconsin Medicare Supplement plans is one of the few states that do not have standardized plans. Residents of Wisconsin are eligible for Medicare supplement plans plan at any time of the year. However, it is beneficial to enroll during your Medicare Supplement open enrollment period.
Wisconsin’s Medicare supplements are a little different than other states. The insurers offer a “Basic Benefit” that includes:
- Part A coinsurance (hospital and Hospice
- Part B coinsurance
- Up to three Pints of blood each year
- Home Health care (40 visits per year in addition to those paid by Medicare)
- Part A Skilled Nursing Facility (SNF) coinsurance
- Inpatient Mental Health Coverage (175 days per lifetime in addition to Medicare’s benefit
- State Mandated benefits
On top of the Basic Benefit the carriers are allowed to offer an additional 7 riders.
Wisconsin has over 30 carriers different Companies that offer Medicare Supplement plans to Wisconsin residents with Original Medicare (Part A & B) as of 2020
Medicare Supplement Open Enrollment Period
People are granted a six-month window, when they turn 65 and/or enroll in Medicare Part B. Insurers can’t medically underwrite to determine eligibility or premiums. Medicare recipients due to disability for people under 65 do not have the same protection according to Federal rules.
Most States have adopted rules to ensure at least some access to a Medicare Supplement plan for enrollees under the age of 65. In Wisconsin, Medicare beneficiaries who are under 65 can apply for a Medigap plan, and they must treat you like an Medicare Supplement Open Enrollment beneficiary for the Basic Plan only. The rule does allow for the Insurance carrier to rate you at the Oldest age bracket. Here is a List of States that Have adopted a rule for Medicare beneficiaries:
A person who has Medicare prior to age 65 as a result of a disability does qualify for an open enrollment period, when they turn 65, during which they can select any Medicare Supplement plan, guaranteed issue, from any insurer offering plans in their area.
People under age 65 who are eligible for Medicare also have the option of enrolling in a Medicare Advantage plan, unless they have end-stage renal disease (in that case, the insurer can reject the application).
How does one Shop for a Medicare Supplement plan in Wisconsin?
This may seem easy but know our agents have saved people well over $400 a year and sometimes over $1,000 a year by going with a different carrier. Here is the <b>WARNING:</b> Some carriers do not have stable rates on their Medicare Supplements. You can buy low and get large increases down the road. When looking at going to a carrier you should look at the Stability of Rates. Our agents know these carriers and can show you.
Every carrier has a different philosophy on how they price their Medicare Supplements. Some come into the market really low buying the Market. Others may come in a bit higher as a way to keep the low-cost buyers out at first. We see some that come in a little higher but have tougher Medical underwriting. These are just three of the many different strategies that Medicare Supplement Carriers may use to different themselves from others and affects what you may pay now and down the road.
Wisconsin Medicare Advantage (Part C)
All Wisconsin Medicare Advantage plans must also follow the same rules set by Medicare. All Medicare Advantage plans must cover the same things that Parts A & B do, but differently. They also offer additional coverage that Original Medicare does not. An example would be covering an annual physical. Original Medicare only cover an annual Wellness visit.
All Medicare Advantage plans are contracts with Medicare and an Wisconsin Medicare Beneficiary on one of these plans is still in Medicare. All right and protections are still given. Centers of Medicare and Medicaid Grade all plans each year on a 5 Start rating.
How does one qualify for a Medicare Advantage in Wisconsin?
- You must legally reside in the Medicare Advantage Plans service area. This is by county.
- The Medicare Beneficiary must have Part A and B. (Continue to pay Part B premium)
You can only enroll in these plans during certain times of the year.
Wisconsin has many Medicare Advantage plans, and the number of Medicare Advantage plans to enroll in varies by county. A person shopping for a Medicare Advantage plan should look up their exact prescription using the retail pharmacy they would use a long with checking all their Doctors. We can help you SHOP for a Medicare Advantage plan in Wisconsin
NOTE: Starting in 2019, there’s a Medicare Advantage open enrollment period (January 1 to March 31) during which people who are already enrolled in Medicare Advantage plans can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead. People who have Original Medicare can switch to Medicare Advantage during the annual open enrollment period in the fall (October 15 to December 7), with coverage effective January 1.
Medicare Part D
Original Medicare and Medicare Supplement plan do not cover outpatient prescription drugs. Medicare beneficiaries can get prescription coverage in a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Part D was introduced by the Medicare Prescription Drug, Improvement Act of 2003. These plans are administered by private insurance companies, all Part D plans are approved and have contracts with Medicare. These plans will vary in the drugs they cover as well as cost. All of these plans are graded by Centers of Medicare and Medicaid annually, based on a 5-star rating. Medicare Part D beneficiaries typically pay a monthly premium, annual deductible and per-prescription cost-sharing.
It is important to shop for these plans every year as they change. When shopping you should have the exact prescription you use (as the prescription reads), and what pharmacies you use or would use.
We have seen people save over $8,000 dollars for the year by shopping.
How We Can Help
Our licensed Wisconsin Medicare Plans Insurance Brokers are available to help you at no charge to you. We pride ourselves on assisting you finding a plan that fits your needs and wants. Because Medicare Supplement plans are required by law to offer standardized coverage, the only difference will be price. We will shop your policy and find you a plan that is Stable.
Medicare Advantage plans are not standardized but some plans offer coverage with no additional costs.
Contact us for free assistance.