Wisconsin Medigap Plans: A Guide to Medicare Supplement Insurance

Wisconsin Medigap plans are designed to fill the gaps in Medicare coverage, providing additional protection for your healthcare expenses. There are 10 standardized Medigap plans available in Wisconsin, labeled A through N.

Plan F is one of the most comprehensive Medigap plans, covering 100% of Medicare Part A coinsurance, hospital costs, and hospice care. It's a popular choice among Wisconsinites, but it's also the most expensive option.

Medicare Supplement Insurance, also known as Medigap, is private insurance that helps pay for out-of-pocket costs associated with Medicare. It's not the same as Medicare Advantage, which is a different type of Medicare plan.

In Wisconsin, you can purchase Medigap plans from private insurance companies, but you must be 65 or older and enrolled in Medicare Part A and Part B to be eligible.

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Medigap plans are designed to fill in the gaps of traditional Medicare, making them an essential supplement for those who want to ensure they have comprehensive coverage.

You can use any doctor or hospital with Medigap plans, as they don't have networks and are national plans.

Medigap plans process claims through the Medicare "crossover" system, which ensures that supplemental companies pay claims on the same schedule and in the same amount.

To be eligible for a Medigap plan, you must have Medicare Parts A and B.

Choosing a Medigap plan can be a bit overwhelming, but don't worry, I've got you covered. The most important thing to remember is that the company you choose isn't as important as you think, as long as they offer the same standard benefits.

The only difference between companies will be the price, so think about what's most affordable for you as you prepare to retire. It doesn't make sense to pay more money just to say you're with a certain company.

In Wisconsin, you can compare Medicare Supplement plans using a chart that shows what the Basic Plan covers, as well as optional riders. This chart helps you understand how coverage works and how riders can help you customize your coverage.

Worth a look: Medigap Comparison Chart

You can save up to 25% with Cigna Healthcare, including a premium discount of up to 20% plus an additional 5% if you apply online. This can be a great way to reduce your costs.

Here are some key things to consider when choosing a Medigap plan:

Remember, the government decides what benefits each plan offers, so coverage remains the same across all companies. This means you can choose the plan that's right for you, based on your individual needs and budget.

Wisconsin Medigap plans have specific mandated benefits that ensure you have enough coverage. These benefits include skilled nursing facility coverage, home health care, diabetes management, and kidney dialysis treatments.

Wisconsin requires that Medigap plans cover 30 days of skilled nursing facility care with no prior hospital stay requirement. This stay must be medically necessary to receive coverage.

Home health care is also a mandated benefit, with up to 40 visits annually beyond Medicare benefits. Your doctor must verify that the need is medically essential.

Dialysis treatment must have inpatient and outpatient coverage, and transplants and donor-related expenses must receive coverage. Coverage must be at least $30,000 annually.

Diabetic supplies, including self-management training and insulin infusion pumps, are also covered. The insurance company must cover this, even if Medicare doesn’t approve the claim.

Some other included mandated benefits are surgery center care, chiropractic care, colorectal cancer screenings, some clinical trials for cancer, and breast reconstruction.

Catastrophic prescription drugs must receive coverage in Wisconsin. For those with policies issued prior to the origin of Part D in 2006, at least 80% of the charges for outpatient prescription drugs must receive coverage if they don’t have Part D.

Riders can be purchased to add additional benefits to your basic plan. In Wisconsin, each insurance company can decide which riders they choose to offer.

Here are the 7 options available for riders in Wisconsin:

By adding riders to your basic plan, you can customize your coverage to fit your needs.

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In Wisconsin, you can enroll in coverage similar to Plan F anytime, but first-dollar coverage plans are unavailable for those newly eligible for Medicare. If you're not newly eligible, you can choose to cover the Part B deductible.

The monthly premium costs for Medicare Supplement Plans differ due to factors like the level of coverage you select. The more coverage you select, the higher your monthly premium will be, with selecting the equivalent of Plan F coverage costing more than selecting the equivalent of Plan N.

You can save up to 25% with Cigna Healthcare, including a premium discount of up to 20% plus an additional 5% if you apply online. This is a good option if you're looking to reduce your costs.

Here's a brief overview of some popular Medicare Supplement Plans:

Cost is a crucial factor to consider when choosing a Medicare Supplement Plan. Each beneficiary's monthly premium costs differ due to factors such as the level of coverage selected.

The more coverage you select, the higher your monthly premium will be. For example, selecting the equivalent of Plan F coverage costs more than if you select the equivalent of Plan N.

You may qualify for guaranteed issue in Wisconsin if your employer plan's annual premium is 125% or more of the Basic Plan for your age and gender. This can result in lower costs.

In Wisconsin, premiums can vary by as much as $100/month for the exact same benefits. This means it's essential to compare plans carefully to find the best rate for your needs.

If you've signed up outside of the Medicare Supplement Open Enrollment Period, the best rate might not be your current rate. Be sure to shop around and compare rates to find the best option for you.

Here are some estimated premium costs to consider:

Keep in mind that these are just estimates and actual costs may vary depending on your individual circumstances.

The Wisconsin Medicare Supplement Basic Plan helps cover what Medicare doesn't, including Part A coinsurance. This can add up quickly, so it's essential to understand how it works.

You'll pay a portion of the cost for skilled nursing facility (SNF) care and hospice care, as well as Part B coinsurance. The plan also covers the first 3 pints of blood and 40 home health care visits.

The Basic Plan is similar to Medicare Supplement Plan A without any riders.

To be eligible for a Medicare Supplement plan in Wisconsin, you must be 65 or older and enrolled in both Medicare Part A and Medicare Part B. You can buy a Medigap plan at any time during the year, but to avoid underwriting, it's best to sign up during your Medicare Supplement Open Enrollment Period or a Special Enrollment Period.

You can enroll in a Medigap plan at any time if you're 65 or older and enrolled in Medicare Part B. However, there's a catch - you can't have both a Medicare Advantage plan and a Medigap plan at the same time.

If you currently have a Medicare Advantage plan and want to switch to a Medigap plan, you'll need to disenroll from your current plan during a valid election period. These periods include the Special Enrollment Period, the Annual Enrollment Period, or the Medicare Advantage Open Enrollment Period.

You have a 6-month window to enroll in a Medigap plan without being turned down for coverage, starting from the first day of the month after you turn 65 and are enrolled in Part B. This is your Medicare Supplement Open Enrollment Period.

In some states, younger people who qualify for Medicare due to a disability may also be eligible for a Medigap policy. However, this is not a guarantee and will depend on your individual circumstances.

Here are the key times when you can enroll in a Medigap plan in Wisconsin:

In Wisconsin, several carriers offer Medicare Supplement plans, including Aetna, Blue Cross Blue Shield of Wisconsin, Cigna, Humana, and UnitedHealthCare. These companies are highly-rated and commonly provide Medigap plans.

Aetna, for example, has an A+ BBB rating, a BBB S&P rating, and an A+ A.M. Best rating. Blue Cross Blue Shield of Wisconsin, on the other hand, has a F BBB rating, an A- S&P rating, and an A A.M. Best rating.

Here's a comparison of Wisconsin Medicare Supplement carriers:

You can save up to 25% on Medicare Supplement policies by applying online and getting quotes from multiple carriers.

Comparing Medigap plans is essential, especially in states like Wisconsin, where premiums can vary by as much as $100/month for the same benefits.

You can compare plans by calling insurance companies directly, but be sure to compare "apples to apples" to avoid confusion.

Independent brokers can also provide a list of Medigap rates for your age and zip code, along with additional resources to help you make an informed decision.

If you're shopping for a plan in Wisconsin, be aware that there are "riders" that complicate the comparison process, so be sure to understand the differences in Wisconsin plans.

Some carriers may offer Optional Benefit Riders for an additional premium, so be sure to ask about these when getting quotes.

For another approach, see: Compare Medicare Supplement Insurance Companies

Medigap carriers in Wisconsin offer a range of plans, but not all carriers are created equal.

Several highly-rated carriers provide Medigap plans in Wisconsin, including Aetna, Blue Cross Blue Shield of Wisconsin, Cigna, Humana, and UnitedHealthCare.

Aetna, for example, has an A+ rating from the Better Business Bureau (BBB) and an A+ rating from A.M. Best.

Blue Cross Blue Shield of Wisconsin, on the other hand, has a lower BBB rating of F, but still has an A- rating from S&P and an A rating from A.M. Best.

Cigna does not have a BBB rating, but has an A- rating from S&P and an A rating from A.M. Best.

Humana has an A+ rating from the BBB and a BBB+ rating from S&P, as well as an A- rating from A.M. Best.

UnitedHealthCare also has an A+ rating from the BBB and an A+ rating from S&P, as well as an A- rating from A.M. Best.

Here is a comparison of the carriers' ratings: