Medicare Supplement Plans Wisconsin 2025 – Plans & Rates

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Russell Noga
by Russell Noga | Updated October 3rd, 2024

WisconsinThere are over 300,000 Medigap policies active in Wisconsin, which accounts for over 41% of all Medicare beneficiaries. In most states, Medigap plans have standardized benefits regulated by the Federal government.

However, Wisconsin, Massachusetts, and Minnesota operate differently from other states regarding the standardized benefits of Medigap plans. Wisconsin and Minnesota have similar offerings regarding the benefits provided in Medigap plans.

You can enhance your plan with “riders,” providing you additional coverage outside of the standardized benefits.

In Wisconsin, you can start with a basic Medigap plan and add riders for the additional coverage you want.

This article unpacks the Medicare Supplement Plans 2025 for Wisconsin has on offer and where to get them.

 

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Medicare Supplement Plans in Wisconsin – Benefits & Coverage

Most states across America use a letter system (A, B, C, D, F, G, K, L, M, & N) to define the selection of Medigap plans on offer. Each plan has a differing level of coverage, allowing you to choose the policy that suits your healthcare needs and budget.

Things are different in Wisconsin regarding how the state classifies Medigap plans and the coverage they offer beneficiaries.

Every Medigap plan sold in Wisconsin comes with the following standardized benefits.

  • Medicare Part A coinsurance coverage for inpatient hospital care.
  • Medicare Part B coinsurance covers medical care.
  • The first three pints of blood for blood transfusions and procedures.
  • Medicare Part A hospice copayments or coinsurance.

 

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The Medigap plans offered to Wisconsin residents include the following.

The Medigap Basic Plan

  • Part A coinsurance, starting after 60 consecutive days of stays at the hospital.
  • Coverage for stays at skilled Nursing Facilities and hospices.
  • First 3 pints of blood not covered by Original Medicare.
  • 40 home health care visits.
  • Part B Coinsurance.
  • An extra 175 days of inpatient mental health care after exhausting standard Medicare benefits.

As mentioned, you start with this basic plan and add the following riders to customize your plan to your healthcare requirements.

  • Part A deductible (100% or 50% coverage).
  • An extra 365 days of home health care.
  • Part B deductible (If you’re eligible for Medicare before January 1, 2020).
  • Part B coinsurance. (Taking this option adds copays of $20 for doctors’ visits and $50 for visits to the emergency room, waived if admitted).
  • Part B excess charges.
  • 80% coverage for foreign travel emergencies.

Each rider you add to your basic plan comes with a cost that adds or subtracts from the base premium of your basic plan.

The most popular riders are the excess charges rider and Part A deductible rider. Some beneficiaries add the Part B deductible and coinsurance rider.

25% Cost-Sharing Plan – This plan is similar in structure to Plan L offered in other states.

50% Cost-Sharing Plan – This plan is similar in structure to Plan K offered in other states.

 

25% and 50% Cost-Sharing Plans

 

Medicare Part D in Wisconsin

Original Medicare doesn’t provide coverage for prescription drugs. Over half of all beneficiaries on Original Medicare plans nationwide have supplemental drug coverage through their employer-sponsored plan or Medicaid.

Medicare beneficiaries who don’t have employer-sponsored drug coverage or Medicaid need Medicare Part D to get coverage for their prescriptions. Medicare Part D is part of the Medicare Modernization Act of 2003.

Beneficiaries can purchase it as a stand-alone plan or as part of their Medicare Advantage plan featuring Part D benefits included.

There are 23 Medicare Part D plans available from providers in Wisconsin in 2023. The monthly premiums for Part D vary between $7 to $113 per month.

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How Much Are Medigap Policy Premiums in Wisconsin?

27 insurers offer Medigap plans in Wisconsin. While the government standardizes the benefits of Medigap policies, they have no say in what private insurers charge in monthly premiums for these policies.

As a result, the price of your plan may vary dramatically between providers.

The average monthly premium for Medicare Supplement plans in Wisconsin varies based on the provider you use and the riders you add to your plan.

Typically, the average premium rate for Medigap plans in Wisconsin is between $111 to $163. Providers will use various factors when assessing the premium they charge you.

For instance, where you live in the state, your age, and whether you use tobacco products count towards the cost of your premiums. Men typically pay more than women, smokers pay more than nonsmokers, and premiums get more expensive as you age.

65 year old Female

 

65-Year-Old Female

Plan                                                                 Monthly Premium

Medigap Basic Plan                                     $94 to $308

Medigap 50% Cost Sharing Plan               $82 to $123

Medigap 25% Cost Sharing Plan               $105 to $154

 

65 Year Old Male

 

65-Year-Old Male

Plan                                                                   Monthly Premium

Medigap Basic Plan                                       $103 to $348

Medigap 50% Cost Sharing Plan                 $83 to $124

Medigap 25% Cost Sharing Plan                 $105 to $154

 

Top Medicare Supplement Providers in Wisconsin

Who you choose for your Medigap provider makes the biggest difference in your monthly premiums.

Here are the average rates from the leading Medigap insurers in Wisconsin.

  • Accendo Insurance Company                                    $121 to $82
  • BCBS Of Wi (Anthem)                                                  $134 to $98
  • Humana Insurance Company                                     $138 to $121
  • United World Life Insurance Company                    $165 to $142
  • Globe Life And Accident Insurance Company        $173 to $190

 

Do Medigap Providers Offer Additional Benefits?

One of the reasons plans vary in price comes from the additional benefits and perks offered by the insurer to beneficiaries.

Some providers offer the following extra benefits when you take a plan with them.

  • 7% household discount.
  • 2% discount for automatic payments.
  • Fitness membership through the Silver&Fit or SilverSneakers
  • Discounts on OTC medications and supplements with preferred providers.
  • Discounts on physiotherapy, acupuncture, nutritional counseling, and other preventative services.
  • Vision, hearing, and dental discounts or plans.

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When Can You Enroll in a Medigap Plan in Wisconsin?

65th Birthday

You can purchase your Medigap policy during the “Medigap Open Enrollment Period.” This window activates on your 65th birthday and stays open for six months.

During this time, the insurer must accept your application to join a Medigap plan, even if you have a pre-existing condition.

The insurer can’t charge you higher than average rates or refuse coverage if you have a chronic health disorder.

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Frequently Asked Questions

 

  What are Medicare Supplement plans, and how do they work in Wisconsin?

Medicare Supplement plans, also known as Medigap plans, are private insurance plans that help cover the gaps in Original Medicare. In Wisconsin, these plans work alongside Medicare Part A and B to provide additional coverage for out-of-pocket expenses.

 

  What are the popular Medicare Supplement plans in Wisconsin?

Popular Medicare Supplement plans in Wisconsin include Plan F, Plan G, and Plan N. These plans offer various levels of coverage for medical costs.

 

  What benefits do Medicare Supplement plans in Wisconsin typically cover?

Medicare Supplement plans in Wisconsin can cover expenses such as deductibles, coinsurance, and copayments associated with Medicare Part A and B. Some plans may also provide coverage for skilled nursing facility care and foreign travel emergencies.

 

  When is the best time to enroll in a Medicare Supplement plan in Wisconsin?

The best time to enroll in a Medicare Supplement plan in Wisconsin is during the six-month Medigap Open Enrollment Period, which starts when you turn 65 and are enrolled in Medicare Part B. This period provides guaranteed issue rights and allows you to enroll without medical underwriting.

 

  Can I switch Medicare Supplement plans in Wisconsin?

Yes, you can switch Medicare Supplement plans in Wisconsin. However, depending on the insurance company, you may be subject to medical underwriting, which could affect eligibility and premiums.

 

  Are Medicare Supplement plans standardized in Wisconsin?

Yes, Medicare Supplement plans are standardized in Wisconsin. This means that the benefits offered by a particular plan, such as Plan F, will be the same regardless of the insurance company. However, pricing may vary.

 

  Do Medicare Supplement plans in Wisconsin cover prescription drugs?

No, Medicare Supplement plans in Wisconsin do not include prescription drug coverage. To obtain coverage for prescription drugs, you need to enroll in a standalone Medicare Part D plan.

 

  Are there any specific restrictions on Medicare Supplement plans in Wisconsin?

In Wisconsin, there are no specific restrictions on Medicare Supplement plans. However, insurance companies may have their own rules and requirements, so it’s important to review the policies and choose one that suits your needs.

 

  How can I find the best Medicare Supplement plan in Wisconsin?

To find the best Medicare Supplement plan in Wisconsin, compare the plans offered by different insurance companies. Consider your healthcare needs, budget, and factors such as premiums, benefits, and customer reviews.

 

  Are there any financial assistance programs available for Medicare Supplement plans in Wisconsin?

No, there are no specific financial assistance programs for Medicare Supplement plans in Wisconsin. However, you may be eligible for other assistance programs like Medicaid, which can help cover Medicare-related costs.

Find the Right Medicare Plan for You

Discovering the perfect Medicare plan for you doesn’t have to be confusing. Whether it’s a Medigap plan or you have questions about Medicare Advantage or Medicare Part D, we can help.

Call us today at 1-888-891-0229 and one of our knowledgeable, licensed insurance agents will be happy to assist you!

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