Wisconsin Medicare Plans

From cheese to the Harley-Davidson Museum, Wisconsin has many sites and cities to visit. There are also some unique attractions like the Circus World Museum you must see to believe. You can take a breathtaking view of the openness of Door County overlooking Green Bay, explore the Land O’ Lakes or take in a Packer’s game. There is a lot to see in your retirement. 

Wisconsin isn’t only unique in it’s attractions! Wisconsin is one of 3 states in the US that does not offer the standard lettered Medicare Supplement plans. Rather, there is a Basic Plan offered with benefits determined by the state of Wisconsin. Along with the Basic Plan, there are optional riders that can be added to expand your coverage. It is important to have a full understand of the differences in Medigap plans in Wisconsin before you begin your enrollment!

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What are Medicare Options in Wisconsin?

Unlike other states, when it comes to Medigap plans, Wisconsin does not offer the traditionally lettered A-N plans. Rather, Wisconsin has a different set of plans available with different coverage levels based on the addition of riders. First, Wisconsin requires all Medicare Supplement plans to offer what are known as Basic Benefits.

Wisconsin Medigap Basic Plan

The base Medicare Supplement plan in Wisconsin is known as the Basic Plan. The Basic Plan includes all of the state mandates basic benefits, as well as additional benefits to increase the coverage.

Wisconsin Medicare Supplement Plan Riders

With the Wisconsin Medicare Supplement Basic Plan, there are also additional riders that can be added to your plan to increase your coverage. The riders offered are at the insurance carrier’s discretion, but typically the majority of carriers offer similar riders. 

The optional Medicare Supplement plan riders can be used to expand coverage from the Basic Plan, and can be tailored to make these plans very similar to the standard Medigap plans throughout the rest of the country.

When is the Open Enrollment Period in Wisconsin?

As a Medicare beneficiary in Wisconsin, you can enroll in any Medicare Supplement within your first six months of your Part B effective date. This is considered your open enrollment period. medicare-open-enrollmentDuring this time, insurance carriers are required to approve your MediGap application, and are prohibited from declining the coverage you need because you have a pre-existing condition. You can still apply outside of this window, but you will be required to go through medical underwriting, and could be denied coverage based on your health history.

Can I Change Medicare Supplement Plans in Wisconsin?

You can apply to change your Medicare Supplement during any month of the year in Wisconsin, however there is one catch. Once you are more than 6 months past your Medicare Part B effective date, you must go through medical underwriting in order to be approved to enroll into, or change your Medicare Supplement plan. This means that insurance carriers are given the ability to assess your health history, prescriptions, height and weight, as well as other health-related factors to determine if you will be approved or denied coverage. During medical underwriting, insurance carriers have the ability to deny a Medicare Supplement plan application based on pre-existing conditions, so it is important to enroll in a MediGap plan during your open-enrollment period to guarantee your acceptance.

When looking at Medicare Supplement plans in Wisconsin, it is important to understand exactly how riders work. Give us a call and we will look through all options.
Keith Armbrecht
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What is the Cost of a Medicare Supplement Plan in Wisconsin?

Monthly premiums for Medicare Supplement plans are based on three main factors- age, gender, and location. There are other things that may impact your premium such as tobacco use. The premium amounts will vary based on these factors, so it is important to receive a quote based on your specific demographic information.

Medicare Plans in Wisconsin for Those Under 65

When it comes to Medicare in Wisconsin, there a 6 month open enrollment for MediGap plans required by the state for those under 65. Insurance carriers are required to accept all applicants within 6 months of their Medicare Part B effective date, although they are only required to offer the Basic Plan to applicants. If you do not applying during your open enrollment window, you’ll be required to go through and pass any medical underwriting that is necessary for acceptance. If you’re under 65 and disabled but still qualify for Medicare, you may not pass this underwriting. If you fit within this category, there are Medicare Advantage Policies that you can look into.

Once you reach 65, more Medicare supplement plans will open up for enrollment in Wisconsin without any health questions. This period guarantees acceptance.

Medicare Advantage in Wisconsin

Wisconsin also offers options for Medicare Advantage plans. In these plans you must live in your plan’s service area and enroll during an appropriate election period.  Medicare Advantage plans do not required medical underwriting if enrolling during an election period, but are also significantly different plans than Medicare Supplement plans.

Medicare and Medicaid in Wisconsin

It is possible to qualify for both Medicare and Medicaid in the state of Wisconsin. These two programs, however, are separate and have different qualifications you must meet in order to receive benefits. To qualify for Medicaid, you must meet  state income requirements. To qualify for Medicare, you must be either over the age of 65, or under 65 but receiving Social Security Disability Insurance for a minimum of 24 months before applying for Medicare. 

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In his book “Medicare Made Clear” the #1 authority on Medicare, Keith Armbrecht outlines all you need to know when starting medicare. Easy to follow with videos included.  Download Now for Free!