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Medicare Plans for Wisconsin Residents

Medicare, the national health insurance program meant mainly for senior citizens, comes in four parts: A, B, C and D. Twelve additional Medicare plans, often called Medigap, supplement Medicare. Some of these plans are standardized and remain the same no matter where you live in the United States, while others change according to area. Wisconsin Medicare is overseen by the state Commissioner of Insurance. It is one of the few states in the U.S. with substantially different Medicare policies for sale than most areas.

  1. Original Medicare

    • Parts A and B Medicare are often called original Medicare, as these were the first created and sold. Purchase original Medicare from the federal government, which sets all rules, regulations, premiums, copayments and benefits. Wisconsin's original Medicare is no different than anywhere else in the country. Most recipients are residents aged 65 or older, although people with disabilities and certain health conditions who are younger than 65 may qualify. Part A and B benefits include home health services, hospice, inpatient and outpatient hospitalizations and preventive health screenings.

    Medicare Part D

    • Part D Medicare is insurance for prescription medications only. Part D is not sold by the government; obtain it through approved private insurance companies in each state. These insurance companies decide their own premiums, deductibles, copays and approved drugs, so the exact policy rules depend on the company you choose. Wisconsin residents who need Part D coverage but cannot afford the plans available in their areas can apply for Extra Help, a subsidy for low-income Medicare beneficiaries. Wisconsin also administers its own prescription drug plan for older Americans, called Wisconsin SeniorCare.

    Medicare Advantage

    • Medicare Part C is more commonly called Medicare Advantage. Medicare Advantage allows customers to combine their Part A and B benefits with extra coverage, such as those for vision, dental and hearing. Medicare Advantage is also sold by private companies. Insurance companies selling MA policies must include all the benefits for Part A and Part B offered by the government, but can decide the extra benefits, premium costs, copays and deductibles. If you have prescription drug coverage through MA, you do not need to also purchase a Part D plan. As of January 2011, Medicare Advantage plans in Wisconsin can be sold as different types of policies, such as HMOs, PPOs, POS plans, special needs plans and plans which can be used with medical savings accounts.

    Medicare Supplement Plans

    • Medicare supplement plans help Medicare recipients pay for premiums, copays, excess charges and deductibles. Medigap plans also feature a few additional medical benefits, such as Part B coinsurance coverage, foreign travel emergency insurance and the costs of the first three pints of blood per year. Wisconsin does not sell the standard 12 Medicare supplements individually but has its own system which covers the same benefits. The state mandates that all, not just a few, Medigap policies offer benefits for outpatient mental health services, foreign travel emergencies and the deductibles for Part A and Part B, in addition to the costs of blood, coinsurance and foreign travel emergencies. Select your Wisconsin Medigap policy as a Medicare Select plan, which operate similar to an HMO plan.

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