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May 19, 2011

Wisconsin Medicare Supplement Plans

Wisconsin, along with Massachusetts and Minnesota, are the three states that do not offer the ten standardized Medigap plans. The principal Wisconsin Medicare Supplement insurance plan is the "Wisconsin Basic Plan." However, Wisconsin also offers versions of Medigap Plans K and L. These plans are called "50% and 75% coverage plans." A high deductible plan is also available.

Wisconsin Basic Plan

The Wisconsin Basic Plan provides the following benefits. These benefits can be expanded through the use of optional riders offered through the insurance company providing the plan.

  • Part A co-insurance costs
  • Part B co-insurance costs (typically 20% of the Medicare-approved amount for a covered medical service)
  • The first three pints of blood each year for Medicare-approved procedures
  • Part A hospice co-insurance or copayment
  • Skilled Nursing Facility co-insurance
  • An additional 175 days inpatient mental health care per lifetime beyond Original Medicare's benefits
  • An additional 40 home health care visits beyond Original Medicare's benefit
  • Outpatient mental health coverage

Optional Riders

Medicare-eligible residents in Wisconsin can add one or more of the following riders to their Wisconsin Basic Plan to extend coverage:

  • Medicare Part A deductible
  • Medicare Part B deductible
  • Foreign travel
  • Additional home health care (365 visits including those paid by Medicare)
  • Medicare Part B Excess Charges

In Wisconsin, insurance companies are allowed to offer additional riders beyond the ones listed above.

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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.