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Medicare Advantage (Part C) provides an alternative way to receive your Medicare benefits. Medicare Advantage plans are offered by private insurance companies contracted with Medicare. If you enroll in a Medicare Advantage plan, you still have Part A (hospital insurance) and Part B (medical insurance) coverage, but you receive your benefits from the insurance company’s Medicare Advantage plan.
All Medicare Advantage plans are required to offer at least the same level of coverage as Original Medicare, Part A and Part B, with the exception of hospice care, which continues to be covered under Part A. Many Medicare Advantage plans offer additional benefits. Depending on the specific plan, you may have coverage for routine vision, dental, health wellness programs, and/or prescription medications. Although specific benefits vary by plan, Medicare Advantage generally works the same way in Wisconsin as in all states.
All Medicare Advantage members must continue to pay the Part B premium, in addition to the Medicare Advantage plan’s premium, if any.
Eligibility rules for Medicare Advantage in Wisconsin are the same as in other states. To enroll in Medicare Advantage, you must:
In most cases, Medicare Advantage plans are not available to individuals who have end stage renal disease (ESRD).
You can enroll in a Medicare Advantage plan during the following periods:
Wisconsin beneficiaries may have several choices when it comes to Medicare Advantage plans, depending on what’s available in their area and whether they meet certain eligibility requirements:
More prevalent types of Medicare Advantage plans include:
As a Medicare beneficiary in Wisconsin, you may find it useful to compare all Medicare Advantage plans available in your area.
The availability and costs of Medicare Advantage plans vary depending on where you live, the insurance company offering the plan, and specific plan details. You may find that some Medicare Advantage plans in Wisconsin offer premiums as low as $0. Be sure you consider other costs as well, such as copayments and deductibles, and that you continue paying your Medicare Part B premium no matter which Medicare Advantage plan you choose.
The Medicare Advantage plans available where you live in Wisconsin may include networks of participating providers. If so, your use of the doctors, hospitals and other health-care providers who participate in the plan’s network has a significant impact on your ability to receive the full benefits of the Medicare Advantage plan. If you currently have doctors and other health-care providers you want to retain, check to see if they participate in the Medicare Advantage plan before you make a final decision to enroll in it.
Some Medicare Advantage plans may offer additional benefits beyond those included in Original Medicare, Part A and Part B. Consider whether a Medicare Advantage Prescription Drug plan would be a good choice to meet your medical and prescription drug coverage needs. If a Medicare Advantage plan offers other extra benefits, such as preventive vision or dental care, consider whether these are important to your coverage needs.
To start comparing Medicare Advantage plans in Wisconsin, enter your zip code above for a customized list of plans available in your area. You can also enter your prescription drug needs to further refine your search and cost estimates.
You can learn more about your Medicare options in Wisconsin by referring to the following pages:
* Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.