Best Medicare Supplement Plans in Wisconsin 2024

Wisconsin has nearly 1.3 million Medicare beneficiaries^[0]

Wisconsinites with Medicare Part A and Part B can purchase Medicare Supplement Insurance, or Medigap, to help cover certain out-of-pocket expenses like copays, coinsurance and deductibles left over after Medicare pays for covered services. Over 300,000 people in Wisconsin had Medigap coverage as of the end of 2022^[0]

How Medicare Supplement Insurance works in Wisconsin

In most states, there are 10 standard Medigap plan types, but Wisconsin uses a different system.

In Wisconsin, all Medicare Supplement Insurance plans must cover these basic benefits, according to the Wisconsin Office of the Commissioner of Insurance^[0]

• Part A copayment through day 150 of hospitalization.

• Part A copayment for days 21 to 100 of skilled nursing care in a skilled nursing facility.

• Part B coinsurance or copayment.

• Blood transfusion (first three pints).

• Inpatient mental health coverage: 175 additional lifetime days beyond what Medicare covers.

• Home health care: 40 additional visits per year beyond what Medicare covers.

• Non-Medicare-covered chiropractic care.

• Non-Medicare hospital and ambulatory surgical center charges.

• Anesthetic for dental care.

• Non-Medicare-covered breast reconstruction.

• Medically necessary non-Medicare skilled nursing facility care: 30 days.

You can choose to add coverage for any or all of these optional benefits as a rider for an additional premium:

• Part A deductible: 50% or 100% coverage.

• Home health care: up to 365 medically necessary visits per year.

• Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).

• Medicare-covered emergency services while traveling abroad.

You can also choose a Part B copayment or coinsurance rider that makes you responsible for certain copays or coinsurance. After you meet the Part B deductible, you would owe 20% of the covered cost of doctor’s office and emergency room visits not resulting in hospitalization, up to a maximum of $20 for doctor’s office visits or $50 per emergency visit.

Unlike the optional benefits that require additional premiums, the rider to add copays or coinsurance generally makes your premiums less expensive. You pay less in premiums, but more out of pocket, similar to how Medigap Plan N works in other states.

Alternative Medicare Supplement plan options in Wisconsin

In addition to the basic plan described above, Wisconsin Medicare beneficiaries have several alternative options for Medicare Supplement plan structures, which might offer lower monthly premiums than the basic plan.

• High-deductible plan: You pay out of pocket up to a deductible of $2,800 in 2024, after which the standard plan benefits kick in.

• 50% cost-sharing plan: You owe 50% of most covered out-of-pocket costs, while the plan covers the other 50%. There’s an out-of-pocket maximum of $7,060 in 2024, after which you won’t pay any more out of pocket for the year. (This option is similar to Medigap Plan K in other states.)

• 25% cost-sharing plan: You owe 25% of most covered out-of-pocket costs, while the plan covers the other 75%. There’s an out-of-pocket maximum of $3,530 in 2024, after which you won’t pay any more out of pocket for the year. (This option is similar to Medigap Plan L in other states.)

Although adding Part B copayments or coinsurance is technically a rider you can choose to add to the basic plan, some insurance companies might show a copay/coinsurance plan as a separate option with lower premiums.

Top Medicare Supplement Insurance companies in Wisconsin

The federal government regulates Medigap plans, but private insurance companies sell them. Here are the five most popular Medicare Supplement Insurance companies in Wisconsin as of the end of 2022^[0]

» MORE: Best Medicare Supplement Insurance companies

Medicare Supplement Insurance prices in Wisconsin

It’s worth comparing companies to find the lowest price. The benefits of each Medigap plan are standardized, so you get the same Medicare benefits regardless of the company you choose.

Here are the prices for the basic Medigap plan from the five Medigap companies with the most members in Wisconsin. The table below shows price estimates for a 65-year-old female nonsmoker in Madison, Wisconsin, as filed with the Centers for Medicare & Medicaid Services^[0]

Note that these prices are for the base plan only, without any additional riders. Companies can offer benefit riders individually or in packages at a variety of prices, so compare carefully to find the best price for the benefits you want included in your plan.

Medicare resources in Wisconsin

• State Health Insurance Assistance Program (SHIP): Provides information and free, confidential counseling about Medicare and related health coverage issues.

• Wisconsin Board on Aging and Long Term Care: Administers helplines and ombudsman programs to help Wisconsin residents navigate Medicare coverage, long-term care and related issues.

• Wisconsin Department of Health Services: Maintains an index of services for older people and people with disabilities, linking to providers and resources.