Medicare Supplement Insurance (Medigap) in Wisconsin

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Medicare is a valuable benefit, but it doesn't pay for everything. If you have Medicare alone, there's a chance you could be left with a real burden of covering the 20% that Medicare usually leaves behind. WPS Medicare supplement insurance plans are the most popular Wisconsin-based Medicare supplements in the state1 and they help reduce these out-of-pocket costs when you need medical care. With WPS Medicare supplement insurance, you get local, Wisconsin-based customer support that is ready to help you.

WPS Medicare supplement insurance offers:
  • Freedom to visit any doctor, specialist, or facility that accepts Medicare
  • Competitive coverage and stable rates2
  • Less paperwork and fewer worries with our automatic claims service
  • 7% premium discount if you and another member of your household enroll3
  • 2% discount when you enroll in automatic bank withdrawal
  • Fitness membership through the Silver&Fit® Healthy Aging and Exercise Program available at no extra cost4
  • Discounts on acupuncture, massage therapy, nutritional counseling, and much more through ChooseHealthy®4
  • EyeMed vision care program4
  • Hearing Care Solutions hearing program4
  • Base plans offer unlimited preventive coverage5
  • Optional foreign travel emergency coverage up to $100,0006
  • Option to purchase dental coverage 7
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  • Medicare Supplement Insurance (Medigap) FAQs


In most cases, yes. You can go to any doctor, health care provider, hospital, or facility nationwide that's enrolled in Medicare and accepting new Medicare patients. There are no networks on a WPS Medicare supplement plan. You won't need a referral, but the specialist must be enrolled in Medicare.

Original Medicare combined with a Medicare supplement plan has some similarities to Medicare Advantage, but they are actually very different. One of the most important decisions you have to make is what type of Medicare coverage to enroll in. There are multiple factors to consider. It can be easy to make the wrong choice, a choice you may not be able to undo. Visit our explainer video page for more information on the differences between Medicare supplement insurance and Medicare Advantage.

No, Medicare supplement policies and Medicare Advantage plans can’t work together. Your Medigap policy can't be used to pay your Medicare Advantage Plan copayments, deductibles, or premiums.

If you joined a Medicare Advantage Plan for the first time and you aren’t happy with the plan, you have special rights under federal law to buy a Medicare supplement policy. You have these rights if you return to Original Medicare within 12 months of joining.

In most cases, you can only leave a Medicare Advantage plan during certain times of the year, such as:

  • The Medicare Advantage Open Enrollment Period (OEP) between Jan. 1 and March 31.
  • Medicare’s Annual Enrollment Period (AEP) between Oct. 15 and Dec. 7. This is also called the Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage.

The best time to buy a Medicare supplement policy is the six-month period that starts the first day of the month you're 65 or older and enrolled in Medicare Part B. For example, if you turn 65 and are enrolled in Part B in June, the best time for you to buy a Medicare supplement policy would be from June until November. If you have questions, please call us at 1-800-332-0891.

You have a once-in-a-lifetime Open Enrollment Period unless you’re collecting Social Security disability insurance. This window:

  • Begins the month you become eligible for Medicare and enroll in Part B.
  • Is not the same as Medicare’s Annual Enrollment Period.
  • Only lasts for six months unless you delay enrolling in Part B due to having other creditable coverage.

If you enroll during your Open Enrollment Period, you have guaranteed issue rights. This means an insurance company is required to:

  • Sell you a Medigap policy.
  • Cover all your preexisting health conditions.
  • Not charge you more for a Medicare supplement policy because of past or present health problems.

Applying outside your open enrollment window can result in higher premiums, as well as restrict your coverage options. However, you can still apply to enroll in a Medicare supplement plan at any time of the year.

There are a handful of instances in which you are eligible for guaranteed issue rights with Medicare supplement plans. They usually occur when you lose coverage for reasons out of your control or when you move. Some of the situations when an insurance company can’t refuse to sell you a Medicare supplement policy include when:

  • Your Medicare Advantage plan is leaving your specific area or leaving Medicare.
  • Your employer plan that supplements Medicare ends.
  • You are eligible for trial rights after enrolling in Medicare Advantage or are dropping your Medigap coverage.
  • You decide to move out of the plan’s service area.
  • The Medicare insurance company did not follow the rules.

It’s critically important to find out from the employer whether you need to enroll in Medicare. If you do, find out exactly how the employer coverage fits in with Medicare. If you’re told you don’t, get that decision in writing. If you’re over 65 and receive coverage under a group health plan provided by an employer for which you or your spouse actively works, you have the right to delay Medicare enrollment until the job ends or the coverage ends, whichever occurs first. At that point, you’re entitled to a special enrollment period of up to eight months to sign up for Medicare without risking late penalties.

If the employer has 20 or more employees, the law stipulates that those 65 and older (and their spouses) must be offered exactly the same health benefits that are offered to younger employees (and their spouses). In this situation, the employer cannot require you to sign up for Medicare when you turn 65 or become eligible for Medicare due to disability.

However, the law does not give the same protection to people who work for smaller employers with fewer than 20 employees. In this situation, an employer is allowed, but not obligated, to require you to sign up for Medicare when you become eligible. In that case, Medicare would become your primary coverage. That means Medicare would settle your medical bills first, and the employer plan would only pay toward services that it covers but Medicare doesn’t. Therefore, if you are required to sign up for Medicare but don’t, you’ll essentially be left with little or no health coverage.

There is one situation when you definitely will need to delay Medicare enrollment until you retire: if your employer’s coverage is a high-deductible health care plan paired with a health savings account (HSA). Under IRS rules you cannot contribute to an HSA in any month in which you are enrolled in any part of Medicare (Parts A, B, or D).

Medicare supplement plans are “guaranteed renewable,” meaning as long as you pay the premium, the insurance company cannot cancel the coverage.

Plans that offer the most comprehensive coverage usually have a higher premium. Premiums vary by insurance company and premium amounts can change multiple times a year. At WPS our rates only increase once a year, so there are no surprises. The main goal of a Medicare supplement insurance plan is to help cover some of the out-of-pocket costs of Original Medicare (Parts A and B).

You can see the chart included below or search and compare Medicare supplement plans offered by your ZIP code at Medicare’s official website.

Add Optional Riders Basic Plan Only
Highest coverage option
Basic Plan with Copay/Coinsurance Rider
Second-highest coverage option
25% Cost-Sharing Plan
Second-lowest coverage option
50% Cost-Sharing Plan
Lowest coverage option
Medicare Part A Deductible 100% or 50% 100% or 50%
Medicare Part B Excess Charges
Additional Home Health Care
Foreign Travel
Additional rider only available to applicants first eligible for Medicare before 1/1/2020.
Medicare Part B Deductible*

*Optional rider only available to applicants first eligible for Medicare prior to 1/1/2020.

No, a Medicare supplement plan does not include outpatient prescription drug benefits. Instead, Medicare offers prescription drug coverage under a stand-alone Part D plan. Our representatives can help you find a plan that works best for you.

Medicare supplement plans typically do not offer coverage for routine dental, vision, or hearing care, or for prescription drugs, but some plans offer stand-alone programs. WPS Medicare supplement insurance plans come with the following services at no additional cost:

  • Vision program
  • Hearing program
  • Fitness program
  • Wellness program
  • Optional dental coverage (requires a premium)

Typically, no. If your provider participates in Medicare (also called accepting Medicare assignment), they will file the claim with Medicare. Medicare will then automatically forward the claim to your insurer for processing.

No, a Medicare supplement policy only covers one person. If you and your spouse both want Medicare supplement coverage, you will have to buy separate policies. However, WPS offers a 7% household discount when two or more individuals who reside together in the same dwelling have WPS Medicare supplement coverage. A dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex.

Yes, you get a 7% household discount when two or more individuals who reside together in the same dwelling have WPS Medicare supplement coverage. A dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex.

You can keep your current Medicare supplement policy no matter where you live, as long as you still have Original Medicare. If you want to switch to a different Medicare supplement policy, you'll have to check with your current or new insurance company to see if they'll offer you a different policy. If you decide to switch, you may have to pay more for your new Medicare supplement policy. You may also have to answer some medical questions if you're buying a new policy outside of your open enrollment period.

Yes, if you have Original Medicare with a Medicare supplement, you are covered anywhere in the United States that accepts Medicare.

Most Medicare supplement insurance carriers have plan options that include foreign travel benefits that provide some medical insurance coverage when traveling abroad. WPS offers travel emergency coverage up to $100,000.

Yes! WPS offers regular free webinars that will explain Medicare and its parts, the pros and cons of different options, expected changes, and more. You can sign up for one of our webinars.

Yes! You can discuss your specific medical and financial needs so you can find the best Medicare supplement plan for you. You can speak with a licensed WPS agent at 1-800-332-0891.

Yes, if you are eligible for Medicare, Wisconsin is a state that requires insurance companies to offer at least one kind of supplement policy to people with Medicare under age 65.

The best plan is one that meets your individual needs, both medically and financially. You can speak with a licensed WPS agent at 1-800-332-0891, call Medicare at 1-800-MEDICARE, or contact an independent agent. If you are already a customer, please call the number on your ID card.

Policies may include preventive health care services such as routine physical examinations, immunizations, health screenings, and private duty nursing services. Call WPS today at 1-800-332-0891 to see which of these services are covered.

Wisconsin is one of three states where Medicare supplement plans are standardized differently. Wisconsin offers a Basic Plan that you can pair with riders for more coverage. The best choice for you depends on your budget and needs. If you prefer, 50% and 25% cost-sharing plans are also available. These are similar to Plans K and L in other states. Talking to a WPS agent can make the process go faster and help you save money. Call us today at 1-800-332-0891.

   

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1Based on enrollment data submitted to the National Association of Insurance Commissioners, 2020. 2Based on historical approved Wisconsin standardized plan rate increases. 3Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex. 4Fitness, vision, hearing, and wellness programs are not part of the insurance policy, are offered at no additional charge, and can be changed or discontinued at any time. The Silver&Fit® program is provided by American Specialty Health Fitness, Inc. The ChooseHealthy® program is provided by ChooseHealthy, Inc. Both are subsidiaries of American Specialty Health Incorporated (ASH), a national provider of fitness, health education, musculoskeletal provider networks, and health management programs. Silver&Fit, Silver&Fit Connected!, and ChooseHealthy are registered trademarks of ASH and used with permission herein. Services that require an additional cost are not included in the Silver&Fit program. For the ChooseHealthy program, you are obligated to pay for all services, but you will receive a discount from participating providers. The program does not make any payments directly to the participating providers and has no liability for the quality of services rendered. Discounts are subject to change; please consult the website for current availability. The Silver&Fit, Silver&Fit Connected!, and ChooseHealthy programs are not included with Medicare supplement cost-sharing plans (Plans K and L). The people in this piece are not Silver&Fit members. 5Basic plans include Medicare Part B preventive services with no maximum benefit amount. Cost-sharing plans do not include this benefit. 6Requires purchase of an additional rider.7WPS has partnered with Delta Dental to provide dental coverage. Dental policies are underwritten by Delta Dental of Wisconsin. Green Bay Packers and Milwaukee Brewers™ partnerships are paid endorsements.



View disclaimer information | Wisconsin Guide to Health Insurance for People with Medicare


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