Medicare Plans in Wisconsin

Get Started Today!

Medicare Plans in Wisconsin

We don’t think that selecting the right Medicare coverage should feel overwhelming. The good news is that Wisconsin offers a wide variety of Medicare plans to choose from, and we here at MedicareMatchup can help you find the right level of coverage that best fits your needs and your budget.

Who’s eligible for a Medicare Plans in Wisconsin?

Medicare is a federally sponsored program that provides healthcare services to those who qualify, by either age or disability/illness. Individuals generally become eligible for Medicare plans in Wisonsin once they reach 65 years of age. Persons under the age of 65 may also qualify if they have been receiving Social Security Disability Insurance (SSDI) for two years or have been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End Stage Renal Disease (ESRD).

To qualify, you must be a citizen or permanent resident, having lived in the US for the past five years. In addition, you or your spouse must have worked and paid Medicare taxes for at least 10 years.

If you are unsure about your eligibility or will be turning 65 in the next six months, we’re here to help. Talk to a licensed insurance agent now by calling the number above.

Seniors at the Gym

What are the Medicare Plans in Wisconsin?

Orginial Medicare Part A & Part B

Original Medicare is made up of two parts:

Part A (Hospital Insurance) covers inpatient services, like hospital care, care received at a skilled nursing facility, and hospice care.

Part B (Medical Insurance) covers outpatient medical services and supplies that are considered medically necessary. Part B also covers some preventive care, like flu shots and cardiovascular screenings.

It’s important to recognize that Original Medicare does not cover everything. For example, it generally does not cover prescription medications, hearing exams/hearing aids, long term care, dental care, or eyeglasses. That’s why there is a wide variety of different types of Medicare plans available, to help obtain a more comprehensive coverage.

Medicare Advantage Plans   (Part C)

Medicare Advantage plans are provided by Medicare-approved private insurance companies and work as an alternative to Original Medicare (Parts A and B). These plans must provide the same coverage as Original Medicare (with the exception of hospice care, which remains covered by Part A). They can also provide additional benefits, such as dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.

To enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Premiums for these plans can start at $0, increasing with the level of coverage selected. You’ll need to continue paying your Part B premium in addition to your Part C premium.

Read more about Medicare Advantage plans here »

Medicare Prescription Drug Plans (Part D)

Prescription Drug coverage is generally not covered by Original Medicare or Medigap Plans. Stand-alone Prescription Drug plans, offered by Medicare-approved private insurance companies, work alongside Original Medicare (Parts A and B) to add prescription drug coverage. With these plans, a tier system is used to grade medications, and copays/coinsurance for each medication are set in accordance with their tiers. Drugs graded in the lowest tiers have the lowest copays/coinsurance, and vice versa. Each plan provides a drug formulary for you to see which tier(s) your medications fall into. This allows you to compare plans and select one with the best overall value for your specific prescription needs.

Read more about Medicare Prescription Drug Plans here »

Medicare Supplement Plans (Medigap)

Medicare Supplement plans add an additional layer of coverage to your Original Medicare by filling in coverage gaps. Medigap plans are provided by Medicare-approved private insurance companies and work alongside your Original Medicare to help reduce your out-of-pocket costs by paying certain healthcare costs, like copayments, coinsurance, and deductibles.

Learn more about Medicare Supplement Plans here »

When Can I Enroll In A Plan?

Medicare Advantage and Medicare Prescription Drug Plans

Your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. This IEP is a seven-month period, starting three months before your 65th birthday month.

You can then make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period runs from October 15th to December 7th every year.

Medicare Initial Enrollment Period

7-Month Initial Enrollment Period  |  Begins 3 months before the month you turn 65

*Signing up for Parts A and B during months 5,6, and 7 may result in delayed coverage.

KEY FACT: The General Enrollment Period provides you an opportunity to enroll in Original Medicare if you missed your IEP. This period occurs every year from January 1st to March 31st. Then, you’ll have an opportunity to select a Medicare Advantage Plan from April 1st through June 30th.

Medicare Supplement Plans

Once you’ve enrolled in both Medicare Part A and B, you can select the Medigap plan of your choice during your Medigap Open Enrollment Period. The enrollment period is a 6-month period that begins the month you are both 65 or older and enrolled in Medicare Part B.

Important Note: If you fail to enroll in a Medigap plan during your Medigap Open Enrollment Period, you’re subject to higher premiums or denial of coverage entirely.

Special Enrollment Periods

Some major life changes, like moving into a new coverage area or transferring to or from a care facility, are qualifying life events for a Special Enrollment Period (SEP). A Special Enrollment Period allows you to enroll or make changes to your coverage outside of the standard enrollment times. Our licensed insurance agents can help determine your eligibility for a Special Enrollment Period.

How Can I Compare Plans?

MedicareMatchup provides a convenient way to explore the many Medicare plans available in Maryland to find the coverage you need. By working with trusted partners, we’ll help you find coverage that best suits your particular needs.

If you’re unsure about your eligibility or will be turning 65 within six months, we can give you some guidance and help you prepare for enrollment. Give us a call today or get plan information online using our simple form below.

Additional Medicare Resources in Wisconsin

The State Health Insurance Counseling and Assistance Program (SHIP) provides help with questions or concerns about Medicare-related issues to those 65 and over or those with disabilities.

The Wisconsin’s Medicare Savings Program, or Medicare Premium Assistance, is available to Medicare beneficiaries in Wisconsin whose income falls beneath a certain amount to help pay for Medicare costs, like premiums and deductibles.

Sources: Medicare.gov; www.dhs.wisconsin.gov