Medigap in Wisconsin

If you live in Wisconsin, you have guaranteed issue rights to buy a Medigap policy, but the policies are different.

Basic benefits

  • Inpatient hospital care: covers the Part A coinsurance
  • Medical costs: covers the Part B coinsurance (generally 20% of the Medicare-approved amount)
  • Blood: covers the first 3 pints of blood each year
  • Part A hospice coinsurance or copayment

Medigap plan

Basic Plan

Covers

  • Basic Benefits [Glossary]
  • Part A: skilled nursing facility coinsurance
  • 175 days per lifetime in addition to Medicare's benefit of inpatient mental health coverage
  • 40 Home health care visits in addition to those paid for by Medicare
  • State mandated benefits

Important plan information

Plans known as "50% and 25% Cost-sharing Plans" are available. These plans are similar to standardized Plans K (50%) and L (25%). A high-deductible plan ($2,340) is also available.

Insurance companies are also allowed to offer these riders to a Medigap policy:

  • Part A deductible
  • Additional home health care (365 visits including those paid by Medicare)
  • Part B deductible
  • Part B excess charges
  • Foreign travel emergency
  • 50% Part A deductible*
  • Part B copayment or coinsurance

*Note: Coverage of the Part B deductible will no longer be available to people who are new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to get this benefit.

For more information