Compare by State – Medicare Plans in Wisconsin

Wisconsin Medicare Plans

Wisconsin residents turning 65 become eligible for Medicare. While the plans are great, some people require Medicare Supplements and Advantage plans to cover additional expenses left behind and offer increased flexibility.

Wisconsin Medicare Supplements plans differ from those plans for sale under federal law in other states. In fact, Wisconsin is one of only three states in the entire nation that doesn’t offer the standard 10 Medigap plans you find elsewhere. Instead, the Wisconsin Basic Plan offers a set of benefits outlined by the state.

Medicare Advantage plans offer similar coverage to Original Medicare, but offer extras, like prescription drug coverage, and don’t always cost you an additional premium.

Wisconsin Medicare Plans Open Enrollment

Medicare beneficiaries in Wisconsin are eligible for Medicare at age 65. Initial enrollment begins three months before your birth month and lasts three months after. During initial enrollment, you can also apply for Medicare Supplements.

Initial enrollment begins three months before your birth month and lasts three months after. This is also the time you can apply for Medicare Supplements. While you can enroll in a supplement at any time, initial enrollment is the best time to do so because you cannot be turned down due to health conditions considering you won’t have to answer health questions on your application. If you miss this window, you’ll likely have to answer health questions to apply, which means you could be turned down by other Wisconsin Medicare supplement plans.

Wisconsin Medigap Basic Plan

Wisconsin Basic Plan offers a set of benefits outlined by the state which includes:

  • Basic benefits
  • 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

Wisconsin Medicare Advantage

The state of Wisconsin offers up to 47 Medicare Advantage plans available, depending on what county you live in. When you enroll in a Medicare Advantage plan, you will get your care from the plan’s network of providers. This means that the private plans will pay instead of Medicare.

Medicare Advantage plans in Wisconsin usually include Part D drug coverage which provides retail medications to you. Based on the drug’s tier, you only pay the copay. Because each plan is different and covers its own drugs, so you’ll want to check to make sure that your medications will be covered before you apply for a plan.

Wisconsin Medicare Part D

While Original Medicare and Medicare Supplement plans don’t offer coverage for prescription drugs, there is an option to enroll in Medicare Part D in the state of Wisconsin. If this is enticing for you, there are 28 Part D plans available.

Wisconsin Medigap plans

Contrary to popular belief, your Part A & Part B benefits do not cover all of your medical expenses during retirement. Wisconsin Medigap plans to help people pay for things like deductibles and coinsurances.

Medicare Supplements in Wisconsin cover some, or even all, of the deductibles and coinsurance left over by Original Medicare.

This can save you thousands in out-of-pocket expenses, putting a cap on those costs, and this plan doesn’t limit you to a network of doctors that accept Medicare only.

There are 10 plans in Wisconsin lettered A through N that offer standardized coverage. This means all plans lettered the same have to offer the same coverage and the only difference is price. So, be sure to shop your coverage.

Medicare Advantage for Wisconsin Residents Under the Age of 65 with Disabilities 

While Medicare is generally reserved for those turning 65, there are cases in which someone may be eligible for Medicare under the age of 65. This includes individuals with disabilities who have received Social Security Disability Income for 24 months or have End Stage Renal Disease (ESRD) or Amyotropic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).

It is important to note that there is a five-month waiting period after a beneficiary is determined to be disabled before they can begin to collect Social Security Disability Income. People who meet all the criteria for Social Security Disability Income are generally automatically enrolled in Medicare Part A and Part B. For the people who meet the standards, but do not qualify for Social Security Income, have an option to purchase Medicare by paying a Part A premium monthly as well as a monthly Part B premium.

An exception to the 5-month waiting people does apply for those people with ESRD and ALS. These individuals do not have to collect benefits for 24 months in order to become eligible for Medicare.

The requirements for Medicare eligibility for people with ESRD and ALS are:

  • ESRD – Generally 3 months after a course of regular dialysis begins or after a kidney transplant
  • ALS – Immediately upon collecting Social Security Disability benefits

Regrettably, those with disabilities often have lower incomes, require more health care, and find it more difficult to pay for and obtain care compared to Medicare beneficiaries over 65 years of age. Take our Medicare quiz now to see if you qualify for incredible Medicare benefits, even if you are under the age of 65.

Every state is different, and so obtaining Medicare benefits in Wisconsin can be complicated or confusing. If you are disabled or under the age of 65 wondering if you qualify, it is best to contact us directly to see if you are eligible.

What Medicare Advantage benefits am I eligible for under the age of 65 in Wisconsin?

At 100 Insure, we can help you discover benefits you might be eligible for including:

  • Premiums starting at $0 per month
  • Coverage for copays and deductibles
  • Prescription drugs
  • Dental
  • Vision
  • Hearing
  • And transportation to the doctor and pharmacy

That’s right. Our company has helped qualified people under the age of 65 in Wisconsin receive benefits like:

  • Massage services
  • Meals after a hospital
  • Food for their service dog
  • A gym membership
  • Money for vitamins and groceries
  • Home improvements
  • In home care & aides
  • And pest control services

Contact us today to see if you qualify.

Medicare Coverage for Working People in Wisconsin with Disabilities

Medicare eligibility for working people with disabilities falls into three distinct time frames.

  • Trial work period – extends 9 months after a disabled individual obtains a job
  • Second period – This period is for 93 months after the end of the trial work period.
  • Third period – An indefinite period following those 93 months.

Keep in mind that Medicare eligibility during each of these periods applies only while the individual continues to meet the medical standard for being considered disabled under Social Security rules.

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