Explore your options
Compare options, including Medicare Advantage, Medicare Supplement, and prescription plans.
Find a Licensed Medicare agent in Wisconsin
Connect with Medicare agents in Wisconsin
Toni Aldridge
Kevin Hatfield
Shannon Davis
Tyler Eby
Kayla Torry
Brandon Kauffman
Calvin Fritz
Sara Morrissey
Matt Willenborg
Ariel De Jesus
Why work with a Medicare agent
Enroll in Medicare
Get the help you need to enroll in Medicare, from Original Medicare to supplemental coverage.
Use your coverage
Receive extended support to help you use your plan effectively, find doctors, and get savings.
A Snapshot of Medicare in Wisconsin
In Wisconsin, 57% of Medicare beneficiaries choose to switch to Medicare Advantage. The remaining 43% choose to stay on Original Medicare. For those on Original Medicare, many also choose to add a Medigap plan and a Part D plan to their overall Medicare coverage.
Original Medicare consists of Part A and Part B, which cover inpatient and outpatient care. Original Medicare doesn't include prescription drug coverage. Wisconsin residents can buy a standalone Part D plan for prescription drug coverage. Most Medicare Advantage plans include Part D coverage. If you are on a Medicare Advantage plan that has Part D coverage, you don’t need a separate Part D plan.
In Wisconsin, Medigap (also known as Medicare Supplement) policies are different from the standard 10 Medigap plans offered across the US. They also include a lifetime benefit of 175 days of inpatient mental health care and 40 home health care visits beyond the visits covered by Original Medicare. Every Medicare Supplement plan sold in the state comes with those benefits.
Medicare Advantage plans in Wisconsin can require prior authorization for certain health care services. Prior authorization policies often apply to high-cost services. Medicare Advantage users should review their plan's prior authorization policies before receiving care the plan may not cover. Typically, Original Medicare requires fewer prior authorizations for covered services.
How to apply for Medicare in Wisconsin?
Medicare eligibility in Wisconsin follows the same nationwide rules as everywhere else in the country. You qualify for Medicare as a US citizen if you meet one of these criteria:
- You're 65 or older
- You have a qualifying disability, such as End-Stage Renal Disease or ALS
- You've received SSDI for 24 months or more
Enrolling in Wisconsin takes three key steps:
- Sign up for Original Medicare (Part A and Part B)
- Decide on your supplemental coverage:
- Medicare Supplement (Medigap)
- Medicare Advantage (Part C)
- Part D (prescription drug coverage)
- Confirm your doctors are in network, update your pharmacy with your new plan, and activate any additional benefits included with your coverage
FAQs
What should Wisconsin residents compare when choosing Medicare coverage?
Wisconsin residents should carefully consider their healthcare needs, preferred doctors, prescription drugs, and budget as they weigh their Medicare options. They should also consider premiums, out-of-pocket costs, and the additional benefits each option offers. Chapter's licensed Wisconsin Medicare Agents provide free, personalized support to help people pick the best plan for their specific needs. Call Chapter at (855) 900-2427 to ask questions or schedule a free consultation.
Why does Medicare Supplement coverage in Wisconsin work differently from the standard lettered Medigap plans used in most states?
Wisconsin is one of three US states that don't use the standard ten Medigap plan types offered across the US. Instead, they offer one “Basic” plan that comes with a core set of required benefits. You can then add different protection riders to a basic plan to build a more comprehensive coverage option. There are also 25% and 50% Cost-sharing plans similar to the standard Medigap Plan L and Medigap Plan K. Finally, there’s a high-deductible plan.
Why can Medicare Advantage options vary across Wisconsin counties?
Insurance companies can choose which counties to offer specific plans. Different counties will have a different set of plans, and, depending on where you live, you may have fewer options. When looking at Medicare Advantage plans, make sure you’re only looking at those available to you. If you move, check to see if your plan is available and if there are additional plans available at your new address.
Will Wisconsin residents be automatically enrolled in Medicare when they turn 65?
Wisconsin residents receiving Social Security benefits at least four months before turning 65 are automatically enrolled in Medicare Part A and Part B. Others should sign up during their Initial Enrollment Period, which begins three months before the month they turn 65, includes their birthday month, and ends three months afterward. People with group health coverage through their own or their spouse's current employer may be able to delay Part B without a late-enrollment penalty. They should confirm that their coverage qualifies before delaying enrollment.
