Wisconsin Medicare Supplement plans compliment your Original Medicare. In spite of Medicare being one of the most comprehensive health care coverage available, there’s still expenses that are left up to the Medicare beneficiary.
The difference between what Medicare pays and those costs that are not covered is better known as a gap or hole in medical coverage. The Medicare beneficiary is responsible for making up the difference.
Since many Medicare recipients may be on a fixed income, the financial responsibility caused by this gap in coverage can be quite a burden on their budget.
Fortunately, there’s a great solution for those that face this issue. Most U.S. states offer some type of Medigap or Supplemental Medicare plan.
This plan picks up some, or all, of the costs that the insured is held accountable for after Medicare pays its portion. Co-payments, deductibles, and coinsurance payments are all examples of costs that a supplement plan will usually cover.
Wisconsin Medicare Supplement Plans
The federal government does put some basic guidelines and restrictions in place, but the insurance product is not a product created by the federal or state government.
The government simply requires that insurance companies provide standardized coverage across the board that provides medical coverage that does not fall below certain minimum requirements; this makes it a safer plan for seniors.
Although there’s many plans available, each plan may have more or less benefits or perks within the policy.
Wisconsin Medicare Supplemental Insurance Plans Mandated Benefits
- Skilled Nursing – Coverage for 30 days of skilled nursing care. The facility must be a licensed skilled care nursing facility but doesn’t need to be certified by Medicare or meed Medicare’s definition of skilled care.
- Home Health Care – Coverage for up to 40 home care visits per year in addition to any coverage from Medicare that you qualify for. Home health aide services are covered on an intermittent basis as well as speech, respiratory, occupational or physical therapy. Medicare Supplement carriers are required to offer coverage for 365 home health care aide visits within a policy year. Please note, “medically necessary” is defined and you have to meet certain criteria.
- Kidney Disease – Coverage for inpatient/outpatient expenses for donor related services, transplantation and dialysis in an amount not less than $30,000 in any calendar year.
- Diabetes Treatment – Coverage for the installation and use of insulin infusion pump, self-management services or other equipment or non-prescription supplies for treatment. This benefit is still available even if Medicare doesn’t cover the claim.
- Chiropractic Care – Coverage for chiropractic services provided by a chiropractor but must meet the company’s standards as medically necessary.
- Hospital and Ambulatory Surgery Center Charges and Anesthetics for Dental Care – coverage for hospital or ambulatory surgery center charges incurred.
- Breast Reconstruction – coverage for breast reconstruction on the affected tissue
- Colorectal Cancer Screening – coverage for Colorectal cancer examinations and laboratory tests.
- Inpatient Mental Health – coverage for an additional 175 days per lifetime on top of Medicare’s benefits.
How Do I Qualify for Wisconsin Medicare Supplement Policies
The basic requirement for Wisconsin Medicare Supplement policies eligibility is to be a Medicare recipient that is enrolled in Medicare Part A and Medicare Part B as well as age 65 or older to be qualified to apply for any of the Wisconsin Medigap plans unless state law states differently.
There are those who receive Medicare benefits that are under the age of 65; these individuals receive Social Security Disability benefits and Medicare coverage. It’s important to look at the Wisconsin Medicare Supplement guide and the private insurance requirements to determine if you are eligible for coverage. In Wisconsin you can add what’s called “riders” to your base policy plan. If you’re under 65, the rates will not be the same as those who are 65+.
Timing plays a key factor in costs of your plan, if you apply during your Medicare Open Enrollment Period, you are protected under federal and state laws. For instance, if you apply during this time, the private insurance company cannot deny you coverage simply because you have health problems and/or pre-existing conditions.
They also cannot charge you more than any other person due to health conditions. However, if you don’t apply during Open Enrollment, you won’t receive Wisconsin Medicare Supplement guaranteed issue. The carrier may require medical underwriting and increase your premiums due to your health status.
Wisconsin Medicare Supplement Riders
Wisconsin Medicare Supplement Riders are optional. Insurance carriers are allowed to offer 7 additional riders to any of the Wisconsin Medicare Supplement plans available.
- Part A deductible
- Additional home health care
- Part B deductible
- Part B excess charges
- Foreign Travel Emergency care
- 50% of your Part A deductible
- Part B co-payment/coinsurance
Wisconsin Medicare Supplement Insurance Rates
Wisconsin Medicare Supplement insurance rates will depend on the company and plan coverage’s you elect to have. There’s many plans to choose from that will benefit you, each plan will have its own cost to consider. Although options are always good, a large number of options can be confusing and overwhelming. There’s a great deal of insurance language that can be difficult to decipher, so utilizing the services of a trained professional is not a bad idea. You can call the number on our site, this is a great resource to help you make an informed medical insurance decision.
WI Medicare Supplement Insurance Plans Carriers
Many WI Medicare Supplement insurance plan carriers are approved by the Office of the Commissioner of Insurance (OCI) to sell plans in the state of Wisconsin. Knowing which carriers are known to have conservative rate increases and good customer ratings is important, that’s where we can help. We’ll discuss one of the top carriers that we work with in Wisconsin.
- Aetna Medicare Supplements – one of the largest health insurance carriers in the world, their known for having conservative rate increases, their an AM Best A Rated Company, 12 month rate lock and much more.