Medicare in Wisconsin
If you live in Wisconsin, you have lots of options to get your Medicare benefits. Here’s an overview of the different parts of Medicare, so you can find what’s right for you.
Original Medicare (Part A and Part B) is the federal government program. When you turn 65, typically you are eligible and automatically enrolled. Be sure to become familiar with the different parts and benefits they offer.
Part A – Hospital Services
Medicare Part A is hospital insurance. Part A benefits cover:
- Inpatient hospital care
- Skilled nursing care facility
- Home health care services
- Hospice care
Most people in Wisconsin won’t have to pay a monthly premium for Part A. You may have to pay for part of the cost of services, and you will have a deductible.
Part B – Medical Services – including preventive care
Medicare Part B is medical insurance. Part B benefits cover:
- Doctors’ office visits
- Preventive care
- Lab tests, blood tests and X-rays
- Diabetic screenings and supplies
- Outpatient hospital care
You will have to pay a Part B monthly premium.
Medicare Advantage – Part C
Another way to get your Medicare benefits is to buy a Medicare Advantage (Part C) plan through private insurance companies contracted with Medicare. These plans cover all of the services that Original Medicare covers plus even more benefits, like prescription drugs. You can get these benefits all in one plan. Some Part C plans have monthly premiums as low as $0. Most plans have deductibles, copays and coinsurance that you’ll pay before you get your healthcare services.
More Benefits: Depending on the plan you choose and where you live (your ZIP code and county in Wisconsin), most Medicare Advantage plans may also cover:
- Prescription drugs (Medicare Part D)
- Routine care for your vision and hearing
- Health, fitness and wellness programs
Limited Costs: Medicare Advantage plans have a yearly limit on your out-of-pocket costs. After you reach this yearly limit, you won’t have to pay anything for covered services. So ask about plans you’re interested in because yearly limits vary.
Prescription Drug Plans – Part D
Medicare Part D is stand-alone prescription drug coverage. You can get Part D through private insurance companies. Certain costs apply depending on the plan you choose. Most people will have to pay a monthly premium. You can also get prescription drug coverage in many Medicare Advantage plans.
Medicare Supplement Plans in Wisconsin
You might want to look into a Medicare Supplement plan to help cover some of your Part A and Part B out-of-pocket healthcare costs such as deductibles, copays, and coinsurance. This can be an especially good choice if you receive medical services quite often, such as care for a chronic condition.
Enrolling in Medicare Plans in Wisconsin
For all the information you need to enroll, please click here
Resources for Medicare recipients in your state:
Take advantage of these free Medicare resources for Wisconsin residents.
Medicare Savings Programs in Wisconsin
You can apply for one of the savings programs through the state’s Department of Health Services. If you qualify, these programs may be able to help you pay your Medicare Part A or Part B premiums. Find more information here: https://www.dhs.wisconsin.gov/medicaid/publications/p-10062.htm
State Health Insurance Assistance Program (SHIP) SHIP has convenient locations throughout Wisconsin. Specialists in Medicare offer free services, helping you through counseling, presentations, and explaining Medicare materials. Read more about this program here: https://www.dhs.wisconsin.gov/benefit-specialists/medicare-counseling.htm
Things to remember:
- Availability of plans in specific areas in Wisconsin depends on the contract between the plans and Medicare
- Benefits and costs vary by the plan you choose and where you live
- You must continue to pay your Original Medicare Part B premium
- Hospice care is offered by Part A
- Review your materials and call a Medicare specialist
How to sign up for your Medicare plan:
- Visit Medicare.gov
- Search the plans you want, choose one and enroll on their website
- Call the plan you’re interested in for a paper form to fill out
- Call 1-800-MEDICARE (1-800-633-4227) (TTY: 711) 24 hours a day, seven days a week. If you have both Medicare and Medicaid benefits, contact your state’s Medicaid office also