Medicare

Medicare in Wisconsin

In Wisconsin, Medicare is compromised of four parts: A, B, C, and D, and you have two plan options:

Option One: Part A & Part B (With a supplement plan) & Part D

Part A & B – Traditional Medicare

Seniors qualify for traditional Medicare starting at age 65 (you may qualify earlier if you qualify for disability), and covers the following:

Benefits include:

• Freedom to chose your own hospitals and doctors
• No referrals required to see a specialist
• Coverage in all 50 states
• No claims paperwork

You are able to enroll in Medicare Part A and Part B during your Initial Enrollment period (which extends from three months before your 65th birthday until three months after your 65th birthday for a total of seven months). However, if you continue to work past this timeframe and have group insurance, you don’t qualify for Medicare. Upon retiring or working only full-time can you then enroll in a Medicare plan.

Supplements for Part A & Part B (Medigap)

Note: You must have Part A and Part B prior to enrolling in a Medigap policy, and are offered through private insurance providers.
Contact Mang for information about specific plans.

Part D – Prescription Drug Coverage

Each Part D plan, like supplements, are available through independent insurance companies. With that being said, each plan has its own list of drugs that it will cover so you will want to ensure you are on the plan that best fits your medical needs upon enrolling in a Part D plan.

Your first opportunity to enroll in Part D in Wisconsin is during your Initial Enrollment period (three months before your 65th birthday, the month of your 65th birthday, and the three months following your 65th birthday). The next opportunity to enroll or change plans is during the Annual Election Period (AEP), which runs every year from October 15 to December 7.

Not on any prescription drugs?

While enrollment in Medicare Part D is voluntary, you may be assessed a late enrollment penalty if you do not have creditable prescription drug plan. In order to bypass that penalty, you can enroll in WI SeniorCare or a Part D plan.

Option Two: Part C/Part D Bundle

Part C – Medicare Advantage Plan

Medicare Advantage offers all of the same treatment as Traditional Medicare, but there may be additional benefits you could take advantage of by enrolling in a Medicare Advantage Plan.

*Most Medicare Advantage Plans include drug coverage, but varies according to insurance company. Contact Mang for specific information.

Medicare Plan Options in Wisconsin

Wondering if you should go with Medicare Advantage or Medicare Supplement? Here is a comparison chart:

	Medicare Advantage	Medicare Supplement
Monthly premiums	As low as $0	Usually has a monthly premium
Can make changes	Two open enrollment periods per year	One period per lifetime (unless there are special circumstances)
Part B premium	Must pay	Must pay
Part B deductible	May not have a deductible	May pay unless you got Plan C before 1/1/2020
Prescription drugs	Generally covers	Does not cover
Network restriction	Yes	No
Dental, vision, hearing	May cover	Does not cover
Copays and coinsurance	Usually have to pay	May cover all
Standardized benefits	No	Yes