Medicare Supplement Insurance (Medigap) helps Wisconsin seniors and eligible disabled residents pay for healthcare costs not fully covered by Original Medicare, such as deductibles, copayments, and coinsurance. Unlike most states, Wisconsin does not use the standard A–N Medigap plan structure. Instead, beneficiaries can choose a Basic Plan and enhance it with optional riders for additional coverage.
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Wisconsin’s Medigap Basic Plan
The Wisconsin Basic Plan includes:
- Part A coinsurance plus 365 additional hospital days after Medicare coverage ends*
- Part B coinsurance*
- The first three pints of blood each year*
- Part A hospice coinsurance or copayment*
- Skilled nursing facility (SNF) coinsurance
- 175 additional inpatient mental health days per lifetime
- 40 additional home health care visits beyond Medicare’s benefit
- State-mandated benefits (varies by insurer)
*These are considered “basic benefits” and are included in every Wisconsin Medigap plan.
Additional Wisconsin Medigap Options
Beyond the Basic Plan, insurers in Wisconsin may also offer:
- 50% Cost-sharing Plan (similar to Plan K)
- 25% Cost-sharing Plan (similar to Plan L)
- High-Deductible Plan with a $2,000 annual deductible
Beneficiaries can also customize their coverage by purchasing riders. Available riders may include:
- Part A deductible
- 50% of the Part A deductible
- Part B deductible*
- Part B excess charges
- Part B copayments or coinsurance
- Foreign travel emergency coverage
- 365 additional home health visits beyond Medicare’s benefit
*Note: The Part B deductible rider is only available to beneficiaries who became eligible for Medicare before January 1, 2020.
Did you know? Wisconsin is one of only three states (along with Massachusetts and Minnesota) that use a state-specific Medigap structure. Instead of choosing a lettered plan, beneficiaries build coverage around the Basic Plan with optional riders — offering more customization than most states allow.
How Medigap Pricing Works in Wisconsin
Premiums for Medigap coverage can vary depending on the pricing method insurers use. In Wisconsin, plans may be priced under one of three models:
- Attained-age rated – Premiums rise as you age.
- Issue-age rated – Premiums are based on your age at purchase and may rise with inflation, not age.
- Community rated – Everyone pays the same premium, regardless of age.
Under-65 Eligibility in Wisconsin
Wisconsin law requires insurers to make Medigap plans available to Medicare beneficiaries under 65 who qualify due to disability or end-stage renal disease (ESRD). However, insurers may charge higher premiums for this age group.
Choosing a Medigap Plan in Wisconsin
Beneficiaries in Wisconsin start with the Basic Plan and then decide whether to add cost-sharing options or riders to fit their healthcare needs. This flexible system allows enrollees to tailor their coverage more precisely than the standardized letter plans used in most states. Every Medigap plan works nationwide with any provider who accepts Medicare, ensuring Wisconsin residents have reliable coverage whether they receive care in Madison, Milwaukee, or across the U.S.
To explore premiums and rider options available in your area, visit our Medigap rate comparison page.