How do Medicare plans work in Wisconsin and Minnesota?

Medicare Supplement Insurance plans are standardized, with most states offering 10 Medigap plans labeled with a letter.  However, Medigap policies are standardized differently in Wisconsin, Minnesota, and Massachusetts. 

WISCONSIN MEDICARE SUPPLEMENT

Wisconsin Medigap Insurance policies start with “Basic Benefits” included in the standardized Medigap plans available in most other states.  

These 4 “Basic Benefits” are:

  1. Medicare Part A: Inpatient Hospital Care Coinsurance.
  2. Medicare Part B: Medical Costs Coinsurance.
  3. Blood: The first 3 pints of blood per year.  And finally, 
  4. Medicare Part A: Hospice Care Coinsurance or Copayment.

The “Wisconsin Basic Plan” also includes these 6 benefits:

  1. Medicare Part A: Skilled Nursing Facility Coinsurance.
  2. Inpatient Mental Health Coverage: 175 days per lifetime, on top of what Medicare covers.
  3. Home Health Care: 40 visits, on top of what Medicare covers.
  4. Medicare Part B: Coinsurance.
  5. Outpatient Mental Health.  And finally, 
  6. Other Wisconsin-Mandated Benefits. 

Along with these benefits, you also have the option of adding “Riders” to your supplemental insurance. Those riders are: 

  • Medicare Part A Deductible.  This is one of the most important riders because there’s a high potential for this deductible to cost you thousands of dollars out-of-pocket.  The Part A Deductible Rider pays the Medicare Part A deductible.
  • Medicare Part B Deductible.  The Part B Deductible Rider pays the Part B deductible of $185 in 2019.  The amount of this deductible can change from year to year. 
  • Medicare Part B Excess Charges.  A doctor may accept Medicare but might not accept Medicare Assignment.  If a doctor doesn't accept Medicare Assignment, he or she can charge you up to 15% more than what Medicare will approve.  The Medicare Part B Excess Charges Rider covers the 15% difference between the Excess Charges and what Medicare has approved as the full payment amount.
  • Additional Home Health Care.  This rider extends the “Wisconsin Basic Plan” coverage from 40 to 365 home health care visits per year.
  • Foreign Travel Emergency.  This rider provides up to $50,000 lifetime of coverage for medical expenses incurred outside the United States, including travel aboard cruise ships that sail beyond U.S. boundary waters.  There is a $250 deductible, but this rider is a necessity for international travelers.

MINNESOTA MEDICARE SUPPLEMENT PLANS

In Minnesota every plan starts by covering what is considered the “Basic Benefits” let’s take a look at what those are: 

  • Medicare Part A Coinsurance
  • Medicare Part B Coinsurance 
  • Blood: The first 3 pints of blood per year 
  • Part A Hospice Care
  • Parts A and B Home Health Care
  • Minnesota State-Mandated Benefits

Now let’s dig into the 3 most popular  Minnesota “Medigap Policy Coverage Options” 

  • The Basic Plan
  • The Extended Basic Plan
  • The Co-Pay Plan

The “Basic Plan” is essentially your “a la carte” option in Minnesota.  It allows you to design a Medigap policy that fits your needs and your budget.  The “Basic Plan” starts with the Minnesota “Basic Benefits” and also covers:

  • Foreign Travel Emergency
  • From there, Minnesota offers these 4 “Optional Riders”:
  • The Part A Deductible Optional Ride
  • The Part B Deductible Optional Rider
  • The Part B Excess Charges Optional Rider
  • The Medicare-covered Preventive Care Optional Rider

Moving on, the “Extended Basic Plan” is virtually identical to the standardized Medigap Plan F available in most other states.  The “Extended Basic Plan” starts with the Minnesota “Basic Benefits” and also covers:

  • The Part A Deductible
  • The Part B Deductible
  • Part B Excess Charges
  • Medicare-Covered Preventive Care
  • Foreign Travel Emergency
  • Foreign Travel Medical Care
  • Preventive Services Not Covered by Medicare
  • The “Co-Pay Plan” which is equivalent to the plan N in other states, starts with the Minnesota “Basic Benefits” and also covers:
  • The Medicare Part A Deductible; and 
  • Foreign Travel Emergency. 

So there you have it that’s how Medicare Supplement plans work in Wisconsin and Minnesota.

Tagged: Wisconsin Medicare, Minnesota Medicare, Medicare Supplements, Medicare

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