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 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.


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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