Senior Health Plans

Although the variety of choices in Senior Health Plans can be very confusing and seem very complicated, your local agents at Wisconsin Benefit Planning have extensive knowledge and experience to help you make the right choice. 


The basics....


Medicare is a federal health insurance program administered by the Centers for Medicare & Medicade Services (CMS) for people age 65 or older, those with any permanent kidney failure, and some individuals that are under 65 and disabled.  Not all services and supplies are fully covered so please reference the handbook titled "Medicare & You 2015".

 Medicare is divided into four parts: 

Part A: Hospital Insurance

This will pay your hospital bills and certain skilled nursing facility expenses. It also provides very limited coverage for skilled nursing care after hospitalization, rehabilitation services, home health care, and hospice care for the terminally ill. It does not pay for personal (custodial) care, such as help with eating, dressing, or moving around. A benefit period begins the dat you are admitted into a hospital. It ends when you have been out of the hospital or a nursing facility for 60 consecutive days. If you are re-admitted within that 60 days, you are still in the same benefit period and would not pay another deductible. If you are admitted to a hospital after that benefit period ends, an entirely new benefit period begins and a new deductible must be paid.

Most people do not have a monthly payment for this coverage however if you do not qualify for to receive it premium-free you may be able to purchase it from Social Security by calling 1-800-772-1213.


Part B: Medical Insurance

It helps pay your doctors' bills and certain other charges, such as surgical care, diagnostics tests and procedures, some hospital outpatient services, laboratory services, physical and occupational therapy, and durable medial equipment. It does not cover prescription drugs, dental care, physicals, or other services not related to treatment of illness or injury. The premium is automatically taken out of your Social Security check each month.


Part C: Medicare Advantage

This provides Medicare coverage through private insurance plans. Medicare Advantage plans provide the same coverage as medicare and also provide supplemental health insurance coverage. You do not need to purchase Medicare supplement policy if you enroll in a Medicare Advantage plan. However, Medicare Advantage plans may include deductibles and copayment and/or coinsurance amounts (out-of-pocket expenses) that do not apply to Wisconsin standardized Medicare supplement policies. You may also have to see doctors that belong to the plan or go to certain hospitals to get services. Additional information regarding these palns is available in the booklet, Medicare Advantage in Wisconsin.


Part D: Prescription Coverage

Medicare Part D is the Medicare program to provide assistance for Medicare beneficiaries to pay for outpatient prescription drug costs. It is an optional program available to Medicare beneficiaries eligible for Medicare Part A and/or enrolled in Medicare Part B.

Medicare Part D coverage is offered by approved Prescription Drug Plans (PDPs). Private companies that contract with Medicare, some of which may be insurance companies, will administer the PDP benefits. The cost of your Medicare Part D coverage will vary based on the PDP that you choose. PDP plans may have deductible, coinsurance and copayment amounts (out-of-pocket expenses) that must be met before the PDP pays for your outpatient prescription drug costs.

 *Information was supplied from the "Wisconsin Guide to Health Insurance for People with Medicare 2015".


Medicare Supplements

The original Medicare plan pays for many health care services and supplies, but it doesn't pay all of your health care costs.  There are costs that you must pay, like coinsurance, co-payments, and deductibles.  These costs are called "gaps" in Medicare coverage.  You might want to consider buying a Medicare Supplement policy to cover these gaps in Medicare coverage.

There are 5 additional riders for Medicare Supplements in Wisconsin

  1. Part A Deductible Rider
  2. Part B Deductible Rider
  3. Additional Home Health Care Rider
  4. Foreign Travel Rider
  5. Part B excess Charges Rider

Medigap Policies 

When choosing a Medicare Supplement Plan you will want to compare the quality of the company, quality of service, price and additional coverage's such as routine physicals and vision discounts etc..  Even though coverage's are the same there is a big difference in price from company to company.  Wisconsin Benefit Planning agents are here to help you through the maze of choices, answer all of your questions, help you enroll as well as provide customer service once your plan is in place.