Compare Medicare Plans in Wisconsin (February 2025)

Key Takeaways:

• Wisconsin offers many Medicare options, including 129 Part C, 16 Part D plans, and a Medigap plan with optional extra coverage.
• All Medicare beneficiaries in the state have access to at least one Part C and Part D plan with zero monthly premiums.
• Compare plans based on provider networks, added benefits, and premiums to get optimal Medicare coverage at a price you’re comfortable with.

Choosing the right Medicare plan in Wisconsin can feel overwhelming given the wide range of coverage options available.

Picking the right plan requires carefully balancing healthcare coverage with costs, provider networks, and access to specialized care.

This guide simplifies the various Medicare plans available in Wisconsin, highlights their costs and benefits, and gives you the tools and information necessary to make confident decisions about your healthcare needs.

Types of Medicare Plans Available in Wisconsin

Medicare plans in Wisconsin cater to a variety of healthcare needs and budgets.

Here’s a breakdown of what each type offers:

Original Medicare (Part A and Part B)

Original Medicare is the foundation of healthcare coverage for US citizens over the age of 65 and those with certain covered disabilities and diseases.

It has two components:

Medicare Part A (Hospital Insurance):

• Hospital Stays: Covers inpatient care in hospitals, skilled nursing facility care, hospice care, and some home health services.
• Premium: Most people don’t pay a premium for Part A if they’ve paid Medicare taxes for at least 10 years. Those who haven’t may pay up to $518 monthly in 2025.
• Deductible: The annual deductible for Part A is $1,676 per benefit period in 2025, with no limit on the number of times the deductible could apply within a year.
• Copayments: They vary depending on the length of stay at a hospital or skilled nursing facility.

Medicare Part B (Medical Insurance):

• Medical Services: Covers outpatient care, doctor visits, preventive services, and durable medical equipment.
• Premium: The standard monthly premium for Part B is $185 in 2025. It could be higher based on your income.
• Deductible: The annual deductible for Part B is $257 in 2025.
• Coinsurance: Once you’ve met your deductible, you typically pay 20% of the Medicare-approved amount for most services.

Note: Data sourced from Medicare Basics

Medicare Advantage (Part C)

Federally approved private insurance companies offer Medicare Advantage or Part C plans as an alternative to Original Medicare.

These plans offer all the benefits of Original Medicare along with added coverage for prescription drugs, dental, hearing, and vision services, and even wellness programs, in some cases.

That makes Part C plans a popular choice among Medicare beneficiaries looking for comprehensive healthcare coverage.

Learn more: Why is Everyone Pushing Medicare Advantage?

Here are some important facts about Medicare Part C plans in Wisconsin in 2025:

• Plan Availability: Wisconsin residents have 129 Part C plans to choose from in 2025, up from 118 plans in 2024.
• Premium Changes: The average monthly premium for Part C plans fell from $26.01 in 2024 to $24.21 in 2025.
• Lowest Monthly Premium: The lowest monthly premium for a Part C plan in Wisconsin is $0.
• Plan Accessibility: All Medicare beneficiaries in Wisconsin have access to at least one Part C plan with zero monthly premiums.

Top Medicare Advantage Plans in Wisconsin:

Note: Data gathered via CMS.gov and direct provider plans. Comparison of plans from Wisconsin Zip Code 53031. Star ratings and plan information reflect publicly available data as of 2025.

Private insurers offering Medicare Advantage plans in Wisconsin include:

• Aetna
• Anthem
• Humana
• UnitedHealthcare

Improve Your Medicare Coverage

At CoverRight, we believe in simplifying the process of navigating Medicare.

Our experts provide personalized guidance and support to help you choose a plan that best aligns with your healthcare needs and budget.

Medicare Part D (Prescription Drug Plans)

Anyone enrolled in Original Medicare can add a stand-alone Part D plan to cover prescription drug costs and ensure access to necessary medications.

Beneficiaries enrolled in Medicare Advantage plans can have Part D coverage added as part of their bundled benefits.

Every Part D plan comes with a formulary, a list of covered drugs organized into different pricing tiers that determine your out-of-pocket costs for each drug.

Compare plans thoroughly to ensure the needed drugs are covered at a cost that fits your budget.

Also, remember to balance out-of-pocket costs with monthly premiums, deductibles, and copayments to find a Part D plan that meets your medical needs and financial situation.

In 2025, Wisconsin will offer 16 stand-alone Medicare Part D plans, with every beneficiary having access to at least one of these plans.

Here are some important facts about Medicare Part D plans in Wisconsin:

• Lower Premiums Available: In 2025, all Medicare beneficiaries in Wisconsin can choose a Part D plan with lower premiums than in 2024.
• Substantial Financial Support: 20.51% of enrollees in Wisconsin qualify for Extra Help, a federal program that provides additional financial assistance for those with limited incomes.
• Most Affordable Options: The lowest monthly premium for a Medicare Part D plan in Wisconsin is $0.

Note: Data from MedicareWire

Learn more: Medicare Part D Donut Hole

Medigap (Medicare Supplement) Plans

Medicare Supplement or Medigap plans cover the numerous out-of-pocket costs associated with Original Medicare, such as copayments, coinsurance, and deductibles.

They offer significant cash benefits, especially for beneficiaries with chronic health conditions and those who require frequent care.

Wisconsin offers only one Medigap plan, commonly referred to as the ‘Basic Plan’.

It covers the Part A coinsurance or copayment, the Part B coinsurance, 3 pints of blood every year, and other state-mandated benefits.

What’s great about Wisconsin’s Medigap plan is that it lets beneficiaries pick optional extra coverage for Part B excess charges, Part A deductible, and foreign travel emergency care, among others.

Typical monthly premiums for Wiscon’s Medigap plan range from $74.86 to $224.23. Actual premiums can vary depending on age, gender, location, and tobacco usage.

Top Medigap providers in Wisconsin include:

• AARP
• State Farm
• Mutual of Omaha
• Anthem

Average Costs of Medicare Plans in Wisconsin

Understanding the various costs associated with Wisconsin Medicare plans is key to managing your healthcare budget.

Here is a detailed overview of each type of Medicare plan and its associated costs:

Note: All data reflect 2025 averages sourced from Medicare.gov, CMS.gov, and MedicareWire and may vary by provider.

Top Medicare Advantage and Medigap Providers in Wisconsin

Wisconsin offers a range of Medicare Advantage and Medigap plans to meet the diverse healthcare needs and budgets of its residents.

Best Medicare Advantage Providers

Choosing the right Medicare Advantage plan is key to aligning coverage with your healthcare needs and budget.

Best Medigap Providers

Here’s what you need to keep in mind when evaluating Medigap providers in Wisconsin.

• Familiarity with Wisconsin-specific Medigap policies and regulations.
• Historical consistency in premium rates within the state.
• Speed in handling claims.
• Accessible and responsive customer service.

Here is a list of some of the top Medigap providers in Wisconsin:

Note: Rating Data from NerdWallet

How to Choose the Right Medicare Plan in Wisconsin

Selecting the right Medicare plan involves a detailed analysis of your current and future healthcare needs and your finances.

Here’s a step-by-step guide to choosing the right Medicare plan in Wisconsin:

1. Identify Your Healthcare Requirements
   • Take stock of your current health condition, including ongoing treatments or chronic issues.
   • Factor in expected medical needs that might arise in the near future, like doctor visits, therapies, or surgeries.
2. Assess Prescription Needs
   • List out the medications you use regularly.
   • Use the Medicare Plan Finder to pick Part D plans that cover your prescriptions at reasonable rates.
3. Examine Costs Thoroughly
   • Compare plans based on monthly premiums, annual deductibles, and copayments.
   • Evaluate your financial capacity to sustain these costs throughout the year.
4. Check Provider Accessibility
   • Confirm if the plan’s network includes your preferred doctors and medical facilities.
   • For frequent travelers, verify if the plan provides out-of-state coverage to maintain continuity of care wherever you are.
5. Evaluate Additional Coverage
   • Explore the extra benefits some Medicare Advantage plans offer, like dental, vision, and hearing care.
   • Decide if any of these benefits are essential given your lifestyle and health status.

How to Enroll in a Medicare Plan in Wisconsin

If you turned 65 and have been receiving Social Security benefits for at least four months, you are automatically enrolled in Original Medicare.

In all other cases, signing up for Medicare is only possible during four enrollment periods.

They include:

• Initial Enrollment Period (IEP)

Your first opportunity to enroll in Original Medicare (Part A and Part B) starts three months before your 65th birthday, includes your birth month, and extends three months thereafter.

This period applies to all Medicare plans except Medigap, which starts when you’re 65 and already enrolled in Part B.

• Open Enrollment Period (OEP)

The OEP runs from October 15th to December 7th of each year. This is when you can adjust your Medicare coverage by:

• Switching between Original Medicare and Medicare Advantage.
• Changing from one Medicare Advantage plan to another.
• Enrolling in, switching, or dropping a Part D plan.
• Medicare Advantage Open Enrollment Period

From January 1 to March 31 of each year, you can switch Medicare Advantage plans or return to Original Medicare.

• Special Enrollment Periods (SEPs)

SEPs are triggered by certain covered life events such as relocating or losing employer coverage. They allow you to change Medicare coverage outside the standard enrollment periods.

Learn more: Guide to Medicare Enrollment: Signs You Are Ready to Retire

Steps to Enroll

Here’s a guide to enrolling in Medicare:

• Review and Compare Plans: Compare plans using the Medicare Plan Finder. Focus on costs, coverage options, and provider networks to find the best fit.
• Enroll Online or by Phone: Enroll online through the Medicare website or Call 1-800-MEDICARE (1-800-633-4227) for assistance.
• Enroll with an Insurance Agent: For personalized help, you can work with a licensed insurance agent such as CoverRight.

Medicare Resources for Wisconsin Residents

Wisconsin offers a variety of supportive resources to guide and assist its residents about Medicare:

• State Health Insurance Assistance Program (SHIP): SHIP offers free, unbiased counseling for Medicare beneficiaries. It helps residents understand coverage options, enroll, and protect their rights. You can get assistance with questions about Medicare, Medigap, Medicare Advantage, and Medicare Part D.

• Aging and Disability Resource Centers (ADRCs): ADRCs work under the Wisconsin Department of Health Services to provide information on various services, including health care, transportation, and more. They serve as a single access point for individuals seeking help to make informed healthcare decisions.
• Area Agencies on Aging (AAA): They offer services to seniors and adults with disabilities, including Medicare counseling, advocacy, and educational workshops. AAAs are dedicated to enhancing the quality of life for older adults by assisting them in maintaining their independence.

Make Medicare simple in Wisconsin.

At CoverRight, our specialists deeply understand the Medicare system and the Wisconsin healthcare market. We’ll help guide you to coverage that fits your life and budget.

Start today.

Sources

1. Centers for Medicare & Medicaid Services (CMS)
   • Medicare Open Enrollment Partner Resources. Published 2024. Available at: cms.gov. Last Accessed January 23, 2025.
2. Centers for Medicare & Medicaid Services (CMS)
   • 2024 Medicare Advantage and Part D Ratings Fact Sheet. Published October 13, 2023. Available at: cms.gov. Last Accessed January 21, 2025.
3. Medicare.gov
   • Medigap Coverage Information: When to Buy. Available at: medicare.gov. Last Accessed January 21, 2025.
4. Medicare.gov
   • Medigap Overview. Available at: medicare.gov. Last Accessed January 20, 2025.
5. Medicare.gov
   • What Does Medicare Cost? Available at: medicare.gov. Last Accessed January 20, 2025.
6. Medicare.gov
   • When Does Medicare Coverage Start? Available at: medicare.gov. Last Accessed December 29, 2024.
7. Medicare.gov
   • What Does Medicare Cost? Available at: medicare.gov. Last Accessed January 20, 2025.
8. Kaiser Family Foundation (KFF)
   • Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2024. Available at: kff.org. Last Accessed January 17, 2025.

Get your personalized
Medicare quote:

View Plans for Free