Private insurance companies offer Medicare supplement insurance plans, known as Medigap. Since 1946, the not-for-profit Wisconsin Physicians Service has provided several health insurance plans, including Medigap.

People enrolled in original Medicare generally pay 20% towards the costs of their covered services. Medicare supplement insurance plans, also known as Medigap, help reduce the out-of-pocket costs.

This article looks at the Wisconsin Physicians Service (WPS Health Solutions) Medicare supplement insurance plans, coverage, options, and costs.

We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
  • Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
  • Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

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Between them, Medicare and Medigap provide coverage for healthcare and out-of-pocket expenses.

Medicare is a federal program that provides healthcare through various parts:

  • Part A provides hospital coverage.
  • Part B is medical insurance.
  • Part C is also known as Medicare Advantage and is a private insurance option to original Medicare parts A and B.
  • Part D is coverage for prescription drugs.

However, the outpatient plan Part B generally provides only 80% coverage, and for most plans, a person must pay out-of-pocket costs including deductibles, coinsurance, copays, and premiums.

Supplemental insurance plans, also called Medigap, help a person pay the out-of-pocket expenses for Medicare parts A and B. However, since January 2020, Medigap has not covered the deductible portion of Part B.

There are 10 Medigap plans, each identified by a letter. All Medigap plans within the same letter category offer the same benefits, irrespective of the provider or location.

However, not all providers offer all plans, and Massachusetts, Minnesota, and Wisconsin administer Medigap policies in a different way from the other states. A person can use this online tool to find a Medigap policy in their area.

A person with a Medicare Advantage plan cannot also have Medigap coverage.

Based in Madison, Wisconsin, WPS health insurance is a not-for-profit insurance corporation that provides health insurance for groups and individuals.

The company also offers an insurance claims processing service for the Centers for Medicare and Medicaid Services, the U.S. Department of Defense, and the U.S. Department of Veterans Affairs.

WPS was founded in 1946 to help civilians and soldiers who were returning from World War II and had difficulty paying for healthcare. The company employs more than 4,000 people throughout the state, including in Eau Claire, Green Bay, Madison, Milwaukee, and Wausau.

WPS offers several healthcare plans, including Medicare Advantage, Medicare prescription drug plans, health savings accounts (HSAs), and Medicare supplement plans, also known as Medigap.

WPS plans are available to people who live in Wisconsin, and to people residing in 14 other states:

  • Arizona
  • Colorado
  • Florida
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Michigan
  • Nebraska
  • Ohio
  • Oklahoma
  • Pennsylvania
  • Tennessee
  • Texas

In most states, Medicare supplement plans offer standardized coverage. However, in Massachusetts, Minnesota, and Wisconsin, the state laws are different, and WPS developed three exclusive plans in these states.

WPS offers seven Medigap plans (A, C, F, G, K, L, and N), with the following benefits:

  • use of any doctor, medical health specialist, or facility that accepts Medicare
  • an automatic claim service
  • membership in Silver&Fit
  • discounts through the ChooseHealthy program
  • discounts on hearing and vision plans

The plans also offer optional dental coverage and optional foreign travel emergency coverage.

What are the three plans in Wisconsin, Massachusetts, and Minnesota?

In the states of Wisconsin, Massachusetts, and Minnesota, WPS Medigap offers three different plans, including its basic plan, with or without a copay/coinsurance rider, a 25% cost-sharing plan, and a 50% cost-sharing plan. The coverage is highest with the basic plan.

Each plan offers different coverage, as shown below.

The basic plan:

  • option to pay 50% or 100% of Medicare Part A hospital deductible
  • $176 per day for days 21–100 for skilled nursing care
  • 100% of Medicare copays and coinsurance for hospice care
  • option to cover Medicare Part B excess charges
  • 40 home healthcare visits, option for up to 365 visits
  • option for foreign travel medical emergency care
  • no limits on out-of-pocket expenses
  • Silver&Fit wellness program
  • discounts on eye exams, eyewear, and hearing aids
  • additional preventive care services
  • option to cover the Medicare Part B deductible for those first eligible for Medicare before January 1, 2020

The 25% cost-sharing plan:

  • 75% of the Medicare Part A hospital deductible
  • up to $132 per day for days 21–100 for skilled nursing care
  • 75% of Medicare copays and coinsurance for hospice care
  • no coverage for Medicare Part B excess charges
  • 40 home healthcare visits, option for up to 365 visits
  • limited out-of-pocket costs
  • discounts on eye exams, eyewear, and hearing aids

The 50% cost-sharing plan:

  • 50% of the Medicare Part A hospital deductible
  • up to $88 per day for days 21–100 for skilled nursing care
  • 50% of Medicare copays and coinsurance for hospice care
  • 40 home healthcare visits, option for up to 365 visits
  • limited out-of-pocket costs
  • discounts on eye exams, eyewear, and hearing aids

There are several enrollment periods when a person can apply for a Medigap plan.

A person enrolled in Medicare can apply for a Medigap plan throughout the year, although they may pay more if they want to enroll outside the Medigap open enrollment period. The open enrollment lasts for 6 months and begins in the month a person turns 65 and is enrolled in Medicare Part B.

Insurance companies cannot refuse a Medigap policy during the open enrollment period, and they cannot ask for information on preexisting medical conditions. However, WPS may not cover a person’s preexisting health conditions for up to 6 months after the start of their policy.

However, if a person wants to get a Medigap plan outside the open enrollment period, they might be refused a policy. This is because the insurer can ask for medical underwriting, which means a person would have to take a physical examination or provide information about their health. An insurance provider might choose to exclude a person based on their health.

A person can use this online tool to find a Medigap plan.

The cost of WPS Medigap plans depends on a person’s age, location, and coverage level.

For example, the cost of Medigap premiums in Wisconsin range as follows:

  • The cost of the basic plan ranges from $106–$300.
  • The 25% cost-sharing plan has costs of between $111–$152.
  • For the 50% cost-sharing plan, costs range between $83–$121.

If a person pays their premiums with automatic bank withdrawal, WPS provides a 2% discount. The company also gives a 7% discount when two or more people in the same household take out a policy.

A person can use the online Medigap plan finder to check prices for a WPS Medigap policy in their area.

Medicare supplement plans can help people with original Medicare (Part A and Part B) pay their out-of-pocket expenses.

Private insurance companies, such as WPS, offer these plans, which are also known as Medigap.

WPS offers healthcare services in 15 states.

The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.