Best Medicare Advantage Plans in Wisconsin for 2019
Anybody who only has Medicare Part A and B as a stand-alone option could face high out-of-pocket expenses because almost every covered service has coinsurance, copayments, and deductibles to pay in addition to the Part B premium. Some of the best Medicare Advantage plans in Wisconsin for 2019 can relieve financial stress by controlling costs better.
In addition, a Wisconsin Medicare Advantage plan may provide extra benefits that Original Medicare doesn’t include, such as drug benefits in the form of a Part D plan. Learn more about the differences between Medicare Part A and Part B and Medicare Part C and how Medicare Part C in Wisconsin can help you save on your health care costs.
You may find you can save on hospital visits, doctor’s office visits, specialized temporary care in a nursing home and more by signing up for one of these plans, and your monthly premiums shouldn’t cost much, either.
Best Time to Enroll in Medicare Advantage Plans in Wisconsin for 2019
Most people just have to be enrolled in Medicare Part A and Part B in order to qualify for a Medicare Advantage plan, also known as Medicare Part C in Wisconsin. People who have Original Medicare and End Stage Renal Disease ESRD may be limited to specific plans to help manage this serious disease.
Most people with Medicare can enroll in Medicare Advantage during these enrollment periods:
- Initial Coverage Election Period: The ICEP is the first time that a new Medicare beneficiary can enroll in a Medicare Advantage plan. This period is for six months around the first enrollment in Medicare Part A and Part B.
- Annual Election Period: Every year, you can take advantage of Open Enrollment in the fall. If you join a new plan at this time, your coverage will begin on January 1.
- Special Election Period: You may get a Special Enrollment Period if you have a qualifying circumstance. Some typical examples could include losing your job’s medical plan or moving out of state so that you can sign up for a plan with a network with care providers in your new area. When insurance companies don’t perform contract renewals with Medicare, their customers have a Special Election Period to check out their cost-sharing plan options and find a new Medicare coverage option.
- Medicare Advantage Disenrollment Period: After the first of each year, you also have a chance to terminate your Medicare Advantage plan and return to Medicare Part A and B. If you’re only enrolled in Medicare Part A and Part B, you can also get a Part D drug plan.
Best & Most Popular Types of Medicare Advantage Plans in Wisconsin for 2019
You may have a choice of different types of Wisconsin Medicare Advantage plans. These are the most popular choices:
Health Maintenance Organization HMO plans:
While an HMO Medicare Advantage plan in Wisconsin for 2019 will have more network restrictions that may limit your choice of a hospital or doctor, it may also come with lower premiums and out-of-pocket costs than other options. This is also the most likely kind of Medicare Advantage plan to have a $0 premium. About half of Wisconsin Medicare recipients enroll in an HMO.
Preferred Provider Organization PPO plans:
You have more flexibility to look for an out-of-network hospital or doctor with a PPO, but you’ll save money if you choose in-network providers. About 35 percent of all MA enrollments go to a PPO Medicare Advantage plan in Wisconsin.
Private Fee-for-Service PFFS plans:
A PFFS won’t use a network, but you still need to make sure your providers accept the insurance. Only about two percent of enrollments are for this Medicare program.
Special Needs Plans SNPs:
Special Needs plans suit people who need extra help with chronic health conditions or institutional conditions.
People who qualify for Wisconsin Medicaid and Medicare Part A and Part B will enroll in this type of plan. Generally, they have a $0 premium and no out-of-pocket costs for covered benefits when a part of one of these assistance programs.
Medicare Savings Account MSA plans:
An MSA includes both a high-deductible plan and a savings account. Your savings account is there so that you can draw money from it and use it for health care expenses before you meet your deductible.
Any of the plans above can come with a Medicare Part D plan, so you’ll probably want to look for an option that includes a Medicare prescription drug plan for maximum savings.
Enrollment Statistics for Medicare Advantage Plans in Wisconsin
These are enrollment statistics for Wisconsin Medicare Advantage plans:
- Enrollment in any Wisconsin Medicare Advantage plan: 434,584
- Percent in MA of total people who qualify for Medicare Part A and Part B: 39 percent
- Most Popular WI Medicare Advantage plans: HMO, PPO, and HMO-Cost
These are the largest Wisconsin counties with their populations. You’ll probably find that there are more Medicare Advantage plans available in these areas for 2019 than in the smaller counties in Wisconsin. However, there are health plans available for those with Medicare Part A and Medicare Part b even in smaller service areas.
- Milwaukee County, WI: 952,085
- Dane County, WI: 536,416
- Waukesha County, WI: 400,621
- Brown County, WI: 262,052
- Racine County, WI: 196,071
How Will a Wisconsin Medicare Advantage Plan Cover Prescriptions for 2019?
Original Medicare will not help pay for most prescription medications. Most Medicare Part C options in Wisconsin do come with Part D. Before you decide on a Wisconsin Medicare Advantage plan for 2019, you should as the insurance company for their formulary to make sure your own prescriptions are covered. Also, Medicare Advantage Prescription Drug Plans have Prescription Drug tiers that will specify the level of benefits for generic, specialty, and brand-name prescriptions.
Network Restrictions on Medicare Advantage Plans in Wisconsin
Medicare Part A and B don’t use networks. However, most of the best Medicare Advantage plans in Wisconsin are HMOs or PPOs. If you’re used to Medicare Part A and Part B or other kinds of non-network health insurance, these are some things to remember:
- If you enroll in an HMO, you will need to pick a primary care doctor, called a PCP. This doctor has to give you referrals to get covered visits with specialists. An HMO will only pay for non-network services in rare situations, so you’ll need to look at provider networks to make sure that you’re happy with the options available to you.
- You don’t need a PCP with a PPO and can get covered services outside of your plan network, but you will still maximize your benefits if you get in-network services.
Extra Benefits of a Typical Medicare Advantage Plan in Wisconsin for 2019
Again, Original Medicare won’t pay for most prescriptions, but most of the best Medicare Advantage plans in Wisconsin for 2019 will include Part D to cover what Medicare benefits don’t. Part D prescription drug coverage may help beneficiaries save money and help avoid possible penalties for not having a prescription plan.
You might also compare some extra perks that you get with Medicare Advantage and not with Original Medicare. For instance, beneficiaries might get benefits that include wellness programs, routine vision and dental care, and hearing care.
Low rates, extra benefits, and access to quality healthcare might attract a Wisconsin beneficiary to Medicare Advantage plans. You should take the time to compare rates and benefits in order to make the best of Medicare.
The Best Wisconsin Medicare Resources
These authority links to Wisconsin resources can help you research more:
- Wisconsin Guide to Medicare Insurance
- Wisconsin Adult Services
- CMS: Centers for Medicare and Medicaid Services
Next, you can give us a call to learn about the best Medicare Advantage plans in Wisconsin for 2019, as well as Medicare Supplement insurance. One of our insurance agents can explain the differences to you and help you sign up for a plan that is right for you.