Hougom Insurance Agency

FAQ

Insurance questions, answered

The questions our western Wisconsin clients ask us most. Don't see yours? Just ask — it's free.

Is Medicare free?

Part A is usually premium-free if you or your spouse paid Medicare taxes 10+ years. Part B has a monthly premium. Advantage and Part D plans vary — some are $0 premium.

Is Medicare the same as Medicaid?

No. Medicare is federal health insurance based mainly on age. Medicaid is a state/federal program based on income. Some people qualify for both (dual-eligible).

Can I have Medicare and Medicaid at the same time?

Yes — that's called being dual-eligible, and it usually unlocks lower costs and extra benefits through a D-SNP plan.

Do I have to take Medicare at 65?

Not always. If you have creditable employer coverage you may delay Part B penalty-free. Without creditable coverage, delaying causes lifelong penalties. We check your situation.

When is Medicare's Annual Enrollment Period?

October 15 to December 7 each year. Changes you make take effect January 1. We review your plan every fall to make sure it's still your best fit.

Where do I sign up for Medicare?

Parts A and B are through Social Security (online, phone, or local office). For your plan choice, a local agent like us compares your options and enrolls you — free.

What is the Part D donut hole in 2026?

The coverage-gap 'donut hole' is effectively gone, replaced by a ~$2,100 annual out-of-pocket cap. After you hit it, covered drugs cost $0 the rest of the year.

Do veterans need Medicare if they have VA benefits?

Often yes — Part B protects access to non-VA care and avoids penalties. VA and Medicare cover different settings, so together they give you the most flexibility.

What is IRMAA?

IRMAA is an income-related surcharge added to your Part B and Part D premiums if your income is above set thresholds. We can estimate whether it applies to you.

Is a $0 premium Medicare Advantage plan really free?

No. A $0 plan premium means no extra monthly premium beyond your Part B premium, but you still have copays, a possible drug deductible, and a max out-of-pocket. Two $0 plans can differ by thousands in real cost.

Will my Gundersen or Mayo doctors be covered?

It depends on the plan's network. We check each plan against your specific doctors and hospital before you enroll.

Does Wisconsin have Plan G or Plan N?

No. Wisconsin does not use the federal A–N Medigap letter system. Wisconsin has a state-standardized Basic Plan with optional riders. We identify the rider combination that gives you equivalent coverage to Plan G or Plan N — and we use the correct Wisconsin terminology so there's no confusion.

Can I switch to a Wisconsin Medigap policy later?

You have a 6-month Medigap Open Enrollment Period when you first enroll in Part B at 65, during which Wisconsin carriers must accept you regardless of health history. After that, switching typically requires health underwriting. We track your window and tell you exactly when to move.

Does Wisconsin Medigap cover prescriptions?

No. Wisconsin Medicare Supplement plans don't include drug coverage. You pair your Medigap policy with a standalone Part D plan — we set both up together so your coverage is complete from day one.

How much does a Wisconsin Medicare Supplement cost?

Premiums depend on your age, the riders you add, and the carrier. A Basic Plan with Part A Deductible and Part B Excess Charges riders (Plan G equivalent) typically runs $80–$180/month for a 65-year-old in the La Crosse area, with significant variation by carrier. We compare every carrier in La Crosse and Winona counties at no cost to you.

What is the Part D late enrollment penalty?

If you go without creditable drug coverage after you're first eligible, a permanent penalty is added to your premium. Enroll on time or keep creditable coverage to avoid it — we'll check your dates.

Can I change Part D plans every year?

Yes. During the Annual Enrollment Period (Oct 15–Dec 7) you can switch Part D plans for the next year. We review yours each fall.

What happens if I see an out-of-network doctor on an HMO?

Except for emergencies and urgent care, out-of-network care usually isn't covered on an HMO — you'd pay full cost. That's why network checks matter.

Do PPO plans cost more than HMOs?

Often slightly, in premium or copays, in exchange for out-of-network flexibility. The right trade-off depends on how you use care.

How do I know if I qualify for a D-SNP?

You qualify if you have both Medicare and Medicaid (or your state's Medicare Savings Program). We can verify your status and enroll you in a SNP if you're eligible.

Does Medicare cover dentures or implants?

Original Medicare generally doesn't. Some Advantage plans and standalone dental policies help — coverage and limits vary widely, so compare carefully.

Does Medicare pay for hearing aids?

Original Medicare doesn't. Some Advantage plans include a hearing-aid allowance — amounts and networks vary, so we compare them for you.

How is hospital indemnity different from Medigap?

Medigap pays providers for Original Medicare's gaps. Hospital indemnity pays YOU a set cash amount for covered stays — often paired with a Medicare Advantage plan.

Can I get life insurance after 65?

Yes. Options exist for most ages and health situations, including simplified and guaranteed-issue final expense policies. We'll find what you qualify for.

Do I need a medical exam for final expense insurance?

Usually no. Most final expense policies use a few health questions or guaranteed acceptance — we'll match you to the best rate you qualify for.

Doesn't Medicare cover nursing homes?

Only short, skilled-care stays after a hospitalization — not long-term custodial care. That's the gap long-term care planning fills.

Are annuities safe?

Fixed and fixed-indexed annuities protect your principal and are backed by the issuing insurer. We only recommend products that fit your goals and risk comfort.

How much homeowners insurance do I need?

At minimum, enough to rebuild your home from the ground up at today's construction costs — not its market value. We calculate the right dwelling coverage amount for your specific home.

Does homeowners insurance cover flooding?

Standard homeowners policies do not cover flood damage. Separate flood insurance is available through the NFIP or private carriers. If you're in a flood zone, we'll discuss your options.

Can you help if my current carrier drops me?

Yes — we work with multiple carriers and can find replacement coverage quickly, even for high-risk properties.