Medicare Resources · Wisconsin
Wisconsin Medicare Supplement (Medigap): Basic Plan & riders explained
Key takeaways
- Wisconsin does not use the national Plan A–N letter system — don't let a non-Wisconsin agent sell you the wrong thing
- Every Wisconsin Medigap policy starts with the mandatory Basic Plan, then you add optional riders
- Basic + Part A Deductible + Part B Excess = functionally the same as national Plan G
- Your 6-month Medigap Open Enrollment Period (when you first enroll in Part B at 65) is your guaranteed-acceptance window — missing it means possible underwriting
- We are licensed in both Wisconsin and Minnesota and compare each state's system correctly
Why Wisconsin is different
When most people search for Medicare Supplement insurance, they find articles about Plan G, Plan N, Plan F, and the full A–N alphabet. That framework applies in 47 states. Not in Wisconsin.
Wisconsin, Massachusetts, and Minnesota each have their own state-standardized Medigap systems, approved by state law and administered through their Departments of Insurance. In Wisconsin, the Office of the Commissioner of Insurance (OCI) sets the rules. Every Wisconsin Medigap carrier must offer the same standardized base coverage — the Basic Plan — and then compete on riders, premiums, and service.
The practical result: Wisconsin residents have more flexibility to build exactly the coverage they want. The tradeoff is that the menu of choices is less obvious — especially if you're getting advice from a national website, a call center, or an agent who primarily works in other states.
We work exclusively in Wisconsin and Minnesota. We explain your options in Wisconsin terms, compare riders across every carrier available in La Crosse and Winona counties, and match you to the right combination for your health, your providers, and your budget.
The Wisconsin Basic Plan — your mandatory foundation
All Wisconsin Medicare Supplement policies must include the Basic Plan as their minimum coverage. Think of it as the floor — everything else is optional riders added on top.
Covers the 20% of Medicare-approved costs that Original Medicare doesn't pay for doctors, specialists, outpatient procedures, and services. This is the single most-used coverage for most people.
If you have an extended hospital stay, Original Medicare stops paying after day 60. The Basic Plan covers your daily coinsurance for days 61–90 ($408/day in 2025) and for lifetime reserve days (days 91–150, $816/day in 2025).
After Medicare's benefits are completely exhausted, the Basic Plan provides 365 additional days of inpatient hospital coverage at Medicare-allowed amounts — for life.
Covers the blood deductible (first 3 pints) that Original Medicare doesn't pay.
Covers Part A hospice care coinsurance and copayments not covered by Original Medicare.
Wisconsin optional riders — what each one covers
Riders are added to the Basic Plan for an additional premium. You choose which riders to add; carriers may offer them individually or in pre-packaged combinations.
| Rider | What it covers | Most people need? |
|---|---|---|
| Part A Deductible | Hospital deductible per benefit period ($1,676 in 2025) | Yes |
| 50% Part A Deductible | Half the Part A hospital deductible | Situational |
| Part B Deductible | Annual Part B deductible ($257 in 2025) — grandfathered only | Situational |
| Part B Excess Charges | Extra 15% from non-participating providers | Yes |
| Foreign Travel Emergency | Emergency care outside the U.S. (after $250 deductible) | Situational |
| Home Health Care (365 days) | Skilled nursing/home health care beyond Medicare limits | Situational |
| Preventive Care | Preventive services not otherwise covered by Medicare | Situational |
| Short-Term At-Home Nursing | Skilled care at home instead of a nursing facility | Situational |
2025 figures from CMS. Deductible amounts are updated annually. Consult a licensed Wisconsin agent to confirm current year amounts.
Wisconsin rider combinations vs. national plan equivalents
If you've researched Medigap nationally and want to know how Wisconsin's system maps to those letter plans, here's the comparison:
| Coverage level | Wisconsin combination | What you still pay | Typical premium (age 65) |
|---|---|---|---|
| National Plan G equivalent | Basic Plan + Part A Deductible + Part B Excess Charges | Annual Part B deductible (~$257/yr) | $80–$180/mo (age 65) |
| National Plan N equivalent | Basic Plan + Part A Deductible (no excess rider) | Part B deductible + possible excess charges | $60–$140/mo (age 65) |
| National Plan F equivalent | Basic Plan + Part A Ded. + Part B Ded. + Part B Excess | Near $0 (grandfathered plans only) | $100–$220/mo (age 65) |
| Minimum coverage | Basic Plan only | Part A deductible + all excess charges | $40–$90/mo (age 65) |
Premium ranges are estimates for La Crosse County, WI as of 2025. Actual premiums vary by carrier and are age-rated. We quote exact current carrier pricing at no charge.
Wisconsin Medigap vs. Medicare Advantage — which path is right for you?
Wisconsin Medicare Supplement
- + See any Medicare provider in the U.S. — no networks
- + No referrals for specialists
- + Predictable, low out-of-pocket costs with the right riders
- + Ideal for travelers, snowbirds, or those splitting time between WI and MN
- + Access to Gundersen, Mayo, or any specialist nationwide without network worries
- − Higher monthly premium than most Advantage plans
- − Does not include drug coverage (add a separate Part D plan)
- − No extra benefits like dental, vision, or gym membership
Medicare Advantage (Part C)
- + Lower or $0 premium beyond Part B
- + Often includes drug, dental, vision, hearing, and OTC benefits
- + Annual out-of-pocket maximum caps your yearly exposure
- − Uses a provider network — must confirm Gundersen/Mayo are in-network
- − Copays and cost-sharing apply at every visit
- − Network and formulary can change each year
- − Switching back to Medigap later may require health underwriting
Neither path is universally better — the right choice depends on your health, your providers, your prescriptions, and how you use care. We model both for your specific situation before recommending anything.
Minnesota Medigap: a note for Winona clients
Our Winona, MN office serves clients under Minnesota's own standardized Medigap system — which is different from both the federal letter plans and Wisconsin's system. Minnesota offers:
- Basic Plan — minimum coverage (similar to WI's Basic Plan)
- Extended Basic Plan — broader coverage with additional benefits
- Optional riders including Part A deductible, foreign travel, and nursing facility coverage
Minnesota residents also cannot simply purchase national Plan G or Plan N from a carrier — they must purchase under Minnesota's standardized framework. We are licensed in Minnesota and compare your options correctly based on your address, not a generic national guide.
Talk to us about your Winona-area Medicare Supplement options →
Wisconsin Medicare Supplement FAQs
Does Wisconsin have Plan G or Plan N?
No. Wisconsin does not use the federal A–N Medicare Supplement letter system. Wisconsin has its own state-standardized system: a Basic Plan that all policies must include, plus optional riders you add to build your coverage. A Basic Plan + Part A Deductible + Part B Excess Charges riders provides functionally equivalent coverage to national Plan G.
What does the Wisconsin Basic Plan cover?
The Basic Plan covers your Medicare Part B 20% coinsurance, Part A hospital coinsurance for days 61–150, 365 additional lifetime hospital days after Medicare benefits are exhausted, the first 3 pints of blood each year, and hospice care coinsurance. Every Wisconsin Medigap policy must include this minimum coverage.
What is the Part A Deductible Rider?
The Part A Deductible Rider covers the Medicare Part A hospital deductible, which is $1,676 per benefit period in 2025 (updated annually by CMS). If you have a hospital stay without this rider, you owe that deductible out of pocket before Medicare begins paying. Most Wisconsin supplement buyers add this rider.
What does the Part B Excess Charges Rider cover?
Certain providers who don't accept Medicare assignment can charge up to 15% more than Medicare's approved amount — called excess charges. The Part B Excess Charges Rider covers that gap. Without it, you'd owe that extra 15% on every visit to a non-participating provider. Gundersen and most major system providers typically accept assignment, but specialists at smaller practices may not.
How is Minnesota Medigap different for our Winona clients?
Minnesota also has its own standardized Medigap system — different from Wisconsin and from the national letter plans. Minnesota offers a Basic Plan and Extended Basic Plan with optional riders. We are licensed in both Wisconsin and Minnesota and compare your options correctly based on where you live, not a generic national framework.
When is the best time to buy a Wisconsin Medicare Supplement?
Your Medigap Open Enrollment Period — the 6 months starting when you're enrolled in Part B at 65 — is the guaranteed window. During this period, Wisconsin carriers must accept you regardless of health history and cannot charge higher premiums for pre-existing conditions. After this window, you may face health underwriting. We track your exact window and make sure you don't miss it.
How much does a Wisconsin Medicare Supplement cost in the La Crosse area?
For a 65-year-old in La Crosse County, a Basic Plan + Part A Deductible + Part B Excess Charges combination typically runs $80–$180/month depending on the carrier. Premiums vary significantly between carriers for identical coverage — shopping matters. We compare all carriers available in your county at no cost to you.
Can I use any doctor or hospital with a Wisconsin Medicare Supplement?
Yes — Medicare Supplement plans have no provider networks. You can see any provider in the United States that accepts Medicare, including Gundersen Health System, Mayo Clinic Health System, and any specialist nationwide. This is one of the key advantages over Medicare Advantage plans, which use networks.
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We compare every Wisconsin Medicare Supplement carrier in La Crosse and Winona counties — Basic Plan + riders, priced for your age and situation. No call-center scripts. A real local advisor who knows the Wisconsin system.
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Not affiliated with or endorsed by the U.S. government or the federal Medicare program. This page is for general information only — not medical, insurance, tax, or legal advice. Eligibility, costs, plan availability, and Wisconsin Medigap rules may change; confirm current details at oci.wi.gov or Medicare.gov. Hougom Insurance Agency is a licensed independent insurance agency (NPN 20742808).