Medicare Supplement

How to compare Wisconsin's Medigap plans across insurers in Madison

Madison, Wis. — If you are turning 65 in Dane County or thinking about switching your Medicare Supplement coverage, you have probably noticed something odd: Wisconsin does not use the familiar Plan G, Plan N or Plan F letters you see in most states. Wisconsin is one of three states — along with Massachusetts and Minnesota — that standardizes its own Medigap policies. That changes how you shop, but it does not change the core rule of Medigap: the same policy is the same coverage at every insurer that sells it. What differs is the price, the way that price is set, and the rules to get in.

Medicare SupplementMadison, WI

What Wisconsin Medigap actually looks like

In most of the country, shoppers compare Plan G to Plan G across carriers. In Wisconsin, you are comparing:

• The Basic Plan, which you can build up by adding optional riders (for example, a Part A deductible rider, a Part B deductible rider, a Part B excess-charges rider, a foreign travel emergency rider, or an additional home health care rider).
• The 50% cost-sharing plan and the 25% cost-sharing plan, which trade a lower premium for a share of the Medicare-approved costs.
• The high-deductible plan, where you pay a set deductible before the policy pays.

Because the state defines what each of these policies covers, an insurer cannot make its Basic Plan "better" than another insurer's Basic Plan. If two policies are the same design with the same riders, they cover the same services.

How to find the insurers selling in Madison

There is no single public list we can hand you here, and we will not name insurers we cannot verify for your ZIP code. Two free tools will show you the current sellers in Dane County:

1. Medicare.gov Medigap policy search. Enter your Madison ZIP code at medicare.gov to see the insurers licensed to sell each Wisconsin Medigap policy in your area. 2. Wisconsin OCI Medigap rate guide. The Office of the Commissioner of Insurance publishes a rate comparison that lists insurers, the policies they sell, and sample premiums by age. 3. Wisconsin SHIP (the Medigap Helpline, 1-800-242-1060). Trained counselors can walk you through the current market without trying to sell you anything.

The table on this page shows the policy types available; use the tools above to pull the current insurer roster for your ZIP.

The three pricing methods — and why they matter

Two policies that look identical on paper can be priced very differently over time. Ask each insurer which method they use:

• Attained-age rated. The premium is based on your current age and generally rises as you get older.
• Issue-age rated. The premium is based on your age when you bought the policy and does not rise simply because you had a birthday (though it can still rise for other reasons).
• Community rated (no-age-rated). Everyone in Wisconsin who has the policy pays the same base rate, regardless of age.

None of these methods is automatically better — they age differently. All three can also rise because of general rate increases, inflation, or claims experience. That is why looking at an insurer's rate history (past increases filed with OCI) matters as much as today's number.

Household discounts, underwriting and open enrollment

A few practical points that often decide which insurer works for a given household:

• Household discounts. Some insurers reduce the premium if two adults in the same home both buy a policy, or sometimes just if another adult lives there. Rules vary — always ask.
• Medical underwriting. Outside a guaranteed-issue window, insurers in Wisconsin may ask health questions and can decline you or charge more.
• Your six-month Medigap Open Enrollment Period. This starts the first month you are 65 or older and enrolled in Part B. During it, any insurer selling Medigap in Wisconsin must sell you a policy at the standard rate, regardless of health.
• Guaranteed-issue rights. Certain life events (losing employer coverage, a Medicare Advantage plan leaving your area, and others) trigger a limited window when insurers must accept you without underwriting.

Wisconsin also has a state rule allowing Medigap enrollees to switch to another policy of equal or lesser benefits with the same insurer without new underwriting — worth asking about if your needs change.

How to actually compare, step by step

1. Decide which Wisconsin policy design fits: Basic (with any riders you want), a cost-sharing plan, or the high-deductible plan. 2. Pull the list of insurers selling that design in your ZIP from Medicare.gov and the OCI rate guide. 3. For each insurer, ask: What pricing method do you use? What have your rate changes looked like over the last five years? Is there a household discount? What are your underwriting questions if I apply outside open enrollment? 4. Confirm the policy is a Wisconsin-standardized Medigap plan (not a look-alike product). 5. If you are inside your six-month Medigap Open Enrollment window, use it.