Medicare Supplement

Wisconsin does Medigap differently: what Milwaukee shoppers should know

Milwaukee shoppers who start comparing Medicare Supplement policies often hit the same speed bump: the letter plans they read about online — Plan G, Plan N, Plan K — aren't what they'll actually see on a Wisconsin quote. That's because Wisconsin is one of three states (along with Massachusetts and Minnesota) that standardizes Medigap its own way. Here is how to read the options in Milwaukee, and where the rules come from.

Medicare SupplementMilwaukee, WI

Why Milwaukee's Medigap menu looks different

Most of the country buys Medigap by federal letter — Plan A, Plan G, Plan N and so on. Wisconsin doesn't. Under state law, insurers here sell a Basic Plan that includes a core set of benefits, and then let you add optional riders to fill in more of what Original Medicare doesn't cover. Wisconsin also allows 50% and 25% cost-sharing plans and a high-deductible plan for people who want a lower premium in exchange for paying more when they use care.

That means when you compare policies in Milwaukee, you'll compare Wisconsin's plan names and riders — not the A-through-N letters. Two people can both own "a Wisconsin Basic Plan" and have very different coverage depending on which riders they added.

How Medigap fits with Original Medicare and Part D

A Medigap policy is designed to sit next to Original Medicare (Part A hospital and Part B medical). Medicare pays first, and your Medigap policy helps with some of the out-of-pocket costs Medicare leaves behind — things like coinsurance and, depending on your riders, the Part A and Part B deductibles.

A few things Medigap does not do:

• It does not work with Medicare Advantage. You pick one path or the other.
• It does not include prescription drug coverage. If you want drug coverage, you enroll separately in a Part D plan.
• It does not cover long-term custodial care, most dental, vision, or hearing.

For 2026, Part D has a $2,100 annual out-of-pocket cap, a maximum deductible of $615, and the old "donut hole" coverage gap is gone (as of 2025 there are three phases instead of four). If monthly drug costs are hard to plan for, the Medicare Prescription Payment Plan lets you smooth them across the year.

Higher-income enrollees should also know about IRMAA — an income-related surcharge on Part B and Part D premiums that starts above $109,000 for a single filer in 2026.

The state rules that shape your choice

Two rules matter most when you shop in Milwaukee:

Standardization. Because Wisconsin sets its own plan design, every insurer selling a Basic Plan in the state has to include the same core benefits. That makes it easier to compare price and service across insurers, since the underlying coverage of the base plan is the same. Riders are also standardized in what they cover.

Guaranteed issue and open enrollment. Under federal law, you have a 6-month Medigap Open Enrollment Period that starts the month you're 65 and enrolled in Part B. During that window, insurers can't turn you down or charge more because of your health. Outside that window, whether you can switch — and at what price — depends on state rules and your situation. Wisconsin has some additional protections; the Wisconsin Office of the Commissioner of Insurance (OCI) and the state SHIP can tell you which apply to you.

How to see what's actually sold in Milwaukee

Milwaukee is in Milwaukee County, and Medigap policies are sold by ZIP code by insurers licensed in Wisconsin. To see the current list for your address:

• Use the Medigap policy search on Medicare.gov and enter your Milwaukee ZIP code. It returns the insurers licensed to sell each Wisconsin plan and rider combination.
• Read the Wisconsin OCI Medigap rate guide, which is updated regularly and shows how insurers price their policies.
• Call Wisconsin's SHIP (the State Health Insurance Assistance Program) for free, unbiased counseling from someone who doesn't sell policies.

Because insurer names and pricing shift, we're not naming carriers here — the sources above will show you the current list for your ZIP.

Questions to ask before you buy

When you talk to an insurer or agent about a Wisconsin Medigap policy, a few plain questions go a long way:

• Which riders am I buying, and what does each one cover? The Basic Plan is only the starting point.
• How is this policy priced? Wisconsin insurers may use different pricing methods (for example, based on your age when you buy, your current age, or a community rate). The rate guide from OCI explains what each method means for future increases.
• Am I in a guaranteed-issue situation right now? If yes, an insurer can't use your health to decline you or raise the price.
• If I want drug coverage, which Part D plan will I pair with this? Medigap and Part D are separate decisions.

The table below lists the standardized Wisconsin plan designs you'll see referenced on quotes and in the OCI guide.