Medicare Supplement
Medigap policies work alongside Original Medicare. In Wisconsin, policy structures differ from the standardized lettered plans used in most other states, which makes local guidance especially useful.
Understand the landscape
Medicare options, without the alphabet soup.
Start with the basic structure. Then compare the details that affect your care, budget, and flexibility.
Two common paths
Most people begin by comparing Original Medicare with supplemental coverage against Medicare Advantage. Each direction has different tradeoffs.
| Consideration | Original Medicare + Medigap | Medicare Advantage |
|---|---|---|
| How coverage works | Original Medicare provides primary coverage; a Medicare Supplement policy may help with certain remaining costs. | A private plan provides your Medicare Part A and Part B benefits and often includes Part D. |
| Provider access | Generally allows any provider nationwide that accepts Medicare. | May use a provider network and service area, depending on the plan. |
| Costs | Typically includes separate premiums with more predictable cost sharing. | Premiums and cost sharing vary; plans include an annual out-of-pocket maximum for covered Part A and B services. |
| Prescription coverage | Usually requires a separate Part D plan. | Often includes Part D coverage, though not every plan does. |
This comparison is only a starting point. Availability, benefits, provider networks, formularies, premiums, and cost sharing vary by plan and location.
Medicare Advantage
These private plans replace how you receive Original Medicare benefits and may include drug coverage and additional benefits. Networks and prior authorization rules may apply.
Part D
Prescription Drug Plans have formularies, pharmacy networks, premiums, deductibles, and cost-sharing structures. Your actual medications should be part of the comparison.