Wisconsin Medigap: The Base Plan, Riders & Options (2026)

Wisconsin does not sell the federal Medigap letter plans. A Wisconsin Medicare Supplement (Medigap) policy here starts from one state base plan you build up with optional riders, not a single lettered plan. Wisconsin is one of just three waiver states, along with Massachusetts and Minnesota, that standardize their own way. This guide walks through what the Wisconsin base plan covers, the riders that customize it, the 50% and 25% cost-sharing plans, and the free state helpline that compares current prices for you.

How does Medigap work in Wisconsin?

A Medigap policy is private insurance that pays deductibles and coinsurance that Original Medicare leaves to you. It works only alongside Original Medicare, not with a Medicare Advantage plan, and each policy covers one person, so a married couple who both want coverage need two policies. Medigap is sold as standardized lettered plans A through N with federally fixed benefits everywhere except Massachusetts, Minnesota, and Wisconsin; Wisconsin holds a federal waiver from that A-N system, so the lettered plans you read about in national Medigap guides are not sold here.1,3

The gaps a Wisconsin Medigap plan closes are real. After the Part B deductible ($283 in 2026), Original Medicare pays 80% of the approved amount for most outpatient care and leaves you the other 20%, and Original Medicare sets no yearly limit on what you pay out of pocket unless you have supplemental coverage such as Medigap. Part A adds a hospital deductible of $1,736 per benefit period in 2026, and because a new benefit period can start more than once in a year, that deductible can apply more than once. A Wisconsin Medigap policy is that supplemental coverage.4

What does the Wisconsin base plan cover?

Wisconsin Medigap is built around essentially one base plan, the traditional basic policy. Every base policy from a traditional insurer must include the same set of state-mandated core benefits, so this is the floor of coverage before you add anything. The core benefits pay the main out-of-pocket costs in Original Medicare:1

• Part A hospital coinsurance for days 61 and beyond of an inpatient stay ($434 a day for days 61 to 90 in 2026), plus coverage of an additional 365 hospital days after your Medicare inpatient benefits run out.
• Part B coinsurance, the 20% of the approved amount Original Medicare leaves you for most outpatient care after the Part B deductible.4
• The first three pints of blood each year.
• Part A hospice care coinsurance for outpatient drugs and inpatient respite care.

Because the base plan is one starting point rather than a menu of letters, the decision that shapes your coverage is which riders you add, not which letter you pick.

Which riders can you add in Wisconsin?

Riders are what make Wisconsin distinctive. OCI lets insurers offer seven of them, and each one an insurer offers must be priced and sold separately from the base policy, so your total premium reflects the riders you choose. The riders are:1

• Part A deductible rider, which covers the $1,736 hospital deductible per benefit period in 2026.4
• Part B deductible rider, which covers the $283 annual Part B deductible. Federal rules bar this rider from being sold to anyone "newly eligible" for Medicare, meaning you turned 65 on or after January 1, 2020 and did not already have Medicare Part A before that date (see the FAQ below).1
• Additional home health care rider, which adds home health coverage beyond the base plan.
• Foreign travel emergency rider, which helps with emergency care during travel outside the United States.
• Three more riders: a Medicare 50% Part A deductible rider, a Part B copayment or coinsurance rider, and a Part B excess charges rider.1

Adding riders raises your premium but narrows what you pay out of pocket. Leaving them off lowers your premium and keeps more cost-sharing with you. The right mix depends on how much predictable, up-front cost you want to trade for a lower monthly bill.

What are Wisconsin's 50% and 25% cost-sharing plans?

Beyond the base-plus-rider approach, Wisconsin offers two cost-sharing plans, the 50% and 25% plans, plus a high-deductible option. The cost-sharing plans keep a lower premium in exchange for more of the cost-sharing staying with you, up to a yearly out-of-pocket limit after which the plan pays the rest. In 2026, that out-of-pocket limit is $8,000 for the 50% plan and $4,000 for the 25% plan, and the plan takes over once you have met that limit and your calendar-year Part B deductible ($283 in 2026). They work much like the federal Plans K and L sold in other states. The percentage in each plan's name is its cost-sharing level, not the share the policy pays: by CMS's comparison to Plans K and L, the 25% plan leaves you the smaller share and carries the lower out-of-pocket limit.1

The high-deductible plan keeps premiums low in exchange for a calendar-year deductible ($2,950 in 2026) that you pay before the plan begins paying benefits. Wisconsin also allows Medicare SELECT policies, which pay benefits only when you get covered services through network providers the insurance company or HMO selects. Under the same federal rule that limits the Part B deductible rider, OCI says the high-deductible plan and Medicare SELECT policies can't be sold to you if you are newly eligible for Medicare (see the FAQ below).1

When can you buy or switch Medigap in Wisconsin?

The single best time to buy is your Medigap Open Enrollment Period. Under federal rules it is a one-time six-month window that begins the first month you are both age 65 or older and enrolled in Medicare Part B, and during it insurers can't refuse to sell you a policy they offer, use medical underwriting, or charge you more because of health problems.5

Wisconsin goes further. OCI says Medicare Supplement and Medicare SELECT insurers must make coverage available to you, regardless of your age, for six months beginning with the date you enroll in Part B. If you joined Medicare before 65 because of a disability or end-stage renal disease, you get a second six-month open enrollment period when you turn 65. A policy bought during open enrollment may still make you wait before it covers a pre-existing condition, but Wisconsin caps that wait at six months and allows it only for conditions treated in the six months before the policy starts. Insurers must waive the wait if you had at least six months of continuous creditable coverage before applying, or if you are replacing one Medicare Supplement policy with another.1

Outside that window, an insurer can require medical underwriting, charge more, or decline to sell you a policy based on your health, unless a federal guaranteed-issue right applies because of a qualifying event such as losing other coverage.6 That is why it is worth settling on your base plan and riders during your six-month open enrollment, when every option is available without health questions.

What does Wisconsin Medigap cost?

Medigap premiums vary widely. The core benefits and each rider are set, but the price is not: it depends on which policy and riders you buy, where you live, and other factors, and it can change each year. A bare base plan costs less than one loaded with riders, and the cost-sharing and high-deductible plans trade lower premiums for more out-of-pocket exposure.1,4

Insurers can price policies in different ways, which shapes how your premium changes as you age. Some don't raise the premium because of your age, though it can still rise with inflation and other factors; others base it on your current age, so a low first-year quote can climb as you get older. Ask which method each insurer uses, not just the first-year premium.1 Medigap does not include prescription drug coverage, so you add a separate Part D plan for that.

Where to get help and compare Wisconsin Medigap prices

The Wisconsin Office of the Commissioner of Insurance (OCI) regulates the insurers that sell these policies and publishes an annual list of the Medicare Supplement policies marketed in Wisconsin. Use it to compare the base plan, riders, and cost-sharing options across carriers, but it includes only companies that agree to be listed.1 For free one-on-one counseling, use Wisconsin's State Health Insurance Assistance Program (Wisconsin SHIP): one way to reach a SHIP counselor by phone is the Wisconsin Medigap Helpline at 1-800-242-1060, run by the Wisconsin Board on Aging and Long-Term Care, and SHIP counselors are screened, trained, and certified, don't sell anything, and aren't paid by a company or plan.2

Learn More

Find personalized help comparing Medicare Supplement options in Wisconsin at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.