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. Most states sell Medigap as standardized lettered plans A through N with federally fixed benefits, but 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.Centers for Medicare & Medicaid Services. (n.d.). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare - Medicare.gov / CMS. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
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%, with no annual cap on that 20%. 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 caps that exposure.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
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:Centers for Medicare & Medicaid Services. (n.d.). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare - Medicare.gov / CMS. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
- 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.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- 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. You add them to the base plan for an additional premium to close specific gaps, and your total premium reflects the riders you choose. Common riders include:Centers for Medicare & Medicaid Services. (n.d.). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare - Medicare.gov / CMS. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
- Part A deductible rider, which covers the $1,736 hospital deductible per benefit period in 2026.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- Part B deductible rider, which covers the $283 annual Part B deductible. This rider is closed to anyone who first became eligible for Medicare on or after January 1, 2020, under federal rules (see the FAQ below).Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
- 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.
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. They work much like the federal Plans K and L sold in other states.Centers for Medicare & Medicaid Services. (n.d.). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare - Medicare.gov / CMS. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
| Option | How it works | Comparable federal plan |
|---|---|---|
| Base (basic) plan plus riders | Core state-mandated benefits, customized with optional riders | None (Wisconsin design) |
| 50% cost-sharing plan | Lower premium; you share costs up to an $8,000 out-of-pocket limit (2026), then the plan pays | Close to Plan K |
| 25% cost-sharing plan | Lower premium; you share costs up to a $4,000 out-of-pocket limit (2026), then the plan pays | Close to Plan L |
| High-deductible plan | Lower premium after a high annual deductible you meet before the plan begins paying | High-deductible designs |
The high-deductible plan keeps premiums low in exchange for a high annual deductible you meet before coverage begins. Wisconsin also allows Medicare SELECT policies, a lower-cost version that asks you to use a network of hospitals for non-emergency care.
When can you buy or switch Medigap in Wisconsin?
The single best time to buy is your federal Medigap Open Enrollment Period, a one-time six-month window that begins the first month you are both age 65 or older and enrolled in Medicare Part B. During it, insurers must sell you any Medigap policy they offer at their best available rate regardless of your health, with no medical underwriting.Centers for Medicare & Medicaid Services. (2025). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS/NAIC, 2025) - Medicare.gov. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
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. 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 the insurer, the riders you add, your age, and other rating factors. 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.Centers for Medicare & Medicaid Services. (n.d.). Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare - Medicare.gov / CMS. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdf
Insurers can price policies in different ways, which shapes how your premium changes as you age. Some hold the premium steady regardless of age; others start lower and increase as you get older, so a low first-year quote can climb over time. Ask which method each insurer uses, not just the first-year premium. 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 current Medicare Supplement policies and premiums, so you can compare the base plan, riders, and cost-sharing options across carriers side by side. For free one-on-one counseling, the Wisconsin Medigap Helpline and the state's State Health Insurance Assistance Program (SHIP) are staffed by certified counselors who are not connected to any insurance company.Wisconsin Department of Health Services. (n.d.). SHIP: Medicare Counseling for Wisconsin Residents. dhs.wisconsin.gov. Retrieved Jul 13, 2026, from https://www.dhs.wisconsin.gov/benefit-specialists/medicare-counseling.htm
Frequently Asked Questions
Does Wisconsin use Medigap Plan G?
No. Wisconsin is one of three non-standardized waiver states, along with Massachusetts and Minnesota, that do not use the federal Plan A through Plan N letters. Instead, Wisconsin starts from one base Medigap plan with state-mandated core benefits, which you customize by adding optional riders. It also offers 50% and 25% cost-sharing plans and a high-deductible option.
What are Medigap riders in Wisconsin?
Riders are optional add-ons that close specific gaps on top of the base plan for an additional premium. Common Wisconsin riders include a Part A deductible rider, a Part B deductible rider, an additional home health care rider, and a foreign travel emergency rider. Each rider you add raises your premium but lowers what you pay out of pocket, which is how Wisconsin enrollees customize their coverage.
What are the Wisconsin 50% and 25% cost-sharing plans?
They are Wisconsin Medigap plans that keep a lower premium in exchange for you sharing more of the costs Original Medicare leaves, up to a yearly out-of-pocket limit after which the plan pays the rest. In 2026 that limit is $8,000 for the 50% plan and $4,000 for the 25% plan. They are similar to the federal Plans K and L used in other states.
Can I get a plan that covers the Part B deductible in Wisconsin?
Only if you had, or were eligible for, Medicare before January 1, 2020. Federal rules (the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA) close any Medigap plan or rider that pays the Part B deductible to anyone who first became eligible on or after that date, the same reason the lettered Plans C and F closed elsewhere. Newer enrollees build coverage without a Part B deductible rider.
Who regulates Medigap in Wisconsin, and where can I compare prices?
The Wisconsin Office of the Commissioner of Insurance (OCI) regulates Medigap in Wisconsin, oversees the insurers that sell these policies, handles consumer complaints, and publishes an annual list of current Medicare Supplement policies and premiums you can use to compare carriers. For free counseling, call the Wisconsin Medigap Helpline at 1-800-242-1060.
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.