Wisconsin is one of just three states that do not use the federal Medigap lettering, so a Medicare Supplement here starts from one base plan you build up with riders. Rather than picking a single lettered plan, Wisconsin enrollees begin with the state's basic Medigap policy and add optional riders, such as a Part A deductible rider or added home health care, to fill in the coverage they want. Wisconsin also offers cost-sharing plans and a high-deductible option. This guide explains the Wisconsin base plan, the riders that customize it, the cost-sharing choices, and who regulates Medigap in the state.
How Medigap works in Wisconsin
A Medigap policy is private insurance that pays the deductibles and coinsurance Original Medicare leaves to you. Medigap in Wisconsin (Medicare Supplement Insurance) works only alongside Original Medicare, not with a Medicare Advantage plan, and each policy covers one person. A married couple who both want coverage need two policies.
Most of the country uses the federal standardized framework, where Medigap is sold as lettered plans A through N and the benefits inside each letter are fixed by federal rule. Wisconsin is one of three "waiver states," along with Massachusetts and Minnesota, that received federal permission to standardize their own way instead. So the lettered plans you read about in national Medigap guides do not exist here. The practical upshot is that you build your coverage from a base plan plus riders rather than picking a single letter.
The gaps Medigap 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. Part A adds a hospital deductible of $1,736 per benefit period in 2026, and that deductible can apply more than once in a year. A Wisconsin Medigap plan caps that exposure.
The Wisconsin base plan plus riders
Wisconsin Medigap is built around essentially one base plan, the traditional basic Medigap policy. It carries state-mandated benefits that cover the main out-of-pocket costs in Original Medicare, and you customize it from there with optional riders.
The base plan is the foundation: a single basic policy with the core protections every Wisconsin Medigap policy must include. Because it 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.
The riders that build up your coverage
Riders are what make Wisconsin distinctive. You add them to the base plan to close specific gaps, and your premium reflects the riders you choose. Common riders include:
- Part A deductible rider, which covers the $1,736 hospital deductible per benefit period in 2026.
- Part B deductible rider, which covers the $283 annual Part B deductible. Note that a plan covering the Part B deductible is closed to newer enrollees under federal rules, the same reason the lettered Plan F closed elsewhere.
- Additional home health care rider, which adds coverage beyond the base plan's home health benefit.
- 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.
Cost-sharing plans and the high-deductible option
Beyond the base-plus-rider approach, Wisconsin offers cost-sharing plans that split certain costs between you and the insurer.
| Option | How it works | Comparable federal plan |
|---|---|---|
| Base (basic) plan plus riders | Core state-mandated benefits, customized with riders | None (Wisconsin design) |
| 50% Cost-Sharing Plan | Insurer pays 50% of covered gaps; you pay 50% | Close to Plan K |
| 25% Cost-Sharing Plan | Insurer pays 75% of covered gaps; you pay 25% | Close to Plan L |
| High-deductible plan | Lower premium after a high annual deductible | High-deductible designs |
In the 50% Cost-Sharing Plan, the insurer pays half of the costs Original Medicare leaves to you and you pay the other half, similar to the standardized Plan K. In the 25% Cost-Sharing Plan, the insurer pays 75% and you pay 25%, similar to Plan L. Both trade a lower premium for more cost-sharing until you reach the plan's out-of-pocket limit. The high-deductible plan keeps premiums low in exchange for a high annual deductible you meet before the plan begins paying.
When you can buy or switch 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.
Outside that window, an insurer can require medical underwriting and charge more, or decline to sell you a policy, based on your health, unless a federal guaranteed-issue right applies because of a qualifying life 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 Medigap costs and how it is priced in Wisconsin
Medigap premiums vary widely. The core benefits in the base plan and each rider are set, but the price is not: it depends on the insurer, the riders you add, your age, and in many cases other rating factors. Adding riders raises the premium; 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.
Insurers can price policies in different ways, which shapes how your premium changes as you age. Some hold the premium steady regardless of age, while 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. Note that Medigap does not include prescription drug coverage, so you add a separate Part D plan for that.
Who regulates Medigap in Wisconsin
Wisconsin Medigap is regulated by the Wisconsin Office of the Commissioner of Insurance (OCI), which oversees the insurers that sell these policies and handles consumer questions and complaints. OCI 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. The state's free Medicare counseling and the federal Medigap in Wisconsin comparison can both help you weigh your choices.
Frequently asked questions
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 cost-sharing plans and a high-deductible option.
Riders are optional add-ons that close specific gaps on top of the base plan. 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.
They are Wisconsin Medigap plans that split costs between you and the insurer. In the 50% Cost-Sharing Plan, the insurer pays 50% and you pay 50% of the gaps Original Medicare leaves, similar to the standardized Plan K. In the 25% Cost-Sharing Plan, the insurer pays 75% and you pay 25%, similar to Plan L. Both trade lower premiums for more cost-sharing.
Only if you had or were eligible for Medicare before January 1, 2020. Federal rules 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 Plan F closed elsewhere. Newer enrollees build coverage without a Part B deductible rider.
The Wisconsin Office of the Commissioner of Insurance (OCI) regulates Medigap in Wisconsin. It 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 options across carriers.
Learn More
- Medicare plans and coverage in Wisconsin
- Medigap (Medicare Supplement): how the lettered plans work
- What is Medicare? Parts A, B, C, and D explained
- Original Medicare vs. Medicare Advantage
Find personalized help comparing Medicare Supplement plans 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.