Wisconsin Medicare Guide
Anthem BlueCross BlueShield
Plan F
High Deductible Plan F
Plan G
Plan N
Mutal of Omaha – Wisconsin Medicare Supplement Plans
Mutual of Omaha Medicare Supplement Plans are highly popular in Wisconsin and usually have the lowest rates. They take an attained-age rating approach to pricing their Medicare supplements and have lower rates for non-tobacco users.
By law, Medicare Supplement insurance is standardized into twelve plans (Plans A through L). That means Plan F from one company must include the same benefits as plan F from another company. While the benefits must be the same, each company’s rates, reputation, membership features and quality of service can vary. With Mutual of Omaha, you don’t have to sacrifice comprehensive benefits or freedom-of-choice for affordability. Their Medicare Supplement plans provide substantial benefits at rates that can save you money over other plans.
In Wisconsin, Mutual of Omaha currently offers the 3 most popular Medicare Supplements – Plan F, Plan G, and Plan N. Plan F is by far the most popular Medicare Supplement plan in Wisconsin, with over 70% of all Texans enrolling in this plan.
What Medicare Doesn’t Cover
Medicare does not cover all health care costs. Medicare coverage consists of Part A (which covers hospital and skilled nursing facility care), and Part B (which covers doctor bills and other medical expenses).
Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:
- Part A hospital deductible ($1,686)
- Part B deductible ($240)
- Copayments for hospital stays over 60 days
- Care in a skilled nursing facility after 20 days
- Twenty percent coinsurance for doctor bills and other medical expenses
Mutual of Omaha Member Benefits
- Guaranteed Acceptance with no health questions asked during intial enrollment period
- Freedom to choose any doctors or specialists
- Coverage with domestic travel (Plans G, F, and N cover foreign travel)
- Guaranteed renewability regardless of changes in your health
- Coverage guaranteed to match Medicare’s cost increases year after year
- No claim forms, in most cases
Medicare Supplement Basic Benefits
Basic benefits included in all plans include:
- Hospitalization – Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses – Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.
- Blood – First three pints of blood each year.
Mutual Of Omaha Wisconsin Medicare Supplement Plans
In Wisconsin, Mutual of Omaha currently offers 3 Medicare Supplements – Plan A, Plan F, and Plan G. Plan F is by far the most popular Medicare Supplement plan.
| Plans | A | F | G | N |
|---|---|---|---|---|
| Basic Benefits | X | X | X | X |
| Skilled Nursing Coinsurance | – | X | X | X |
| Part A Deductible | – | X | X | X |
| Part B Deductible | – | X | – | – |
| Part B Excess (100%) | – | X | X | X |
| Foreign Travel Emergency | – | X | X | X |
| At Home Recovery | – | – | – | – |
| Annual Out-of-Pocket Cost | – | – | – | – |
| Benefit | Plan F | Plan G |
|---|---|---|
| Part A Deductible | √ | √ |
| Coinsurance | √ | √ |
| Extended Hospital | √ | √ |
| Blood | √ | √ |
| SNF Care | √ | √ |
| Hospice Care | √ | √ |
| Part B Deductible | √ | X |
| Coinsurance | √ | √ |
| Excess Benefits | √ | √ |
| Care Outside The US | √ | √ |
SHOW THE SAVINGS
Go through the following cost comparison with your clients to see if you can save money. The Plan G annual premium plus the Part B deductible cost could still be less than the annual Plan F premium. And, clients have all the significant Plan F coverage. Think of it as getting all the benefits of Plan F for the Plan G premium plus the Part B deductible. STEP 1 Quote annual premiums for Plans F and G
- Plan F: $1,612 Plan G: $1,186
STEP 2 Add the Part B deductible amount to the Plan G premium for the total cost
-
- Plan G Premium $1,186
Part B Deductible + $166
-
- (Can change annually)
$1,352 STEP 3 Determine the annual difference between Plans F and G plus the deductible for the savings
-
- Plan F Premium $1,612
Plan G Premium & Part B Deductible -$1,352
-
- Annual Savings with Plan G
$260
Plan F Benefit Information
Plan F is the most popular Anthem Mutual of Omaha Medicare Supplement plan. No other standardized Medicare Supplement plan offered in Wisconsin offers more complete protection for your uncovered Part B medical expenses than Plan F.
Plan F covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- Medicare Part A hospital deductible and copayments
- Skilled nursing facility copayment
- Foreign travel emergency care
- $240 Part B Medicare deductible
- Part B doctor charges that are in excess of Medicare-approved amounts
| Benefit | What Plan F Covers |
|---|---|
| Part A Deductible You may need this benefit if you have to stay in the hospital. The Part A deductible is $1,686 This amount can change every year. You have to pay this deductible for each benefit period. |
Plan F covers 100% of the $1,686 deductible. |
| Part B Deductible You may want to consider this benefit if you have Medicare Part B. Each year you must pay the Part B deductible (which is $240 in 2024) before Medicare starts to pay its share. If you have this benefit, the Medigap plan would pay this amount each year. |
Plan F covers 100% of the $240 deductible. |
| Part B Coinsurance Without this benefit, you generally pay 20% of the Medicare-approved amount for Medicare Part B covered services and supplies (like doctor services and outpatient hospital care). This benefit will help you to reduce your out of pocket after Part B deductible. |
Plan F covers 100% of the 20% remainder costs |
| 365 Extra Days of Hospital Stay After you use all Medicare hospital benefits, you can receive up to 365 more days for hospital stays during your lifetime. |
Plan F covers all of the costs for an additional 365 additional hospital days |
| 3 Pints of Blood The first 3 pints of blood or equal amounts of packed red blood cells per calendar year, unless this blood is replaced. |
Plan F covers all of the costs of 3 pints of blood per calendar year |
| Part B Excess Charges Under federal law, doctors who don’t accept “assignment ” (take Medicare’s approved amount as payment in full) may charge up to 15% more than the approved amount. You might want to think about this benefit if your doctors don’t accept assignment. You may also want this benefit if you have to stay in the hospital and can’t control whether the doctors you see accept assignment. |
Plan F covers 100% of the excess charges |
| Foreign Travel Emergency If you travel outside the United States, this benefit could save you money for emergency care. |
Plan F covers 80% (after a $250 deductible) to a lifetime maximum benefit of $50,000. |
| Skilled Nursing Coinsurance Medicare pays for the first 20 days of a skilled nursing facility. If you need to go to a Skilled Nursing Facility (SNF) after a hospital stay and stay in the SNF longer than 20 days, this benefit begins. |
Plan F covers up to $137.50 per day for days 21-100. |
| Home Health Care Home Health Care is skilled nursing care and certain other health care services you get in your home for the treatment of an illness or injury. |
Plan F covers the 20% remainder not paid by Medicare Part B. |
Plan G Benefit Information
Plan G covers:
- Your $1,686 Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- 80% of Part B physician charges that are in excess of the Medicare-approved amount (By law no physician may charge more than 115% of Medicare-approved amounts).
- Skilled nursing facility copayment
- Emergency care for foreign travel
Plan G does NOT cover:
- Your $240 Medicare Part B deductible
Benefit |
What Plan G Covers |
| Part A Deductible You may need this benefit if you have to stay in the hospital. The Part A deductible is $1,316. This amount can change every year. You have to pay this deductible for each benefit period. |
Plan G covers 100% of the $1,686 deductible. |
| Part B Deductible You may want to consider this benefit if you have Medicare Part B. Each year you must pay the Part B deductible (which is $240 in 2024) before Medicare starts to pay its share. If you have this benefit, the Medigap plan would pay this amount each year. |
Plan G does NOT cover the $240 Part B deductible, you must pay out of pocket. |
| Part B Coinsurance Without this benefit, you generally pay 20% of the Medicare-approved amount for Medicare Part B covered services and supplies (like doctor services and outpatient hospital care). This benefit will help you to reduce your out of pocket after Part B deductible. |
Plan G covers 100% of the 20% remainder costs |
| 365 Extra Days of Hospital Stay After you use all Medicare hospital benefits, you can receive up to 365 more days for hospital stays during your lifetime. |
Plan G covers all of the costs for an additional 365 additional hospital days |
| 3 Pints of Blood The first 3 pints of blood or equal amounts of packed red blood cells per calendar year, unless this blood is replaced. |
Plan G covers all of the costs of 3 pints of blood per calendar year |
| Part B Excess Charges Under federal law, doctors who don’t accept “assignment ” (take Medicare’s approved amount as payment in full) may charge up to 15% more than the approved amount. You might want to think about this benefit if your doctors don’t accept assignment. You may also want this benefit if you have to stay in the hospital and can’t control whether the doctors you see accept assignment. |
Plan G covers 100% of the excess charges |
| Foreign Travel Emergency If you travel outside the United States, this benefit could save you money for emergency care. |
Plan G covers 80% (after a $250 deductible) to a lifetime maximum benefit of $50,000. |
| Skilled Nursing Coinsurance Medicare pays for the first 20 days of a skilled nursing facility. If you need to go to a Skilled Nursing Facility (SNF) after a hospital stay and stay in the SNF longer than 20 days, this benefit begins. |
Plan G covers up to $137.50 per day for days 21-100. |
| Home Health Care Home Health Care is skilled nursing care and certain other health care services you get in your home for the treatment of an illness or injury. |
Plan G covers the 20% remainder not paid by Medicare Part B. |
Plan N Benefit Information
Plan N is identical to Plan G except there is a $20 copay for office visits and a $50 copay for emergency room visits. Like Plan G, Plan N does not cover the Medicare Part B deductible.
Plan N covers:
- Your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
- 80% of Part B physician charges that are in excess of the Medicare-approved amount (By law no physician may charge more than 115% of Medicare-approved amounts).
- Skilled nursing facility copayment
- Emergency care for foreign travel
Plan N does NOT cover:
- Your $183 Medicare Part B deductible
Plan N Benefits
| Benefit | What Plan N Covers |
|---|---|
| Part A Deductible You may need this benefit if you have to stay in the hospital. The Part A deductible for 2022 is $1,486. This amount can change every year. You have to pay this deductible for each benefit period. |
Plan N covers 100% of the $1,686 deductible. |
| Part A Coinsurance Medicare requires you to pay your coinsurance on hospital expenses. This benefit generally pays all or part of your coinsurance for hospital stay. |
Medicare pays for days 1- 60. Plan N covers:
|
| Part B Deductible You may want to consider this benefit if you have Medicare Part B. Each year you must pay the Part B deductible ($240 in 2024) before Medicare starts to pay its share. If you have this benefit, the Medigap plan would pay this amount each year. |
Plan N does NOT cover the $240 Part B deductible, you must pay out of pocket. |
| Part B Coinsurance Without this benefit, you generally pay 20% of the Medicare-approved amount for Medicare Part B covered services and supplies (like doctor services and outpatient hospital care). This benefit will help you to reduce your out of pocket after Part B deductible. |
Plan N covers 100% of the 20% remainder costs after a $20 office visit copay and $50 emergency room copay |
| 365 Extra Days of Hospital Stay After you use all Medicare hospital benefits, you can receive up to 365 more days for hospital stays during your lifetime. |
Plan N covers all of the costs for an additional 365 additional hospital days |
| 3 Pints of Blood The first 3 pints of blood or equal amounts of packed red blood cells per calendar year, unless this blood is replaced. |
Plan N covers all of the costs of 3 pints of blood per calendar year |
| Part B Excess Charges Under federal law, doctors who don’t accept “assignment ” (take Medicare’s approved amount as payment in full) may charge up to 15% more than the approved amount. You might want to think about this benefit if your doctors don’t accept assignment. You may also want this benefit if you have to stay in the hospital and can’t control whether the doctors you see accept assignment. |
Plan N covers 100% of the excess charges |
| Foreign Travel Emergency If you travel outside the United States, this benefit could save you money for emergency care. |
Plan N covers 80% (after a $250 deductible) to a lifetime maximum benefit of $50,000. |
| Skilled Nursing Coinsurance Medicare pays for the first 20 days of a skilled nursing facility. If you need to go to a Skilled Nursing Facility (SNF) after a hospital stay and stay in the SNF longer than 20 days, this benefit begins. |
Plan N covers up to $137.50 per day for days 21-100. |
| Home Health Care Home Health Care is skilled nursing care and certain other health care services you get in your home for the treatment of an illness or injury. |
Plan N covers the 20% remainder not paid by Medicare Part B. |
Plan A Benefit Information
Plan A is the most basic and least expensive Medicare Supplement plan. By federal law, every insurance company must offer Plan A.
Basic Plan A covers:
- Your Part A coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Your Part B coinsurance and the cost of the first three pints of blood
Plan A Benefits
| Benefit | What Plan A Covers |
|---|---|
| Part A Deductible You may need this benefit if you have to stay in the hospital. The Part A deductible for 2017 is $1,316. This amount can change every year. You have to pay this deductible for each benefit period. |
Plan A does not cover the $1,316 deductible |
| Part A Coinsurance Medicare requires you to pay your coinsurance on hospital expenses. This benefit generally pays all or part of your coinsurance for hospital stay. |
Medicare pays for days 1- 60. Plan A covers:
|
| Part B Deductible You may want to consider this benefit if you have Medicare Part B. Each year you must pay the Part B deductible (which is $183 in 2017) before Medicare starts to pay its share. If you have this benefit, the Medigap plan would pay this amount each year. |
Plan A does not cover the Medicare Part B $183 deductible |
| Part B Coinsurance Without this benefit, you generally pay 20% of the Medicare-approved amount for Medicare Part B covered services and supplies (like doctor services and outpatient hospital care). This benefit will help you to reduce your out of pocket after Part B deductible. |
Plan A covers 20% of the remaining costs after you pay the $183 Part B deductible |
| 365 Extra Days of Hospital Stay After you use all Medicare hospital benefits, you can receive up to 365 more days for hospital stays during your lifetime. |
Plan A covers all of the costs for an additional 365 additional hospital days |
| 3 Pints of Blood The first 3 pints of blood or equal amounts of packed red blood cells per calendar year, unless this blood is replaced. |
Plan A covers 100% of the costs of 3 pints of blood per calendar year |
| Part B Excess Charges Under federal law, doctors who don’t accept “assignment” (take Medicare’s approved amount as payment in full) may charge up to 15% more than the approved amount. You might want to think about this benefit if your doctors don’t accept assignment. You may also want this benefit if you have to stay in the hospital and can’t control whether the doctors you see accept assignment. |
Plan A does not covers Part B Excess Charges |
| Hospice Care Hospice is a special way of caring for people who are terminally ill and for their families. This care includes physical care and counseling. The goal of hospice is to care for you and your family, not to cure your illness. |
Plan A does not cover hospice care |
| Foreign Travel Emergency If you travel outside the United States, this benefit could save you money for emergency care. |
Plan A does not cover foreign travel emergencies |
| Skilled Nursing Coinsurance Medicare pays for the first 20 days of a skilled nursing facility. If you need to go to a Skilled Nursing Facility (SNF) after a hospital stay and stay in the SNF longer than 20 days, this benefit begins. |
Plan A does not cover skilled nursing |
| Home Health Care Home Health Care is skilled nursing care and certain other health care services you get in your home for the treatment of an illness or injury. |
Plan A covers 20% of the remainder after the $183 Medicare Part B deductible. |
| Out of Pocket Limit The maximum costs you are responsible for in a calendar year. |
There is not out of pocket limit for Basic Plan A |
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