Medicare Plans in Wisconsin

How Do I Enroll in Medicare in Wisconsin?

To enroll in Original Medicare, do one of the following:

  • Submit an online application.
  • Apply in person at a Social Security office.
  • Call 800-772-1213 to speak with a Social Security employee.

What Wisconsin Medicare Plans Are Available? 

Wisconsin offers Medicare Part A, B, D and Medicare Advantage (also known as Part C) plans to eligible residents. Most of the funding for Medicare comes from Social Security, but it is important to understand how your plan works and what your financial responsibilities will be regarding your medical needs. Following are the key differences between each plan. 

  • Medicare Part A: This plan covers inpatient care and services, emergency room treatment and extended hospital stays. It also covers nursing home stays, home health care and hospice. 

  • Medicare Part B: This plan covers the cost of most preventative care, mental health care, medical equipment and supplies and the cost of medical transport services, which would include the cost of an ambulance in an emergency.  

  • Medicare Advantage: In 2006, Medicare Part C came into effect, which allows you to choose a private insurance company to administer your benefits. Medicare Advantage plans are similar to private policies but are required to cover all of the things that traditional Part A and B plans cover. You may be able to obtain coverage for dental care, vision and other services not covered by Parts A or B by selecting a Medicare Advantage plan. 

  • Medicare Part D: All of your prescription medications are covered under Medicare Part D. Some Medicare Advantage plans offer coverage for prescription drugs while others do not. If these items aren't covered by your Medicare Advantage plan, you may add Part D to your coverage. 

Medicare plans in the state are pretty evenly distributed. Around 649,000 Wisconsinites were enrolled in traditional Medicare in 2020 compared with 543,000 who elected to enroll in Medicare Advantage plans. While it is possible to also obtain Medicare Supplement Insurance (Medigap) coverage in Wisconsin, the state standardizes this coverage differently than the rest of the country.  

Who Is Eligible for Wisconsin Medicare? 

You need to be 65 years of age to qualify for Medicare and you may be enrolled automatically when you become eligible if you have been receiving Social Security benefits for at least 4 months. Some people do need to apply for their Medicare plans, so make sure that if you are not receiving Social Security benefits that you inquire about your status. Signing up shortly before or upon turning 65 years old helps ensure that you avoid any penalties for not signing up when you needed to do so. 

Medicare Part A is free for those who have paid into Social Security for at least 10 years during their lifetime. If you do not meet this requirement, you are still able to access Medicare but may be required to pay a monthly premium for your benefits. Medicare Part B plans cost up to $150 per month as of 2021, and this premium is usually automatically deducted from your pension or government retirement benefits. 

It is possible to get a Medicare Advantage plan for little to no money, depending on the coverage that you seek. You may be required to pay additional premiums for services not covered by traditional Medicare. Medicare Part D plans also require monthly premiums, so be sure to check the cost of your plan prior to enrollment. 

The initial enrollment period (IEP) begins 3 months before your 65th birthday. You have from the start of the IEP until 3 months after your birthday to enroll for benefits without any penalties. If you do miss this window, the General Enrollment period begins on January 1 of each year and ends on March 31. Another way to avoid penalties is to sign up during a Special Enrollment Period. 

To qualify for special enrollment, you must be enrolled in a group health plan provided by an employer or you or a loved one must suffer from a disability or be volunteering or serving abroad.  

How Do I Enroll for Medicare in Wisconsin? 

Enrolling in Medicare is a fairly simple and straightforward process. Medicare allows you to learn more about each plan and enroll online on its website: medicare.gov. If you were enrolled automatically, you can also use Medicare’s website to change plans.  

Average Cost of Medicare Advantage Plans in Wisconsin

Average Cost of Medicare Advantage Plans in Wisconsin
Average Monthly Premium $81.50
Average in-network out-of-pocket spending limit $5,407.19
Average drug deductible in 2022 (weighted) $294.06
Percentage of plans rated 4 stars or higher 69.2%
Average Cost of Medicare Advantage Plans in Wisconsin
Average Monthly Premium
$81.50
Average in-network out-of-pocket spending limit
$5,407.19
Average drug deductible in 2021 (weighted)
$294.06
Percentage of plans rated 4 stars or higher
69.2%

Wisconsin Medicare Advantage Plans by County

The chart below provides more information about Medicare Advantage plan costs and enrollment in Wisconsin by county in 2021.

Scroll to the right to continue reading the chart
County Average Premium Average Annual Drug Deductible % of Plans Rates 4 Stars or Higher # of Plans Available
Adams $71 $277 40.0% 15
Ashland $107 $322 77.8% 18
Brown $85 $282 79.3% 29
Buffalo $91 $322 57.1% 7
Calumet $86 $277 82.8% 29
Clark $78 $281 46.7% 15
Columbia $64 $301 56.3% 16
Dane $62 $309 64.3% 14
Dodge $87 $284 76.9% 26
Door $56 $265 70.6% 17
Douglas $106 $360 68.2% 22
Florence $58 $263 50.0% 16
Fond du Lac $91 $288 77.8% 27
Forest $60 $287 57.1% 21
Green $56 $282 77.8% 18
Green Lake $85 $282 79.3% 29
Iowa $60 $261 66.7% 15
Iron $78 $256 50.0% 14
Jackson $91 $322 57.1% 7
Jefferson $59 $291 66.7% 18
Juneau $78 $281 46.7% 15
Kenosha $48 $274 70.8% 24
Kewaunee $86 $270 82.1% 28
Lafayette $57 $296 72.2% 18
Langlade $60 $285 47.1% 17
Lincoln $68 $285 55.6% 18
Manitowoc $85 $288 80.0% 30
Marathon $66 $284 65.2% 23
Marinette $57 $265 73.7% 19
Marquette $90 $281 69.0% 29
Menominee $56 $276 76.5% 17
Milwaukee $46 $260 73.1% 26
Monroe $91 $322 57.1% 7
Oconto $93 $270 80.0% 25
Oneida $70 $285 55.6% 18
Outagamie $85 $288 80.0% 30
Ozaukee $46 $259 73.1% 26
Pepin $91 $322 57.1% 7
Pierce $115 $401 78.6% 14
Portage $94 $269 71.4% 28
Price $78 $256 50.0% 14
Racine $47 $260 73.1% 26
Richland $79 $334 63.6% 11
Rock $53 $277 80.0% 20
Sauk $68 $352 63.6% 11
Shawano $91 $288 69.0% 29
Sheboygan $82 $278 80.6% 31
St. Croix $117 $416 80.0% 15
Taylor $75 $256 50.0% 14
Trempealeau $88 $361 50.0% 8
Vernon $91 $322 57.1% 7
Vilas $78 $277 58.3% 12
Walworth $55 $275 72.7% 22
Washington $46 $259 73.1% 26
Waukesha $46 $260 73.1% 26
Waupaca $92 $288 77.8% 27
Waushara $87 $279 75.0% 32
Winnebago $85 $288 80.0% 30
Wood $68 $265 58.8% 17
Washburn $125 $436 53.8% 13
Rusk $120 $480 0.0% 3
Sawyer $115 $401 76.9% 13
Polk $125 $463 75.0% 12
La Crosse $91 $322 50.0% 6
Grant $65 $376 57.1% 7
Dunn $125 $480 70.0% 10
Eau Claire $120 $480 63.6% 11
Crawford $79 $309 66.7% 9
Chippewa $125 $480 70.0% 10
Burnett $125 $463 75.0% 12
Barron $120 $480 63.6% 11
Bayfield $114 $355 58.8% 17

Contact Information for Wisconsin Medicare, Medicaid and Insurance Help

For more information about Medicare and other health coverage benefits offered by the State of Wisconsin, please refer to the following. 

Medicare Counseling Services 

Wisconsin State Health Insurance Assistance Program 

Information on Wisconsin Medicaid Benefits and Eligibility 

Learn More About Medicare Advantage Plans 

Prescription Drug Assistance Programs