People in Wisconsin have access to 129 Medicare Advantage plans, 16 prescription drug plans, and 4 Medigap options. Your exact options depend on where you live.
Medicare is a health insurance program for individuals ages 65 and older, as well as younger people with certain health conditions and disabilities.
It consists of four components:
- Part A (hospital insurance) and Part B (medical insurance) are known as Original Medicare.
- Part C, known as Medicare Advantage, offers an alternative to Original Medicare.
- Part D covers prescription medications.
If you have Original Medicare, you can also enroll in a supplemental insurance plan (Medigap) to help with additional out-of-pocket expenses.
According to the Centers for Medicare & Medicaid Services (CMS), 1,304,783 people in Wisconsin are enrolled in Medicare.
The CMS reported the following trends for the 2025 plan year:
- The average Medicare Advantage monthly premium decreased by $1.80 — from $26.01 in 2024 to $24.21 in 2025.
- The number of available Medicare Advantage plans increased by 11 — from 118 in 2024 to 129 in 2025.
- All Medicare beneficiaries have the option to enroll in a Medicare Advantage plan, including plans with $0 premiums.
- All Original Medicare enrollees have the option to buy a stand-alone prescription drug plan.
- There are 16 stand-alone prescription drug plans available, and the lowest monthly premium is $0.
- All Medicare beneficiaries with a stand-alone prescription drug plan have the option to enroll in a plan with a lower premium than they paid in 2024.
- About 20% of people with a stand-alone prescription drug plan receive Extra Help.
Each part of Medicare provides specific services, making it important to understand the details of each component.
Original Medicare
Original Medicare is a federal program that includes Part A and Part B, available to anyone who qualifies for Medicare.
Most people qualify for premium-free Part A. In 2025, the standard monthly premium for Part B is estimated to be $185, but your premium may be higher based on your income.
Medicare Advantage
Medicare Advantage plans are offered by private insurers that partner with Medicare to combine Part A and Part B coverage with additional health and wellness benefits.
Many of these plans also include prescription drug coverage, as well as vision, dental, and hearing services.
Some of the companies that offer Medicare Advantage plans in Wisconsin include:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- Humana
- Network Health Medicare Advantage Plans
- Quartz Medicare Advantage
- UnitedHealthcare
Service areas can differ by plan, and each plan establishes its own costs and coverage options.
Stand-alone prescription drug plans
Private insurance companies collaborate with Medicare to provide prescription drug coverage, and you must be enrolled in Part A or Part B to qualify.
People in Wisconsin can choose from 16 different prescription drug plans offered by some of the following companies:
- Aetna Medicare
- Anthem / Anthem or Blue KC in Missouri
- Cigna Healthcare
- Humana
- UnitedHealthcare
- Wellcare
Service areas can differ by plan, and each plan establishes its own costs and coverage options.
Medigap
Private insurers offer supplemental coverage for Original Medicare beneficiaries. Medigap plans are not health insurance; they are designed to help cover out-of-pocket costs like deductibles, copayments, and coinsurance.
People in Wisconsin can choose from options:
- Medigap 25% Cost Sharing Plan
- Medigap 50% Cost Sharing Plan
- Medigap Basic Plan
- Medigap High Deductible Plan
Some of the companies that offer Medigap plans in Wisconsin include:
- Ace Property and Casualty Insurance Company
- Aetna Health Insurance Company
- AFLAC
- Allstate Health Solutions
- American Benefit Life Insurance Company
- American Financial Security Life Insurance Company
- American Home Life Insurance Company
- Anthem Blue Cross and Blue Shield – Wisconsin
- Catholic United Financial
- Cigna National Health Insurance Company
- Erie Family Life Insurance Company
- Globe Life and Accident Insurance Company
- GPM Health and Life Insurance Company
- Guarantee Trust Life Insurance Company
- Humana Achieve (Emphesys Insurance Company)
- Humana (Humana Insurance Company)
- Manhattan Life Assurance Company
- Medico Insurance Company
- MedMutual Protect
- Mutual of Omaha (Omaha Insurance Company)
- Pekin Life Insurance Company
- Philadelphia American Life Insurance Company
- Physicians Select Insurance Company
- Security Health Plan of Wisconsin, Inc.
- State Farm Mutual Automobile Insurance Company
- United American Insurance Company
- UnitedHealthcare/AARP
- Washington National Insurance Company
- Wellcare (Centene)
- Wisconsin Physicians Service Insurance Corporation
Service areas can differ by plan, and each plan establishes its own cost and coverage options.
You’re eligible for Medicare if you:
- are age 65 or over
- are a U.S. citizen or have been a legal resident for 5 years or longer
If you’re under age 65, you may be eligible for Medicare if you:
- have received Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) benefits for 24 months or longer
- have end stage renal disease (ESRD) or have received a kidney transplant
- have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
When can you enroll in Medicare in Wisconsin?
You can only enroll in Medicare or change your coverage during specific periods. This includes:
- Initial Enrollment Period (IEP): This lasts for seven months — three months before your 65th birthday, your birth month, and three months afterward.
- Open Enrollment Period (OEP): From October 15 to December 7, you can enroll, switch, or drop coverage.
- Medicare Advantage OEP: If you’re already enrolled in a Medicare Advantage plan, you can make changes from January 1 to March 31.
- Medigap OEP: You have six months after turning 65 to enroll in Medigap.
Certain life events can trigger a special enrollment period, which allows you to sign up for Medicare outside of standard enrollment.
Tips for enrolling in Medicare in Wisconsin
To help you narrow down your options, consider the following:
- Provider network: If you enroll in a Medicare Advantage plan, you may need to use in-network providers. Confirm that your healthcare team is included in the network.
- Prescription drugs: Compare your current medication list with the coverage offered by stand-alone prescription drug and Medicare Advantage plans in your area. Ensure your medications are covered and reasonably priced.
- Travel coverage: Some Medicare Advantage plans offer coverage outside the plan’s main service area. If you travel a lot, it may be beneficial to choose a plan that offers this coverage.
- Plan performance: The CMS publishes annual ratings ranging from one to five stars, with five being the best rating.
Medicare has a helpline with staff available 24 hours a day, 7 days a week (excluding some federal holidays) to answer your questions. You can call Medicare at 1-800-633-4227 (TTY: 1-877-486-2048).
For personalized health insurance counseling, contact Wisconsin’sState Health Insurance Assistance Program (SHIP)at 1-800-242-1060 (TTY: 711).
More than 1.3 million Wisconsin residents are enrolled in Medicare.
Dozens of private insurance companies offer Medicare Advantage, Medigap, and stand-alone prescription drug coverage throughout the state.
Overall, monthly premium costs have decreased for Medicare Advantage plans in Wisconsin.