Medicare in Wisconsin

Medicare enrollment in Wisconsin

Medicare enrollment in Wisconsin stood at 1,360,081 people as of January 2026.¹

In most cases, individuals are eligible for enrollment in Medicare when  turning 65. But Medicare also provides coverage for disabled individuals under age 65 if they have been receiving disability benefits for 24 months, and for people with amyotrophic lateral sclerosis (ALS) or end-stage renal disease. Nationwide, about 9% percent of Medicare beneficiaries are under age 65,² and around the same proportion of Wisconsin beneficiaries are under 65.³

Medicare Advantage plan availability and enrollment in Wisconsin

Medicare Advantage includes all of the coverage provided by Medicare Parts A and Medicare Part B, and the plans often provide additional benefits, typically including integrated Medicare Part D prescription drug coverage and often coverage for expenses like dental and vision care. But Medicare Advantage insurers establish their own provider networks, which are generally localized and more limited than the nationwide network for Original Medicare. Out-of-pocket costs for Medicare Advantage are often higher than they would be if a beneficiary had Original Medicare plus a Medigap plan.

Medicare Advantage plans in Wisconsin are available for purchase statewide, and residents on average have access to  21 Medicare Advantage plans in 2026.⁴

As of January 2026, there were 781,420 Wisconsin Medicare beneficiaries enrolled in Medicare Advantage coverage.¹

Learn more about Medicare Advantage, Medicare’s annual open enrollment period, and the Medicare Advantage open enrollment period.

Medicare supplement (Medigap) enrollment and regulations in Wisconsin

Medigap plans (also known as Medicare supplement insurance plans, or MedSupp) will pay some or all of the out-of-pocket costs that enrollees would otherwise have to pay if they had only Original Medicare – which does not have a cap on out-of-pocket costs.

Sixteen insurers offer individual Medigap plans in Wisconsin in 2026, and three offer Medicare SELECT plans (Medigap with a provider network).⁵

According to an AHIP analysis, 299,015 Wisconsin Medicare beneficiaries had Medigap coverage as of 2023.⁶

Although private insurers sell Medigap plans, the policies in nearly every state are standardized under federal rules.⁷ But Wisconsin is one of just three states that have waivers from the federal government allowing the state to conduct its own Medigap standardization.⁷ So, Medigap plans in Wisconsin are not the same as they are in most of the rest of the country.⁸

Instead of having ten different plan designs available (as is the case in most states), Wisconsin Medigap is structured so that there’s one Medigap Basic Plan, plus versions with higher out-of-pocket costs (similar to Medigap Plans K and L that are available in other states). Then enrollees can choose to add riders that make the coverage more comprehensive.⁹ So instead of buying “Plan G” (as newly eligible enrollees in many states would do if they want the most comprehensive Medigap plan), Wisconsin Medigap enrollees buy the Medicare Basic Plan and then add on the optional riders.¹⁰

Wisconsin Medigap insurers have to offer “basic benefits” that include coverage for Medicare Part A coinsurance (including the Medicare Part A hospice coinsurance and hospital coinsurance), Medicare Part B coinsurance, and up to three pints of blood each year. Each Wisconsin Medigap insurer has to offer a “Basic Plan,” which includes the basic benefits in addition to Medicare Part A skilled nursing facility coinsurance, additional coverage for home health care and inpatient mental health care (both have limits on the number of days that are covered), outpatient mental health care, and Wisconsin state-mandated benefits.¹⁰

In addition, Wisconsin Medigap insurers can offer up to seven optional policy riders that beneficiaries can purchase, with coverage for expenses like the Medicare Part A deductible, additional home health care, the Medicare Part B deductible (for those who became eligible for Medicare prior to 2020)¹¹ and excess charges, and foreign travel coverage for emergencies abroad.¹²

Medigap coverage similar to the various lettered plans sold in other states can thus be obtained in Wisconsin by layering various riders on top of the Basic Plan.¹⁰

Medigap insurers in Wisconsin can also offer cost-sharing plans that require the enrollee to pay a portion of the out-of-pocket costs until they reach a specified out-of-pocket limit (similar to Medigap Plans K and L that are sold in other states), and high-deductible plans that require the member the pay all costs until they meet the deductible for the year (similar to the high-deductible versions of Medigap Plans F and G that are sold in other states).¹⁰

Medicare Part D plan availability and enrollment in Wisconsin

There are 10 stand-alone Medicare Part D prescription drug plans in Wisconsin in 2026, with premiums starting at $0 per month.¹⁴

As of January 2026, 455,187 of Wisconsin’s Original Medicare beneficiaries had stand-alone Medicare Part D plans.¹ Another 635,424 Wisconsin Medicare beneficiaries had Medicare Part D prescription drug coverage integrated with their Medicare Advantage plans.¹

Learn how Medicare Part D prescription drug coverage works, what it pays for, how and when to enroll.