Wisconsin Medicare; WI; Medicare Part D in Wisconsin
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The Medicare Coverage Gap (The Doughnut Hole) A directory of web sites, articles, and publications that helps explain what and how the Prescription Drug Coverage Gap works.
Wisconsin Medicare Coverage, Prescription Drug Plans
Wisconsin Medicare Help Articles & Resources
Information from varied resources about Medicare in Wisconsin
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Publication or Brochure: Medigap Helpline (State Health Insurance Assistance Program) source:State of Wisconsin, Board on Aging and Long Term Care 19 pages; languages: English from the web page: "The Medigap Helpline (State Health Insurance Assistance Program) can help you with questions about health insurance; primarily Medicare Supplements, Long Term Care Insurance, and other health care plans available to Medicare beneficiaries..." more from State of Wisconsin, Board on Aging and Long Term Care: Publication or Brochure: MEDICARE ADVANTAGE PLANS: WHAT HAS HAPPENED SINCE 2006? file size: 2 pg. languages: English from the publication: "In 2007, the Medigap Helpline has received calls from people all over Wisconsin with questions and concerns about Medicare Advantage plans. Advantage Plan seminars and countless home visits took place all over the state last year touting the value of enrolling in an Advantage Plan. There have been a variety of calls to the Medigap Helpline about those meetings. Here is some of what we have heard in our office:." Learn About Medicare Rx source:Medicare Part D: Prescription Drugs - CWAG Elder Law Center languages: English topics listed on the web page: "What is Medicare Part D?; Who is eligible? What is covered under the plan? What will my prescriptions cost? What if I can't afford the cost? Who provides the drug coverage? What if I have other drug coverage? How do I enroll in a Part D Plan? ..." more from Medicare Part D: Prescription Drugs - CWAG Elder Law Center: Web Page: Discover Your Rx Coverage Options languages: English topics listed on the web page: "First Steps to an Rx Program in Wisconsin; A Tool for Discovering Your Rx Coverage Options; Prescription Drug Programs in Wisconsin; Special Concerns; Get Help with Your Options..." SeniorCare and Medicare Part D source:Wisconsin Department of Health and Family Services languages: English From the web page: "SeniorCare is Creditable Coverage... The Wisconsin SeniorCare prescription drug assistance program is considered “creditable coverage.” This means SeniorCare is as good as the standard Medicare Part D plan..." more from Wisconsin Department of Health and Family Services: Publication or Brochure: Frequently Asked Questions About HIRSP and Medicare’s Prescription Drug Coverage file size: 2 pg. languages: English date:August, 2005 Q & A about how new Medicare Prescription drug coverage will effect people enrolled in HIRSP, and HIRSP coverage. Web Page: Wisconsin Consumer Guide to Health Care: Medicare languages: English date:August, 2005 topics covered include Medigap, Medicare Advantage, Prescription drugs and more Wisconsin Guide to Health Insurance for People with Medicare - 2007 source: State of Wisconsin, Office of the Commissioner of Insurance 57 pgs; languages: English from the publication: "This booklet briefly describes the Medicare program. It also describes the health insurance available to those on Medicare." more from State of Wisconsin, Office of the Commissioner of Insurance: Publication or Brochure: Medicare Supplement Insurance Approved Policies - January 2007 file size: 174 pg. languages: English from the booklet: "This booklet contains information on Medicare supplement insurance policies approved by the Office of the Commissioner of Insurance (OCI). It includes only policies currently being sold in Wisconsin. Group policies sold through employers are not included in this booklet. The annual premium rates listed are current as of the date on the front of the booklet..." Publication or Brochure: Medicare Advantage – Questions and Answers file size: 174 pg. languages: English from the booklet: "This booklet contains information on Medicare supplement insurance policies approved by the Office of the Commissioner of Insurance (OCI). It includes only policies currently being sold in Wisconsin. Group policies sold through employers are not included in this booklet. The annual premium rates listed are current as of the date on the front of the booklet..." DeanCare Rx: Wisconsin’s Own Prescription Drug Plan source:Dean Health System file size: 2 pg. languages: English date:August, 2005 our comments: from the document: "Choosing a Prescription Drug Plan is an important decision. With DeanCare Rx, you can feel secure in your choice because..." Wisconsin Medicare Drug Plan Ratings source:AARP file size:5 pg. languages: English "...This AARP rating tool contains information about “stand-alone” Medicare plans in your state that cover only prescription drugs...." Find a Medicare Participating Physician/Supplier source:Wisconsin Physicians Service (WPS) languages: English ".Participating physicians and suppliers are health care providers that have entered into a contract with the Medicare Part B program..." BenefitsCheckUp - NCOA's Online Screening Service source:National Council on Aging. languages: English "BenefitsCheckUp screenings help Wisconsin seniors with limited income find programs to help pay for prescription drugs, energy assistance, food stamps, Alzheimer's care and more...." Northern Area Agency on Aging languages: English "The Northern Area Agency on Aging is one of five regional area agencies on aging in Wisconsin that administers federal and state resources for the development and maintenance of programs and services for older adults...." more Area Agencies on Aging concerning Wiconsin: Wisconsin Association of Areas on Aging Southern Area Agency on Aging Wisconsin Association of Areas on Aging Milwaukee Area Agency on Aging Dane County Area Agency on Aging National Indian Council on Aging Medicare: Understanding Your Options source:Coalition of Wisconsin Aging Groups 2 pp; languages: English ""...This brochure will explain the differences between traditional Medicare and Medicare Advantage..." Wisconsin: Medicare Hospital Payments source:Kaiser Family Foundation / statehealthfacts.org languages: English Range of Medicare Payments (Low-25th Percentile/High-75th Percentile) for Top Five Elective Inpatient Hospital Procedures, FY2005 What Medicare Covers & How Much You Will Pay source:Medicare Rights Center languages: English Charts of premiums, deductables, and other information for medicare coverage under Part A, Part B, and Part D Your Medicare Rights and Protections source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 44pp languages: English Fairly detailed explanations and descriptions about your Medicare rights and protections. A Consumer's Guide to Getting and Keeping Health Insurance in Wisconsin source:healthinsuranceinfo.net file size: 46pg. languages: English from GEORGETOWN UNIVERSITY HEALTH POLICY INSTITUTE. "...As a Wisconsin resident, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a Wisconsin resident...." State Pharmacy Listing - Aetna Medicare RxSM Plans - Wisconsin Aetna Medicare Medicare Topics and CMS News source:Wisconsin Medical Society Your Medicare Rights and Protections source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 44pp languages: English Fairly detailed explanations and descriptions about your Medicare rights and protections. Medicare & You 2007 (Wisconsin specific version) source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services languages: English and Spanish from www.medicare.gov: "Medicare & You 2007... contains important information about what’s new, health plans, prescription drug plans, and rights and protections to help people with Medicare review their coverage options and prepare to enroll in a new plan if they choose. These files are ... the printed version that people with Medicare will get in the mail this fall. Plan information contained in each book may change after printing." Lanscape: 2007 Wisconsin Stand-Alone Prescription Drug Plans source:CENTERS FOR MEDICARE & MEDICAID SERVICES, U.S. Department of Health and Human Services file size:3 pg. languages: English date:2007 Wisconsin 2007 Medicare Part D Stand-Alone Prescription Drug Plans. Data as of September 12, 2006. Includes all contracts/plans regardless of 2007 approval status. Employer sponsored plans (800 series) are excluded." Publication or Brochure: Landscape: Wisconsin Medicare Advantage, Cost Plans, and Demonstrations source:CENTERS FOR MEDICARE & MEDICAID SERVICES file size:33 pg. languages: English "Wisconsin 2007 Medicare Advantage, Cost, and Demonstration Plans. Data as of September 29, 2006. Includes all contracts/plans regardless of 2007 approval status. PACE, Special Needs Plans, and Employer sponsored plans (800 series) are excluded." |
How to get more information about Wisconsin Medicare Prescription Drug Programs
Medicare.gov has summary information about the plans offered by the companies listed in the tables below. The data sheets are called "Landscapes".
- The Landscape of Local Plans is a list of all plans available in your area. You can get answers to important questions for people with Medicare based on what matters to them, including:
- Cost (premiums, deductibles and payments)
- Coverage (important issues around what and how drugs are covered)
- Convenience (pharmacy and mail-order options)
- Medicare.gov has an important help page that explains how to read and interpret the information in both Medicare Prescription Drug Plan "Landscapes. You can access the help page through this link: How to read the Medicare Prescription Drug Plans Landscape
- We have provided links to the landscape documents for this state in the list of publications above.
Medicare prescription drug coverage plans offered in Wisconsin:
Important advice about how to use this
data: The data for the table below came from www.medicare.gov, "The Official U.S. Government Site for People with Medicare", in December, 2006, and is subject to change at any time. To check for changes and the newest data, you should visit www.medicare.gov. Your state insurance administrator might have different data; be sure to check with them before making any decisions. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action.
| 45 Prescription Drug Plans in Wisconsin This list is to familiarize you with Medicare Prescription Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
|---|---|---|---|---|---|---|
| Plan Name and ID Numbers |
Company (w. link to plan web site) |
Coverage in the Gap About the gap |
Contact Service Phones |
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| AARP MedicareRx Plan (S5820-015) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-867-5564 TTY Users should call: 1-877-730-4192 Members 1-888-867-5575 TTY Users should call: 1-888-867-5575 |
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| AdvantraRx Premier (S5670-082) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| AdvantraRx Premier Plus (S5670-084) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| AdvantraRx Value (S5670-081) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| Aetna Medicare Rx Essentials (S5810-050) |
Aetna Medicare | No gap coverage | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| Aetna Medicare Rx Plus (S5810-152) |
Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| Aetna Medicare Rx Premier (S5810-186) |
Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| Blue MedicareRx Plus (S5596-022) |
Blue Cross Blue Shield of Wisconsin | No gap coverage | Non-Members 1-800-216-5572 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| Blue MedicareRx Premier (S5596-023) |
Blue Cross Blue Shield of Wisconsin | Generic Only | Non-Members 1-800-216-5572 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| Blue MedicareRx Value (S5596-021) |
Blue Cross Blue Shield of Wisconsin | No gap coverage | Non-Members 1-800-216-5572 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| CIGNATURE Rx Complete Plan (S5617-186) |
CIGNA HealthCare | Generic Only | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| CIGNATURE Rx Plus Plan (S5617-080) |
CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| CIGNATURE Rx Value Plan (S5617-078) |
CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| Community Care Rx BASIC (S5803-085) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Community Care Rx CHOICE (S5803-153) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Community Care Rx GOLD (S5803-119) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| DeanCare Rx Classic (S5954-004) |
Dean Health Insurance, Inc. | No gap coverage | Non-Members 1-888-422-3326 Members TTY Users should call: 1-608-827-4372 |
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| DeanCare Rx Enhanced (S5954-005) |
Dean Health Insurance, Inc. | No gap coverage | Non-Members 1-888-422-3326 Members 1-888-422-3326 TTY Users should call: 1-608-827-4372 |
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| DeanCare Rx Premium (S5954-006) |
Dean Health Insurance, Inc. | Generic Only | Non-Members 1-888-422-3326 Members 1-888-422-3326 TTY Users should call: 1-608-827-4372 |
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| Humana PDP Complete S5884-044 (S5884-044) |
Humana Insurance Company | Generic and Brand | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Humana PDP Enhanced S5884-014 (S5884-014) |
Humana Insurance Company | No gap coverage | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Humana PDP Standard S5884-074 (S5884-074) |
Humana Insurance Company | No gap coverage | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| MedicareRx Rewards (S5960-016) |
Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| MedicareRx Rewards Plus (S5960-052) |
Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| MedicareRx Rewards Premier (S5960-086) |
Unicare | Generic Only | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| PacifiCare Comprehensive Plan (S5921-073) |
UnitedHealthcare | Generic Only | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| PacifiCare Saver Plan (S5921-072) |
UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| PacifiCare Select Plan (S5921-071) |
UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| Prescription Pathway Bronze Plan Reg 16 (S5597-081) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Gold Plan Reg 16 (S5581-032) |
Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Prescription Pathway Gold Plan Reg 16 (S5597-048) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Platinum Plan Reg 16 (S5581-056) |
Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Prescription Pathway Silver Plan Reg 16 (S5581-128) |
Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Prescription Pathway Silver Plan Reg16 (S5597-180) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| SilverScript (S5601-032) |
SilverScript Insurance Company | No gap coverage | Non-Members 1-866-552-6106 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| SilverScript Plus (S5601-033) |
SilverScript Insurance Company | No gap coverage | Non-Members 1-866-235-4582 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| Sterling Prescription Drug Plan (S4802-027) |
Sterling Life Insurance Company | No gap coverage | Non-Members 1-888-909-1713 TTY Users should call: 1-888-858-8567 Members 1-866-865-0664 TTY Users should call: 1-866-865-0664 |
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| UA Medicare Part D Prescription Drug Cov (S5755-019) |
United American Insurance Company | No gap coverage | Non-Members 1-866-524-4169 TTY Users should call: 1-866-524-4170 Members 1-866-524-4169 TTY Users should call: 1-866-524-4169 |
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| United Medicare MedAdvance (S5820-119) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-556-6657 TTY Users should call: 1-888-556-7065 Members 1-888-556-7047 TTY Users should call: 1-888-556-7047 |
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| WellCare Complete (S5967-084) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| WellCare Premier (S5967-119) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| WellCare Signature (S5967-050) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| WPS Medicare Prescription Drug Plan 1 (S5753-006) |
WPS Health Insurance | No gap coverage | Non-Members 1-800-490-5974 TTY Users should call: 1-888-877-2837 Members 1-800-688-1604 TTY Users should call: 1-800-688-1604 |
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| WPS Medicare Prescription Drug Plan 2 (S5753-007) |
WPS Health Insurance | Generic Only | Non-Members 1-800-490-5974 TTY Users should call: 1-888-877-2837 Members 1-800-688-1604 TTY Users should call: 1-800-688-1604 |
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| YOURx PLAN (S5660-016) |
Medco YOURx PLAN | No gap coverage | Non-Members 1-800-758-3605 TTY Users should call: 1-800-716-3231 Members 1-800-758-4574 TTY Users should call: 1-800-758-4574 |
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| 8 Medicare Special Needs Plans in Wisconsin This list is to familiarize you with Medicare Special Needs Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
|---|---|---|---|---|---|---|
| Community Care's Partnership Program (H5207-001-0) |
Community Care | For people in certain long-term care facilities. | Non-Members 1-866-992-6600 TTY Users should call: 1-414-385-6626 Members 1-866-992-6600 TTY Users should call: 1-414-385-6626 |
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| Community Health Partnership, Inc. (H5206-002-0) |
Community Health Partnership | For people in certain long-term care facilities. | Non-Members 1-800-842-1814 TTY Users should call: 1-800-842-1814 Members 1-800-842-1814 TTY Users should call: 1-800-842-1814 |
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| Elder Care InFocus Health (H5893-001-0) |
Elder Care Health Plan, Inc | For people in certain long-term care facilities. | Non-Members 1-800-963-0035 TTY Users should call: 1-800-947-3529 Members 1-800-963-0035 TTY Users should call: 1-800-947-3529 |
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| Elder Care Partnership (H5209-002-0) |
Elder Care Health Plan, Inc. | For people in certain long-term care facilities. | Non-Members 1-800-963-0035 TTY Users should call: 1-800-947-3529 Members 1-800-963-0035 TTY Users should call: 1-800-947-3529 |
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| Elder Care Reliance Health (H5893-002-0) |
Elder Care Health Plan, Inc | For people with certain chronic or disabling conditions. | Non-Members 1-800-963-0035 TTY Users should call: 1-800-947-3529 Members 1-800-963-0035 TTY Users should call: 1-800-947-3529 |
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| Evercare Plan DH (H5253-024-0) |
SecureHorizons | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-524-2478 TTY Users should call: 1-888-685-8480 Members 1-800-524-2448 TTY Users should call: 1-888-685-8480 |
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| Evercare Plan DH (H5253-025-0) |
SecureHorizons | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-524-2478 TTY Users should call: 1-888-685-8480 Members 1-800-524-2448 TTY Users should call: 1-888-685-8480 |
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| Partnership at Community Living Alliance (H5204-002-0) |
Health Plan for Community Living | For people in certain long-term care facilities. | Non-Members 1-888-459-5255 TTY Users should call: 1-608-242-8583 Members 1-888-459-5255 TTY Users should call: 1-608-242-8583 |
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data from federal and state agencies
