Wisconsin Standardized Medicare Supplement Plans
Basic Benefits - Included in all plans:
Inpatient Hospital Care: Covers the Part A coinsurance.
medicare supplement plans, Medical Costs: Covers the Part B coinsurance
(generally 20% of Medicare-approved payment amount) or copayment amount
which may vary according to the service. For hospital outpatient services,
the copayment amount will be paid under a prospective payment system. If
this system is not used, then 20% of eligible expenses will be paid.
Blood: Covers the first 3 pints of blood each year.
|Part A: Skilled-Nursing Facility Coinsurance
|Inpatient Mental Health Coverage
||175 days per lifetime in addition to Medicare
|Home Health Care
||40 visits in addition to those paid by Medicare
|Part B Coinsurance
|Outpatient Mental Health
Insurance companies are permitted to offer additional riders to a Medicare Supplement plan.
Mandated State Benefits under Medicare Supplement Basic Plan:
- Usual and customary expenses for chiropractic services
- Usual and customary expenses for diabetic supplies and equipment
- 30 day skilled nursing home confinement
- Kidney disease treatment for dialysis, transplantation and donor-related
services with a $30,000 maximum
- Usual and customary expenses for breast reconstruction following a
- Usual and customary expenses for hospital and ambulatory surgery center
charges and anesthetics for dental care
- Nervous and mental disorder and alcoholism and other drug abuse
- Coverage for at least 80% of the charges for outpatient prescription drugs
after a drug deductible of no more than $6,250 per calendar year
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