Janesville Wisconsin Medicare Options
Janesville Wisconsin Medicare Options
Many seniors near Janesville/Beloit, Wisconsin are trying to compare their Medicare options. This can be challenging because most people aren’t experts in insurance so you don’t know what option is in your best interest.
Picking the right plan can be tough, especially when there are so many choices!
I’ll help you take a look at Wisconsin Medicare plans and explore the key points to help find the right one for you.
Below are some of the highlights for the Medicare Advantage and Medicare supplement options in Janesville/Beloit area aka Rock County, Wisconsin.
Rock County Medicare Advantage
As of January 2020, Rock County has almost 36,000 people on Medicare. Just over 10,000 of those people have enrolled in a Medicare Advantage plan. Here are the numbers of people enrolled in several of the Advantage plans available:
- Aetna 3,806
- United Healthcare 2,708
- Humana 1,943
- Dean 865
Hospital Systems
There are 2 main hospital systems in the Janesville/Beloit, WI area.
- Dean clinics with St. Mary’s Hospital.
- Mercy Hospital system plus UW health system up in Madison
This is important because Medicare Advantage plans use networks.
This means there are only certain doctors and hospitals you can see with that plan. If you go to an out of network provider then the insurance company may not pay for any of your treatment.
HMO VS PPO
Medicare Advantage plans typically use networks which means there only certain doctors and hospitals you can see while using that plan’s coverage.
HMO and PPO are the two major types of networks.
PPO plans are a type of network where you typically do not need a referral to go see a specialist. But you do need to stay in network to maximize your benefits. Because the insurance company may offer you coverage if you go to a doctor that is not in network. They typically reduce the coverage so you have to pay a higher portion of that bill.
HMO plans may require referrals to see specialist. But the biggest difference from a PPO is that HMOs do not pay for any procedures done out of network unless it is an emergency room or urgent care visit. For this reason, they are much more restrictive than PPOs.
Aetna
Aetna has 1 PPO Medicare Advantage plan that includes prescription drug coverage. It primarily uses the Mercy hospital system for its network.
United Healthcare
United Healthcare has 3 HMO and 2 PPO Medicare Advantage plans that include prescription drug coverage. United Healthcare also uses the Mercy health system for their network.
Humana
Humana has 2 PPO Medicare Advantage plans that include prescription drug coverage. Humana primarily uses the Mercy health system for their network. But they do have 1 plan which has very appealing out of network benefits which could give you access to Dean/St. Mary’s providers.
Dean
Dean has 5 Medicare Advantage plans that are all HMOs. They are all built around the Dean Clinic doctors and St. Mary’s hospital.
Comparing Medicare Advantage Plans
When comparing Medicare Advantage plans, the first thing you want to consider is the network. Confirm your doctor and hospital are in network. Otherwise you need to be willing to switch doctors and hospitals to use the plans coverage.
Other key things to consider are:
- Monthly Premium
- Copays
- Maximum out of pocket limit (your worst case scenario each year)
- Extra benefits like vision or dental coverage
Much of this information can be found at Medicare.gov if you know where to look. But it can be confusing to go it alone, so that’s where I can come in and make it really easy for you.
You can call me directly at 608-571-4461 for a FREE comparison of all of your options so you can easily decide what you prefer.
Best Medicare Supplement Plans in Wisconsin
Many people prefer Original Medicare and a Medicare Supplement policy over Medicare Advantage.
Original Medicare plus a Medicare supplement gives a person a more predictable budget because Medicare supplements help fill in the gaps of Original Medicare.
This means you have fewer costs when you need to use the plan. So if you have a major incident like a heart attack, you don’t have a large hospital bill because the Medicare supplement helped fill in the gaps of Original Medicare to pay your medical bills.
Two other perks of supplements are that there are no networks. So you have the flexibility to see any doctor or hospital you want. This is true not only in Madison, but nationwide.
The other perk is claims are automatically filed, so you don’t have the stress of having to reconcile bills and write checks.
Wisconsin Medicare supplements are unlike any other state. But Wisconsin mandates that supplements offer the same basic coverage regardless of the company offering it.
This means you can compare “apples to apples” coverage from many different companies such as Anthem, United Healthcare, WPS, Humana, CVS, Aetna, and many others.
I have access to specialized software so we can compare all of them at one time which makes it much easier for you.
If you want to find the best Medicare supplement plan for your unique needs, please call me at 608-571-4461 or email me at Mike@askMedicareMike.com.