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Medicare Part D Plans in Wisconsin


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More than 72% of people on Medicare in Wisconsin have prescription drug coverage under Medicare Part D in Wisconsin. That’s about 815,000 out of approximately 1,152,127Medicare beneficiaries in the state.

What’s Medicare Part D in Wisconsin?

Medicare in Wisconsin, as in all states, has four “parts:”

  • Part A is hospital insurance.
  • Part B is medical insurance.
  • Part C is the Medicare Advantage program.
  • Part D is prescription drug coverage.

The first two “parts” make up Original Medicare, the federal health insurance program. The second two parts are available from private insurance companies that contract with Medicare.

Why would you need Medicare Part D in Wisconsin?

Some Medicare beneficiaries in Wisconsin might believe that Original Medicare will help pay for their medications. But Part A and Part B only cover certain medications and in limited situations. For example, Part A typically covers prescription drugs that providers give you as part of your inpatient treatment.

That’s why so many people turn to Medicare Part D in Wisconsin.

How do I get coverage under Medicare Part D in Wisconsin?

Medicare Part D in Wisconsin is optional, and available through private plans approved by Medicare. There are two avenues to sign up for Part D in Wisconsin.

  • You can enroll in a Medicare Advantage Prescription Drug plan. This is a way to receive your Part A and Part B benefits through a Medicare Advantage plan in Wisconsin – and most plans include prescription drug coverage.
  • You can enroll in a stand-alone Medicare Part D Prescription Drug Plan. This plan would work alongside your Part A and/or Part B benefits.
  • You need to live within the plan’s service area to be eligible for coverage under Medicare Part D in Wisconsin.
  • You must continue paying your Part B premium, along with any premium your plan may charge.

Will a Medicare Part D plan in Wisconsin cover my prescription?

Not necessarily. This is something you’ll want to check on before you sign up for a Medicare Prescription Drug Plan in Wisconsin.

Each plan develops and maintains its own formulary (a list of drugs the plan covers). Even if your medications are listed in the formulary of the plan you choose, be aware that you’ll need to watch for notices of formulary changes. Every Medicare Prescription Drug Plan in Wisconsin sends out a notice every fall, called an Annual Notice of Change. If you want to switch to a different plan, you can do so during the Annual Election Period described below.

A plan’s formulary may change at any time (not just in the fall). You will receive notice from your plan when necessary.

When can I get coverage under Medicare Part D in Wisconsin?

Your first opportunity to sign up for coverage under Part D in Wisconsin is usually your Initial Enrollment Period. For most people, this period spans seven months, three months before and after the month you first qualify for Medicare.

Your next opportunity to sign up happens every year. The Medicare Annual Election Period  runs from October 15 to December 7.

If you already have a Medicare Advantage plan, but it doesn’t have the prescription drug coverage you need, you may be able to switch from one Medicare Advantage plan to another during the Medicare Advantage Open Enrollment Period. It runs from January 1 through March 31 each year.

If you’re able to find a Medicare Prescription Drug Plan that has a 5-star rating, you may get a one-time opportunity to enroll almost anytime during the year: it goes from December 8 to November 30 every year.

In some cases, you might be eligible for a Special Election Period to enroll in a Medicare Prescription Drug Plan in Wisconsin.

Are you ready to start comparing Medicare Part D plans in Wisconsin? You can do so instantly – just enter your ZIP code on this page and click the button. You can even enter your prescriptions to see if a particular plan may cover them.

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