wps medicare supplement insurance plans · 2019. 2. 26. · wps medicare supplement insurance plans...
TRANSCRIPT
WPS MEDICARE SUPPLEMENT INSURANCE PLANSYou’re never alone—we’re committed to helping you with your health careRates effective March 1, 2019
Choose the right Medicare supplement with complete customer support!Visit mywpsmedicare.com
MI
Plans A, C, F, G, K, L, and N
This is an advertisement for insurance. Neither Wisconsin Physicians Service Insurance Corporation, nor its products, nor agents are connected with or endorsed by the United States government or the federal Medicare program.
2 | mywpsmedicare.com | 1-800-236-8809
ContentsMedicare alone is not enough ...............................................................2
Stable rates provide peace of mind .....................................................2
Medicare supplements are a great choice .........................................3
Top reasons to choose WPS Medicare supplement insurance plans ..........................................................................................3
Valuable options included with your plan .......................................4-7
WPS provides convenient payment options ......................................8
Optional dental coverage...... ..................................................................9
Enrollment timeline..... ............................................................................ 10
Premium rates ....................................................................................11-14
Parts of Medicare ................................................................................... 15
Limitations and exclusions ................................................................... 15
Medicare is a valuable benefit, but it doesn’t pay everything. Deductibles and coinsurance can add up. If you have Medicare alone, there’s a chance a serious illness or injury could exhaust your savings. WPS Medicare supplement insurance plans help protect your health and retirement savings.
Stable rates provide peace of mindAs you look at Medicare supplement plans, you may find that some companies offer lower initial premiums than WPS does. However, a lower rate can increase quickly in subsequent years. Choose WPS Medicare supplement insurance plans for valuable benefits and a stable rate.1 You can help protect your health and finances and count on a consistent premium payment.
Medicare alone is not enough
Personal service ensures you get the kind of attention you need when you have questions. We know your concerns and are equipped to help you get the answers you need to your Medicare supplement questions. WPS has your back!
“I felt like I had a home at WPS. Someone to take care of me and someone I can turn to.”
—Jewel Customer since 2005
Eliminate the worry“ “
Judy is a WPS customer service rep who helps seniors get the most from their Medicare supplements.
1Based on historical approved Wisconsin standardized plan rate increases.
1-800-236-8809 | mywpsmedicare.com | 3
1Household: Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex. 22010-2018 World’s Most Ethical Companies®, Ethisphere® Institute, worldsmostethicalcompanies.ethisphere.com.
“Medicare supplement insurance plans are a great choiceMedicare supplement insurance plans give you the freedom to choose your own doctors and hospitals that accept Medicare anywhere in the U.S. This means you can keep your doctor or select a new doctor at any time. You have complete freedom to choose! And if you move, your coverage moves with you—anywhere in the U.S.
Plus, you always can keep your plan as long as you pay your premium. Your policy will never be canceled because of your health. As long as you pay your premium on time, your plan is guaranteed renewable for life.
Also, there is less paperwork and fewer worries. Automatic claims service means you don’t have to worry about filing claims or dealing with medical bills. Medicare sends WPS your claims electronically, so we handle them while you enjoy almost no paperwork.
Top reasons to choose WPS Medicare supplement insurance plans• Save money with our discounts
WPS offers a 7% discount when you and a second household member are enrolled in a WPS Medicare supplement insurance plan.1 You also can get a 2% discount when you choose automatic bank withdrawal.
• You get treated like family When you call WPS, you reach caring people right here in the Midwest. Your questions are answered promptly and accurately by our highly trained Customer Support team.
• Strong commitment to ethics In 2018, WPS Health Solutions was named one of the World’s Most Ethical Companies® for the ninth year in a row by the international Ethisphere® Institute.2
• You deserve to live your life Health care and health insurance are important, but honestly, you’ve got better things to do than worry about all of it. Let WPS help handle your medical bills while you handle all the activities you enjoy.
4 | mywpsmedicare.com | 1-800-236-8809
Valuable programs included with your planWPS strives to provide the greatest value possible to its customers. WPS Medicare supplement insurance plans include an impressive collection of added programs that costs absolutely nothing extra for customers.
The Silver&Fit® Exercise and Healthy Aging Program1
When you choose a base plan option (not available with cost-sharing Plans K and L), you also get this great perk! At no extra cost, the Silver&Fit program gives you fitness center or select YMCA exercise center membership.
The Silver&Fit network includes Michigan locations of national fitness chains as well as dozens of regional and local gyms.2
National Fitness Chains with Michigan Locations
Planet Fitness YMCA Anytime Fitness
Snap Fitness Curves Gold’s Gym
Kalamazoo area
» Family Fitness
» Otsego Health & Fitness
» Endurance Fitness and Wellness
Grand Rapids area
» Family Fitness
» Fitness 19
» Endurance Fitness Center of Kentwood
» Northern Physical Therapy Services
» Walker Ice and Fitness Center
Lansing area
» Conquest Fitness
» Powerhouse Gym-East Lansing
Detroit area
» HYPE Recreation Center
» LA Fitness
» Fitness 19
» Powerhouse Gym
1The Silver&Fit® program is provided by American Specialty Health Fitness, Inc. The ChooseHealthy® program is provided by ChooseHealthy, Inc. Both are subsidiaries of American Specialty Health Incorporated (ASH), a national provider of fitness, health education, musculoskeletal provider networks, and health management programs. Silver&Fit and ChooseHealthy are registered trademarks of ASH and used with permission herein. Services that require an additional cost are not included in the Silver&Fit program. Please note that these programs are not insurance. You should check any insurance benefits you have before using this discount program, as those benefits may result in lower costs to you than using this discount program. The program provides for discounts from participating specialty health care providers. You are obligated to pay for all services, but you will receive a discount from those providers who have contracted with the program. The program does not make any payments directly to the participating providers. The program has no liability for providing or guaranteeing services and assumes no liability for the quality of services rendered. Discounts on products available through the ChooseHealthy program are subject to change; please consult the website for current availability. Fitness programs are not part of the insurance policy and are offered at no additional charge. Enrollment in these programs is subject to contract renewal and can be changed or discontinued at any time. The Silver&Fit and ChooseHealthy programs are not included with Medicare supplement cost-sharing plans (Plans K and L.) 2The fitness centers listed are participating in the Silver&Fit network as of Nov. 2018. For the most current fitness center locations, please check the online directory at silverandfit.com.
The Silver&Fit network is continually growing, including the additions of fitness centers nominated by WPS customers. Visit silverandfit.com for a complete list of participating locations.
Plus, additional fitness centers throughout Michigan!
The ChooseHealthy® program1The Silver&Fit program also offers: » Fitness centers with group classes for older
adults, where available, such as:• Signature Series• Senior Dance• Senior Yoga• Aqua• Cardio• Strength• And more
Or, if you would prefer to work out at home, home fitness kits are available which can include:
• DVDs• Pedometer• Quick starts guides• And more
» Fitness challenges and rewards
» And more
WPS Medicare supplement insurance Plans A, C, F, G, and N also offer the ChooseHealthy discount program at no extra cost to you. You can save more on wellness products and services and be empow-ered with health improvement tools to help you live better every day. The program allows you to:
» Save 25% on services from 66,000 specialty health care practitioners
» Learn from evidence-based, online health classes and articles offered at no extra cost
» Get discounts up to 57% on popular health and fitness brands including: • Garmin®
• Vitamix®
• PRO Compression®
• Fitbit®
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EyeMed Vision Care discount program
All WPS Medicare supplement insurance plan customers receive access to the EyeMed Vision Care discount program at no additional cost.1 EyeMed offers substantial savings on eye care and eyewear at thousands of provider locations nationwide.
WPS Medicare supplement insurance plan customers receive a discount simply by showing their WPS ID card at participating EyeMed providers.
EyeMed’s provider network includes many familiar optical retailers, including:
» Rx Optical
» SVS Vision Optical Centers
» Premier Family Eye Care
» LensCrafters
» Target Optical
» Pearle Vision
» and many more!
Does your vision provider accept EyeMed? We would be happy to explain how this valuable program works and help you find a provider.
Vision Care Services Member Benefits
Eye exam (with dilation, as necessary)
$5 off routine exam$10 off contact lens exam
Complete Pair Eyeglass Purchase2
Frames
Any available frame at provider location 35% off retail price
Standard Plastic Lenses
Single vision $50
Bifocal $70
Trifocal $105
Lens Options
UV coating $15
Tint (solid and gradient) $15
Standard scratch-resistant coating $15
Standard polycarbonate $40
Standard anti-reflective coating $45
Standard progressive (add-on to bifocal) $65
Other add-ons and services 20% off retail price
Contact Lenses (discount applies to materials only)
Conventional 15% off retail price
Laser Vision Correction
LASIK or PRK from U.S. Laser Network
15% off retail price5% off promotional price
Frequency of use for examination, frames, lenses, or contact lenses unlimited
1Vision discount program is not part of the insurance policy and is offered at no additional charge. Enrollment in this program is subject to contract renewal. 2Frame, lens, and lens option discounts apply only when purchasing a complete pair of eyeglasses. If purchased separately, customers receive 20% off the retail price. Benefits may not be combined with any discount, promotional offering, or other group benefit plans, except as indicated. Discount plan is effective March 1, 2019, through Feb. 29, 2020.
Call us toll-free at 1-800-236-8809
EnrollWithEyeMed.com/access
6 | mywpsmedicare.com | 1-800-236-8809
Hear In America programThe Hear In America discount program, available to all WPS Medicare supplement insurance plan customers, makes you eligible to receive:
» Free hearing screenings
» A three-year warranty on new hearing aids
» Free office services (including retests, cleanings, and adjustments) for three years
» A 45-day trial period for your hearing aid
» Discounts from 35 to 70% off of manufacturer’s suggested retail price (MSRP) for hearing aids from all nine major manufacturers including:
Sample SavingsMSRP or
Average PriceYou Pay* Savings % Saved
FREE annual hearing screening $0 100%
Three-year repair warranty, three-year loss and damage warranty
$500 $0 $500 100%
Three years of hearing aid batteries $315 $0 $315 100%
Three years of office service $600 $0 $600 100%
12 months financing (to those who qualify)$0 service charges
and interestUp to
$1,160
Basic digital hearing aid $1,450 $995 $455 31%
Mid-level hearing aid $3,995 $1,475 $2,520 63%
Premium digital hearing aid $5,996 $2,540 $3,456 58%
Examples of how you can save
• Phonak• Starkey• ReSound• Rexton• Siemens• Sonic Innovations• Oticon• Unitron• Widex
*These are savings examples only. May be used in conjunction with your existing insurance coverage. Hearing discount programs are not part of the insurance policy and are offered at no additional charge. Enrollment in these programs is subject to contract renewal.
Call us toll-free at 1-800-236-8809
1-800-236-8809 | mywpsmedicare.com | 7
WPS Medicare supplement insurance plans have seven smart options
• Automatic bank withdrawal (includes 2% discount!)• Credit/debit card payment• Direct billing
Please see our Medicare supplement insurance plan enrollment application for additional instructions for selecting a payment option.
Choose from convenient payment options
Coverage of Plan A Plan C Plan F Plan G Plan K Plan L Plan N
Basic benefits √ √ √ √ √1 √2 √
Part B coinsurance √ √ √ √ √1 √2 √3
Part A deductible √ √ √ 50% 75% √
Skilled nursing facility coinsurance
√ √ √ 50% 75% √
Foreign travel emergency
√ √ √ √
Part B excess charges
√ √
Part B deductible √ √1After deductible, hospitalization and preventive care paid at 100%; other basic benefits paid at 50%. Out-of-pocket limit set by CMS; pays at 100% after limit reached.2After deductible, hospitalization and preventive care paid at 100%; other basic benefits paid at 75%. Out-of-pocket limit set by CMS; pays at 100% after limit reached.3After deductible, requires up to $20 copayment for office visits; up to $50 copayment for emergency room visits. Copayments do not count toward the annual Part B deductible.
Foreign travel coverage for emergency care that is not covered by Medicare is subject to a $250 calendar year deductible. Benefits are payable at 80% to a lifetime maximum benefit of $50,000 for services beginning during the first 60 days of each trip outside the USA.
The level of benefits available under the plan directly correspond to the premium amount.
8 | mywpsmedicare.com | 1-800-236-8809
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Eligibility: Anyone at least 18 years of age who is not a current Ameritas dental plan customer is eligible for these dental plans. Please refer to the website for plan availability in your state. EXCEPTIONS, REDUCTIONS, AND LIMITATIONS OF THE POLICY—Your policy will contain a complete listing of procedures covered and any frequency or other limitations on specific procedures. Certain covered expenses may be subject to a waiting period (an elimination period). Alternate Benefit Provision—At times, two or more procedures are considered adequate and appropriate treatment. In this case, the benefit paid will be based on the charge for the least expensive procedure. Certain expenses are not covered—For instance, procedures begun prior to your effective date are not covered. The policy does not provide benefits for lost or stolen appliances or cosmetic procedures. It does not cover hospitalization or prescription drugs. This is not a complete list of exclusions. A full list will be included in your policy. To preview the policy, please send us a request using the contact form on our website, www.CoreDentalinsurance.com. Plans are marketed by SASid, Inc., administered by InsuranceTPA.com and insured by Ameritas Life Insurance Corp. Plan designs may not be available in all areas. Ameritas Group’s individual plans [Indiv. 9000 Ed. 11-09] are issued by Ameritas Life. Ameritas, the bison symbol, Dental Rewards, LASIK Advantage and “We’re Ameritas. We’re for people.” are registered service marks of Ameritas Life or Ameritas Mutual Holding Company and are used with permission.
Optional dental coverageYou’re free to visit any licensed dentist. Also,these plans offer customers more than 235,000Ameritas PPO (participating provider organization)access points for dental care nationwide. AmeritasPPO network providers have agreed to chargediscounted fees to our customers, so you can almostalways save money.
When you purchase the plan, you have 10 daysfrom the date you receive your policy to cancel itwith no penalty or obligation except for the onetimeapplication fee. Following that 10-day period,we require that customers make a commitmentthrough the initial 12 monthly periods. Optional dental coverage includes:
» Preventive/Type 1: Routine exams, cleanings, fluoride treatments, sealants, and more.
» Basic/Type 2: X-rays, filling restoration, extractions, and more.
» Major/Type 3 (Platinum, Gold, Silver Plans): Onlays, dentures, denture repair, endodontics—root canal, periodontal scaling and root planing, crown and crown repairs, pontics, fixed bridges, surgical removal of teeth, deep sedation/general
Monthly Rates
Platinum Gold Silver ValueCalendar year maximum $2,500 $1,500 $1,000 $1,000Individual only $46 $36 $26 $16Individual and spouse $92 $72 $52 $32
anesthesia, and more. A six-month waiting period applies to all Type 3 Procedures before benefits are payable.
» Teeth Whitening (Platinum, Gold, Silver Plans): Professional tooth bleaching, also referred to as whitening. With this benefit, customers can have a healthy, white smile that may boost self confidence and enhance their appearance.
» Dental Rewards®: A valuable feature which allows qualifying plan customers to carry over part of their unused annual maximum.
» LASIK Vision Correction: These plans also include access to savings on LASIK vision correction. LASIK Advantage® provides for LASIK and related procedures.
Contact us for more information about enrolling in this optional dental coverage.
BRANDING GUIDELINES
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coredentalSM
10 | mywpsmedicare.com | 1-800-236-8809
Turn
65!Turn
65!
If you apply during your one-time open enrollment period, you won’t need to answer any health questions; simply submit a policy enrollment application.
One-time open enrollment
period ends
You cansubmit an application
or enroll in Part B
66Months
AfterMonths
After
66Months Before
Months Before
Enrollment timeline when you turn 65
WPS Medicare supplement insurance plan monthly premium ratesEffective March 1, 2019Determine your rate area:
Area 1=Detroit area480__: All ZIPs that begin with these 3 numbers481__: All ZIPs that begin with these 3 numbers482__: All ZIPs that begin with these 3 numbers483__: All ZIPs that begin with these 3 numbers484__: All ZIPs that begin with these 3 numbers485__: All ZIPs that begin with these 3 numbers
Area 2=All other Michigan ZIP codes
RelocationIf, in the future, you permanently relocate to another state, Area 1 rates will apply. If you relocate to another Michigan ZIP code, you will pay the rates for the area to which you move.
21
Rating Area
Have other coverage that’s terminating or changing?If so, you may be eligible for guaranteed acceptance of this policy. Contact your agent or call a WPS sales representatives at 1-800-236-8809 for information.
Enroll anytime after you turn 65Already passed the 65-year milestone?You can switch Medicare supplement insurance plans at any time throughout the year. You don’t have to wait for an annual enrollment period like you do with Medicare Advantage plans. If you can answer “no” to simple health questions or if you qualify for guaranteed issue, it’s easy to make the switch! Just contact your agent or call a WPS sales representatives at 1-800-236-8809.
Coverage begins on the first of the month that you turn 65 and/or enroll in Medicare Part B, or on the effective date you request up to six months in the future.
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$20
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4.76
$26
2.73
$24
4.34
$27
0.85
$25
1.89
$24
5.10
$22
7.94
$12
0.32
$11
1.90
$15
2.82
$14
2.12
$21
3.95
$19
8.98
66$
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71$
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61$
270.
60$
251.
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97$
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44$
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43$
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76$
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94$
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96
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211.
12
68
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2.83
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7.09
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5.96
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7.81
$24
9.07
$13
1.50
$12
2.29
$16
6.98
$15
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$23
3.80
$21
7.43
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8.69
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8.68
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7.01
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1.46
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8.46
$43
5.67
$23
0.02
$21
3.91
$29
2.11
$27
1.66
$40
8.97
$38
0.35
84
$41
2.29
$38
3.43
$51
7.24
$48
1.04
$53
3.21
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5.88
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2.49
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8.72
$23
6.92
$22
0.34
$30
0.83
$27
9.77
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1.25
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1.77
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$42
4.66
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4.94
$53
2.75
$49
5.46
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9.20
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0.76
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7.00
$46
2.21
$24
4.04
$22
6.96
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3.89
$40
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586.
73$
545.
66$
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79$
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68 N
/AN
/A N
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/A N
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/A N
/AN
/A N
/AN
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Pla
n N
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
65
$18
3.01
$17
0.19
$22
9.56
$21
3.49
$23
6.65
$22
0.08
$21
4.15
$19
9.16
$10
5.14
$97
.78
$13
3.53
$12
4.18
$18
6.94
$17
3.86
66$
188.
47$
175.
28$
236.
45$
219.
90$
243.
77$
226.
70$
220.
56$
205.
12$
108.
28$
100.
70$
137.
51$
127.
89$
192.
55$
179.
07
67$
194.
14$
180.
55$
243.
55$
226.
50$
251.
09$
233.
51$
227.
18$
211.
28$
111.
55$
103.
74$
141.
66$
131.
74$
198.
33$
184.
45
68
$19
9.95
$18
5.95
$25
0.85
$23
3.29
$25
8.59
$24
0.49
$23
4.02
$21
7.64
$11
4.91
$10
6.86
$14
5.89
$13
5.68
$20
4.31
$19
0.01
69$
205.
95$
191.
53$
258.
38$
240.
29$
266.
36$
247.
72$
241.
05$
224.
18$
118.
36$
110.
08$
150.
29$
139.
77$
210.
42$
195.
69
70$
212.
13$
197.
28$
266.
14$
247.
51$
274.
35$
255.
15$
248.
27$
230.
89$
121.
89$
113.
36$
154.
80$
143.
96$
216.
77$
201.
59
71$
219.
56$
204.
19$
275.
45$
256.
17$
283.
96$
264.
08$
256.
95$
238.
96$
126.
17$
117.
33$
160.
22$
149.
00$
224.
30$
208.
60
72$
228.
33$
212.
35$
286.
44$
266.
39$
295.
32$
274.
65$
267.
25$
248.
54$
131.
22$
122.
04$
166.
62$
154.
96$
233.
29$
216.
96
73$
237.
48$
220.
86$
297.
91$
277.
06$
307.
13$
285.
63$
277.
92$
258.
46$
136.
47$
126.
91$
173.
27$
161.
14$
242.
63$
225.
64
74$
246.
99$
229.
70$
309.
80$
288.
11$
319.
43$
297.
07$
289.
04$
268.
81$
141.
93$
132.
00$
180.
21$
167.
60$
252.
32$
234.
66
75$
256.
86$
238.
88$
322.
21$
299.
66$
332.
19$
308.
94$
300.
60$
279.
55$
147.
59$
137.
26$
187.
43$
174.
31$
262.
44$
244.
07
76$
268.
41$
249.
62$
336.
73$
313.
16$
347.
15$
322.
85$
314.
13$
292.
14$
154.
23$
143.
44$
195.
86$
182.
15$
274.
24$
255.
05
77$
280.
48$
260.
84$
351.
87$
327.
24$
362.
75$
337.
35$
328.
26$
305.
28$
161.
19$
149.
91$
204.
68$
190.
36$
286.
57$
266.
51
78$
293.
11$
272.
59$
367.
70$
341.
96$
379.
06$
352.
53$
343.
04$
319.
03$
168.
42$
156.
63$
213.
89$
198.
91$
299.
47$
278.
51
79$
306.
29$
284.
85$
384.
25$
357.
35$
396.
15$
368.
42$
358.
48$
333.
39$
176.
01$
163.
69$
223.
49$
207.
84$
312.
95$
291.
05
80
$32
0.09
$29
7.68
$40
1.55
$37
3.44
$41
3.96
$38
4.98
$37
4.61
$34
8.38
$18
3.94
$17
1.06
$23
3.56
$21
7.21
$32
7.03
$30
4.13
81$
329.
68$
306.
60$
413.
60$
384.
65$
426.
39$
396.
54$
385.
83$
358.
82$
189.
46$
176.
20$
240.
57$
223.
73$
336.
84$
313.
26
82$
339.
57$
315.
80$
426.
01$
396.
19$
439.
18$
408.
43$
397.
42$
369.
60$
195.
13$
181.
47$
247.
80$
230.
46$
346.
95$
322.
66
83
$34
9.74
$32
5.26
$43
8.80
$40
8.08
$45
2.35
$42
0.68
$40
9.31
$38
0.66
$20
1.00
$18
6.93
$25
5.22
$23
7.36
$35
7.36
$33
2.34
84
$36
0.25
$33
5.03
$45
1.94
$42
0.30
$46
5.92
$43
3.31
$42
1.61
$39
2.09
$20
7.02
$19
2.52
$26
2.89
$24
4.48
$36
8.08
$34
2.31
85+
$37
1.08
$34
5.10
$46
5.51
$43
2.92
$47
9.92
$44
6.32
$43
4.26
$40
3.86
$21
3.23
$19
8.30
$27
0.76
$25
1.81
$37
9.13
$35
2.59
Und
er 6
5$
512.
68$
476.
79$
663.
06$
616.
64N
/AN
/AN
/AN
/AN
/AN
/AN
/AN
/AN
/AN
/A
*Hou
seho
ld: T
wo
or m
ore
indi
vidu
als
who
resi
de to
geth
er in
the
sam
e dw
ellin
g. D
wel
ling
is d
efine
d as
a
sing
le h
ome,
con
dom
iniu
m u
nit,
or a
part
men
t uni
t with
in a
n ap
artm
ent c
ompl
ex.
7% H
ouse
hold
Dis
coun
t: G
et th
e be
st ra
te p
ossi
ble
whe
n yo
u en
roll
with
a
seco
nd m
embe
r of y
our h
ouse
hold
.* Yo
u ea
ch p
ay th
e “Y
ou w
ith D
isco
unt”
ra
te s
how
n be
low
.
Not
e: R
ates
incl
ude
a 2%
dis
coun
t for
cus
tom
ers
who
enr
oll
in a
utom
atic
ban
k w
ithdr
awal
. Tho
se w
ho p
ay b
y cr
edit
card
or
pap
er b
ill w
ill p
ay a
slig
htly
hig
her p
rem
ium
than
thos
e lis
ted
here
. Ple
ase
cont
act u
s w
ith a
ny q
uest
ions
.
Are
a 2
Rat
es—
Mal
e
Age
W
hen
Pla
n Ta
kes
Eff
ect
Pla
n A
Pla
n C
Pla
n F
Pla
n G
Pla
n K
Pla
n L
Pla
n N
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
65
$14
8.23
$13
7.85
$18
5.96
$17
2.94
$19
1.71
$17
8.29
$17
3.48
$16
1.34
$85
.16
$79
.20
$10
8.16
$10
0.59
$15
1.44
$14
0.84
66$
152.
67$
141.
99$
191.
53$
178.
12$
197.
45$
183.
63$
178.
67$
166.
17$
87.7
3$
81.5
9$
111.
43$
103.
63$
155.
99$
145.
07
67$
157.
25$
146.
24$
197.
27$
183.
46$
203.
38$
189.
14$
184.
03$
171.
15$
90.3
7$
84.0
4$
114.
74$
106.
71$
160.
67$
149.
42
68
$16
1.98
$15
0.65
$20
3.20
$18
8.98
$20
9.48
$19
4.82
$18
9.56
$17
6.29
$93
.07
$86
.56
$11
8.19
$10
9.91
$16
5.48
$15
3.90
69$
166.
82$
155.
14$
209.
27$
194.
62$
215.
76$
200.
65$
195.
25$
181.
58$
95.8
6$
89.1
5$
121.
75$
113.
22$
170.
45$
158.
52
70$
171.
83$
159.
80$
215.
56$
200.
47$
222.
25$
206.
70$
201.
11$
187.
03$
98.7
4$
91.8
3$
125.
39$
116.
61$
175.
57$
163.
28
71$
177.
85$
165.
40$
223.
12$
207.
50$
230.
01$
213.
91$
208.
14$
193.
57$
102.
19$
95.0
4$
129.
77$
120.
69$
181.
71$
168.
99
72$
184.
97$
172.
02$
232.
04$
215.
80$
239.
21$
222.
46$
216.
47$
201.
32$
106.
29$
98.8
5$
134.
98$
125.
53$
188.
99$
175.
76
73$
192.
36$
178.
90$
241.
33$
224.
43$
248.
78$
231.
37$
225.
13$
209.
37$
110.
54$
102.
81$
140.
37$
130.
54$
196.
55$
182.
79
74$
200.
06$
186.
05$
250.
98$
233.
41$
258.
72$
240.
61$
234.
13$
217.
74$
114.
97$
106.
93$
145.
98$
135.
76$
204.
40$
190.
09
75$
208.
05$
193.
49$
260.
99$
242.
72$
269.
09$
250.
25$
243.
51$
226.
46$
119.
56$
111.
19$
151.
82$
141.
19$
212.
57$
197.
69
76$
217.
43$
202.
21$
272.
75$
253.
66$
281.
19$
261.
51$
254.
46$
236.
65$
124.
95$
116.
20$
158.
64$
147.
54$
222.
15$
206.
60
77$
227.
19$
211.
29$
285.
02$
265.
07$
293.
85$
273.
28$
265.
90$
247.
29$
130.
56$
121.
42$
165.
80$
154.
19$
232.
15$
215.
90
78$
237.
42$
220.
80$
297.
87$
277.
02$
307.
07$
285.
58$
277.
87$
258.
42$
136.
43$
126.
88$
173.
24$
161.
12$
242.
57$
225.
59
79$
248.
13$
230.
76$
311.
25$
289.
46$
320.
89$
298.
43$
290.
39$
270.
07$
142.
58$
132.
60$
181.
05$
168.
37$
253.
50$
235.
75
80
$25
9.28
$24
1.13
$32
5.26
$30
2.49
$33
5.33
$31
1.85
$30
3.43
$28
2.19
$14
9.00
$13
8.57
$18
9.21
$17
5.96
$26
4.92
$24
6.38
81$
267.
05$
248.
36$
335.
03$
311.
58$
345.
38$
321.
20$
312.
54$
290.
66$
153.
46$
142.
72$
194.
86$
181.
22$
272.
86$
253.
76
82$
275.
06$
255.
80$
345.
08$
320.
92$
355.
75$
330.
85$
321.
91$
299.
38$
158.
06$
147.
00$
200.
72$
186.
67$
281.
04$
261.
37
83
$28
3.33
$26
3.49
$35
5.43
$33
0.55
$36
6.42
$34
0.77
$33
1.57
$30
8.36
$16
2.81
$15
1.41
$20
6.75
$19
2.28
$28
9.47
$26
9.21
84
$29
1.81
$27
1.39
$36
6.11
$34
0.48
$37
7.41
$35
0.99
$34
1.51
$31
7.60
$16
7.70
$15
5.96
$21
2.92
$19
8.02
$29
8.17
$27
7.29
85+
$30
0.58
$27
9.54
$37
7.07
$35
0.68
$38
8.73
$36
1.52
$35
1.77
$32
7.15
$17
2.73
$16
0.64
$21
9.33
$20
3.98
$30
7.10
$28
5.61
Und
er 6
5$
415.
28$
386.
21$
537.
08$
499.
48 N
/AN
/A N
/AN
/A N
/AN
/A N
/AN
/A N
/AN
/A
*Hou
seho
ld: T
wo
or m
ore
indi
vidu
als
who
resi
de to
geth
er in
the
sam
e dw
ellin
g. D
wel
ling
is d
efine
d as
a
sing
le h
ome,
con
dom
iniu
m u
nit,
or a
part
men
t uni
t with
in a
n ap
artm
ent c
ompl
ex.
7% H
ouse
hold
Dis
coun
t: G
et th
e be
st ra
te p
ossi
ble
whe
n yo
u en
roll
with
a
seco
nd m
embe
r of y
our h
ouse
hold
.* Yo
u ea
ch p
ay th
e “Y
ou w
ith D
isco
unt”
ra
te s
how
n be
low
.
Not
e: R
ates
incl
ude
a 2%
dis
coun
t for
cus
tom
ers
who
enr
oll
in a
utom
atic
ban
k w
ithdr
awal
. Tho
se w
ho p
ay b
y cr
edit
card
or
pap
er b
ill w
ill p
ay a
slig
htly
hig
her p
rem
ium
than
thos
e lis
ted
here
. Ple
ase
cont
act u
s w
ith a
ny q
uest
ions
.
Are
a 2
Rat
es—
Fem
ale
Age
W
hen
Pla
n Ta
kes
Eff
ect
Pla
n A
Pla
n C
Pla
n F
Pla
n G
Pla
n K
Pla
n L
Pla
n N
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
You
You
with
D
isco
unt
65
$12
9.53
$12
0.46
$16
2.48
$15
1.11
$16
7.50
$15
5.78
$15
1.58
$14
0.97
$74
.42
$69
.21
$94
.51
$87
.90
$13
2.32
$12
3.06
66$
133.
40$
124.
06$
167.
36$
155.
65$
172.
54$
160.
46$
156.
11$
145.
19$
76.6
4$
71.2
7$
97.3
3$
90.5
2$
136.
29$
126.
75
67$
137.
42$
127.
80$
172.
38$
160.
32$
177.
72$
165.
28$
160.
80$
149.
54$
78.9
6$
73.4
3$
100.
26$
93.2
5$
140.
38$
130.
55
68
$14
1.52
$13
1.62
$17
7.56
$16
5.13
$18
3.03
$17
0.22
$16
5.64
$15
4.04
$81
.33
$75
.64
$10
3.26
$96
.03
$14
4.61
$13
4.49
69$
145.
77$
135.
56$
182.
88$
170.
08$
188.
53$
175.
34$
170.
62$
158.
67$
83.7
8$
77.9
2$
106.
38$
98.9
3$
148.
93$
138.
51
70$
150.
15$
139.
64$
188.
38$
175.
19$
194.
19$
180.
59$
175.
72$
163.
42$
86.2
8$
80.2
4$
109.
56$
101.
89$
153.
43$
142.
69
71$
155.
41$
144.
53$
194.
96$
181.
31$
200.
99$
186.
92$
181.
87$
169.
14$
89.3
0$
83.0
5$
113.
41$
105.
47$
158.
76$
147.
65
72$
161.
61$
150.
30$
202.
74$
188.
55$
209.
03$
194.
40$
189.
16$
175.
92$
92.8
7$
86.3
7$
117.
93$
109.
68$
165.
12$
153.
56
73$
168.
09$
156.
32$
210.
86$
196.
10$
217.
38$
202.
17$
196.
72$
182.
95$
96.5
9$
89.8
3$
122.
65$
114.
06$
171.
74$
159.
71
74$
174.
82$
162.
58$
219.
28$
203.
93$
226.
10$
210.
27$
204.
58$
190.
26$
100.
46$
93.4
3$
127.
56$
118.
63$
178.
60$
166.
09
75$
181.
80$
169.
07$
228.
07$
212.
10$
235.
12$
218.
66$
212.
76$
197.
86$
104.
46$
97.1
5$
132.
66$
123.
38$
185.
76$
172.
76
76$
189.
98$
176.
68$
238.
34$
221.
65$
245.
71$
228.
51$
222.
34$
206.
78$
109.
16$
101.
52$
138.
63$
128.
93$
194.
11$
180.
52
77$
198.
52$
184.
62$
249.
06$
231.
62$
256.
75$
238.
78$
232.
34$
216.
07$
114.
09$
106.
11$
144.
87$
134.
73$
202.
83$
188.
63
78$
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47$
192.
94$
260.
26$
242.
04$
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30$
249.
52$
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80$
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81$
119.
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86$
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39$
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79$
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96$
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13
79$
216.
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62$
271.
97$
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93$
280.
39$
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76$
253.
73$
235.
97$
124.
58$
115.
86$
158.
18$
147.
11$
221.
51$
206.
00
80
$22
6.56
$21
0.70
$28
4.21
$26
4.32
$29
3.00
$27
2.49
$26
5.15
$24
6.59
$13
0.19
$12
1.08
$16
5.32
$15
3.74
$23
1.47
$21
5.26
81$
233.
35$
217.
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292.
75$
272.
25$
301.
80$
280.
67$
273.
09$
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97$
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10$
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72$
170.
28$
158.
36$
238.
41$
221.
73
82$
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35$
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52$
301.
53$
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42$
310.
85$
289.
09$
281.
29$
261.
60$
138.
11$
128.
44$
175.
39$
163.
11$
245.
57$
228.
38
83
$24
7.55
$23
0.22
$31
0.58
$28
8.84
$32
0.18
$29
7.76
$28
9.71
$26
9.43
$14
2.27
$13
2.31
$18
0.64
$16
8.00
$25
2.94
$23
5.23
84
$25
4.99
$23
7.14
$31
9.88
$29
7.49
$32
9.78
$30
6.70
$29
8.41
$27
7.52
$14
6.53
$13
6.27
$18
6.07
$17
3.05
$26
0.52
$24
2.29
85+
$26
2.65
$24
4.26
$32
9.49
$30
6.42
$33
9.69
$31
5.91
$30
7.37
$28
5.85
$15
0.92
$14
0.36
$19
1.65
$17
8.23
$26
8.35
$24
9.57
Und
er 6
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362.
87$
337.
47$
469.
31$
436.
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Dis
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1-800-236-8809 | mywpsmedicare.com | 15
Parts of Medicare
The Medicare program has several different parts, which can be confusing if you’re unfamiliar with them. A Medicare supplement insurance plan works with your Medicare Part A and Part B coverage.
Part A Part B Part D
• Hospital care• Skilled nursing
facility care• Nursing home care• Hospice• Home health services
• Medically necessary outpatient services to diagnose or treat your medical condition
• Most preventive outpatient services, including an annual wellness exam
• Stand-alone prescription drug plans (PDP) help pay for medications
• Mail order options and access to retail pharmacies nationwide
Limitations and exclusionsNo insurance policy covers everything. Here’s a list of things this Medicare supplement doesn’t cover:
• Personal comfort items• Routine physical exams and any related diagnostic, X-ray,
and laboratory tests except those covered by Medicare• Eye exams or hearing exams, except for those services
covered by Medicare• Orthopedic shoes or other supporting devices for
the feet• Routine foot care not covered by Medicare• Custodial care, including maintenance care or
supportive care• Cosmetic surgery, except as stated in the policy• Outpatient prescription drugs• Professional services not provided by a physician, except
as required by law• Routine immunizations, except if eligible under Medicare
and except as stated in the policy• Preparation, fitting, or purchase of eyeglasses or hearing
aids, unless covered by Medicare• Care, treatment, filling, removal, or replacement of teeth;
dental X-rays, root canals, surgery for impacted teeth, or other surgical procedures to the teeth or supporting structures
• Nursing home care costs beyond what is covered by Medicare
• If you terminate your Medicare coverage, expenses which would have been covered by Medicare
• Your Medicare Part A deductible, unless you purchase full or partial coverage of the Medicare Part A deductible
• Your Medicare Part B deductible, unless you purchase Plan C or F
• Physician charges above Medicare’s approved charge, unless you purchase Plan F or G
• Home health care beyond what is covered by Medicare• Any health care treatments, services, or supplies received
outside the United States, unless you purchase Plan C, F, G, or N
• Any health care treatments, services, or supplies:- Not covered by Medicare, unless specifically stated in
the policy- You, or anyone on your behalf, aren’t legally obligated
to pay for- Paid for by Medicare or another government entity or
program- For any injury, occurring on or after your effective date,
caused by an act of war- Provided by immediate family members or by anyone
else who lives with you- To the extent covered by workers’ compensation or
similar laws- Provided before the effective date of coverage or
after coverage ends- Determined by Medicare to be unreasonable or
unnecessary- For a military service-related condition treated at
any military or veterans hospital, or at any hospital contracted by any national government or agency
This is an advertisement for insurance. Neither Wisconsin Physicians Service Insurance Corporation, nor its products, nor agents are connected with or endorsed by the United States government or the federal Medicare program. This plan summary provides only a general description of benefits and limitations. A detailed description of coverage is in the applicable policy. If there is ever a discrepancy between the policy and this document, the policy has final authority.
Medicare supplements give you peace of mindOriginal Medicare covers a lot—about 80% of your approved health care costs. But covering even just the 20% that Medicare leaves behind can be a real burden and hassle. WPS Medicare supplement insurance plans help reduce these out-of-pocket costs when you need medical care.
Join our WPS Medicare supplement insurance plan family today and get worry-free peace of mind you’ll enjoy for years to come!
Ready to take the next step?Contact your local agent or call WPS today at 1-800-236-8809.
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