A "traditional" Individual/Group Medicare Supplement does not restrict the ability to receive services from a provider the beneficiary chooses as long as the doctor/provider accepts Medicare.
A Medicare Select policy is similar to a traditional Medicare supplement, however, a Medicare select policy pays supplemental benefits only if covered services are obtained through doctors or providers contracted by the insurance company or health maintenance organization (HMO) except in cases of emergency services.
A High-Deductible Medicare Supplement policy provides benefits after a calendar year deductible has been paid by the beneficiary. The deductible consists of all expenses that would ordinarily be paid by a full coverage Medigap policy. Once the deductible amount is met, the policy will pay 100% of costs like a "normal" traditional Supplement. The deductible amount is adjusted annually.
In a Medicare Supplement / Select Cost-Sharing policy (K&L policy), the beneficiary will pay either a 25% or 50% cost-sharing amount on the remaining balance after Medicare covers its share on Medicare approved services. The beneficiary continues to pay the cost-sharing amounts until that year's out-pocket-maximum amounts have been met, at which time the policy will continue to cover the costs for services after Medicare.
A Medicare Cost policy offered by HMOs, have entered into a special arrangement with the federal Centers for Medicare & Medicaid (CMS). These HMOs agree to provide Medicare benefits. A Medicare cost policy will pay full supplemental benefits if covered services are obtained through the HMO plan's contracted doctors or providers, called the plan's "network". A beneficiary is not "locked" in to the HMO's providers, however, if he/she choose to use services outside of the network, the beneficiary will be responsible for the out of pocket co-insurance and deductibles after Original Medicare. To obtain coverage for Wisconsin Mandated benefits or to minimize any out of pocket copays/coinsurance, beneficiaries may need to purchase the "Enhanced" policy or the additional mandated benefit rider.
Wisconsin Guide to Health Insurance for People with Medicare
Medicare Supplement Insurance Approved Policies List
