Top Rated Medicare Special Needs Plans in Wisconsin
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Find Plans in your area with your ZIP Code
Use our zip code lookup above to see which plans are available in your region. Or click below to select your county. Keep reading to learn more about Wisconsin's Special Needs Plans program.
How-To Enroll in a Wisconsin Special Needs Plan
Most people living in Wisconsin, age 65 and older, qualify for Medicare Advantage but do not qualify for a Special Needs Plan (SNP). A SNP is a Medicare Advantage plan, but they are only available to people with one of the following special needs:
- Chronic Condition (C-SNP): You have one or more severe or disabling chronic conditions.
- Institutional (I-SNP): You live in an institution (like a nursing home), or you require nursing care at home.
- Dual Eligible (D-SNP): You have both Medicare and Medicaid.
Compare 2025 Special Needs Plans in Wisconsin by County
Each SNP limits membership to people in one of these groups or a subset of one of these groups. For instance, a SNP that's designed to serve people with congestive heart failure might include access to a network of healthcare providers who specialize in treating congestive heart failure. Such a plan would also feature clinical case management that's designed to serve people with this condition.
You can get enrolled three ways:
- Call a plan directly. If you know the plan you want, this way is quick and easy.
- Go to www.Medicare.gov and enroll through the government website. From there you can look up your medications, compare plans, and get your application started online.
- Use an independent Wisconsin insurance agent. This is the best way to go if you need someone to help advise you.
If You Don't Qualify for SNP
If you don't qualify to enroll in a Special Needs Plan, you have other options, including:
Find Plans in your area with your ZIP Code
Frequently Asked Questions
Still have questions? These common questions and answers might help. Or, call 1-855-728-0510 (TTY 711) to speak with a licensed advisor.
What are the three types of Medicare special needs plans?
There are three types of Medicare Special Needs Plans (SNPs). Each type has different eligibility requirements. The SNP plan options are Chronic Condition Special Needs Plan (C-SNPs), Institutional Special Needs Plan (I-SNP), and Dual-Eligible Special Needs Plan (D-SNP).
Are SNP and D-SNP plans the same thing?
SNPs are Medicare Advantage private health plans that cater to individuals with special needs. There are three types of SNP plans: D-SNP for dual-eligible (Medicare or Medicaid) individuals; I-SNP plans to support people who are institutionalized or homebound; and C-SNP plans that support people with certain chronic conditions. Learn how to qualify.
What are the advantages of a SNP plan?
SNPs, like all Medicare Advantage plans sold in Wisconsin, must provide the same benefits as Medicare Part A and Part B. But, unlike regular Medicare Advantage plans, all SNPs must provide Part D benefits for outpatient prescriptions. Other benefits are dependent on the plan type. D-SNP plans are designed to coordinate Medicare and Medicaid benefits for dual-eligible people. Many plans also cover dental, vision, and hearing.
Citations & References
medicare.gov- CMS.gov, "2024 Medicare Part C Landscape Source Files", Last Accessed October 14, 2023
- Medicare.gov: the official U.S. government site for Medicare | Medicare http://www.medicare.gov/
- Find a Medicare plan https://www.medicare.gov/plan-compare/
- Medicare Benefits | SSA https://www.ssa.gov/medicare/
- Extra Help with Medicare Prescription Drug Plan Costs | SSA https://www.ssa.gov/medicare/prescriptionhelp/
- Medicare Benefits | SSA https://www.ssa.gov/benefits/medicare/
- Five-Star Quality Rating System | CMS https://www.cms.gov/medicare/provider-enrollment-and-certification/certificat...
- https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS10106.pdf
- Medicare Open Enrollment | CMS https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-h...
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.