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WI

Wisconsin Medicare Coverage Guide

Find dental, vision, hearing aid, and nursing home Medicare benefits available to Wisconsin residents.

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Wisconsin Dental Coverage

Moderate

Wisconsin Medicaid covers dental for dual-eligible beneficiaries. Marquette University School of Dentistry in Milwaukee is a top regional dental school.

Available Programs

  • Wisconsin Medicaid Dental
  • Medicare Advantage dental plans
  • Marquette University School of Dentistry

Typical Out-of-Pocket Cost

$400โ€“$1,800/year

Costs vary by plan, provider, and income. Dual-eligible (Medicare + Medicaid) beneficiaries often pay much less.

Tips for Wisconsin Residents

  1. Marquette dental school in Milwaukee offers quality low-cost care
  2. Wisconsin SHIP (1-800-242-1060) for plan guidance
  3. Competitive MA markets in Milwaukee and Madison
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Wisconsin Vision Coverage

Moderate

Wisconsin Medicaid covers vision for dual-eligible members. Competitive MA market in Milwaukee and Madison.

Available Programs

  • Wisconsin Medicaid vision
  • Medicare Advantage vision
  • Wisconsin Council of the Blind and Visually Impaired

Typical Out-of-Pocket Cost

$150โ€“$350/year

Costs vary by plan, provider, and income. Dual-eligible (Medicare + Medicaid) beneficiaries often pay much less.

Tips for Wisconsin Residents

  1. WCBVI: 608-255-1166 for vision resources
  2. University of Wisconsin Eye Clinic offers specialized care
  3. Wisconsin SHIP: 1-800-242-1060
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Wisconsin Hearing Aids Coverage

Limited

Wisconsin MA plans offer hearing benefits. Wisconsin has good audiology resources in Milwaukee and Madison.

Available Programs

  • Medicare Advantage hearing plans
  • Wisconsin Association of the Deaf
  • Wisconsin Assistive Technology Initiative

Typical Out-of-Pocket Cost

$1,000โ€“$6,500 per pair

Costs vary by plan, provider, and income. Dual-eligible (Medicare + Medicaid) beneficiaries often pay much less.

Tips for Wisconsin Residents

  1. WATI: 800-991-8731 for assistive technology
  2. OTC hearing aids available statewide
  3. Wisconsin SHIP: 1-800-242-1060
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Wisconsin Nursing Home Coverage

Not Covered

Medicare Part A covers SNF. Wisconsin Medicaid covers long-term care. Wisconsin has strong PACE and IRIS programs for home-based care.

Available Programs

  • Medicare Part A SNF
  • Wisconsin Medicaid LTC
  • PACE Wisconsin (Milwaukee, Madison)
  • IRIS self-directed care
  • Wisconsin SHIP (1-800-242-1060)

Typical Out-of-Pocket Cost

$240โ€“$320/day semi-private

Costs vary by plan, provider, and income. Dual-eligible (Medicare + Medicaid) beneficiaries often pay much less.

Tips for Wisconsin Residents

  1. IRIS program allows self-directed home-based care
  2. PACE programs in Milwaukee and Madison areas
  3. Wisconsin SHIP: 1-800-242-1060
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๐Ÿ“Š Live CMS Data Wisconsin Medicare Snapshot

Source: CMS Medicare Monthly Enrollment 2024 & CMS MA Landscape 2025 โ€” public data from data.cms.gov

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1,316,127
Total Medicare Beneficiaries (2024)
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749,027
Enrolled in Medicare Advantage (2024) 56.9% of total
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567,100
Original Medicare (Parts A & B) Only
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180,950
Dual Eligible (Medicare + Medicaid)
2025 Medicare Advantage Plans
89
Plans available in Wisconsin
Average Monthly Premium (2025)
$12.9
Weighted avg across all MA plans
Top Medicare Advantage Insurers
  1. Common Ground Healthcare
  2. UnitedHealth
  3. Anthem BCBS
Free SHIP Counseling
Wisconsin SHIP
1-800-242-1060
Free, unbiased Medicare help

Get Free Help in Wisconsin

SHIP Counseling

Your state's State Health Insurance Assistance Program (SHIP) offers free, unbiased Medicare counseling from trained volunteers. They can help you compare plans and enroll.

Find Wisconsin SHIP โ†’

1-800-MEDICARE

Call 1-800-633-4227 (TTY: 1-877-486-2048) 24/7 for Medicare questions, plan comparisons, and enrollment help. Free and official.

Medicare.gov โ†’

Medicare Plan Finder

Use the official Medicare Plan Finder tool at Medicare.gov to compare all Medicare Advantage, Part D, and Medigap plans available in Wisconsin by ZIP code.

Compare Plans โ†’

Nursing Home Compare

Research and compare nursing home quality ratings, staffing levels, health inspection results, and more for facilities across Wisconsin.

Care Compare โ†’