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WPS Medicare

WPS stands for the Wisconsin Physicians Service Insurance Corporation, a health insurance company headquartered in Wisconsin. This company offers traditional Medicare Part D and Medigap plans but also provides Medicare Parts A & B benefit administration as well as other Medicare-related contracting work. Additionally, WPS has offerings in the individual health insurance market, Medicaid, and TRICARE.

WPS was founded in 1946. The company is headquartered in Madison, Wisconsin. WPS has three wholly owned subsidiaries:

  • Arise Health Plan
  • EPIC Life Insurance Company
  • WPS Community Bank

WPS Medicare Plans

With respect to Medicare insurance coverage, WPS offers Medicare Part D prescription drug plans and Medicare Supplement (i.e. Medigap) plans. The WPS corporate web site claims 24,000 enrollees in the company’s Medicare Part D plans and 35,000 enrollees in the company’s Medicare Supplement plans.

WPS' MedicareRx stand-alone prescription drug plans are the only Part D plans in Wisconsin to have a 5-star rating in the 2015 plan year. The 5-star rating means Wisconsin Medicare beneficiaries can switch to the WPS MedicareRx plans any time during the year, not just during the normal Medicare annual enrollment period.

In Wisconsin, the 10 standard Medicare Supplement plan designs are not used. In Wisconsin residents who are Medicare eligible have guaranteed issue rights to buy a Medicare Supplement policy. Wisconsin has one type of Medicare Supplement policy, the Basic plan, but it has optional riders that can be purchased for additional benefits.

Basic benefits

Inpatient hospital care: Covers the Part A coinsurance fees

Medical costs: Covers the Part B coinsurance fees (generally 20% of the Medicare-approved amount)

Blood: Covers the first 3 pints of blood each year

Part A hospice coinsurance fees or copayments are covered

Insurance companies are allowed to offer the following optional riders to a Basic Plan policy in Wisconsin:

  • Full Part A deductible coverage or 50% Part A deductible coverage
  • Additional home health care (365 visits including those paid by Medicare)
  • Part B deductible coverage
  • Part B excess charges coverage
  • Foreign travel emergency coverage