Medicare Supplement Insurance — Wisconsin

Medicare Supplement Insurance is currently available through State Farm Mutual Automobile Insurance Company. Details about coverages and benefits are listed below. Please read a brief description of the Medicare Supplement Insurance plans State Farm® offers in Wisconsin.

State Farm Medicare Supplement insurance is designed to cover the gaps in Medicare, helping to pay deductibles, coinsurance and copayment amounts not covered by Medicare. Once you have a Medicare Supplement plan, both your plan and Medicare help pay your covered medical expenses, lowering your out-of-pocket costs and giving you the confidence that your health insurance needs are met.

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Basic Medicare Supplement Policy

Part A coinsurance, plus coverage for 365 days after Medicare hospital benefits end
Part A inpatient mental health coverage for 175 days (lifetime) after Medicare inpatient benefits end
Skilled nursing facility coinsurance
Part B coinsurance
Hospice care coinsurance
First three (3) pints of blood each year
Home Care: coverage for the usual and customary charges for qualified home care (up to 40 visits per 12–month period)
State mandated benefits that include, but are not limited to, 30 additional days of skilled nursing facility care when certified as medically necessary, preventive care ($150 per year) and diabetic self-management education

Additional Benefits Available Through Rider

Part A inpatient hospital deductible
Medicare Part B excess charges — 100% of the excess charge above Medicare's reasonable charge if medical provider does not accept Medicare assignment, subject to Federal/State mandated limits
Additional home health care — up to 365 visits in a 12–month period
Foreign travel emergency coverage — 80% of the cost of emergency care beginning during first 60 days of each trip (after you pay the $250 deductible, subject to $50,000 lifetime maximum), if such care would have been covered by Medicare if provided in the U.S.

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Changing a Health Insurance Policy

This is a marketing tool intended for use in the sale of insurance. Completion of an application for a State Farm insurance policy will require contact with a State Farm agent/licensed insurance producer.

In some states coverage is available if you are under age 65 and are Medicare eligible due to disability and/or End Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). These policies are not connected with or endorsed by the U.S. Government or the Federal Medicare program. This information is only a general description of coverage. It is not a contract and certain exclusions and limitations apply. A complete statement of coverage is found only in the policy. Policy coverage's, exclusions and limitations may vary in some states. For exact terms and conditions see: Medicare Supplement Insurance Policy series 97049HWI1. For additional details on coverage and cost, contact a State Farm agent/licensed insurance producer.

State Farm Mutual Automobile Insurance Company
Bloomington, IL

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