Senior Choice

Medicare provides medical coverage for people eligible for Part A and enrolled in Part B.

However, Medicare pays only a portion of most medical bills. You’ll still have deductibles and coinsurance costs to cover.

Senior Choice is a Medicare Supplement (Medigap) plan. It helps to cover some of the extra charges not paid for by Medicare.

With Senior Choice you can –

  • Go to any healthcare provider of your choice who accepts Medicare. Senior Choice does not require a provider network.
  • Live outside of the state of Wisconsin for extended periods of time. The plan is available to anyone who is a resident of the state of Wisconsin on the date Senior Choice coverage is effective.
  • Work with a health insurance advisor to learn about the plans and enroll.
Eligibility and Enrollment

You are eligible to enroll in Senior Choice if you are disabled or age 65 and older, enrolled in Medicare Parts A and B and a Wisconsin resident on the initial effective date of the policy. You cannot be covered by Medicaid (BadgerCare) or a Medicare Advantage plan and also have Senior Choice.

Open Enrollment Period

Each Medicare beneficiary has an Open Enrollment Period. During this time, enrollment in a Medicare Supplement plan is guaranteed, and a supplement plan cannot turn down the applicant's enrollment request (as long as all other eligibility criteria are met). This period lasts ten calendar months and includes the:

  • Three calendar months before enrolling in Medicare Part B
  • One calendar month of enrollment in Medicare Part B
  • Six calendar months immediately following the month of enrollment in Medicare Part B

Special Enrollment Periods

This type of enrollment occurs when an individual loses other health insurance coverage. In this case, the individual will receive a notice from their prior insurance company indicating they are eligible to sign up for a Medicare Supplement plan and that they are guaranteed coverage (the plan cannot turn down the applicant's enrollment request based on health factors).

A copy of the notice is attached to the application and both the application and notice must be received by Senior Choice no later than 63 days following the end of coverage.

Other Enrollment Periods

If an individual is enrolling outside of either an Open or Special enrollment period, the application will be reviewed to determine whether the plan will accept the applicant, based on health factors.

Effective Dates

Coverage with Senior Choice will begin the first of the month following the completion of an application, unless a member requests a different date (as coverage can actually begin on any day of the month).

An effective date can also be delayed and begin up to three months following the date of the application, if a member chooses.

To learn more about Senior Choice and to enroll, contact a Senior Choice health insurance advisor.

Frequently Asked Questions

Can Senior Choice increase member premiums?

Yes, Medicare Supplement policy premiums can increase each year on the renewal date of the plan, on the birthday of the member or if the member moves into a new rating area. Otherwise, premiums can only be raised if they are also raised for all similar policies in the state. Senior Choice chooses not to increase premiums on birthdays.

Is Medicare Supplement open enrollment the same as Medicare?

No. To learn more about the Senior Choice Enrollment Periods, review the Eligibility and Enrollment section above.

Can a member get all Medicare Part B expenses covered by selecting the Part B Deductible Rider and the Part B Copay/Coinsurance Rider?

No, a member can only elect one Part B optional rider. This is mandated by the State of Wisconsin.

How do I obtain an Outline of Coverage?

You can view an Outline of Coverage here. Contact a Senior Choice health insurance advisor to review the Outline of Coverage document. You can also contact an Account Executive at (800) 926-8277.

Does Senior Choice offer Part D prescription coverage?

No, Senior Choice does not offer prescription coverage. A Part D prescription plan must be purchased separately. Gundersen Health Plan offers a Medicare Advantage product, Senior Preferred. Senior Preferred does have plan options that include Part D prescription coverage.

What if I want to make a change to my Senior Choice plan?

If you are a current Senior Choice member and want to make a plan change throughout the year, please contact your agent and they will work with you to complete the appropriate forms.

What if I want to terminate my Senior Choice plan?

Requests to terminate coverage need to be submitted in writing. You can submit a letter or print and complete the Senior Choice Waiver of Coverage Form. Please send your request by mail or fax to:

Mail:

Attn: Senior Choice
840 Carolina Street
Sauk City, WI 53583

Fax Number: (608) 643-2564
Customer Service Phone: (800) 362-3310


This health plan is underwritten by Gundersen Health Plan, Inc.