Great views, great ways to relax on Sunday morning, great cheese. Madison, Wisconsin has it all! But how does Madison hold up when it comes to medical costs and healthcare accessibility? The answer is: not too well. Unfortunately, thousands of seniors in Madison are currently going without the proper insurance programs that they need in order to stave off poverty and poor health. However, there are thousands of other seniors in the area that don’t suffer from these circumstances. What is the difference between these two groups of people? One has Medicare Advantage or Medigap supplement insurance and the other doesn’t. While the former group typically enjoys high-quality healthcare at little to no cost, the latter tends to either pay fully out of pocket during the Medicare coverage gap or go without healthcare altogether. Let’s take a look at the specific numbers below to get a better idea of where you fit in:

Facts and Figures

  • As of right now, there are 28,643 seniors living in Madison, Wisconsin.
  • There are a grand total of 10 hospitals at which seniors in Madison can receive emergency and/or in-patient care.
  • 39% of Wisconsin seniors have a Medicare Advantage plan.
  • 26% of Wisconsin seniors have a Medicare Supplement (Medigap) plan.
  • That leaves 35% of seniors uninsured or underinsured against costly Medicare coverage gaps!

Judging from these numbers, it looks like Madison is one of the healthiest places in the country, at least in terms of access to healthcare. However, the only reason for this is that the overwhelming majority of seniors in the area have already taken care of securing their healthcare coverage options. In reality, there are still more than 10,000 seniors who lack the necessary access to healthcare. For senior citizens, this can mean the difference between an end to your retirement and other much worse consequences. This becomes particularly troublesome when combined with the fact that there are a wide number of diseases, illnesses, and disorders that become more frequent and/or more severe as you age, catching seniors in a sort of double jeopardy. For a better understanding of the prevalence of a few of these diseases, consult the chart below.

Disease Prevalence in Madison
Arthritis 18%
High Blood Pressure 23%
Coronary Heart Disease 5%
Diabetes 7%
Kidney Disease 2%

Healthcare Costs in Madison, WI

Each of these diseases are what researchers in the healthcare field refer to as “age-related illnesses.” What does that mean? To put it simply, every single one of these diseases becomes more frequent and/or more severe with age. For example, although only 2% of seniors in Madison currently suffer from chronic kidney disease, that number could increase with each year as the number of people in the “65 years and older” category increases. Of course, when the frequency and severity of a disease increases, so too do the costs associated with treating that disease. There are a wide number of reasons as to why this happens, one of which being that seniors today are living far longer than seniors of yesteryear, a phenomenon that allows the frequency and severity of age-related illnesses to increase over a longer period of time, which further increases the costs of the treatments necessary to enable a longer life. Thus, the cycle continues.

Disease Prevalence in Madison Annual Cost of Treatment
Arthritis 18% $280
High Blood Pressure 23% $288
Coronary Heart Disease 5% $8,105
Diabetes 7% $2,158
Kidney Disease 2% $9,130

Medicare Advantage Savings in Madison, WI

When confronted with the option to switch from original Medicare to Medicare Advantage, many seniors balk at the idea of swapping out one government program that’s been failing them for another version of the same thing. However, Medicare Advantage couldn’t be more different. Although Medicare Advantage plans are required by law to cover all of the same things as original Medicare, Medicare Advantage plans are privately owned and privately operated. Aside from controlling the minimum coverage availabilities, the government has almost no control over your Medicare Advantage plan, meaning that your healthcare choices become entirely yours to make. Furthermore, many providers of Medicare Advantage plans also offer the option to increase coverage benefits by paying a little extra each month. Paying a little extra might seem like the exact opposite of what you’re looking to do, but keep in mind that the government will likely end up paying most or all of your premiums, turning that “little extra” into an average monthly premium of $0.

Medicare Advantage can also help you get out of the Medicare coverage gaps in a wide variety of Original Medicare fields, including prescription drug coverage. Where Original Medicare falls short of covering your medications, leaving you with the option to either spend all of your retirement savings before reaching late retirement or to go without healthcare altogether, Medicare Advantage plans enable to fill as many prescriptions as your need each month in order to maintain perfect health. In addition to covering prescription drugs, many Medicare Advantage plans also cover the “miscellaneous” expenses associated with chronic illnesses, such as the purchase of glucose monitors and testing strips. This is one of the main reasons why seniors with chronic health conditions (such as diabetes and kidney disease) turn to Medicare Advantage plans rather than struggling for air on Original Medicare. Over the five- and ten-year periods, Medicare Advantage can save you thousands of dollars.

Another benefit that Medicare Advantage plans have other other Medicare plans is that they enable you to add on vision and dental care as well. Through options such as this, you stand to save even more money in both the short and long terms. This is an option that isn’t even available or offered in original Medicare or Medicare Supplement (Medigap) plans. What this means for you is no more wondering whether you’re going to have to take a second disbursement from your 401(k) this month in order to see a dentist about that toothache that’s been bothering you. With most Medicare Advantage plans, you could simply call up your favorite doctor and schedule a visit.

Medicare Supplement (Medigap) Savings in Madison, WI

Medicare Supplement policies, on the other hand, are not quite as comprehensive as Medicare Advantage; however, they offer quite a bit of versatility in order to ensure that all of your needs are met. Since many of these policies are easier to find, secure, and afford (assuming you don’t qualify for a $0-per-month premium rate through Medicare Advantage), they make a great option for seniors who are looking to boost their access to healthcare without losing their current Medicare providers, hence the moniker “Medicare Supplement.” Many such plans are designed specifically to alleviate the burdens of Medicare Part A expenses, such as hospital visits, because Medicare Part A costs can be exceptionally high and unaffordable for all seniors, particularly those with age-related heart and kidney diseases.

Medigap supplement plans A, D, K, and L all fall into this category. These plans are ideal for seniors who have been spending a lot of money on Medicare Part A coverage gaps and little (if any) funds elsewhere. Unfortunately, these plans only apply to Medicare Part A costs and don’t provide any assistance in paying off Medicare Part B costs. This means that these plans pose no benefits to seniors with high Medicare Part B coverage gaps and no Medicare Part A coverage gaps.

Does this mean that there are no Medigap options for seniors who need help paying down both Medicare Part A and Medicare Part B costs? Absolutely not! In fact, there are almost twice as many plan types that cover both Medicare Part A and Medicare Part B than there are plans that only cover Medicare Part A. For instance, Medigap supplement plans type B, C, D, F, G, M, and N not only increase access to care for one category but do so to varying extents for both categories. By enrolling in one of these plans, you can ensure that your specific needs are met in the best possible way. Unfortunately, not all of these plans are destined to last forever. Medigap supplement plans of type F are no longer going to be offered after 2020. In order to avoid the sudden cut-off of your access to medical care, it is important to speak with a Medigap expert to help guide you through the selection process.

Medigap plans are not all roses and dandelions, however. One of the sharpest thorns is the fact that no Medigap plan offers coverage for prescription drugs or vision or dental care. This means that, in order to have access to all forms of healthcare, you would need to further supplement your Medicare costs with the addition of private prescription drug, vision, and dental coverage. On the bright side, these categories tend to be among the cheapest on the market, with all three coming together for rates lower than $100 in some areas.

The most important takeaway from this article is that you need to take back control over your healthcare and your finances. Whether you choose to go with a Medicare Advantage plan like 11,170 other seniors in Madison or with Medicare Supplement (Medigap) plan like 7,447 others is completely up to you. You know your healthcare needs better than anybody else, so why should you have to rely on the support of your children or charity from strangers to pay those costs? You don’t have to. Not anymore. Head over to today and begin the process of retaking control over your future.

Medigap Plan Minimum Monthly Premium Maximum Monthly Premium Average Estimated Monthly Premium (Part B Premium Included)
High Deductible Plan $40 $235 $273
50% Cost Sharing Plan $76 $117 $232
Medigap Basic Plan $93 $228 $296
25% Cost Sharing Plan $97 $148 $258
by Lindsay Malzone, Lindsay Malzone is the Medicare expert for She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.