​​Last Updated: February 21, 2020

Understanding Medicare

Medicare​ is the health insurance program administered by the federal Centers for Medicare & Medicaid Services (CMS) for people 65 years of age or older, people of any age with permanent kidney failure, and some disabled individuals under age 65. Although Medicare may pay a large part of your health care expenses, it does not pay for them all. Some services and medical supplies are not fully covered. A handbook titled Medicare is available free from the Social Security Administration. The handbook provides a detailed explanation of Medicare.

Medicare was designed to increase access to health care and reduce its financial burden on older, retired or disabled Americans. Medicare was never intended to pay 100% of all medical bills, but instead was created to offset the most pressing medical expenses by providing a basic foundation of benefits. Thus, while Medicare will pay a significant portion of your medical bills, it does not cover all services that you might need. Even those services that are covered are not covered in full. You still have to pay Medicare's coinsurance and deductibles.

Medicare requires that you pay deductibles and pays many Part B expenses at 80% of the Medicare-approved amount.

Insurance companies sell policies that pay some of these expenses if you are enrolled in both Part A and Part B of Medicare. These policies are referred to as "Medicare supplement" or "Medigap" policies and provide a way to fill the coverage gaps left by Medicare.

Related Resources

View the Consumer Publications page for additional insurance publications and resources.

Board on Aging and Long Term Care (BOALTC)

​The mission of the Board on Aging and Long Term Care is to advocate for the interests of the state's long-term care consumers, to inform those consumers of their rights, and to educate the public at large about health care systems and long-term care.

Listed below is a statewide toll-free number set up by the Wisconsin Board on Aging and Long-Term Care and funded by the Office of the Commissioner of Insurance to answer questions about health insurance and other health care benefits for the elderly. It has no connection with any insurance company.

​1-800-242-1060 Medigap Helpline
(608) 246-7001 Fax

Board on Aging and Long Term Care
1402 Pankratz​ St., Ste. 111
Madison, WI 53704-4001

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