WPS Health Insurance Medicare Review

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WPS Health Insurance is a Wisconsin-based not-for-profit insurance company providing a wide range of coverage options. In addition to having a major Medicare contract, the company administers VA benefits as well as individual, group, and specialty coverage plans.

About WPS Health Insurance

WPS stands for Wisconsin Physicians Service, which was formed in 1946 by the State Medical Society to help those who could not afford health insurance coverage. Originally located in Milwaukee, WPS moved to Madison, WI in 1950 and proceeded to expand coverage across the state. In 1977 new legislation forced WPS to cut ties with the State Medical Society; from that point on they became a licensed not-for-profit corporation.

In 1966, WPS was awarded the governments Medicare administration contract for the state of Wisconsin. They have since expanded the administration of Medicare Parts A & B across several other states. In the 1960s, WPS introduced its first Medicare Supplement plan, the Century Plan. The plan was welcomed into the market with immediate popularity. Today, the Century plan is known as WPS Medicare Companion.

WPS has been a Military Health System claims administrator since 1956, and in addition to other VA work, WPS continues to assist with TRICARE and the Veteran’s Choice program.

Subsidiaries of WPS include EPIC Specialty Benefits. These offer life, disability, dental and other benefits across the Midwest. Additional subsidiaries include Arise Health Plan, which recently merged with Aspirus to form Aspirus Arise Health Plan of Wisconsin, Inc. The newly formed partnership will begin offering insurance in 2017 to Wisconsin residents.

Today WPS is one of the largest providers of health benefits in the state of Wisconsin, and they are consistently listed among the nation’s most ethical companies. They offer both group and individual coverage, in addition to supplemental and government products.

WPS Medicare Plans

WPS has a long history with Medicare. In addition to their assignment of Part A & B Medicare administration, they offer Medicare Supplement and Part D Prescription Drug plans. These plans are available to residents of the state of Wisconsin. The company does not offer Medicare Advantage.

Medicare Supplement

Having written their first supplemental Medicare policies back when Medicare first started, WPS has a lot of experience in this area. They continue to offer their Medicare Companion supplemental policy as they have for more than 50 years, with benefits that can be customized.

The Medicare Companion Plan starts with a base coverage and rate, and then offers the option to add a selection of additional benefits at an added cost. The base policy covers coinsurance for Medicare Parts A & B.

After this basic coverage, the plan can be customized to cover the costs you most need – there is an option to choose from 0%, 50%, or 100% coverage for the Part A deductible. Options for the Part B deductible are 0%, a co pay, or 100%. Home Health Care, Foreign Travel, and Medicare Excess Costs coverage can also be added as riders to the base policy. Each of these options can be individually selected to create a personalized policy.

Additionally, there is a Dental Insurance option that can also be added to the Medicare Companion plan. With an additional premium, this option will cover a variety of dental care services through Delta Dental.

Part D Prescription Drug

WPS has two levels of Part D coverage for prescriptions. The first policy has a lower premium and a deductible, while the more expensive policy holds no deductible.

The WPS MedicareRx Plan 1 is the more affordable option, with a $400 annual deductible. Tier 1 preferred generics are covered with a $1 co pay, Tier 2 generics a $17 co pay. Tiers 3 Preferred Brand drugs have a $47 co pay, while Tier 4 and Tier 5 are covered at 50% and 25% respectively.

The WPS MedicareRx Plan 2 has similar coverage, but there is no deductible and preferred generics have no co pay. Tier 2 is covered with a $19 co pay, and Tier 5 at 33%; the other rates are the same for the remaining Tiers.

The plans are similar, with the main differences being in the deductible and gap coverage options; the premium difference allows the choice of whether the consumer would like to pay less monthly and deal with a deductible when the time comes, or pay more monthly and not have to worry about paying the deductible out of pocket. Looking at the options, Plan 2 does offer slightly more coverage in addition to no deductible.

WPS Medicare Rates

Since these plans are only available in Wisconsin, we are not able to show a comparison of the rates to national companies. WPS does offer easy price quoting online, however, which makes it easy to shop around.

The Medicare Supplement plan, quoted for a 66-year-old woman in Madison, WI who is a non-smoker ranged from $147.90 for the most basic coverage, to $202.83 with all of the optional riders selected in the highest level of coverage. Dental coverage was quoted at $36.62 a month. Please note, these rates will vary based on the age, location, and smoking status of the insured.

Rates are provided with no quoting process or required information for the Part D plans. Plan 1 is $77.90 a month, and Plan 2 is $151.90 a month.

Ratings and Reviews of WPS

WPS holds an A+ rating with the Better Business Bureau, and there are only five complaints filed in the past three years. One of those was closed in the past 12 months. Even for a regional insurance company, this is a very low number of complaints.

The National Committee for Quality Assurance ranked WPS Health Plan at number 227 nationwide and number 20 in the top health plans for the state of Wisconsin.

There do not appear to be any direct reviews of WPS Medicare Supplement or Part D plans. In general, there seem to be few complaints against the company and they enjoy a good reputation.

The Bottom Line

WPS plans will appeal to those who want a customizable Medicare Supplement Plan or need simple Part D coverage – or both. As a regional insurance company, they may not be able to compete with the nationwide insurers in terms of rates. However, as a local company homegrown in Wisconsin with a very long history in the Medicare niche, they will appeal to those who seek smaller and closer to home over larger and potentially cheaper. WPS has a good reputation and is worth a look for Wisconsin residents seeking to cover Medicare’s gaps.

For a list of companies that we recommend, visit our Best Insurance Companies page.

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