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About WPS Health Insurance
Wisconsin Physicians Service was created in 1946 by the State Medical Society of Wisconsin in Milwaukee, with the goal of assisting local residents with the cost of medical care. In 1950 operations moved to Madison, and over the following years, offices were opened across the state. In 1977 WPS became an independent not-for-profit company, separating from the Medical Society in compliance with state law.
WPS operates three major branches: TRICARE, which serves veterans through a VA contract, WPS Health Insurance, which offers individual and group plans, and Medicare. WPS Government Health Administrators handles the WPS Medicare contract, which the company was first awarded in 1966. Through this contract, they administer Medicare benefits in Wisconsin and is parts of several other states as well. In 2005 they acquired Mutual of Omaha’s Medicare Part A division.
WPS introduced its first Medicare Supplement plan in the 1960s; their Century Plan proved popular and led to expansion and growth of the company’s supplemental products line.
Among the subsidiaries of WPS Health Solutions are EPIC Specialty Benefits and Aspirus Arise Health Plan of Wisconsin. They operated WPS Bank until it was purchased by Starion Bank of South Dakota in 2015. WPS also has several branches in technology as well as a staffing service.
Still operating out of Madison, WPS has become one of the largest health insurance providers in the state of Wisconsin.
WPS Medicare Plans
WPS currently offers both Part D prescription drug plans and Medicare Supplement plans, but no Medicare Advantage options.
Part D Plans
Part D prescription drug plans are offered to Wisconsin residents, with two options to choose from.
Medicare Rx Plan 1 has an annual deductible of $405 and $0 copays for Tier 1 generic drugs when purchased from preferred retail locations. Tier 2 drugs have a $15 copay and tier 3 drugs have a $42 copay. Tiers 4 and 5 have a coinsurance amount at 47% and 25% respectively.
Medicare Rx Plan 2 has no deductible, and copays are very similar to Plan 1, with the exception of Tier 5 drugs, which have a 33% coinsurance. This plan is designed for those who prefer to pay more monthly in return for not paying a deductible.
While only Wisconsin residents can enroll in the plan, coverage is provided nationwide to allow access to medications while traveling.
In addition to Wisconsin, WPS writes Medicare Supplement in Arizona, Colorado, Illinois, Indiana, Iowa, Kansas, Michigan, Missouri, Nebraska, Ohio, Oklahoma, and Texas. More states are expected to be added soon. The plans that are available vary by state; for the purpose of this review, we selected the company’s home state of Wisconsin as a sample.
Wisconsin does not use the letter-coded standard plans that are used in most other states. They have their own set of standard plans that are offered by health insurance companies across Wisconsin.
WPS offers the base plan, which pays 100% of Part A & B coinsurance for hospital and medical as well as covering three pints of blood each year. It also covers your choice of either 100% or 50% of the hospitalization deductible, and coverage of $167.50 for skilled nursing care starting on day 21 through day 100. 40 home health care visits are covered each year, and the plan also includes discounts on vision and hearing care needs, fitness programs, and other preventative care. Other coverage can be added to this plan as optional riders.
The 25% Cost-Sharing plan covers 75% each of the Part A deductible, hospice coinsurance, and three pints of blood. Skilled nursing facility care for days 21-100 is included at $125.62 a day. This plan also pays for the first 40 home care visits each year and includes discounts on vision and hearing care needs, but unlike the base plan, further coverage can’t be added.
The 50% Cost-Sharing plan is very similar, with the difference that coverage is at 50% rather than 75%. The skilled nursing facility coverage is limited to $83.75 a day for days 21-100.
Part D plan rates are readily available on the WPS site, without a quoting process required. Plan 1 is $76.80 a month, and Plan 2 is $141.50 a month.
Quoting is not available for the Medicare Supplement plans, but the website does offer a rate chart that outlines prices based on age, location, and the choice of plan and options. The base plan rates range from $127.82 to $136.30 for a 65-year-old depending on the area.
These rates are difficult to compare outside of Wisconsin since the standard plans differ from most other states. They can only be compared to other Wisconsin providers in the same area.
As with all health insurance providers, most claims are handled directly with providers. There may be situations where an insured is required to submit a claim for reimbursement, but we were unable to find any information on this process on the website.
Ratings and Consumer Reviews
The Better Business Bureau (BBB) file for WPS is found under the name WPS Health Solutions, and the company has an A+ rating. There is only one complaint on file in the past three years, and none have been closed in the past 12 months.
The National Committee for Quality Assurance gives WPS an overall 4.0 rating, with high ratings for most areas of customer satisfaction and preventative care areas. There were a few areas in which WPS did not score as well, particularly in the mental and behavioral health categories.
We were unable to find any customer reviews for this health plan in the usual places, and we did not find anything specifically related to their Medicare plans. Overall, this company seems to enjoy a solid reputation.
The Bottom Line
WPS Health Insurance is a good choice for those needing Medicare Supplement or Part D insurance in Wisconsin and beyond. They have a good reputation and have been working in Medicare coverage for as long as it has been around, giving them plenty of experience. They are well worth adding to your comparison list.
For a list of companies that we recommend, visit our Best Insurance Companies page.