Wisconsin Physicians Service (WPS) Insurance Review & Complaints: Medicare & Health Insurance (2023)

Based out of Wisconsin, WPS Health Insurance offers a variety of health insurance plans including major medical for individuals and groups and Medicare products. WPS Health Insurance Medicare Supplement plans are offered in addition to Part D prescription drug options. They operate as a not-for-profit organization in multiple states. Read our WPS insurance review to learn more.

This review will look at the plans that are available and how to get quotes.

Before you decide to buy WPS Health Insurance Medicare insurance, shop around to see what your options are. Enter your ZIP code above to get a FREE insurance quote today.

What is WPS Health Insurance?

Wisconsin Physicians Service Insurance Corporation was created in 1946 by the State Medical Society of Wisconsin in Milwaukee, with the goal of assisting local residents with the cost of any medical service. In 1950 operations moved to Madison, and over the following years, offices were opened across the state, including in Green Bay. In 1977, the insurance company 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 Veterans Affiars contract
• WPS Health Insurance, which offers individual and group benefit plans
• Medicare

WPS Government Health Administrators handles the WPS Medicare contract, which the company was first awarded in 1966. Through this contract, the insurance company administers Medicare benefits in Wisconsin and several other states as well. In 2005, they acquired Mutual of Omaha’s Medicare Part A division.

WPS introduced its first Medicare Supplement Insurance plan in the 1960s. Its Century Plan proved popular and led to expansion and growth of the company’s supplemental product 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. A WPS Health Insurance Medicare opt-out list can be found on the company website.

Still operating out of Madison, WPS has become one of the largest health insurance providers in the state of Wisconsin. It also operates in 14 other states.

What plans are offered?

WPS currently offers both Part D prescription drug plans and Medicare Supplement insurance plans, but no Medicare Advantage plans. Plan options vary from state to state. For the purpose of this review, we will look at program options available in WPS Health Insurance‘s home state, Wisconsin. In other states, the letter-coded Medicare Supplement insurance system is used, but Wisconsin has its own system.

What Part D options are offered?

Part D prescription drug plans for individuals and groups are offered to Wisconsin residents, with two insurance products 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 prescription drug plan, coverage is provided nationwide to allow access to medications while traveling. Read about Medicare Part D for more information.

What is the WPS Medicare Supplement?

In addition to Wisconsin, WPS writes Medicare Supplement in these states to help reduce the out-of-pocket costs associated with receiving health services:

• Arizona
• Colorado
• Illinois
• Indiana
• Iowa
• Kansas
• Michigan
• Missouri
• Nebraska
• Ohio
• Oklahoma
• 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 supplement insurance plans that are offered by health insurance companies across Wisconsin. To discover more on Wisconsin Medicare Advantage Companies, read our guide today.

WPS Medicare 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.

As many as 40 home health care providers visits are covered each year. And the plan also includes extra benefits, like discounts on out-of-pocket costs for vision and hearing care needs, fitness programs, and other preventive care services. Other coverage can be added to this plan as optional riders.

The WPS Medicare 25% Cost-Sharing plan covers 75% each of the Part A deductible, hospice coinsurance, and three pints of blood. Skilled nursing 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 a discount program for vision and hearing care needs, but unlike the base plan, further coverage can’t be added because there are no optional riders available.

The WPS Medicare 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.

What are the Part D plan rates?

Part D plan costs are readily available on the WPS site, without a quoting process required. Plan 1 costs $76.80 a month, and Plan 2 costs $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 costs range from $116.47 to $130.73 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. Make sure you compare a plan’s affordability to the average health insurance cost per month in the U.S.

How are claims filed?

As with all United States health insurance providers, most claims are handled directly with WPS health providers departments. There may be situations where an insured is required to submit a claim for reimbursement, but the issue is that we were unable to find any information on this process on the website and its access for users.

They do list their service availability business hours as Monday–Friday, 7:30 a.m. to 5 p.m. Central Time.

Does the company have positive 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 service reviews for this WPS 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. you can read more reviews on insurance companies through the review directory.

What’s the bottom line?

WPS Health Insurance is a good choice for those needing Medicare Supplement Insurance Plans or Part D insurance WPS health plan in Wisconsin and beyond, including those who are looking to get WPS military and veterans health insurance. 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.

You might be able to get affordable WPS Health Insurance Medicare coverage, but make sure it’s the best price first. Enter your ZIP code to compare rates and find the best Medicare company today.