Medicare isn't one thing — it's a system of parts, plans, and windows that interact in ways most people don't realize until they're already enrolled. This guide covers what you need to know if you're turning 65, newly eligible, or simply wondering whether your current coverage is still the right fit for life in the La Crosse area.
The Four Parts of Medicare
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health. Most people pay no premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years.
Part B covers doctor visits, outpatient care, preventive services, and durable medical equipment. The standard 2026 Part B premium is $202.90/month, though higher-income beneficiaries — 2026 MAGI above $109,000 (single) or $218,000 (married filing jointly) — pay more through IRMAA.
Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare. Private insurers bundle Parts A and B — and usually Part D — into a single plan, often with network restrictions but lower out-of-pocket costs for those who stay in-network.
Part D covers prescription drugs. It's available as a stand-alone plan added to Original Medicare or built into a Medicare Advantage plan. The IRA introduced a hard annual out-of-pocket cap on drug costs — $2,000 in 2025, rising to $2,100 in 2026 — a major improvement over the $8,000+ exposure beneficiaries faced before 2025.
Medicare Advantage vs. Medigap — Which Track Is Right for You?
This is the most consequential decision most Medicare beneficiaries make, and it's not reversible without health underwriting in most states.
Medicare Advantage plans typically have $0 or low monthly premiums and bundle prescription drug coverage. The trade-off: provider networks. In the La Crosse area, you'll want to confirm whether your plan includes Gundersen Health System and/or Mayo Clinic Health System providers before enrolling. Advantage plans also have annual cost-sharing (copays, deductibles) that can add up for heavy users.
Medigap (Medicare Supplement) plans pay after Original Medicare and can eliminate nearly all out-of-pocket costs. In Wisconsin, Medicare Supplement coverage starts with the mandatory Basic Plan. Most clients add the Part A Deductible Rider and Part B Excess Charges Rider — which together provide comprehensive supplement coverage comparable to the most complete plans available in other states, structured under Wisconsin's state-specific standardization. The trade-off: a monthly premium — as a rough illustration, premiums often fall in the range of $120–$250 per month, but actual premiums vary by age, tobacco use, carrier, and rider selection. Medigap works with any provider who accepts Medicare — no networks to navigate. Request a personalized quote for your exact rate.
The right answer depends on your health usage, your providers, your prescriptions, and your tolerance for variable vs. predictable costs. We run this comparison for you — for free.
Local Networks: Gundersen and Mayo
The La Crosse area is served by two major health systems: Gundersen Health System (headquartered in La Crosse) and Mayo Clinic Health System (with campuses in La Crosse and Onalaska, among others). Before you choose a Medicare Advantage plan, we verify your specific providers are in-network — a step many people skip and later regret.
The Part D Out-of-Pocket Cap ($2,100 in 2026)
The Inflation Reduction Act created the first hard annual out-of-pocket cap on covered Part D drug costs: $2,000 starting in 2025, adjusted to $2,100 in 2026. Once you reach the cap, your plan pays 100% of covered drug costs for the rest of the year. This is a major protection for beneficiaries on expensive specialty medications, and it makes formulary tier placement more important than ever — a drug on a higher tier costs more before you hit the cap.
Enrollment Windows You Cannot Miss
- Initial Enrollment Period (IEP): A 7-month window centered on your 65th birthday (3 months before, the month of, and 3 months after). Missing this without other qualifying coverage triggers a permanent Part B late-enrollment penalty of 10% for each full 12-month period you could have enrolled but didn't.
- Annual Enrollment Period (AEP): October 15 – December 7 each year. Any Medicare beneficiary can switch plans; coverage starts January 1.
- Special Enrollment Periods (SEPs): Triggered by life events like losing employer coverage, moving, or plan termination.
How We Help — At No Cost to You
Insurance companies pay our commission, so there's no charge to work with us. We compare every Medicare Advantage and Part D plan available in your county against your doctors and prescriptions, explain the trade-offs plainly, and handle your enrollment paperwork. We also review your coverage every fall during AEP to make sure it still makes sense as plans change.
Ready to compare plans? Call or text (608) 799-8434 or schedule a free conversation with our team in Onalaska.
Frequently Asked Questions
Are Gundersen Health System and Mayo Clinic Health System in-network for Medicare Advantage plans in La Crosse?
It depends on the specific plan and whether it's an HMO or PPO — provider networks vary by carrier and can change from year to year. Some La Crosse-area Medicare Advantage plans include both Gundersen Health System and Mayo Clinic Health System, while others cover only one or use a narrower network. We check your specific doctors and hospitals against every available plan before you enroll, not just the network name on the brochure.
If I see doctors at both Gundersen and Mayo, is Medicare Advantage or Medigap the better fit?
Medigap (Wisconsin Medicare Supplement) works with any provider who accepts Medicare, so splitting your care between Gundersen and Mayo — or seeing specialists at both — never raises a network question. Medicare Advantage can still work if your specific plan includes both systems, but you'd need to reconfirm that every year during Annual Enrollment as networks change. We compare both paths against your actual providers before you decide.
What does Wisconsin Medicare Supplement coverage actually include?
Wisconsin doesn't use the national Plan A–N letter system. Every Wisconsin Medigap policy starts with a mandatory Basic Plan, and most La Crosse-area clients add the Part A Deductible Rider and Part B Excess Charges Rider on top — a combination that covers nearly all of Original Medicare's cost-sharing gaps. Rider selection affects your premium, so we walk through the trade-offs for your specific health and budget.
Roughly what does a Wisconsin Medicare Supplement cost in the La Crosse area?
As a rough illustration, a Basic Plan with the Part A Deductible and Part B Excess Charges riders often runs $120–$250 per month, but your actual premium depends on your age, tobacco use, carrier, and rider selection. Request a personalized quote for your exact rate — we compare every carrier available in La Crosse and Winona counties.
Do you only help with Medicare when I first turn 65, or every year after?
Every year. We review your Medicare Advantage and Part D coverage each fall during the Annual Enrollment Period (October 15–December 7) to confirm your plan, network, and formulary still fit — plans and provider networks can change annually even if you're happy with your current choice. This ongoing review is included at no cost, for as long as you're a client.
Sources
- Medicare.gov. What Does Medicare Cost? medicare.gov
- Centers for Medicare & Medicaid Services (CMS). Medicare Deductible, Coinsurance, and Premium Rates for CY 2026 (MLN MM14279). cms.gov
- Centers for Medicare & Medicaid Services (CMS). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov
- Centers for Medicare & Medicaid Services (CMS). Final CY 2026 Part D Redesign Program Instructions. cms.gov
- Medicare.gov. Avoid Late Enrollment Penalties. medicare.gov
- Medicare.gov. Joining a Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan. medicare.gov
Compliance disclosures: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Not affiliated with or endorsed by the U.S. government or the federal Medicare program. This article is for general information only and is not medical, insurance, tax, or legal advice. Eligibility, costs, and plan availability may change; confirm current details at Medicare.gov. Consult a licensed agent. Hougom Insurance Agency is a licensed independent insurance agency (NPN 20742808). Plan year 2026 figures used throughout.