√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the Wisconsin Guide to Health Insurance for People with Medicare, available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(c) [For policies that pay fixed dollar amounts for specified diseases or other specified impairments. This includes cancer, specified disease, and other health insurance policies that pay a scheduled benefit or specific payment based on diagnosis of the conditions named in the policy.]
-
See PDF for table 
This is not Medicare Supplement Insurance
This insurance pays a fixed amount, regardless of your expenses, if you meet the policy conditions, for one of the specific diseases or health conditions named in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
This insurance duplicates Medicare benefits because Medicare generally pays for most of the expenses for the diagnosis and treatment of the specific conditions or diagnoses named in the policy.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
○ hospitalization
○ physician services
○ hospice
○ [outpatient prescription drugs if you are enrolled in Medicare
Part D]
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare," available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(d) [Alternative disclosure statement for policies that pay fixed dollar amounts for specified diseases or other specified impairments. This includes cancer, specified disease, and other health insurance policies that pay a scheduled benefit or specific payment based on diagnosis of the conditions named in the policy.]
-
See PDF for table
Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance pays a fixed amount, regardless of your expenses, if you meet the policy conditions, for one of the specific diseases or health conditions named in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
○ hospitalization
○ physician services
○ hospice
○ [outpatient prescription drugs if you are enrolled in Medicare
Part D]
○ other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.
- See PDF for table
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the Wisconsin Guide to Health Insurance for People with Medicare, available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(e) [For indemnity policies and other policies that pay a fixed dollar amount per day, excluding long-term care policies.]
-
See PDF for table
This is not Medicare Supplement Insurance
This insurance pays a fixed amount, regardless of your expenses, for each day you meet the policy conditions. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
This insurance duplicates Medicare benefits when:
○ any expenses or services covered by the policy are also covered by Medicare.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
○ hospitalization
○ physician services
○ hospice
○ [outpatient prescription drugs if you are enrolled in Medicare
Part D]
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare," available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(f) [Alternative disclosure statement for indemnity policies and other policies that pay a fixed dollar amount per day, excluding long-term care policies.]
-
See PDF for table
Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance pays a fixed dollar amount, regardless of your expenses, for each day you meet the policy conditions. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
○ hospitalization
○ physician services
○ hospice
○ [outpatient prescription drugs if you are enrolled in Medicare
Part D]
○ other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.
- See PDF for table
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare," available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(g) [For other health insurance policies not specifically identified in the previous statements.]
-
See PDF for table
This is not Medicare Supplement Insurance
This insurance provides limited benefits if you meet the conditions listed in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
This insurance duplicates Medicare benefits when it pays:
○ the benefits stated in the policy and coverage for the same event is provided by Medicare
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
○ hospitalization
○ physician services
○ hospice
○ [outpatient prescription drugs if you are enrolled in Medicare
Part D]
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare," available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
(h) [Alternative disclosure statement for other health insurance policies not specifically identified in the preceding statements.]
-
See PDF for table
Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance provides limited benefits if you meet the conditions listed in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:
○ hospitalization
○ physician services
○ hospice
○ [outpatient prescription drugs if you are enrolled in Medicare
Part D]
○ other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.
- See PDF for table
√ Check the coverage in all health insurance policies you already have.
√ For more information about Medicare and Medicare Supplement insurance, review the “Wisconsin Guide to Health Insurance for People with Medicare", available from the insurance company.
√ For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.
Ins 3.40
Ins 3.40
Coordination of benefits provisions in group and blanket disability insurance policies.
