Medigap in Wisconsin, Minnesota and Massachusetts: The 3 Waiver States Explained

Why These Three States Have Their Own Medigap Rules

When Congress standardized Medicare Supplement insurance in 1990 (effective 1992), it wrote a specific carve-out into federal law. The statute at 42 U.S.C. § 1395ss required insurers everywhere to sell only the standardized federal letter plans, but it also acknowledged that Wisconsin, Minnesota, and Massachusetts had already built their own uniform Medigap systems years earlier. Rather than force those states to scrap policies that were working, Congress grandfathered them in.

That is why these three states are called "waiver states." Their Medigap policies are still standardized, just under state-specific designs that predate the national A-N framework. As Medicare's own consumer publication puts it, in Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way from the federal letter chart.

The practical result: if you live in one of these states, you cannot buy a Plan G or Plan N by name. You buy your state's version, and it is your job to match it against what generic Medigap advice describes. That is also why our Medigap comparison chart and our state-by-state Medigap guide both call out these three states separately.

Wisconsin: One Base Plan Plus Optional Riders

Wisconsin uses a single Medigap chassis called the Basic Plan. Every carrier that sells Medigap in Wisconsin must offer it, and every Basic Plan must include the same state-mandated benefits. You then customize it by adding riders.

What the Wisconsin Basic Plan covers

The Basic Plan already includes:

• Part A hospital coinsurance plus 365 additional lifetime days after Medicare benefits end
• Skilled nursing facility coinsurance (days 21-100)
• Part B coinsurance (the 20% you would otherwise owe)
• First 3 pints of blood per year
• Hospice coinsurance and copayments
• 175 additional lifetime inpatient mental health days
• 40 additional home health visits per year
• 30 days of medically necessary skilled nursing care even if Medicare will not pay
• State-mandated chiropractic, non-Medicare hospital and ASC charges, dental anesthetic when medically necessary, and breast reconstruction after mastectomy

Riders you can add on top

To approximate Plan G or Plan N coverage, Wisconsin carriers offer these optional riders:

Cost-sharing and high-deductible versions

Beyond the standard Basic Plan, Wisconsin allows three lower-premium variants: a 50% cost-sharing plan (with an $8,000 out-of-pocket max in 2026), a 25% cost-sharing plan, and a high-deductible Basic Plan with a $2,950 deductible for 2026. These work like federal Plans K, L, and High-Deductible Plan G do elsewhere.

2026 premiums and top Wisconsin carriers

For 2026, NerdWallet's Wisconsin comparison shows monthly Basic Plan premiums ranging roughly from $102 to $152, depending on the carrier: HealthSpring (Cigna) at $102, Anthem at $112, Mutual of Omaha at $121, AARP/UnitedHealthcare at $130, Wellabe at $136, and State Farm at $152. By enrollment share, Wisconsin Physicians Service (WPS) is the largest carrier at about 23.5% of members, followed by AARP/UnitedHealthcare, Physicians Mutual, Anthem, and Wellabe. For a deeper carrier breakdown, see our AARP Medicare Supplement review and Cigna/HealthSpring review.

Minnesota: Basic vs Extended Basic (Now With a Post-2020 Version)

Minnesota uses two main state-standardized designs: the Basic Plan (a lean chassis you customize with riders) and the Extended Basic Plan (a bundled comprehensive plan). Minnesota also allows a small set of lettered plans (K, L, M, N, and Plan F for pre-2020 eligibles) to be sold in parallel.

What both plans share

Both Basic and Extended Basic cover Part A and B coinsurance, the first 3 pints of blood, hospice cost-sharing, some home health, at least 50% of outpatient mental health and 20% of physical therapy, and state-mandated benefits like diabetic supplies, cancer screenings, and reconstructive surgery.

Where they diverge in 2026

The 2020 update that changed everything

Federal MACRA rules banned any Medigap policy from covering the Part B deductible for people first Medicare-eligible on or after January 1, 2020. Minnesota responded by splitting Extended Basic into two versions:

• Legacy Extended Basic (for pre-2020 eligibles) still covers the Part B deductible
• Extended Basic-new (for post-2019 eligibles) does not cover the Part B deductible and typically runs about $25/month less

For the Basic Plan, the Part B deductible rider is likewise closed to anyone newly Medicare-eligible after 2019. This is Minnesota's version of the same rule that closed Plan F to new enrollees nationwide.

Mapping Minnesota to Plan G and Plan N

• Extended Basic-new is Minnesota's closest analog to a comprehensive Plan G. It bundles the Part A deductible, excess charges, and expanded benefits automatically.
• Basic Plan plus Part A deductible rider plus excess charges rider approximates Plan G at a possibly lower total cost.
• Basic Plan alone functions more like a stripped-down Plan N, but without Plan N's office and ER copays.

Top Minnesota Medigap carriers include Blue Cross Blue Shield of Minnesota, HealthPartners, UCare, Medica, AARP/UnitedHealthcare, and Mutual of Omaha. For 2026, Minnesota also added a new August guaranteed-issue window for ages 65 to 70, which we cover in our Medicare Supplement plans by state guide.

Massachusetts: Core, Supplement 1A, and Legacy Supplement 1

Massachusetts is the simplest of the three waiver states in terms of shelf. There are only two plans you can actually buy in 2026 as a new enrollee: Core and Supplement 1A. The third design, Supplement 1, is closed to anyone first Medicare-eligible on or after January 1, 2020, and a legacy plan called Medigap 2 was closed to new sales after December 31, 2005 (existing members can keep it).

Basic benefits in all three plans

Every Massachusetts Medigap plan includes:

• Part A hospital coinsurance (days 61-90 and 91-150, plus 365 extra lifetime days)
• Part B coinsurance
• First 3 pints of blood
• Hospice coinsurance and copays
• State-mandated preventive benefits like yearly Pap tests and mammograms

What separates Core, Supplement 1A, and Supplement 1

Using 2026 CMS figures (Part A deductible $1,736, SNF coinsurance $217/day, Part B deductible $283):

Massachusetts equivalents to Plan G and Plan N

Supplement 1A is essentially the Massachusetts version of Plan G. Supplement 1 acts like the old Plan F for those still eligible. Core has no direct federal analog, but functionally exposes you to more out-of-pocket risk in exchange for the lowest premium.

2026 Massachusetts premiums and carriers

NerdWallet cites sample lowest-in-state premiums of about $123/month for Core and $176/month for Supplement 1A in 2026. Top Massachusetts Medigap carriers include Blue Cross Blue Shield of Massachusetts, Tufts Health Plan Medicare Preferred, Harvard Pilgrim Health Care, and national names like AARP/UnitedHealthcare, Mutual of Omaha, and Aetna. Because Massachusetts is a higher-cost Medigap state overall, see our Medicare Supplement cost guide for context on how the state compares nationally.

Guaranteed Issue, Birthday Rules, and Switching

None of these three states use a traditional California-style birthday rule. Instead, they lean on strong initial and event-triggered guaranteed-issue protections. Here is what actually applies:

Wisconsin

• Standard 6-month federal Medigap Open Enrollment when you enroll in Part B
• 63-day guaranteed-issue window when you lose group coverage, a Medicare Advantage plan, a Medicare Cost plan, prior Medigap, or Medicaid
• No active state birthday rule (a proposal has been discussed but not enacted)

Minnesota

• Standard Open Enrollment plus event-triggered guaranteed issue
• New for August 2026: an expanded guaranteed-issue window for ages 65 to 70 that lets more Minnesotans switch without underwriting
• No traditional birthday rule

Massachusetts

• Standard Open Enrollment plus event-triggered guaranteed issue
• An annual February through March guaranteed-issue window during which any Medicare beneficiary can enroll in or switch Medigap plans without medical underwriting. This is one of the most generous consumer protections in the country.

If you want the full national comparison, our Medigap birthday rule guide shows how these three states stack up against the 15+ birthday-rule states.

Frequently Asked Questions

Why can't I buy Plan G in Wisconsin, Minnesota, or Massachusetts?

Because federal law grandfathered these three states' pre-1992 Medigap systems, insurers there sell state-designed plans instead of the federal letter plans. You can still build coverage equivalent to Plan G by choosing the right state-specific plan (Wisconsin Basic plus riders, Minnesota Extended Basic-new, or Massachusetts Supplement 1A). The benefits are nearly identical; only the plan name and packaging differ.

Which Minnesota plan is closest to Plan G?

Extended Basic-new is Minnesota's closest analog to Plan G for anyone first Medicare-eligible on or after January 1, 2020. It automatically includes the Part A deductible, Part B excess charges, 120 days of SNF coverage, and expanded non-Medicare benefits. If you prefer to pay less upfront, a Basic Plan with the Part A deductible and excess charges riders can approximate the same coverage at a potentially lower total premium.

How does the Massachusetts February to March window work?

Each year from February 1 through March 31, any Medicare beneficiary in Massachusetts can enroll in or switch Medigap plans without medical underwriting. Insurers cannot deny coverage, impose waiting periods, or charge higher premiums based on health during that window. It is functionally an annual open enrollment period unique to Massachusetts, and it makes shopping there much more forgiving than in most states.

Are Wisconsin Medigap premiums cheaper than the national average?

Yes, in most cases. Basic Plan premiums from major Wisconsin carriers in 2026 range from about $102 to $152 per month per NerdWallet's data, which sits at or below the roughly $166 national average for Plan G at age 65. Adding riders raises that total, but even a fully loaded Wisconsin Basic Plan usually costs less than a comparable Plan G in high-premium states like New York, Connecticut, or Massachusetts.

If I move out of Wisconsin, Minnesota, or Massachusetts, what happens to my Medigap?

Your waiver-state Medigap policy generally cannot travel with you as-is. When you move to a state that uses federal letter plans, you typically need to enroll in a new Medigap policy there, and you may qualify for a guaranteed-issue right if you apply within 63 days of losing your prior coverage. Our switching Medicare Advantage to Medigap guide explains the guaranteed-issue mechanics in detail, and the same 63-day rules generally apply when you relocate out of a waiver state.