WPS MEDICARE COMPANION...WPS MEDICARE COMPANION You’re never alone—we’re committed to helping...

WPS MEDICARE COMPANIONYou’re never alone—we’re committed to helping you with your health careRates effective January 1, 2018

Choose the rightMedicare supplement with complete customer support!Visit mywpsmedicare.com

Plans A, C, F, G, K, L, M, and N

IA

Underwritten by:

The EPIC Life Insurance CompanyA WPS Company

2 | mywpsmedicare.com | 1-800-332-1406

ContentsMedicare alone is not enough ............................................................. 2

Stable rates provide peace of mind ................................................... 2

Top 7 reasons to choose WPS Medicare Companion .............................................................................................. 3

Valuable options included with your plan ..................................... 4-7

WPS provides convenient payment options .................................... 8

Optional dental coverage...... ............................................................. ..9

Premium rates ..................................................................................10-13

Enrollment timeline..... ..........................................................................14

Parts of Medicare .................................................................................15

Limitations and exclusions ..................................................................15

Medicare is a valuable benefit, but it doesn’t pay every-thing. Deductibles and coinsurance can add up. If you have Medicare alone, there’s a chance a serious illness or injury could exhaust your savings. WPS Medicare Companion supplement plan helps protect your health and retirement savings.

Stable rates provide peace of mindAs you look at Medicare supplement plans, you may find that some companies offer really low premiums. Don’t fall for these lowball plans! A rate that looks too good to be true usually is. A low rate right now can increase quickly in subsequent years. Choose WPS Medicare Companion for valuable benefits plus a stable rate that won’t jump wildly from year to year. You can protect your health and finances with security that also provides peace of mind.

Medicare alone is not enoughWPS Medicare Companion has your back

“I know other people who are frightened by Medicare. But not us—WPS helps us every step of the way.”

—Linda K. member since 2015

Eliminate the worry“ “Midwest-based service ensures you get the kind of attention you need when you have questions. Unlike big national carriers, we know your concerns and are equipped to help you get the answers you need to your Medicare supplement questions. WPS has your back! Wayne R. helps seniors get

the most from their Medicare supplements.

1-800-332-1406 | WPS Medicare Companion | 3

Top 7 reasons to choose WPS Medicare Companion

1. Freedom to choose your own doctors and hospitals that accept Medicare anywhere in the U.S. Keep your doctor or select a new doctor at any time. You have complete freedom to choose! And if you move, your coverage moves with you—anywhere in the U.S.

2. Less paperwork, fewer worries Automatic claims service means you don’t have to worry about filing claims or dealing with medical bills. Medicare sends WPS your claims electronically, so we handle them while you enjoy almost no paperwork.

3. Save money with our discounts WPS offers a 7% discount when you and a second household member are enrolled in a WPS Medicare supplement plan.1 You also can get a 2% discount when you choose automatic bank withdrawal.

4. You can always keep your plan as long as you pay your premium Your policy will never be canceled because of your health. As long as you pay your premium on time, your plan is guaranteed renewable for life.

5. You get treated like family When you call WPS, you reach caring people right here in our home state of Wisconsin. Your questions are answered promptly and accurately by our highly trained Customer Support team.

6. Strong commitment to ethics In 2017, WPS Health Solutions was named one of the World’s Most Ethical Companies® for the eighth year in a row by the international Ethisphere® Institute.2

7. You deserve to live your life Health care and health insurance are important, but honestly, you’ve got better things to do than worry about all of it. Let WPS help handle your medical bills while you handle all the activities you enjoy.

1Household: Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex. 22010-2017 World’s Most Ethical Companies®, Ethisphere® Institute, worldsmostethicalcompanies.ethisphere.com.

“


Valuable programs included with your planWPS strives to provide the greatest value possible to its members. WPS Medicare Companion includes an impressive collection of added benefits that, unlike in other plans, costs absolutely nothing extra for members.

The Silver&Fit® Exercise and Healthy Aging Program1

When you choose a plan option (not available with cost- sharing Plans K and L), you also get this great perk! At no extra cost, the Silver&Fit program gives you a fitness club or exercise center membership.

The Silver&Fit network includes Iowa locations of national fitness chains as well as dozens of regional and local gyms.2

National Fitness Chains with Iowa Locations

Planet Fitness YMCA Anytime Fitness

Snap Fitness Curves Gold’s Gym

Des Moines area

» Fitness World West

» Mercy Health and Fitness Center

» Aspen Athletic Clubs

Cedar Rapids

» MAC Xpress 24/7

» Aspen Athletic Clubs

» Rockwell Collins Recreation Center

» Sisters Health Club

» Gold Pointe Fitness Club

» Iowa Fitness 24-7

Davenport/Bettendorf area

» Ultimate Fitness

» Life Fitness Center

Waterloo/Cedar Falls

» River Plaza Athletic Club

» Cedar Valley Sportsplex

» The W: Wartburg-Waverly Sports and Wellness Center

1The Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit, Silver&Fit logo, and the Silver&Fit Signature Series are registered trademarks of ASH. ChooseHealthy is a product of American Specialty Health Administrators, Inc., a subsidiary of American Specialty Health Incorporated. Services that require an additional cost are not included in the Silver&Fit program. Please note that these programs are not insurance. You should check any insurance benefits you have before using this discount program, as those benefits may result in lower costs to you than using this discount program. The discount program provides for discount specialty health care services from participating practitioners. You are obligated to pay for all health care services, but will receive a discount from those health care practitioners who have contracted with the discount program. The discount program does not make payments directly to the participating practitioners in the discount program. The discount program has no liability for providing or guaranteeing services and assumes no liability for the quality of services rendered. Fitness discount programs are not part of the insurance policy and are offered at no additional charge. Enrollment in these programs is subject to contract renewal. The Silver&Fit and ChooseHealthy programs are not included with Medicare supplement cost-sharing Plans K and L. 2The facilities listed are participating in the Silver&Fit network as of July 2017. For the most up-to-date listing of participating facilities, please visit silverandfit.com.

The Silver&Fit network is continually growing, including the additions of facilities nominated by WPS members. Visit silverandfit.com for a complete list of participating facilities.

Plus, additional fitness centers throughout Iowa!

Sioux City

» Ultimate Fitness

» Four Seasons Health Club

Iowa City area

» FIT—Iowa City

» North Dodge Athletic Club

» Core Fitness

» Performance Health and Fitness

The ChooseHealthy® Affinity Program1The Silver&Fit program also offers: » Fitness clubs with group classes for older

adults, where available, such as:• Signature Series• Senior Dance• Senior Yoga• Aqua• Cardio• Strength• And more

Or, if you would prefer to work out at home, home fitness kits are available which can include:

• DVDs• Pedometer• Quick starts guides• And more

» Fitness challenges and rewards

» And more

All WPS Medicare Companion plan options, except cost-sharing Plans K and L, also include the ChooseHealthy program at no extra cost. You receive valuable discounts on services from nearly 33,000 providers in the ChooseHealthy network, including:

» Chiropractors

» Acupuncturists

» Massage therapists

» Registered dietitians

You also get a broad choice of health and wellness products in the online store:

» Vitamins and minerals

» Food supplements

» Sports nutrition

» Herbs and botanicals

4ChooseHealthy is a product of American Specialty Health Administrators, Inc., an affiliate of ASH Group and a subsidiary of American Specialty Health Incorporated.


EyeMed Vision Care discount program

All WPS Medicare Companion members receive access to the EyeMed Vision Care discount program at no additional cost.1 EyeMed offers substantial savings on eye care and eyewear at thousands of provider locations nationwide.

WPS Medicare Companion members receive a discount simply by showing their WPS ID card at participating EyeMed providers and mentioning EyeMed discount No. 9238049.

EyeMed’s provider network includes many familiar optical retailers, including:

» Whylie Eye Care Centers » Eyemart Optical Outlets » All About Eyes » Target Optical » Pearle Vision » LensCrafters » And many more!

Find a vision care provider in your area:

Vision Care Services Member Benefits

Eye exam (with dilation, as necessary)

$5 off routine exam$10 off contact lens exam

Complete Pair Eyeglass Purchase2

Frames

Any available frame at provider location 35% off retail price

Standard Plastic Lenses

Single vision $50

Bifocal $70

Trifocal $105

Lens Options

UV coating $15

Tint (solid and gradient) $15

Standard scratch-resistant coating $15

Standard polycarbonate $40

Standard anti-reflective coating $45

Standard progressive (add-on to bifocal) $65

Other add-ons and services 20% off retail price

Contact Lenses (discount applies to materials only)

Conventional 15% off retail price

Laser Vision Correction

LASIK or PRK from U.S. Laser Network

15% off retail price5% off promotional price

Frequency of use for examination, frames, lenses, or contact lenses unlimited

1Vision discount program is not part of the insurance policy and is offered at no additional charge. Enrollment in this program is subject to contract renewal. 2Frame, lens, and lens option discounts apply only when purchasing a complete pair of eyeglasses. If purchased separately, members receive 20% off the retail price. Benefits may not be combined with any discount, promotional offering, or other group benefit plans, except as indicated. Discount plan is effective Oct. 1, 2017 through Sept. 30, 2019.

Call EyeMed toll-free at 1-866-559-5252

EnrollWithEyeMed.com/access


Hear In America programThe Hear In America discount program, available to all WPS Medicare Companion members, makes you eligible to receive:

» Free hearing screenings

» A three-year warranty on new hearing aids

» Free office services (including retests, cleanings, and adjustments) for three years

» A 45-day trial period for your hearing aid

» Discounts from 35 to 70% off of manufacturer’s suggested retail price (MSRP) for hearing aids from all 9 major manufacturers including:

Sample SavingsMSRP or

Average PriceYou Pay* Savings % Saved

FREE annual hearing screening $0 100%

Three-year repair warranty, three-year loss and damage warranty

$500 $0 $500 100%

Three years of hearing aid batteries $315 $0 $315 100%

Three years of office service $600 $0 $600 100%

12 months financing (to those who qualify)$0 service charges

and interestUp to

$1,160

Basic digital hearing aid $1,450 $995 $455 31%

Mid-level hearing aid $3,995 $1,475 $2,520 63%

Premium digital hearing aid $5,996 $2,540 $3,456 58%

Examples of how you can save

• Phonak• Starkey• ReSound• Rexton• Siemens• Sonic Innovations• Oticon• Unitron• Widex

*These are savings examples only. May be used in conjunction with your existing insurance coverage. Hearing discount programs are not part of the insurance policy and are offered at no additional charge. Enrollment in these programs is subject to contract renewal.



WPS Medicare Companion has eight smart plan options

• Automatic bank withdrawal (includes 2% discount!)• Credit/debit card payment• Direct billing

Please see the WPS Medicare Companion enrollment application for additional instructions for selecting a payment option.

Choose from convenient payment options

Coverage of Plan A Plan C Plan F Plan G Plan K Plan L Plan M Plan N

Basic benefits √ √ √ √ √1 √2 √ √

Part B coinsurance

√ √ √ √ √1 √2 √ √3

Part A deductible

√ √ √ 50% 75% 50% √

Skilled nursing facility coinsurance

√ √ √ 50% 75% √ √

Foreign travel emergency

√ √ √ √ √

Part B excess charges

√ √

Part B deductible

√ √

1After deductible, hospitalization and preventive care paid at 100%; other basic benefits paid at 50%. Out-of-pocket limit set by CMS; pays at 100% after limit reached.2After deductible, hospitalization and preventive care paid at 100%; other basic benefits paid at 75%. Out-of-pocket limit set by CMS; pays at 100% after limit reached.3After deductible, requires up to $20 copayment for office visits; up to $50 copayment for emergency room visits. Copayments do not count toward the annual Part B deductible.


Eligibility: Anyone at least 18 years of age who is not a current Ameritas dental plan member is eligible for these dental plans. Please refer to the website for plan availability in your state. EXCEPTIONS, REDUCTIONS, AND LIMITATIONS OF THE POLICY—Your policy will contain a complete listing of procedures covered and any frequency or other limitations on specific procedures. Certain covered expenses may be subject to a waiting period (an elimination period). Alternate Benefit Provision—At times, two or more procedures are considered adequate and appropriate treatment. In this case, the benefit paid will be based on the charge for the least expensive procedure. Certain expenses are not covered—For instance, procedures begun prior to your effective date are not covered. The policy does not provide benefits for lost or stolen appliances or cosmetic procedures. It does not cover hospitalization or prescription drugs. This is not a complete list of exclusions. A full list will be included in your policy. To preview the policy, please send us a request using the contact form on our website, www.CoreDentalinsurance.com. Plans are marketed by SASid, Inc., administered by InsuranceTPA.com and insured by Ameritas Life Insurance Corp. Plan designs may not be available in all areas. Ameritas Group’s individual plans [Indiv. 9000 Ed. 11-09] are issued by Ameritas Life. Ameritas, the bison symbol, Dental Rewards, LASIK Advantage and “We’re Ameritas. We’re for people.” are registered service marks of Ameritas Life or Ameritas Mutual Holding Company and are used with permission.

Optional dental coverageYou’re free to visit any licensed dentist. Also,these plans offer members more than 235,000Ameritas PPO (participating provider organization)access points for dental care nationwide. AmeritasPPO network providers have agreed to chargediscounted fees to our members, so you can almostalways save money. In Texas, the PPO network isreferred to as the Ameritas Dental Network.

When you purchase the plan, you have 10 daysfrom the date you receive your policy to cancel itwith no penalty or obligation except for the onetimeapplication fee. Following that 10-day period,we require that members make a commitmentthrough the initial 12 monthly periods. Optional dental coverage includes:

» Preventive/Type 1: Routine exams, cleanings, fluoride treatments, sealants, and more.

» Basic/Type 2: X-rays, filling restoration, extractions, and more.

» Major/Type 3 (Platinum, Gold, Silver Plans): Onlays, dentures, denture repair, endodontics—root canal, periodontal scaling and root planing, crown and crown repairs, pontics, fixed bridges,

Monthly Rates

Platinum Gold Silver ValueCalendar year maximum $2,500 $1,500 $1,000 $1,000Individual only $51 $41 $31 $21 Individual and spouse $97 $77 $57 $37

surgical removal of teeth, deep sedation/general anesthesia, and more. A six-month waiting period applies to all Type 3 Procedures before benefits are payable.

» Teeth Whitening (Platinum, Gold, Silver Plans): Professional tooth bleaching, also referred to as whitening. With this benefit, members can have a healthy, white smile that may boost self confidence and enhance their appearance.

» Dental Rewards®: A valuable feature which allows qualifying plan members to carry over part of their unused annual maximum.

» LASIK Vision Correction: These plans also include access to savings on LASIK vision correction. LASIK Advantage® provides for LASIK and related procedures.

Contact us for more information about enrolling in this optional dental coverage.

BRANDING GUIDELINES

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Age When Plan

Takes Effect

Plan A Plan C Plan F Plan G Plan K Plan L Plan M Plan N

YouYou with Discount








65 $116.13 $108.00 $145.18 $135.01 $149.81 $139.33 $135.56 $126.07 $78.21 $72.74 $99.44 $92.48 $132.78 $123.49 $118.46 $110.17

66 $122.01 $113.47 $152.51 $141.83 $157.39 $146.37 $142.42 $132.45 $82.15 $76.40 $104.47 $97.16 $139.47 $129.71 $124.45 $115.74

67 $127.87 $118.92 $159.83 $148.64 $164.93 $153.39 $149.24 $138.80 $86.10 $80.08 $109.48 $101.81 $146.18 $135.94 $130.42 $121.29

68 $133.74 $124.38 $167.16 $155.46 $172.52 $160.44 $156.11 $145.19 $90.05 $83.75 $114.50 $106.49 $152.88 $142.18 $136.40 $126.85

69 $139.58 $129.81 $174.49 $162.27 $180.08 $167.47 $162.95 $151.55 $93.99 $87.41 $119.52 $111.15 $159.57 $148.40 $142.38 $132.42

70 $145.47 $135.29 $181.83 $169.10 $187.65 $174.51 $169.80 $157.92 $97.96 $91.10 $124.54 $115.82 $166.32 $154.67 $148.37 $137.99

71 $151.31 $140.72 $189.14 $175.90 $195.21 $181.54 $176.65 $164.28 $101.90 $94.77 $129.57 $120.50 $172.99 $160.88 $154.37 $143.56

72 $157.18 $146.18 $196.48 $182.73 $202.77 $188.58 $183.49 $170.64 $105.84 $98.43 $134.58 $125.16 $179.71 $167.13 $160.34 $149.11

73 $163.03 $151.62 $203.81 $189.54 $210.34 $195.61 $190.34 $177.01 $109.79 $102.10 $139.59 $129.82 $186.39 $173.34 $166.32 $154.67

74 $168.91 $157.09 $211.14 $196.36 $217.90 $202.65 $197.18 $183.37 $113.75 $105.79 $144.63 $134.50 $193.12 $179.60 $172.30 $160.24

75 $174.77 $162.54 $218.47 $203.18 $225.46 $209.68 $204.02 $189.74 $117.70 $109.46 $149.63 $139.15 $199.80 $185.82 $178.26 $165.78

76 $180.64 $168.00 $225.80 $210.00 $233.02 $216.71 $210.87 $196.11 $121.64 $113.12 $154.66 $143.84 $206.52 $192.06 $184.25 $171.35

77 $186.50 $173.45 $233.13 $216.81 $240.58 $223.74 $217.70 $202.46 $125.59 $116.80 $159.68 $148.50 $213.22 $198.29 $190.24 $176.92

78 $192.36 $178.90 $240.45 $223.62 $248.15 $230.78 $224.55 $208.83 $129.55 $120.48 $164.70 $153.17 $219.92 $204.53 $196.22 $182.48

79 $198.21 $184.34 $247.78 $230.44 $255.71 $237.81 $231.40 $215.20 $133.48 $124.13 $169.72 $157.84 $226.62 $210.75 $202.19 $188.04

80 $204.09 $189.81 $255.13 $237.27 $263.30 $244.87 $238.26 $221.58 $137.45 $127.82 $174.75 $162.52 $233.32 $216.99 $208.17 $193.60

81 $208.35 $193.76 $260.45 $242.22 $268.77 $249.96 $243.22 $226.19 $140.32 $130.49 $178.39 $165.90 $238.20 $221.52 $212.52 $197.65

82 $212.68 $197.79 $265.83 $247.23 $274.34 $255.14 $248.25 $230.88 $143.22 $133.19 $182.08 $169.34 $243.12 $226.10 $216.92 $201.74

83 $217.05 $201.86 $271.30 $252.31 $279.99 $260.39 $253.36 $235.62 $146.16 $135.93 $185.84 $172.83 $248.12 $230.75 $221.39 $205.89

84 $221.48 $205.98 $276.87 $257.49 $285.72 $265.72 $258.54 $240.45 $149.16 $138.72 $189.64 $176.37 $253.22 $235.50 $225.91 $210.10

85+ $226.00 $210.18 $282.50 $262.73 $291.53 $271.12 $263.81 $245.34 $152.17 $141.52 $193.48 $179.94 $258.38 $240.29 $230.53 $214.39

*Household: Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex.

Iowa Rates—Male7% Household Discount: Get the best rate possible when you enroll with a second member of your household.* You each pay the “You with Discount” rate shown below.

WPS Medicare Companion monthly premium ratesEffective January 1, 2018

Age When Plan

Takes Effect










65 $116.13 $108.00 $145.18 $135.01 $149.81 $139.33 $135.56 $126.07 $78.21 $72.74 $99.44 $92.48 $132.78 $123.49 $118.46 $110.17

66 $122.01 $113.47 $152.51 $141.83 $157.39 $146.37 $142.42 $132.45 $82.15 $76.40 $104.47 $97.16 $139.47 $129.71 $124.45 $115.74

67 $127.87 $118.92 $159.83 $148.64 $164.93 $153.39 $149.24 $138.80 $86.10 $80.08 $109.48 $101.81 $146.18 $135.94 $130.42 $121.29

68 $133.74 $124.38 $167.16 $155.46 $172.52 $160.44 $156.11 $145.19 $90.05 $83.75 $114.50 $106.49 $152.88 $142.18 $136.40 $126.85

69 $139.58 $129.81 $174.49 $162.27 $180.08 $167.47 $162.95 $151.55 $93.99 $87.41 $119.52 $111.15 $159.57 $148.40 $142.38 $132.42

70 $145.47 $135.29 $181.83 $169.10 $187.65 $174.51 $169.80 $157.92 $97.96 $91.10 $124.54 $115.82 $166.32 $154.67 $148.37 $137.99

71 $151.31 $140.72 $189.14 $175.90 $195.21 $181.54 $176.65 $164.28 $101.90 $94.77 $129.57 $120.50 $172.99 $160.88 $154.37 $143.56

72 $157.18 $146.18 $196.48 $182.73 $202.77 $188.58 $183.49 $170.64 $105.84 $98.43 $134.58 $125.16 $179.71 $167.13 $160.34 $149.11

73 $163.03 $151.62 $203.81 $189.54 $210.34 $195.61 $190.34 $177.01 $109.79 $102.10 $139.59 $129.82 $186.39 $173.34 $166.32 $154.67

74 $168.91 $157.09 $211.14 $196.36 $217.90 $202.65 $197.18 $183.37 $113.75 $105.79 $144.63 $134.50 $193.12 $179.60 $172.30 $160.24

75 $174.77 $162.54 $218.47 $203.18 $225.46 $209.68 $204.02 $189.74 $117.70 $109.46 $149.63 $139.15 $199.80 $185.82 $178.26 $165.78

76 $180.64 $168.00 $225.80 $210.00 $233.02 $216.71 $210.87 $196.11 $121.64 $113.12 $154.66 $143.84 $206.52 $192.06 $184.25 $171.35

77 $186.50 $173.45 $233.13 $216.81 $240.58 $223.74 $217.70 $202.46 $125.59 $116.80 $159.68 $148.50 $213.22 $198.29 $190.24 $176.92

78 $192.36 $178.90 $240.45 $223.62 $248.15 $230.78 $224.55 $208.83 $129.55 $120.48 $164.70 $153.17 $219.92 $204.53 $196.22 $182.48

79 $198.21 $184.34 $247.78 $230.44 $255.71 $237.81 $231.40 $215.20 $133.48 $124.13 $169.72 $157.84 $226.62 $210.75 $202.19 $188.04

80 $204.09 $189.81 $255.13 $237.27 $263.30 $244.87 $238.26 $221.58 $137.45 $127.82 $174.75 $162.52 $233.32 $216.99 $208.17 $193.60

81 $208.35 $193.76 $260.45 $242.22 $268.77 $249.96 $243.22 $226.19 $140.32 $130.49 $178.39 $165.90 $238.20 $221.52 $212.52 $197.65

82 $212.68 $197.79 $265.83 $247.23 $274.34 $255.14 $248.25 $230.88 $143.22 $133.19 $182.08 $169.34 $243.12 $226.10 $216.92 $201.74

83 $217.05 $201.86 $271.30 $252.31 $279.99 $260.39 $253.36 $235.62 $146.16 $135.93 $185.84 $172.83 $248.12 $230.75 $221.39 $205.89

84 $221.48 $205.98 $276.87 $257.49 $285.72 $265.72 $258.54 $240.45 $149.16 $138.72 $189.64 $176.37 $253.22 $235.50 $225.91 $210.10

85+ $226.00 $210.18 $282.50 $262.73 $291.53 $271.12 $263.81 $245.34 $152.17 $141.52 $193.48 $179.94 $258.38 $240.29 $230.53 $214.39

Note: Rates include a 2% discount for members who enroll in automatic bank withdrawal. Those who pay by credit card or paper bill will pay a slightly higher premium than those listed here. Please contact us with any questions.


Age When Plan

Takes Effect










65 $102.99 $95.78 $128.73 $119.72 $132.85 $123.55 $120.22 $111.80 $69.35 $64.50 $88.17 $82.00 $117.75 $109.50 $105.06 $97.70

66 $108.19 $100.62 $135.24 $125.77 $139.56 $129.79 $126.29 $117.45 $72.85 $67.75 $92.64 $86.15 $123.70 $115.04 $110.35 $102.62

67 $113.39 $105.45 $141.74 $131.82 $146.27 $136.03 $132.36 $123.09 $76.35 $71.01 $97.08 $90.28 $129.63 $120.56 $115.66 $107.56

68 $118.59 $110.29 $148.23 $137.86 $152.98 $142.27 $138.43 $128.74 $79.86 $74.27 $101.54 $94.43 $135.58 $126.09 $120.94 $112.48

69 $123.79 $115.13 $154.71 $143.88 $159.68 $148.50 $144.49 $134.38 $83.36 $77.52 $106.00 $98.58 $141.53 $131.62 $126.26 $117.42

70 $128.99 $119.96 $161.26 $149.97 $166.41 $154.76 $150.59 $140.05 $86.87 $80.79 $110.44 $102.71 $147.47 $137.15 $131.57 $122.36

71 $134.20 $124.81 $167.74 $156.00 $173.11 $160.99 $156.64 $145.68 $90.37 $84.04 $114.89 $106.84 $153.42 $142.68 $136.87 $127.29

72 $139.40 $129.64 $174.24 $162.05 $179.83 $167.24 $162.73 $151.34 $93.86 $87.29 $119.35 $111.00 $159.36 $148.20 $142.20 $132.24

73 $144.57 $134.45 $180.74 $168.09 $186.53 $173.48 $168.80 $156.98 $97.36 $90.55 $123.80 $115.14 $165.29 $153.72 $147.47 $137.15

74 $149.79 $139.31 $187.24 $174.13 $193.23 $179.70 $174.85 $162.61 $100.88 $93.82 $128.24 $119.27 $171.26 $159.27 $152.79 $142.10

75 $154.98 $144.13 $193.72 $180.16 $199.93 $185.93 $180.92 $168.25 $104.38 $97.07 $132.70 $123.41 $177.18 $164.78 $158.09 $147.03

76 $160.19 $148.98 $200.25 $186.24 $206.63 $192.17 $186.98 $173.90 $107.88 $100.33 $137.14 $127.54 $183.13 $170.31 $163.39 $151.95

77 $165.40 $153.83 $206.73 $192.26 $213.35 $198.41 $193.06 $179.55 $111.37 $103.57 $141.59 $131.68 $189.07 $175.84 $168.69 $156.88

78 $170.59 $158.65 $213.24 $198.31 $220.05 $204.65 $199.13 $185.19 $114.87 $106.83 $146.07 $135.84 $195.03 $181.38 $173.99 $161.81

79 $175.78 $163.48 $219.74 $204.35 $226.74 $210.87 $205.18 $190.82 $118.36 $110.08 $150.50 $139.96 $200.96 $186.89 $179.29 $166.74

80 $181.00 $168.33 $226.24 $210.41 $233.49 $217.14 $211.28 $196.49 $121.87 $113.34 $154.96 $144.11 $206.92 $192.43 $184.61 $171.69

81 $184.78 $171.84 $230.96 $214.79 $238.36 $221.67 $215.69 $200.59 $124.42 $115.71 $158.20 $147.13 $211.23 $196.44 $188.45 $175.26

82 $188.60 $175.40 $235.74 $219.24 $243.29 $226.26 $220.16 $204.75 $127.00 $118.11 $161.47 $150.17 $215.61 $200.52 $192.36 $178.90

83 $192.48 $179.01 $240.59 $223.75 $248.28 $230.90 $224.67 $208.95 $129.61 $120.54 $164.80 $153.26 $220.05 $204.65 $196.32 $182.58

84 $196.41 $182.66 $245.52 $228.33 $253.39 $235.65 $229.29 $213.24 $132.27 $123.01 $168.18 $156.41 $224.55 $208.83 $200.36 $186.34

85+ $200.41 $186.38 $250.53 $232.99 $258.52 $240.43 $233.94 $217.56 $134.97 $125.52 $171.59 $159.58 $229.12 $213.09 $204.43 $190.12


Iowa Rates—Female7% Household Discount: Get the best rate possible when you enroll with a second member of your household.* You each pay the “You with Discount” rate shown below.

WPS Medicare Companion monthly premium ratesEffective January 1, 2018

*Household: Two or more individuals who reside together in the same dwelling. Dwelling is defined as a single home, condominium unit, or apartment unit within an apartment complex.

Age When Plan

Takes Effect










65 $102.99 $95.78 $128.73 $119.72 $132.85 $123.55 $120.22 $111.80 $69.35 $64.50 $88.17 $82.00 $117.75 $109.50 $105.06 $97.70

66 $108.19 $100.62 $135.24 $125.77 $139.56 $129.79 $126.29 $117.45 $72.85 $67.75 $92.64 $86.15 $123.70 $115.04 $110.35 $102.62

67 $113.39 $105.45 $141.74 $131.82 $146.27 $136.03 $132.36 $123.09 $76.35 $71.01 $97.08 $90.28 $129.63 $120.56 $115.66 $107.56

68 $118.59 $110.29 $148.23 $137.86 $152.98 $142.27 $138.43 $128.74 $79.86 $74.27 $101.54 $94.43 $135.58 $126.09 $120.94 $112.48

69 $123.79 $115.13 $154.71 $143.88 $159.68 $148.50 $144.49 $134.38 $83.36 $77.52 $106.00 $98.58 $141.53 $131.62 $126.26 $117.42

70 $128.99 $119.96 $161.26 $149.97 $166.41 $154.76 $150.59 $140.05 $86.87 $80.79 $110.44 $102.71 $147.47 $137.15 $131.57 $122.36

71 $134.20 $124.81 $167.74 $156.00 $173.11 $160.99 $156.64 $145.68 $90.37 $84.04 $114.89 $106.84 $153.42 $142.68 $136.87 $127.29

72 $139.40 $129.64 $174.24 $162.05 $179.83 $167.24 $162.73 $151.34 $93.86 $87.29 $119.35 $111.00 $159.36 $148.20 $142.20 $132.24

73 $144.57 $134.45 $180.74 $168.09 $186.53 $173.48 $168.80 $156.98 $97.36 $90.55 $123.80 $115.14 $165.29 $153.72 $147.47 $137.15

74 $149.79 $139.31 $187.24 $174.13 $193.23 $179.70 $174.85 $162.61 $100.88 $93.82 $128.24 $119.27 $171.26 $159.27 $152.79 $142.10

75 $154.98 $144.13 $193.72 $180.16 $199.93 $185.93 $180.92 $168.25 $104.38 $97.07 $132.70 $123.41 $177.18 $164.78 $158.09 $147.03

76 $160.19 $148.98 $200.25 $186.24 $206.63 $192.17 $186.98 $173.90 $107.88 $100.33 $137.14 $127.54 $183.13 $170.31 $163.39 $151.95

77 $165.40 $153.83 $206.73 $192.26 $213.35 $198.41 $193.06 $179.55 $111.37 $103.57 $141.59 $131.68 $189.07 $175.84 $168.69 $156.88

78 $170.59 $158.65 $213.24 $198.31 $220.05 $204.65 $199.13 $185.19 $114.87 $106.83 $146.07 $135.84 $195.03 $181.38 $173.99 $161.81

79 $175.78 $163.48 $219.74 $204.35 $226.74 $210.87 $205.18 $190.82 $118.36 $110.08 $150.50 $139.96 $200.96 $186.89 $179.29 $166.74

80 $181.00 $168.33 $226.24 $210.41 $233.49 $217.14 $211.28 $196.49 $121.87 $113.34 $154.96 $144.11 $206.92 $192.43 $184.61 $171.69

81 $184.78 $171.84 $230.96 $214.79 $238.36 $221.67 $215.69 $200.59 $124.42 $115.71 $158.20 $147.13 $211.23 $196.44 $188.45 $175.26

82 $188.60 $175.40 $235.74 $219.24 $243.29 $226.26 $220.16 $204.75 $127.00 $118.11 $161.47 $150.17 $215.61 $200.52 $192.36 $178.90

83 $192.48 $179.01 $240.59 $223.75 $248.28 $230.90 $224.67 $208.95 $129.61 $120.54 $164.80 $153.26 $220.05 $204.65 $196.32 $182.58

84 $196.41 $182.66 $245.52 $228.33 $253.39 $235.65 $229.29 $213.24 $132.27 $123.01 $168.18 $156.41 $224.55 $208.83 $200.36 $186.34

85+ $200.41 $186.38 $250.53 $232.99 $258.52 $240.43 $233.94 $217.56 $134.97 $125.52 $171.59 $159.58 $229.12 $213.09 $204.43 $190.12


Note: Rates include a 2% discount for members who enroll in automatic bank withdrawal. Those who pay by credit card or paper bill will pay a slightly higher premium than those listed here. Please contact us with any questions.

Turn

65!Turn

65!

If you apply during your one-time open enrollment period, you won’t need to answer any health questions; simply submit a policy enrollment application.

One-time open enrollment

period ends

You cansubmit an application

or enroll in Part B

66Months

AfterMonths

After

44Months Before

Months Before

Enrollment timeline when you turn 65


Have other coverage that’s terminating or changing?If so, you may be eligible for guaranteed acceptance of this policy. Contact your agent or call a WPS sales representative at 1-800-332-1406 for information.

Enroll anytime after you turn 65Already passed the 65-year milestone?You can switch Medicare supplement plans at any time throughout the year. You don’t have to wait for an annual enrollment period like you do with Medicare Advantage plans. It’s easy to make the switch! Just contact your agent or call a WPS sales representative at 1-800-332-1406.

Coverage begins on the first of the month that you turn 65 and/or enroll in Medicare Part B, or on the effective date you request up to four months in the future.


Parts of Medicare

The Medicare program has several different parts, which can be confusing if you’re unfamiliar with them. A Medicare supplement works with your Medicare Part A and Part B coverage.

Part A Part B Part D

• Hospital care• Skilled nursing

facility care• Nursing home care• Hospice• Home health services

• Medically necessary outpatient services to diagnose or treat your medical condition

• Most preventive outpatient services, including an annual wellness exam

• Stand-alone prescription drug plans (PDP) help pay for medications

• Mail order options and access to retail pharmacies nationwide

Limitations and exclusionsNo insurance policy covers everything. Here’s a list of things this Medicare supplement doesn’t cover:

• Personal comfort items• Routine physical exams and any related diagnostic, X-ray,

and laboratory tests except those covered by Medicare• Eye exams or hearing exams, except for those services

covered by Medicare• Orthopedic shoes or other supporting devices for

the feet• Routine foot care not covered by Medicare• Custodial care, including maintenance care or

supportive care• Cosmetic surgery, except as stated in the policy• Outpatient prescription drugs• Professional services not provided by a physician, except

as required by law• Routine immunizations, except if eligible under Medicare

and except as stated in the policy• Preparation, fitting, or purchase of eyeglasses or hearing

aids, unless covered by Medicare• Care, treatment, filling, removal, or replacement of teeth;

dental X-rays, root canals, surgery for impacted teeth, or other surgical procedures to the teeth or supporting structures

• Nursing home care costs beyond what is covered by Medicare

• If you terminate your Medicare coverage, expenses which would have been covered by Medicare

• Your Medicare Part A deductible, unless you purchase full or partial coverage of the Medicare Part A deductible

• Your Medicare Part B deductible, unless you purchase Plan C or F

• Physician charges above Medicare’s approved charge, unless you purchase Plan F or G

• Home health care beyond what is covered by Medicare• Any health care treatments, services, or supplies received

outside the United States, unless you purchase Plan C, F, G, M, or N

• Any health care treatments, services, or supplies:- Not covered by Medicare, unless specifically stated in

the policy- You, or anyone on your behalf, aren’t legally obligated

to pay for- Paid for by Medicare or another government entity or

program- For any injury, occurring on or after your effective date,

caused by an act of war- Provided by immediate family members or by anyone

else who lives with you- To the extent covered by worker’s compensation or

similar laws- Provided before the effective date of coverage or

after coverage ends- Determined by Medicare to be unreasonable or

unnecessary- For a military service-related condition treated at

any military or veterans hospital, or at any hospital contracted by any national government or agency

This is an advertisement for insurance. Neither Wisconsin Physicians Service Insurance Corporation, nor The EPIC Life Insurance Company, nor their products or agents are connected with or endorsed by the United States government or the federal Medicare program. WPS Health Insurance is underwritten by The EPIC Life Insurance Company. This plan summary provides only a general description of benefits and limitations. A detailed description of coverage is in the applicable policy. If there is ever a discrepancy between the policy and this document, the policy has final authority.

Medicare supplements give you peace of mindOriginal Medicare covers a lot—about 80% of your approved health care costs. But covering even just the 20% that Medicare leaves behind can be a real burden and hassle. WPS Medicare Companion, a Medicare supplement plan, helps reduce these out-of-pocket costs when you need medical care.

Join our WPS Medicare Companion family today and get worry-free peace of mind you’ll enjoy for years to come!

Ready to take the next step?Contact your local agent or call WPS today at 1-800-332-1406.

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The EPIC Life Insurance CompanyA WPS Company

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