Wisconsin Health Insurance

wisconsin health insurance text overlaying image of capital building There are numerous affordable health insurance options available in Wisconsin that will meet your specific needs. The majority of these plans will also allow for the addition of dental and vision insurance. The lowest-priced health insurance plans in your state start at $380 per month, dental add-ons at $46 per month, and vision plans at $5 per month. Rates and coverage depend on your age, gender, household size, and other factors, but a full-coverage health insurance plan will cost Wisconsin residents on average $428 per month, but some might even be eligible for free plans.

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Wisconsin Health Insurance Companies

With around 15 companies offering health insurance in Wisconsin, residents have a variety of options. To help you start your search, we’ve highlighted a few of the more popular companies:

Medica

Medica has a wide network of more than 33,000 physicians, and offers individual, family, group, and Medicare Advantage plans. Dental insurance policies are also available.

Security Health Plan of Wisconsin

Security Health Plan is one of Wisconsin’s biggest carriers offering Health Maintenance Organizations (HMO) plans. Plans benefits include a nursing hotline, wellness resources, and global emergency care. The BadgerCare Plus program enables those in need of financial assistance to select an affordable HMO plan.

Molina Healthcare of Wisconsin

Individuals and families shopping for insurance with Molina Healthcare of Wisconsin have the option of selecting from among Bronze, Silver, or Gold tier coverage options. Some enrollees may benefit from their payment assistance programs if they qualify. They also offer a 24-hour nurse advice line, health management plans, and health education programs.

 

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Health Insurance Marketplace in Wisconsin

If you’re looking for health insurance in Wisconsin, the health insurance Marketplace is a great place to start. Marketplace health insurance, which was created by the Affordable Care Act, offers certain consumer protections, guarantees coverage for pre-existing conditions, and includes coverage for what are known as the “10 essential health benefits”:

  • Ambulatory patient services (outpatient care)
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

The ACA-compliant plans offered on the Marketplace are divided into different types, known as metal tiers: Bronze, Silver, and Gold. These tiers do not signal a difference in quality of care, though. The tiers differ in your out-of-pocket costs versus what your plan covers. 

It’s important to remember that the Marketplace only offers the plans of participating providers. So unfortunately, while the Marketplace is a great tool, you may not be able to compare every plan available to you.

Whether you want a Marketplace plan, or a plan from a private insurer, an EZ agent can help. We work with all carriers in your state in order to compare all options available.

 

Over half of the uninsured in Wisconsin who qualify for Marketplace insurance coverage could get a Bronze plan for FREE.

 

Wisconsin’s Short Term Health Insurance Guidelines

If you’ve missed the health insurance Open Enrollment Period (OEP), or if you need health insurance for a short amount of time, short-term plans are a great option. It’s important to note, though, that these policies tend to only cover the basics, and you can be denied one of these plans if you have a pre-existing condition. 

There are some rules around short-term plans, both at the federal and the state level. Some states choose to have their own guidelines separate from federal guidelines, or don’t allow short-term plans at all. Wisconsin has its own state regulations: plans can initially be purchased for a term of 365 days, and you can only renew your plan for up to 18 months of coverage. You can buy a new short-term plan with the same company after that, but you have to wait 63 days after your plan expires.

 

Wisconsin Health Insurance Options

There is no ideal strategy for finding the right health insurance, but if you’re aware of your options, you can choose what’s best for you and your family without going over budget. You have access to a number of tools that you can use to make your decision.

For example, your employer is actually a great resource for affordable healthcare, so speak to them about your group plan options. While employers in Wisconsin are not required to offer health insurance to their employees, the majority of employers do, and these plans are often less expensive than individual plans.

Looking into programs supported by the government is another option. Adults with specific disabilities of any age, or those over 65 can qualify for affordable Medicare plans. Families and individuals with low incomes may potentially be eligible for Medicaid, which provides free health insurance, if they meet eligibility requirements.

But the best resource at your disposal is an insurance agent. Your EZ agent will evaluate all of your options and even determine if you are eligible for any assistance programs. They can find you affordable insurance plans that offer the coverage you need.

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How to Get the Most Savings

In terms of per-capita healthcare spending, Wisconsin is ranked 42nd out of the 50 states, with an average annual healthcare cost of $9,626 per person. While you’re lucky to live in a relatively affordable state for healthcare, you can still find ways to lower your health insurance costs.

One of the first things that health insurance companies take into account is your health, especially your body mass index (BMI). That means you could be paying more for your insurance if you’re among the 34.2% of adults in Wisconsin who are obese. Maintaining a healthy BMI is a great way to lower your premiums, and your healthcare costs in general.

Tobacco use is also a big red flag for insurance companies. In fact, a smoker’s insurance premiums can be up to 50% higher than those of a nonsmoker. So if you’re among the 15.5% of people who smoke in Wisconsin, you could lower your insurance premiums – and your healthcare costs in general – by kicking the habit.

But there is an even simpler way to save money: working with an insurance agent. An EZ agent can compare all of the plans available in your area that are within your price range, as well as help you find any discounts you might be eligible for. The experts at EZ could help you save hundreds of dollars on health insurance each year! Not only that, but all of our services are completely free!

 

Wisconsin Health Insurance FAQS

  • Does Wisconsin require you to have health insurance?

No, residents in Wisconsin are not required to have health insurance, and as of 2019, there is no longer a federal tax penalty for not having coverage, either.

  • What is the cheapest health insurance in Wisconsin?

The cheapest health plan will be a Bronze plan, which can start as low as $380 a month. Remember, though, health insurance plan prices can vary depending on age, zip code, gender, and other factors. More than half of Wisconsin residents who qualify for a Marketplace plan can actually get a Bronze plan for free.

  • How much does health insurance cost in Wisconsin?

The average monthly health insurance premium in Wisconsin is $428, or $5,136 per year, with plans as low as $380 a month to as high as $1,045. But do not let these numbers scare you. More than half of uninsured people in Wisconsin qualify for a $0 Bronze plan and don’t even know it.

  • Which companies offer health insurance in Wisconsin?

The top 15 insurers in your state are Aspirus Arise Health Plan of Wisconsin, Children’s Community Health Plan, Common Ground Healthcare Cooperative, Dean Health Plan, Inc., Group Health Cooperative of South Central Wisconsin, HealthPartners Insurance Company, Medica Community Health Plan, MercyCare HMO, Inc., Molina Healthcare of Wisconsin, Inc., Network Health Plan, Quartz Health Benefit Plans Corporation, Security Health Plan of Wisconsin, Inc., Wisconsin Physicians Service Insurance Corporation, and WPS Health Plan, Inc. (Arise).

How to Enroll in Health Insurance in Wisconsin

There are various ways to sign up for a health insurance plan. You can sign up for your employer’s group insurance plan if they offer one or do so directly through an insurance carrier. Another choice is to sign up through the federal Health Insurance Marketplace. On the exchange, residents can look at all plans offered by participating companies.

However you choose to enroll in health insurance, you should work with an agent. EZ agents can compare all available plans from all carriers in a flash and will be on hand to guide you throughout the enrollment process.

If you still have questions, feel free to give us a call at 877-670-3557. When you call, you will be directly connected to a local insurance agent who can answer all of your questions and help you find the health insurance plan that works best for you.

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About The Author:
Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.

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