Wisconsin Health Insurance

Health Insurance Overview

Wisconsin residents have many options for health care coverage. There are numerous Wisconsin insurance providers to choose from, along with a variety of Wisconsin medical insurance plans designed to meet the specific needs of individuals, families and groups.

Whether you need independent self-employed health coverage, or your employer simply doesn’t offer group Wisconsin health insurance benefits. Whether you are looking to cover your spouse and children under the same low rate, or you are a small business that wants to provide your employees with affordable coverage. Whatever your situation, we are your one stop resource for all your health care needs – including reliable Wisconsin medical insurance from the best Wisconsin insurance providers around.

Each state is unique in its laws and regulations, as well as the types of coverage it offers. Here you will find an array of resources and useful information to help you better understand Wisconsin health insurance and the range of options available to you. This includes current facts and statistics about residents, important state legislation, financial assistance and public Wisconsin health insurance programs, and even details on some of the top Wisconsin insurance providers.

To compare specific Wisconsin medical insurance plans offered by the various Wisconsin insurance providers, and get a personalized quote for the options that are right for you, contact us now for free. We’ll connect you with a highly qualified insurance agent near you who will be happy to help you with all of your Wisconsin health insurance needs.

At Healthcare Solutions Team, we’re committed to making affordable health care accessible to everyone. Our group of elite Wisconsin health insurance advisors is dedicated to helping match the right coverage to fit the unique needs of all families, individuals and groups. Not a resident of Wisconsin? Find your state here.

Wisconsin Health Insurance Facts & Statistics

Total Wisconsin Residents – 5,584,700

Total Health Insurance Coverage In Wisconsin:
Employer – 55%
Individual – 5%
Medicaid – 15%
Medicare – 15%
Other Public – NSD
Uninsured – 9%

Average Individual Monthly Premiums – $201

Average Annual Single Employee Contribution for Employer-Based Health Insurance Plan – 22%

Average Annual Single Employee Premium for Employer-Based Health Insurance Plan – $1,174

Average adjusted hospital cost per inpatient day – $1,935

Source data according to the Kaiser Family Foundation (http://www.kff.org/) (2009-2012 data) and http://www.statehealthfacts.org/

Wisconsin Medical Insurance Laws, Regulations & Policies

There are several Wisconsin health insurance laws and regulations that are put in place to protect policyholders living in the state. Before a Wisconsin insurance provider will accept an applicant for coverage and set their premiums, they look at the applicant’s health status. However, Wisconsin residents do have some protections according to state and federal laws. For example, insurers in the state are not allowed to cancel a policyholder’s coverage if they become sick or get injured.

Additionally, all Wisconsin health insurance plans are required to cover certain medical services. Some of these mandated services include:

  • Screening for cervical and breast cancer
  • Diabetes care
  • Care for pregnant women
  • Vaccinations for children

Also, Wisconsin health insurance law requires insurers to cover mental and physical health conditions equally. The federal government provides protection for Wisconsin residents as well. For example, individuals who recently left an employer’s group health plan and meet other requirements are HIPAA-eligible, which prohibits insurers from restricting coverage.

If an individual is turned down for coverage because of their health status, they can purchase coverage through the state’s high risk health insurance pool, the Wisconsin Health Insurance Risk Sharing Plan. However, it is important to note that these plans can be quite expensive.

Wisconsin Health Insurance Resources

Wisconsin Health Insurance High Risk Pools

The Patient Protection and Affordable Care Act established temporary national high risk pools to provide health insurance to those with pre-existing conditions. The Pre-Existing Condition Insurance Plan (PCIP) in Wisconsin runs similar to regular Wisconsin health insurance policies and requires enrollees to pay monthly premiums and out-of-pocket expenses.

Enrollees in the Wisconsin PCIP pay about the same that people without medical conditions pay for health insurance. The estimated monthly premium cost for Wisconsin residents ranges from $127 to $474. The deductible ranges from $500 to $3,500, which must be met before coverage for health insurance benefits will kick in. There is an out-of-pocket limit set at $1,000 for medical services. Those residents who are eligible for the plan will then have access to health insurance coverage for doctor and hospital visits, emergency services, prescription drugs, and more.

Individuals are eligible for Wisconsin PCIP if they are a United States’ citizen, have an existing medical condition, and have been uninsured for six months. For more information on the Wisconsin health insurance high risk pools visit http://www.healthcare.gov.

To stay up-to-date on the latest health care reform news, visit: http://healthreform.kff.org/

Wisconsin Medical Insurance and Health Care Programs

The state of Wisconsin offers residents quite a few public health insurance programs to assist low-income residents in getting access to affordable health care and insurance coverage. These programs include:

  • Medicaid
    The Wisconsin Medicaid program is designed to provide health insurance for qualifying low-income residents and disabled citizens. To learn more about the Medicaid program in Wisconsin, visit online at http://dhs.wisconsin.gov/medicaid/.
  • BadgerCare Plus
    This program provides health coverage for any child in Wisconsin whose family has no existing health insurance. To find out more information about this Wisconsin health insurance program, visit online.
  • Wisconsin Well Woman Program
    Low-income women in Wisconsin can receive free screening for cervical and breast cancer through this program. Find out more about this women’s Wisconsin medical insurance program.
  • Wisconsin Medicare
    Seniors can get Wisconsin health insurance through Medicare Advantage, Medicare Supplement and Original Medicare.

Certain trade workers and early retirees in Wisconsin can also get financial assistance from the federal government through the Federal Health Coverage Tax Credit. To learn more, visit the program’s website, http://www.irs.gov/individuals/article/0,,id=109960,00.html.

Wisconsin Insurance Providers

Anthem Blue Cross and Blue Shield of Wisconsin Health Insurance

Anthem is one of Wisconsin’s largest providers of health insurance. It offers residents affordable plans and access to an extensive network of doctors and hospitals.

Arise Health Plan Health Insurance

Arise Health Plan is a wholly owned subsidiary of the parent company, which allows for it to have access to all the technological resources their customers and the health insurance market need.

Assurant Health Insurance

Assurant Health, headquartered in Milwaukee, has been offering quality insurance products and coverage to more than 1 million members since 1982. Assurant is committed to providing health insurance plans that have broad coverage while providing valuable protection.

Celtic Health Insurance

Celtic concentrates on individual health insurance, offering a wide variety of plans for both individuals and families.

Dean Health Plan, Inc. Health Insurance

Dean Health Plan is one of the largest integrated health insurance delivery systems in the United States with more than 250,000 members and more than 1,900 physicians to serve them.

Golden Rule Health Insurance

Golden Rule Insurance Company provides affordable and customized health insurance plans for millions of individuals and families.

Humana Health Insurance

Through affordable health insurance options, Humana helps its members better manage their healthcare and make informed health decisions.

John Alden Health Insurance

John Alden Life Insurance has been selling health coverage throughout America since 1961. Today, it is part of Assurant. John Alden plans include individual health and small group coverage. It also sells Health Savings Account plans.

Physicians Plus Health Insurance

Physicians Plus, founded in 1986, is a nationally recognized, managed care organization location in Madison, Wisconsin. It provides primary, specialty and hospital care to more than 110,000 members through its network of more than 3,000 doctors and health professionals.

Security Health Plan Health Insurance

Security Health Plan is a physician-directed health plan established in 1986. It covers more than 185,000 members in Wisconsin and has a network of 42 hospitals, 4,000 physicians, and more than 55,000 pharmacies.

Standard Security Life Health Insurance

The Independence Holding Company (IHC) provides management services to large companies that deliver insurance solutions to groups and individuals. As divisions of IHC, the Standard Security Life Insurance Company of New York and the Independence American Insurance Company offer various lines of life, health and disability insurance.

Time Insurance Health Insurance

Today, Time Insurance is known as Assurant Health with insurance coverage for individuals, students, families, seniors, and businesses.

Time Short Term Health Insurance

Today, Time Short Term health insurance is offered through the Assurant name. Time short-term health plans provide comprehensive coverage for a temporary period of time at affordable rates.

UnitedHealthOne Health Insurance

Golden Rule, a United Healthcare company, has been offering affordable health insurance solutions for more than 60 years.

Unity Health Insurance

As an affiliate of the University of Wisconsin Hospital and Clinics and the University of Wisconsin Medical Foundation, Unity Health Insurance is part of the academic medical center and health system for the University of Wisconsin.

WPS Health Insurance

The WPS Health Insurance Company helps consumers select the right individual, family, Medicare, and prescription drug plan to fulfill their health care needs as well as their budgets.

WorldIns ExpressMed Health Insurance

World Insurance offers several types of individual health insurance ranging from dental coverage to comprehensive major medical plans.

Important Contacts and Links

Wisconsin Office of the Commissioner of Insurance and Department of Health and Family Services

Find the contact information for the Wisconsin health insurance and health and family services departments at:

Wisconsin Office of the Commissioner of Insurance
125 South Webster Street
Madison, Wisconsin 53703-3474
Phone: (800) 236-8517

Wisconsin Department of Health and Family Services
1 W. Wilson Street
Madison, WI 53703
Phone: (608)266-1865