Wisconsin Health InsuranceIndividuals and Families
Wisconsin Health Insurance
How to find an affordable plan.
For the vast majority of Americans, paying for medical costs out of pocket is out of the question. Health insurance reduces the financial risks associated with medical visits, procedures, illness, and medications/supplies. With most traditional health plans, your chosen insurance company guarantees payment of a large portion of your medical bills in return for a premium (monthly payments to the insurance company based on individual criteria) and, depending on your coverage, certain percentages of your total cost up to an agreed amount. There are many different types of health insurance coverage ranging from individual health insurance, health insurance for seniors, employer-group insurance, and state-sponsored insurance for low-income individuals. An insurance company creates their revenue by pooling the premiums of policy holders. For example: you are an individual paying $75 per month. In one year, you had only one health checkup and a minor ankle sprain totaling only $150. Your total premium for the year cost you $900 generating a profit of $750 for your insurance company. Your neighbor, on the other hand, was in and out of the hospital for knee surgery. By pooling their premiums, insurance companies are able to pay for situations like this and still generate the profit needed to provide affordable health insurance. With increasing developments in the medical world, the average lifespan of humans has risen dramatically. It now costs insurance companies more to provide care and with rising premiums, it is more important than ever to understand your health insurance and how to utilize your coverage.
Leading Wisconsin Health Insurance Companies
Consider the Following Health Insurance Coverage Options
Major medical coverage is offered by many insurance companies as 1) your sole source of coverage, covering only expenses associated with a major catastrophe and/or 2) a supplemental insurance guarding against major medicals expenses in a case such as cancer, heart attacks, etc.
Short-term insurance is also an option should you be in between jobs. Short-term is purchased for a set amount of time, often times very helpful for families experiencing job transitions.
Group insurance is most often available to companies with numerous employees. Group rates are determined by the number of employee ensured. This is often times the best policy for those suffering chronic health problems. Rates are determined solely by the group versus individual assessment. Should your family experience serious health conditions, you may be eligible for Wisconsin’s Family or Medical Leave Act - requiring employers with 50+ employees to allow you to care for your family. Under the federal law, COBRA requires employers with 20+ employees to offer health benefits up to 18 months following voluntary or involuntary termination.
Individual health insurance is perhaps the most flexible though not necessarily most affordable insurance for Americans. Individual insurance allows you to purchase plans tailored for your health needs.
Medicaid SCHIP is Wisconsin’s federal program for low-income families with children. The State Children’s Health Insurance Program is a flexible federal program that allows states to offer a variety of plans, but is held to a basic standard of provisions for children’s health insurance. Eligibility is based on the number of family members and income.
Medicare is the nation’s largest insurance program, also offering insurance for disabled and/or blind residents. Medicaid is also a federal insurance program offering insurance for low-income residents/families. Also based on family members and income.
Wisconsin also offers a program for the uninsurable. The Wisconsin Health Insurance Risk Sharing Plan (HIRSP) offers two different plans for those not eligible for Medicare - residents of Wisconsin who are unable to obtain any insurance.
Health Insurance Exchanges in Wisconsin
To learn more about the benefits of the Health Insurance Exchange in your state, click here
Resources and Information
Wisconsin Medicare Plans
Seniors age 65 and older are eligible for a variety of Medicare plans in Ohio. Medicare plan options include Medigap and Medicare Advantage policies:
Wisconsin Doctor Directory
Doctors practicing medicine in the State of Wisconsin are licensed by the state. Doctors accept different forms of health insurance which you can verify before setting an appointment.