Wisconsin is a unique state for health insurance. Like many states, Wisconsin uses the federal Marketplace as its health insurance exchange. However, Wisconsin is one of only three states that still operate an insurance CO-OP. The interaction between the federal exchange and the CO-OP can be confusing for consumers. Luckily, Apollo Insurance Group can help explain.
Health insurance in Wisconsin is rapidly changing, but Apollo is keeping up. Read on to learn the basics of health insurance in Wisconsin.
Quick Facts about Health Insurance in Wisconsin
- Wisconsin uses the federal Marketplace as its ACA Exchange
- Open Enrollment for On-Exchange plans will be from November 1, 2022 – December 15, 2022.
- Off-Exchange plans can be purchased at any time.
- Apollo Insurance Group can help broker plans from 12 different carriers.
What is the Wisconsin Health Insurance CO-OP?
Common Ground is the Wisconsin health insurance CO-OP established by the Affordable Care Act. Common Ground is a “qualified nonprofit health insurer” meant to compete with private insurers to help keep insurance costs low.
When to Enroll in Wisconsin Health Insurance
Enrolling in health insurance in Wisconsin depends on the type of insurance you are enrolling in. For ACA insurance, most people have to enroll during Open Enrollment. Open Enrollment is the time of the year that everyone is able to freely change their health insurance plan. Open Enrollment in Wisconsin is from November 1 to December 15 every year.
Health insurance that is not purchased on the ACA Exchange can be purchased at any time, with some carrier-specific exceptions.
How to Enroll in Wisconsin Health Insurance
To enroll in a health insurance plan in Wisconsin, contact us now. We will work with you to find the best plan for your budget and needs.
Health insurance in the United States is a complicated beast, and Wisconsin is no exception. Let one of the experts at Apollo Insurance Group guide you.
This is just a brief overview of health insurance in Wisconsin and the United States at large. For a more in-depth breakdown, read our article on individual health insurance.
Contact Us To Get Affordable Health Coverage For Your Needs At No Extra Cost!
Health Insurance in Wisconsin – Important Factors to Consider
There are several different options for health insurance in Wisconsin. Without it, you run a high risk of incurring medical bills. Even if you have a job, you are not guaranteed a good insurance plan. If you are self-employed, you will likely have to find insurance on your own. There are some important factors to consider before choosing a plan.
Cost of health insurance in Wisconsin
Costs for health insurance in Wisconsin are high, as they are nationwide. A survey of workplace health plans by the Commonwealth Fund found that, in 2017, the average family spent 11 percent of their income on health insurance, compared to a national average of 12 percent. The study used the federal Medical Expenditure Panel Survey to compare health insurance costs.
The premiums charged by individual health companies vary, so it is important to compare the premium rates before choosing a plan. Individual health insurance plans usually have higher deductibles, so they cost more money when filing a claim. It’s important to consider the premium and deductible before deciding on an insurance plan.
The average cost of health insurance in Wisconsin varies according to age. For example, the price of Silver health insurance for a twenty-one-year-old is $318 compared to $547 for a sixty-year-old. In Wisconsin, silver health insurance plans are slightly more expensive than bronze plans, and there’s also a difference depending on your county. In Dane and Green counties, for example, the Silver health plan costs $374 per month.
Health insurance plans in Wisconsin are categorized based on their deductible amounts and monthly premiums. Higher deductibles and out-of-pocket expenses are associated with plans with cheaper metals. It’s important to know the advantages and disadvantages of each metal tier when choosing a plan. The lowest monthly premiums in Wisconsin are often associated with the highest deductible amounts and out-of-pocket maximums. Buying a policy in this tier could be a wise investment if you anticipate high medical costs for the next year.
The Affordable Care Act has made coverage more affordable for families and individuals in Wisconsin. Since the law passed, the state’s uninsured rate has remained below the national average. Today, six percent of the population is uninsured, compared to nine percent in the entire country. However, the state’s uninsured rates were lower before the Marketplace.
In addition to the Marketplace plans, Wisconsin has a Medicaid program that offers low-cost insurance for low-income people. There are also several Medicaid options for children, including BadgerCare Plus and Care4Kids. For Medicare-recipients, many Medicare Advantage plans cover Part D. Original Medicare does not cover most prescription drugs.
There are many different plans available for health insurance in Wisconsin. The most basic is the HMO, which covers all medical expenses within a certain network. A PPO, on the other hand, has a broader provider network and a higher premium. The PPO also allows you to see any specialist you choose, while the EPO limits you to the network’s doctors and hospitals.
If you’re relatively healthy and rarely need medical care, a Health Savings Account (HSA) may be a good option. These accounts allow you to contribute money before taxes are withheld. However, a high deductible means you’ll pay more out-of-pocket for major medical expenses.
The cost of a health insurance plan in Wisconsin varies greatly depending on the tiers, deductible amount, and age of the buyer. Using a money-saving tool like MoneyGeek, you can compare plans available in Wisconsin and get an idea of which ones are best for your budget and medical needs.
Health insurance premiums in Wisconsin differ depending on your age, the metal tier, and how many people you’re insuring. A family of three, for example, would pay an average of $1,337 a month for health insurance. With an additional child, the cost would rise to $1,645 a month.
In addition to private and employer-based health insurance, Wisconsin residents can also take advantage of Medicaid. Medicaid covers many low-income adults and children. The state’s Medicaid program also offers several children’s health insurance programs such as BadgerCare Plus and Care4Kids. Additionally, Medicare Advantage plans often include Part D coverage. Original Medicare does not cover prescription drugs, so a separate plan can be a good option for you and your family.
Another option is short-term health insurance. Short-term health insurance plans in Wisconsin are available from private companies. These plans are not as comprehensive as those offered under the Affordable Care Act (ACA), but they can be a good option for those who need temporary coverage. Unfortunately, short-term plans do not include essential health benefits such as mental health services, prescription drugs, and maternity care.
The best choice for you depends on your specific needs. There are various kinds of plans available, and you can tailor your plan to meet your needs. Choosing one that meets your needs best can help reduce the cost of your plan. Some plans have deductibles, which you can choose to pay out of your own pocket. Other plans offer more flexible benefits.
There are several options for health insurance in Wisconsin, including Medicaid, CO-OP, and the state-sponsored marketplace. The Affordable Care Act (ACA) has made it easier to purchase health insurance in Wisconsin. The law makes it possible for individuals and families to get coverage at a reasonable price. In addition, many Wisconsin residents are eligible for financial assistance through the Marketplace.
Medicaid is a free health insurance program for low-income individuals and families in Wisconsin. There are many different kinds of Medicaid plans. Medicaid is the cheapest government program for people who meet certain income requirements. The state of Wisconsin has not yet adopted the Medicaid expansion program, but Medicaid is free to low-income people who can’t afford insurance. The cost of Medicaid depends on age, income, and disability. However, Medicaid may not cover all your medical expenses.
Individuals and families in Wisconsin can also purchase short-term health insurance through private companies. However, Wisconsin has stricter eligibility requirements than federal guidelines. These plans provide coverage for up to 18 months, and can be renewed. These plans are the best option if you need temporary health insurance coverage and don’t need comprehensive coverage. Unfortunately, short-term plans do not cover essential health benefits like maternity care, mental health services, and prescription drugs.
If you are relatively healthy and want to avoid the higher costs of individual health insurance, you may be a candidate for a Health Savings Account (HSA). This type of plan allows individuals to contribute pre-tax money to pay for medical expenses. However, the downside is a higher monthly premium.
When choosing a health insurance plan, be sure to compare the deductible amount, out-of-pocket costs, and premium rates. Some plans may be less expensive than others, and some may not cover as many services as others. Regardless, it’s important to know the pros and cons of each type of health insurance in Wisconsin.
Out-of-network providers covered
If you have health insurance, you might be wondering whether your plan covers services provided by out-of-network providers. If so, you can use your health plan to get a second opinion from a doctor in another state. If you live in Wisconsin, you can use your plan to see doctors outside of the network in Wisconsin. In most cases, out-of-network providers are covered at full price. However, there are some exceptions.