Wisconsin Individual and Family Health Insurance

Examine the features of different Wisconsin health insurance plans, offered in the metropolitan areas of Milwaukee, Madison, Green Bay, Kenosha, Racine, Appleton, Waukesha, Oshkosh, Eau Claire, and Janesville.

The State of Affairs of Wisconsin’s Health Insurance

Wisconsin paid $31.7 billion in healthcare expenses in 2004, with the largest portion allocated towards hospital, physician, and professional fees.  Wisconsin residents must manage rising healthcare costs that increase 7% annually, which makes securing Wisconsin health insurance imperative.

America’s Dairyland is home to more than 5.4 million residents.  24% of the population obtains insurance through Medicaid and/or Medicare coverage. About 61% or 3.3 million obtain their Wisconsin small business health insurance coverage through their employers, and they share the burden by paying average premiums of $891 for individual health insurance and $2,448 for family health insurance plans.

The people of Wisconsin are hard working, with the greater part of the population relying on employer-based health insurance. Unfortunately, this kind of insurance is not guaranteed because of the rising unemployment rates.  In addition, entrepreneurs consistently seek out affordable Wisconsin self employed health insurance plans.  To find Wisconsin healthcare coverage that would not be easily affected by unemployment, let InsureMonkey help as your health insurance agent.

Wisconsin Health Insurance Providers

Wisconsin’s High Risk Pool

In Wisconsin, the high-risk pool program is called HIRSP or the Health Insurance Risk-Sharing Plan. Created in 1981, HIRSP aims to help Wisconsin residents in securing health insurance coverage, even when they have a pre-existing health conditions. This program also provides health plans for those who just lost their employer-sponsored Wisconsin health insurance.

There are several health insurance plans available through HIRSP, including a health savings account and a plan for those who are Medicare beneficiaries. There are no income eligibility requirements, but there are deductible and lower premiums for those who earn less than $33,000 a year.

For more information and application instructions, visit the website at http://www.hirsp.org/ or call Customer Service at (800) 828-4777 or (608) 221-4551. Online application is also encouraged.

Wisconsin’s Uninsured

The Urban Institute and the Kaiser Commission surveyed Wisconsin in 2006-2007, and they found that the uninsured population in Wisconsin totals more than 465,000. About 16% of this number, or 72,000, are uninsured children. 

The rising unemployment rate contributes to these statistics. Laid-off workers may still get health insurance coverage through COBRA or Consolidated Omnibus Budget Reconciliation Act. But a nationwide survey of the unemployed showed that only one in fourteen would be eligible for COBRA.

This means that the people of Wisconsin must search for other ways to obtain health insurance coverage. InsureMonkey help in simplifying the search.

Wisconsin SCHIP

The publicly funded State Children’s Health Insurance Plan in Wisconsin is a part of the State’s BadgerCare Plus Program. This healthcare program, managed by the Department of Health Services, allows children aged 19 years old and younger to be eligible for coverage, regardless of the income level.

The BadgerCare Plus also provides coverage for parents and caretakers who are up to 200% of the Federal Poverty Level. This amounts to an annual income of $36,620 for a three-member family.

For more information, please contact the Wisconsin BadgerCare Plus at 1-800-362-3002. To obtain assistance in applying, call the Enrollment Services Center at 1-800-291-2002 or personally visit a local county or tribal agency.

Medicaid in Wisconsin

Wisconsin’s Medicaid is better known as “ForwardHealth.” This public health insurance plan has several programs that are modified to address the needs of its citizens, depending on the type of care needed and income eligibility. Some of the programs include the following:

1.    Elderly, Blind or Disable Medicaid – for people who are aged 65 or older and people who are blind and/or disabled
2.    Community Waivers – for the elderly, blind or disabled who live in their own houses and not in nursing homes or state institutions
3.    Family Care – long-term care for people who are elderly and people who have developmental disabilities or physical disabilities
4.    Medicaid Purchase Plan – for the disabled people who still work
5.    Medicaid Deductible Plan – for low-income families who face high medical bills

The income eligibility requirements are:

•    Children
      o    Infants Ages 0-1:  $44,000 or 250% of the Federal Poverty Level as of January 2009
      o    Children Ages 1-5:  $44,000 or 250% of the Federal Poverty Level as of January 2009
      o    Children Ages 6-19:  $44,000 or 250% of the Federal Poverty Level as of January 2009
•    Parents
      o    Non-Working:  $3,036 or 17% of the Federal Poverty Level as of January 2009
      o    Working:  $5,988 or 34% of the Federal Poverty Level as of January 2009
•    Women
      o    Pregnant women: $52,800 or 300% of the Federal Poverty Level as of January 2009
      o    Women with breast and/or cervical cancer/pre-cancer: 250% of the Federal Poverty Level as of January 2009

For more information about eligibility, please the state’s website at
http://dhs.wisconsin.gov/medicaid/. To apply for Wisconsin’s Medicaid, contact the local county or tribal agency or call 1-800-362-3002.

If a citizen needs health care coverage, but does not meet the primary requirements for Wisconsin’s ForwardHealth Medicaid, he or she may enroll in an alternative program called “BadgerCare Plus Plan.” For information about this program, contact BadgerCare Plus at 1-800-362-3002.

(Facts throughout this page provided by the Kaiser Family Foundation at www.statehealthfacts.org and by The New Health Insurance Solution at www.tnhis.com.  Commentary provided by InsureMonkey.)

State Resources

ACCESS
Website: https://access.wisconsin.gov/
Phone: 1-800-362-3002

BadgerCare
Website: http://www.badgercareplus.org/
Phone: 1-800-362-3002

Department of Health Services
Website: http://dhs.wisconsin.gov/
Phone: 608-266-1865

Office of the Commissioner of Insurance
Website: http://oci.wi.gov/
Phone: (800) 236-8517