It is true that health is riches. This is why health insurance in Wisconsin has been sought after. Changing living patterns, rising pollution levels, and a variety of other factors all have a negative impact on an individual’s health.
This can result in a variety of health problems and medical disorders. If you are self-employed or do not have insurance through your employer- in other words, if you are seeking individual or family health insurance in Wisconsin – you may be interested in Affordable Care Act insurance, sometimes known as Obamacare.
This article will inform you about health insurance types, cheap health insurance in Wisconsin as well as the top 7 health insurance companies in Wisconsin.
Overview of health insurance in Wisconsin
Health insurance is a contract in which an insurer agrees to pay some or all of a person’s medical expenses in exchange for a premium.
More specifically, health insurance often covers the insured’s medical, surgical, prescription drug, and occasionally dental expenses. Health insurance can either repay the insured for illness or injury-related expenses or pay the care provider directly.
It is frequently included in employer benefit packages to entice quality employees, with premiums partially funded by the employer but frequently withheld from employee paychecks. With limited exclusions for company employees, the cost of health insurance premiums is deductible to the payer, and the benefits received are tax-free.
Types of Health Insurance in Wisconsin
Here are the health insurance plans offered in Wisconsin, you may find plans of all or any of these types at each metal level – Bronze, Silver, Gold, and Platinum.
- Exclusive Provider Organization (EPO)
A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network.
- Health Maintenance Organization (HMO)
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO.
It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
- Point of Service (POS)
A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
- Preferred Provider Organization (PPO)
A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
Cheap Health Insurance in Wisconsin
Affordable health insurance in Wisconsin is available through the state’s marketplace. Finding the best health insurance plan for you can be difficult, so to help you get started, below are all Silver policies available on the state exchange.
Although availability depends on the county you live in, the table below provides a good starting point to compare the costs and benefits you can expect from a given metal tier.
|Metal tier||Cheapest plan||Monthly cost||Deductible||Maximum out-of-pocket|
|Bronze||Dean Focus Network Bronze Value Copay 8650X||$255||$8,650||$8,650|
|Bronze Expanded||Dean Focus Network Bronze Copay Plus 8650X||$263||$8,650||$8,650|
|Silver||CGHC Value 1 Silver $7500 Deductible||$368||$6,000||$8,700|
|Gold||MercyCare HMO Gold Option B||$354||$2,250||$7,900|
|Platinum||Select Platinum 500 Ded/1500 MOOP||$470||$500||$1,500|
As you can see above, health plan rates vary widely depending on the metal tier. Although the cheapest options for health insurance plans in Wisconsin offer low rates, they are limited in availability by location.
Health Insurance Companies in Wisconsin
Here is the list of the top 7 health insurance companies in Wisconsin.
- Prevea360 Health Plan
Wisconsin-based Prevea360 Health Plan offers one of the best health insurance in Wisconsin. They connect providers, hospitals, and your insurance partner into one integrated system to provide you with the highest quality, affordable care.
Unlike most health care providers, Prevea360 offers the best of three worlds-strong networks of providers, innovative hospitals, and comprehensive insurance coverage-all working for you.
The Prevea360 network is filled with local health care professionals who are here to help you and your loved ones remain as healthy as possible. With hundreds of providers in the Green Bay, Brown County, and the surrounding counties throughout Northeastern Wisconsin, they provide many choices for accessing care near your home or workplace.
And, don’t worry about traveling outside of the service area, they cover you for emergency and urgent care situations wherever you are and whenever you should need assistance. This is one of the best health insurance companies in Wisconsin.
Address: 2710 Executive Dr, Green Bay, WI 54304, United States
Phone: +1 877-230-7555
Quartz is a Qualified Health Plan issuer in the Health Insurance in Wisconsin Marketplace. Quartz does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.
Unity Health Plans Insurance Corporation, Gundersen Health Plan, Gundersen Health Plan Minnesota, and Physicians Plus Insurance Corporation are co-owned by Gundersen Health System, UW Health, and UnityPoint Health. In October 2017, the insurance plans all joined forces under the brand name Quartz.
Quartz products offer extensive provider networks while focusing on community-based health care, and services 339,172 customers who live in southern and western Wisconsin, parts of Illinois, Iowa, and Minnesota.
Unity Health Plans Insurance Corporation (Unity) was recognized among the nation’s highest-rated private health insurance plans for its commercial HMO / POS products as part of the National Committee for Quality Assurance’s Private (Commercial) Health Insurance Plan Ratings 2017-2018. This makes it one of the best health insurance companies in Wisconsin.
Address: 840 Carolina St, Sauk City, WI 53583, United States
Phone: +1 608-644-3430
- Security Health Plan
Security Health Plan of Wisconsin, Inc. is a physician-sponsored health insurance company in Wisconsin and serves more than 180,000 members in a 32-county service area of Wisconsin. Because Security Health Plan is sponsored by Marshfield Clinic, and is led by physicians, they are committed to keeping members’ best interests at heart and offer great health insurance in Wisconsin.
Also, Security Health Plan has been named one of the nation’s top private health care plans for the sixth consecutive year, according to the National Committee for Quality Assurance.
This means you will receive some of the highest quality health care and service available in the nation with a Security Health Plan.
Security Health Plan is the fourth largest health insurance company in Wisconsin and offers a variety of insurance and benefit options including employer group products, individual policies, third-party administration for self-funded groups, Medicare supplemental insurance, Medicare Advantage plans, and BadgerCare Plus Managed Care.
Address: 1515 St Joseph Ave, Marshfield, WI 54449, United States
Phone: +1 715-221-9555
- Dean Health Plan, Inc.
Dean Health Plan is the insurance services subsidiary of Dean Health System and SSM Health Care. Founded in 1983, Dean Health Plan is one of the largest and most diversified HMOs in the Midwest, and maintains a position of leadership in health in Wisconsin services through a physician-led integrated health system that improves the health status of its members and delivers a superior level of service and care.
Products include HMO and freedom-of-choice insurance plans for commercial and individual customers, Medicare and Medicaid programs and third party administrator services.
Dean Health Plan holds an Excellent Accreditation – the highest accreditation available – from the National Committee for Quality Assurance (NCQA) for their commercial HMO product.
Address: 1277 Deming Way, Madison, WI 53717, United States
Phone: +1 800-279-1302
- Anthem Blue Cross and Blue Shield
Anthem Blue Cross and Blue Shield is a mutual health insurance company in Wisconsin providing health care management, health care coverage products and services, and government program administration to millions of Americans.
Today, the Blue Cross and Blue Shield symbols are among the nation’s most familiar and trusted trademarks. Founded in 1944, and based in Indianapolis, Anthem’s Central Region offers residents of Indiana, Kentucky, Ohio, Missouri, and Wisconsin a wide variety of innovative and affordable health coverage plan options.
One out of every four Americans enjoys the benefits of Blue Cross and Blue Shield coverage.
Address: 135 East Ave, Iron Ridge, WI 53035, United States
Phone: +1 312-757-8315
- Molina Healthcare
Molina Healthcare is a Fortune 500 company that delivers managed health insurance in Wisconsin through Medicaid, Medicare, and the Health Insurance Marketplace. For over 35 years, Molina Healthcare has provided quality health services to financially vulnerable families and individuals covered by government programs.
Serving over 4 million members the NCQA (National Committee for Quality Assurance) has ranked Molina health insurance plans among the nation’s top Medicaid plans since 2005.
Address: 11002 W Park Pl, Milwaukee, WI 53224, United States
Phone: +1 888-999-2404
- MercyCare Health Plans
MercyCare Health Plans and Mercyhealth together offer a complete continuum of health care services readily available to its members close to home.
MercyCare and Mercyhealth give you access to Mercyhealth’s seven hospitals and 85-plus primary and specialty care facilities throughout 50 northern Illinois and southern Wisconsin communities. Mercyhealth also offers post-acute services (home health care, home health equipment, hospice), full-service pharmacies, and retail services.
As a nationally recognized, vertically integrated health system, Mercyhealth’s 800-plus primary and specialty care physicians and 8,000 employee-partners do whatever it takes to keep you well.
MercyCare Health Plans offers a variety of plans and products. Their goal is to provide affordable, attainable health care for seniors, individuals, and area employers and their employees. This is one of the best health insurance companies in Wisconsin.
Address: 580 N. Washington St, Janesville, WI 53547-0550
Advantages of Health Insurance in Wisconsin
Following are five major advantages of purchasing health insurance in Wisconsin:
- Coverage against medical expenses The primary goal of health insurance in Wisconsin to ensure that you obtain the best medical treatment possible while being financially secure. Health insurance policies provide protection against high medical bills.
It pays for hospitalization, day care procedures, domiciliary fees, and ambulance rates, among other things. You can therefore concentrate on your quick recuperation rather than worrying about such large charges.
- Protection against serious illnesses Critical illness insurance is now available from insurance companies as a solo policy or as a rider. A policy of this type covers life-threatening disorders such as kidney failure, bone marrow transplant, stroke, and limb loss, among others.
You are eligible to a lump sum payment if you are diagnosed with any of the serious illnesses on your policy’s specified list. This sum may be used to cover the costs of your illness-related treatment, everyday expenses, and any other financial commitments.
- Cashless claim advantage Many insurance companies provide cashless claim services. You will not have to make any out-of-pocket payments under this agreement. Your insurer and the hospital negotiate the hospitalization costs.
To be eligible for this benefit, you must be admitted to one of the insurer’s network hospitals. To use the cashless facility, fill out a pre-authorization form and show your health insurance card.
- Additional protection beyond what your company provides Many businesses provide group insurance to their employees. However, such rules are not tailored to the specific needs of each individual. Furthermore, if you lose your work or change jobs, you may be uninsured. Purchase individual health insurance to safeguard yourself against such an incident.
- Tax advantages Tax advantages are provided by health care plans. Premiums paid for your health insurance policy are tax deductible under Section 80D of the Income Tax Act of 1961.
FAQs about health insurance in Wisconsin
See below for answers to the most asked questions about the health insurance in Wisconsin;
- Is short-term health insurance available for purchase in Wisconsin?
Wisconsin allows short-term health insurance plans to have a total initial duration of up to 12 months. But if the plans are renewable, the total duration, including the renewal period, can’t exceed 18 months.
- How many people are enrolled in Medicare in Wisconsin?
More than 1.2 million Wisconsin residents were enrolled in Medicare as of January 2021. Wisconsin is one of just three states that does its own standardization for Medigap plans.
And Medicare enrollees under age 65 are guaranteed access to Medigap plans in Wisconsin, as long as they enroll within six months of enrolling in Medicare Part B.
- What health insurance resources are available in Wisconsin?
- BadgerCare PLUS
- Black Health Coalition of Wisconsin
- Medicaid for the Elderly, Blind, or Disabled
- Wisconsin Department of Health Services
- Medicare Counseling for Wisconsin Residents
- Medicare Rights Center
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