Wisconsin Health Insurance

According to the Center for Disease Control, an average of 9.5% of Wisconsin residents went uninsured for Wisconsin health insurance each year between 2001 and 2003.

Wisconsin Health Insurance Regulations

All Wisconsin residents who are covered under a group or employer’s health insurance plan cannot be denied or limited access to the Wisconsin health insurance coverage under the plan. Individuals looking for individual Wisconsin health insurance plans, however, can be denied or limited coverage based on health, age and other factors. Any individual who wishes to renew an existing Wisconsin health insurance policy is guaranteed the right to renew the existing policy provided all contract terms were met. This is called guaranteed renewability.

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Pre-Existing Conditions

Individual Wisconsin health insurance plans can impose elimination riders and pre-existing condition exclusion periods. Elimination riders can exclude any condition from coverage for the duration of the Wisconsin medical insurance policy. Any condition that existed prior to the beginning of the Wisconsin health insurance plan can count as a pre-existing condition and can be excluded from coverage for up to 2 years.

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Pregnancy

Pregnancy can count as a pre-existing condition. Newborns and adopted children are automatically covered under the parent’s individual Wisconsin health insurance plan for the first 60 days after birth or adoption provided the health insurance plan covers dependents. Disabled children may remain under a parent’s Wisconsin health insurance policy beyond the age at which most dependents cease being covered.

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Rates

Wisconsin health insurance rates vary depending on the health and age of an individual. Premiums may also increase with policy renewals depending on the policy and changes of an individual.

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Temporary Insurance

Temporary Wisconsin health insurance is also available for individuals who wish to purchase coverage for times between plans or employer coverage.

Alternative Wisconsin Health Insurance Options

For individuals who have difficulty obtaining individual Wisconsin health insurance, there are some state programs that my help:

• Wisconsin Medicaid is available to any individual who meets the eligibility and qualifying criteria.
• Wisconsin Health Insurance Risk Sharing Plan is the state’s high risk pool that allows “uninsurable” individuals to purchase health insurance through a state plan. Pre-existing condition periods may apply.
• BadgerCare is Wisconsin’s Children’s Health Insurance Program that is designed to provide health insurance to children up to age 19 and their parents who may not qualify for Medicaid and who may not be able to afford Wisconsin health insurance.

Wisconsin Insurance Commission

Office of the Commissioner of Insurance
125 South Webster Street
Madison, Wisconsin 53702

(608) 266-3585, Madison
(800) 236-8517, statewide
711 (TDD)(ask for 608-266-3586)
fax: (608) 266-9935

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For other Wisconsin Insurance Resources, See:

• Wisconsin Auto Insurance
• Wisconsin Home Insurance
• Wisconsin Health Insurance

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