Affordable Wisconsin Health Insurance Plan

No, Wisconsin follows the federal guidelines of the Affordable Care Act (ACA), which no longer requires individuals to have health insurance. There are no state-specific mandates for coverage, and residents can explore plans through the federal exchange or private insurers.

The cost of health insurance in Wisconsin varies by factors such as zip code, age, plan type, and metal tier. On average, an individual ACA-qualified plan costs $482 per month, but non-qualified and short-term plans may offer lower premiums.

BadgerCare is Wisconsin’s Medicaid program, offering free or low-cost health insurance to eligible low-income individuals and families. It includes services like doctor visits, hospital care, and prescriptions. Medicaid is a federal program, while BadgerCare is Wisconsin’s state-specific implementation.

Wisconsin offers a variety of health insurance options, including:

• ACA-Qualified Plans: Comprehensive coverage with essential health benefits.
• Employer-Sponsored Plans: Coverage provided by employers.
• Medicaid (BadgerCare): For low-income individuals and families.
• Medicare: For seniors 65+ and certain disabled individuals.
• Short-Term Plans: Temporary coverage for gaps in insurance.
• Children’s Health Insurance Program (CHIP): Coverage for children in eligible families.

Open enrollment runs annually from November 1 to January 15. Outside of this period, you can qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event, such as:

• Loss of health coverage.
• Marriage or divorce.
• Having a baby or adopting a child.

Yes, eligible low-income residents can access free or low-cost health insurance through Medicaid or BadgerCare programs.

As of September 1, 2024, short-term health insurance in Wisconsin is limited to four months, including renewals. These plans are more affordable but do not cover pre-existing conditions and have limited benefits compared to ACA-compliant plans.

Eligibility for Medicaid and BadgerCare in Wisconsin depends on income, family size, and special conditions. For example, families earning up to 138% of the federal poverty level may qualify for BadgerCare Plus.

To find the best plan:

• Compare options on the Wisconsin Health Insurance Marketplace (HealthCare.gov).
• Consider your healthcare needs, budget, and potential eligibility for subsidies or Medicaid.
• Use resources like AHiX Marketplace to explore qualified and non-qualified plans.

Health insurance premiums may be tax-deductible, particularly for self-employed individuals or small businesses. Check with a tax professional for guidance tailored to your circumstances.

Group health insurance is a valuable benefit that businesses can offer to their employees and their dependents. In Wisconsin, group health insurance plans are available to businesses of all sizes, from small employers to large corporations. These plans provide comprehensive health insurance coverage, making healthcare more accessible and affordable for employees and their families.

Security Health Plan, for example, offers group health insurance plans that cover employees, dependents, and retirees. These plans are designed to be affordable and can be customized to fit the unique needs of each business. By offering group health insurance, businesses can ensure their employees have access to essential healthcare services, promoting overall well-being and job satisfaction.

Medicare is a federal health insurance program designed for individuals aged 65 or older, certain younger individuals with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant). Medicare Part D is a prescription drug coverage program that helps cover the cost of prescription medications.

In Wisconsin, there are various health insurance plans that offer Medicare and Part D coverage. For instance, the Security Health Plan provides options that include coverage for prescription medications, doctor visits, and hospital stays. These plans are tailored to meet the unique needs and budgets of individuals, ensuring that seniors and those with specific health conditions receive the necessary care and support.