Finding health insurance in Wisconsin is a straightforward process. At healthcare.gov, you can browse Affordable Care Act (ACA) marketplace plan options and quickly see if you qualify for a subsidy to pay your premiums. Like other states, Wisconsin has extended the Special Enrollment Period for coverage to August 15. 2021 due to COVID-19.
Highlights and Updates
- Wisconsin uses the federally-run health insurance marketplace. Residents enroll through healthcare.gov.
- The 2021 Benefits Special Enrollment Period is from February 15 to August 15.
- Short-term health insurance for up to 18 months is available in Wisconsin.
- Wisconsin has an average benchmark premium of $457 for 2021.
- For 2021, Wisconsin has eight health insurance company options on the marketplace.
How To Buy Health Insurance in Wisconsin
To purchase coverage through the Health Insurance Marketplace, visit healthcare.gov. You can enroll in a plan during the open enrollment, a Special Enrollment Period, or if you experience a qualifying event. If you are eligible for coverage that meets the minimum standards through your employer, you will not be eligible for a premium subsidy for a marketplace plan. Low-income individuals may qualify for Medicaid or BadgerCare Plus coverage with low or no premiums.
How To Apply for Health Insurance in Wisconsin
To apply for health insurance in Wisconsin, visit healthcare.gov and complete an application. The application will ask questions about your income and family, and you will need to submit proof of income to enroll in a plan. All of the available plan options offer Essential Health Benefits.
Health Insurance Carriers in Wisconsin
Wisconsin has eight health insurance carriers: Anthem Blue Cross Blue Shield, Common Ground Healthcare Cooperative, Dean Health Plan, Molina Healthcare, Network Health, Quartz, Together with CCHP, and WPS Health Plan.
What Are the Cheapest Health Insurance Companies in Wisconsin?
Anthem Blue Cross Blue Shield offers the four cheapest health insurance plans on the marketplace and the cheapest plans in the Bronze and Silver tiers. Quartz has the cheapest plans in the Gold tier.
How Has Obamacare Helped Wisconsin‘s Uninsured?
Before the ACA, Wisconsin’s uninsured rate was 9.1% of the population in 2013. In 2016, the uninsured rate was 5.3%. More than 185,000 people were enrolled in Wisconsin marketplace plans in 2020, and 87% of them were receiving premium subsidies.
Wisconsin Health Insurance Costs Overview
There are three main metal tiers for health insurance in Wisconsin: Bronze, Silver, and Gold.
How Much Does Health Insurance Cost in Wisconsin?
Wisconsin has an average benchmark premium of $457 for 2021.
What Is the Cheapest Health Insurance Plan in Wisconsin?
The cheapest marketplace plan for Wisconsin residents is the Anthem Bronze Pathway X 8550 plan for $335.13 per month for a 35-year-old. The plan has a yearly deductible of $8550. Your premium may be significantly less if you qualify for a tax credit premium subsidy.
Cheapest Wisconsin Health Insurance Coverage by Metal Tier
The Quartz One Gold I402 Maintenance plan is the least expensive Gold plan. It features a $1500 deductible and an out-of-pocket maximum of $7900. The plan premium is $463.72 a month.
Anthem Silver Pathway X 6550 is the cheapest Silver plan, with a premium of $413.83. The deductible is $6550, and the out-of-pocket maximum is $8,550.
The most affordable Bronze plan is the Anthem Bronze Pathway X 8550 plan for $335.13 a month. The plan has a deductible of $8550 and an out-of-pocket maximum of $8550.
Wisconsin Health Insurance Costs by Occupation
What Is the Average Cost of Health Insurance for a Student in Wisconsin?
Students in Wisconsin have the option to enroll in coverage through their university, remain on a parent’s health coverage until they turn 26, or enroll in a marketplace plan. Costs vary, but staying on a parent’s coverage is generally the least expensive option.
What Is the Average Cost of Health Insurance for the Self-Employed In Wisconsin?
Self-employed persons can enroll in an individual marketplace plan at the standard rates.
What Is the Average Cost of Health Insurance for Small Business Owners in Wisconsin?
Wisconsin small business owners with 1-50 employees can purchase health insurance for them through SHOP, the Small Business Health Options Program. Costs for these plans vary based on plan and employee age.
Wisconsin Health Insurance Costs by Number of Participants
What Is the Average Cost of Health Insurance for Families in Wisconsin?
Costs vary with age and plan selection. An average plan for a family of four would be approximately $1585 per month. This amount is the total premium; if your family qualifies for subsidies, the amount you pay could be substantially less. Children may be eligible for coverage under Medicaid or BadgerCare Plus.
What Is the Average Cost of Health Insurance for Individuals in Wisconsin?
The coverage benchmark for Wisconsin is $457. That amount does not include any premium subsidies. For individuals who qualify for subsidies, the premium they pay may be substantially less.
What Is the Average Cost of Health Insurance for a Child in Wisconsin?
Children in Wisconsin are eligible for Medicaid if their family income is below a certain amount. Children not eligible for Medicaid may qualify for coverage through BadgerCare Plus, which offers dental and health coverage. Depending on income, there may be a monthly premium for BadgerCare Plus of $8. For more information about eligibility or to apply for these programs, visit ACCESS Wisconsin.
Other Types of Wisconsin Health Insurance Coverage
Catastrophic Health Insurance in Wisconsin
Wisconsin has catastrophic health plans available. Catastrophic plans offer low premiums and high deductibles, and they are only offered to applicants under the age of 30. If you qualify for premium subsidies, other plan options may be equally affordable.
Short-Term or Temporary Health Insurance in Wisconsin
Short-term health insurance is available in Wisconsin for up to 18 months. If enrolling in a short-term plan, be advised they are not required to meet the federal minimum standards set forth by the ACA. Short-term plans may exclude pre-existing conditions, preventive care coverage, or entire coverage categories like prescriptions or mental health.
Low-Income Health Insurance in Wisconsin
Wisconsin Medicaid offers coverage for adults with income up to the poverty line. To see if you are eligible for Wisconsin Medicaid, visit the ACCESS Wisconsin website.