Wisconsin Health Insurance Exchange: Affordable Plans and Enrollment

Wisconsin's health insurance exchange offers affordable plans to residents, making it easier to access quality healthcare. These plans are available to individuals and families who meet certain income requirements.

To qualify for these plans, you must be a Wisconsin resident and not be eligible for other health insurance coverage, such as through an employer. This includes people who are self-employed or have a spouse with employer-sponsored coverage.

The exchange offers a range of plans from various insurance providers, including Ambetter, Anthem, and UnitedHealthcare. You can compare these plans and choose the one that best fits your needs and budget.

Enrollment in the Wisconsin health insurance exchange typically takes place during an annual open enrollment period, which usually runs from November to December.

In Wisconsin, you have several health insurance options to choose from. You can stay on your parent's health insurance until you turn 26, but you may find a better plan on your own. Look into all your options from work, BadgerCare Plus (Medicaid), and the Marketplace to find the best option for your budget and health.

The Marketplace offers financial support based on your income, with 8 out of 10 people getting financial help. To qualify for a plan, you'll need to consider factors like household income, an affordable offer of health insurance from your job, age, and immigration status. Everyone in your family may qualify for different options.

Here's a quick breakdown of the levels of coverage available in the Marketplace:

Dental coverage is a smart addition to your health coverage, especially if you're hoping to improve your smile. You can explore dental coverage options in Wisconsin, as mentioned in our guide.

Some people may not realize that dental insurance can help prevent costly dental problems down the line. This is especially true for those living in Wisconsin, where access to dental care is a concern.

Wisconsin residents can explore various dental coverage options, including those that offer preventive care services like cleanings and check-ups. These services can help catch oral health issues early on.

Many dental insurance plans in Wisconsin also offer coverage for restorative services, such as fillings and crowns. This can help you save money on out-of-pocket expenses.

By investing in dental coverage, you can enjoy a healthier smile and reduced financial stress.

In Wisconsin, you have several health insurance options to choose from. You can stay on your parent's health insurance until you turn 26, but you may find a better plan on your own.

Most people in Wisconsin who enroll in health insurance through the Marketplace receive premium subsidies, which can save them an average of $573 per month. As a result, the average enrollee's net premium is about $161.

To find the best option for your budget and health, you should consider all your options, including work-based insurance, BadgerCare Plus (Medicaid), and the Marketplace. You may qualify for different options based on your household income, whether you have an affordable offer of health insurance from your job, your age, and your immigration status.

If you're eligible for subsidies, you can enroll in a Silver-level plan with reduced out-of-pocket costs through the Marketplace. In fact, 8 out of 10 people who enroll in the Marketplace receive financial help.

Here are some factors to consider when choosing a health insurance plan in Wisconsin:

Wisconsin has a unique approach to Medicaid, allowing adults with income under the poverty level to enroll. This means that there is no coverage gap in the state, unlike in some other non-expansion states.

Wisconsin's health insurance exchange offers a range of affordable options for residents. Almost nine out of ten enrollees receive premium subsidies, which can save you an average of $573 per month.

You can find affordable health insurance options by signing up through HealthCare.gov, especially if you're eligible for subsidies, which most people are. The average enrollee's net premium, including those who paid full price, was about $161 as of early 2024.

The Affordable Care Act ensures that people with household incomes up to 250% of the poverty level can enroll in Silver-level plans with reduced out-of-pocket costs, thanks to cost-sharing reduction subsidies. This can make a big difference in your healthcare costs.

To qualify for financial assistance, you must not have access to affordable health coverage offered by an employer. You can use the Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.

Here are some key eligibility requirements for financial assistance:

Enrollment in the Marketplace has been growing, with a record high of 266,327 people enrolling in private individual market plans through Wisconsin's exchange during the open enrollment period for 2024 coverage.

To enroll in a Wisconsin Marketplace plan, you can visit HealthCare.gov or call the HealthCare.gov call center at 1-800-318-2596 (TTY: 1-855-889-4325). The Marketplace call center is available 24 hours a day, 7 days a week (closed on holidays).

You can also purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor. Use the “find local help” tool to locate enrollment assisters in your area. Alternatively, you can enroll via an approved enhanced direct enrollment entity.

Here are the different levels of coverage available in the Marketplace:

All Marketplace plans will offer a core set of 10 essential health benefits, including doctor visits, emergency services, hospital care, and more.

Short-term coverage can be a viable option for those in need of temporary health insurance. Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage.

In Wisconsin, these plans are available for those who require short-term coverage. Short-term plan availability in Wisconsin can be a lifesaver for individuals who need immediate health insurance.

If you're considering short-term coverage, be aware that it's meant to be temporary, so you won't be able to keep it long-term.

You can enroll in a Wisconsin Marketplace plan in several ways. Visit HealthCare.gov to access Wisconsin's health insurance Marketplace, where you can shop, compare, and choose the best health plans.

If you prefer to talk to someone, you can call the HealthCare.gov call center at 1-800-318-2596 (TTY: 1-855-889-4325), which is available 24 hours a day, 7 days a week (closed on holidays).

You can also get help from an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.

To find local help, use the "find local help" tool on HealthCare.gov. This tool will connect you with enrollment assisters in your area.

During the open enrollment period for 2024 coverage, 266,327 people enrolled in private individual market plans through Wisconsin's exchange, which is a record high for Wisconsin Marketplace enrollment.

Here are the ways to enroll in a Marketplace plan in Wisconsin:

Marketplace premiums are increasing in Wisconsin, with a weighted average rate increase of 8.2% approved for 2025.

This increase is based on the average rate changes approved for Wisconsin's Marketplace insurers, which vary from a 2.42% increase by Aspirus Health Plan Inc to a 13.2% increase by Security Health Plan.

The rates were almost entirely approved as proposed, with the final rate increase for Group Health being a little smaller than initially proposed.

Most Wisconsin Marketplace enrollees receive premium subsidies, which means they don't pay full-price for their coverage.

Here's a brief overview of how full-price premiums have changed in Wisconsin's individual/family health insurance market over time:

When choosing a Marketplace Plan, it's essential to understand the different levels of coverage available.

The plan pays a percentage of your medical costs, and you pay the remaining percentage, in addition to your monthly premium.

The Bronze plan pays 60 percent on average, leaving you to pay 40 percent.

The Silver plan offers a higher level of coverage, paying 70 percent on average, with you paying 30 percent.

The Gold plan pays 80 percent on average, while you pay 20 percent.

The Platinum plan provides the highest level of coverage, paying 90 percent on average, with you paying just 10 percent.

Here's a summary of the levels of coverage:

Enrollment for Medicare in Wisconsin is relatively straightforward, and our guide is here to walk you through the process. You can learn about Medicare, Medicare Advantage, and Medigap coverage available in Wisconsin.

Medicare Advantage plans in Wisconsin are offered by private insurance companies, and they can provide additional benefits not covered by Original Medicare. These plans often have network restrictions, so it's essential to check the provider network before enrolling.

Medigap coverage is also available in Wisconsin, but it's only available to supplement Original Medicare, not Medicare Advantage plans. You can purchase Medigap coverage from private insurance companies, and the state regulates the plans to ensure they meet minimum standards.

In Wisconsin, you can enroll in Medicare during your Initial Enrollment Period, which starts three months before your 65th birthday and ends three months after. You can also enroll during the Annual Enrollment Period, which runs from October to December each year.