Individual Health Insurance Wisconsin

Individual health insurance Wisconsin:  Under the Affordable Care Act (ACA), health insurance is required, and the latter must be able to comply with the standards that have been set. Nonetheless, when buying individual health insurance in Wisconsin, it is important to keep in mind that there are instances wherein it may not meet the ACA standards, and hence, making additional payments will be necessary. With the abundance of the options, each claiming to have the best offers, you might end up being overwhelmed. Keep on reading and know more about some of the most important things that you should consider in selecting individual health insurance in Wisconsin

Individual Health Insurance Wisconsin:  Identify the Essentials 

When looking for individual health insurance in Wisconsin, the first thing that you have to do is to state the must-haves. The more extensive the coverage is, the more expensive the premium will be. By having an assessment of your healthcare needs, you will easily identify which ones do you need and which ones will only add up to the cost. Some of the most common inclusions of individual health insurance Wisconsin are: ambulatory patient services, hospitalization, emergency services, pregnancy, mental health services, chronic disease management, pediatric services, prescription drugs, and rehabilitative services. Know which ones will be essential and avoid overbuying. 

Individual Health Insurance Wisconsin:  Look Beyond the Premiums

There is no doubt that a lot would be examining the premiums when they evaluate the choices for individual health insurance in Wisconsin. However, it is important to look beyond such. For instance, you should also take a look at your share of costs. Think about the percentage of the medical service that you will personally shoulder and evaluate how viable it is given your financial capacity. Make sure to have a comprehensive understanding of the out-of-pocket maximum to better weigh the pros and cons of the choices.

Take Time to Compare 

Individual health insurance Wisconsin: it is also important to have an educated comparison of the options for individual health insurance in Wisconsin. You should never make a choice after seeing only one plan from a specific company. Rather, you have to take a look at as many choices as possible. You should compare them with each other, such as in terms of the premiums, limits, and coverage. This will make it possible to see how insurance is better than the other. 

Review the Plan 

Individual health insurance Wisconsin: before making any final decision on which to choose for individual health insurance in Wisconsin, make sure to reevaluate the plan. The certificate of coverage will specify the inclusions and exclusions. Make sure to read and understand it thoroughly before having your signature affixed. Do not be afraid to seek for help from other people so that you can have a clearer understanding of what the terms mean, as well as their long-term implications.

Individual Health Insurance Wisconsin: 
Wisconsin Sen. Larson says it's time to take on the health insurance companies - La Crosse's NewsTalk 1410AM 92.3FM

"It's more expensive to be healthy," he says.

Individual health insurance Wisconsin: health insurance deductibles are out of control according to Wisconsin Sen. Chris Larson.

Wisconsin residents are paying $3,347 a year just on doctor visit deductibles. On top of that, they're paying $1,203 for deductibles on prescription drugs.

That, according to Citizen Action of Wisconsin organizing director Kevin Kane. 

Those in the Gundersen Health System insurance plan pay $1,100 out of pocket for prescriptions per year, and more than $3,200 for doctor's visits.

Individual health insurance Wisconsin: "it's more expensive to be healthy in Wisconsin at this point than many other places in the nation," Larson said.

He continued to say someone needs to take on the insurance companies, "because we can't always count on the insurance industry to base their decisions on what's good for consumers, rather than what their bottom line is. It's clear that legislative intervention is needed, at this point."

Larson is supporting a plan from Citizen Action, calling for low, out-of-pocket health plans - with no deductibles for all prescription drugs and most doctor visits - for 2017, which has been suggested by the federal government. The deadline, however, for insurance companies to decide is July 22. Sign a Citizen Action petition here to bring down Rx costs.

Individual health insurance Wisconsin: Larson received a letter from a La Crosse woman recently, and described it like this: "I get very little health care because, even paying insurance premiums and having coverage, I still end up paying 90 percent of my healthcare service bill. I cannot afford high premiums and turn around and pay healthcare, too."

Wisconsin lags in getting children on health insurance - WBAY

MADISON, Wis. (AP) — States across the country are making strides in getting children onto health insurance rolls, but Wisconsin’s rate of uninsured children is stagnant.

Wisconsin dropped from ranking sixth best in the percentage of children with health insurance in 2008 to 16th in 2014.

According to a report the Wisconsin Council on Children and Families released Tuesday, about 4.4 percent, or 58,000, of the state’s children were uninsured in 2014.

That’s lower than the national average of 6.0 percent, but other states have been improving at a much faster rate. The council says Wisconsin now trails its four neighboring states — and if it had maintained the same rate of insuring children as its neighbors, would have about 11,800 more children insured.

The report says that’s partially because Wisconsin cut Medicaid eligibility for about 60,000 parents in 2014 and lost about 15,500 still-eligible children in the process, likely because parents didn’t renew them.

Individual Health Insurance Wisconsin: 
Wisconsin Democrat among those urging health insurance providers to bring down costs - La Crosse's NewsTalk 1410AM 92.3FM

A message to those insurance companies offering plans in Wisconsin: Make it cheaper. 

That's the plea from a handful of Wisconsin lawmakers, including La Crosse state rep., Jill Billings.

Individual health insurance Wisconsin: the Democrat is among those urging insurance providers offering plans on the healthcare exchanges to make the plans standardized or, at least, design plans with lower out-of-pocket fees, like deductibles, premiums and prescription drug costs.

The group of lawmakers complains especially about the growing cost of deductibles, which they claim have increased by nearly 50 percent just from last year.

Individual health insurance Wisconsin: earlier this month, it was Wisconsin Sen. Chris Larson urging insurance providers to do the same, after a Citizen Action of Wisconsin figures showed Wisconsin residents are paying $3,347 a year just on doctor visit deductibles and another $1,203 for deductibles on prescription drugs.

Individual Health Insurance Wisconsin: 
Where and When to Purchase Individual Health Insurance - Clarifying Health

For those purchasing individual health insurance for the first time, the transition may seem daunting.

Individual Health Insurance Wisconsin:

Fortunately, the process is not too complicated. This guide provides helpful information on where and when to buy individual health insurance as well as information on factors that could influence a person’s decision to buy a Marketplace or non-Marketplace plan.

Where to Purchase Individual Health Insurance Wisconsin:

A handful of options exist for those seeking to buy individual health insurance. First, plans are available through the Affordable Care Act (ACA) Marketplaces online. A number of states and the District of Columbia have their own Marketplace websites; for those residing in the remaining states, applications for an individual plan can be made through

The second option is to purchase a plan directly from an insurance company. An individual may contact any health insurance company and inquire about plans that are available in the area. has a plan finder to help individuals find private coverage outside of the Marketplace.

Third, individual healthcare insurance can be purchased through a broker or agent. While a broker will sell plans from a variety of health insurance companies, an agent typically works on behalf of just one company. A person does not need to pay extra fees to use the services of an agent or broker, and either one can assist by comparing plans and processing the enrollment.

Finally, one could also purchase individual health insurance from online sellers, such as HealthSherpa. These sites can help with plan comparisons and enrollment with the insurance company.

When to Purchase Individual Health Insurance Wisconsin:

Insurance that qualifies for the minimum essential coverage under the ACA cannot be purchased year-round. Instead, one can only buy individual health insurance during an open enrollment period or if there is a qualifying life event or change in employment. Because all private insurers have adopted the ACA’s open enrollment period, this limitation applies regardless of whether the individual insurance is purchased on or off Marketplace. The open enrollment period for this year ended on January 31, 2016, and open enrollment for 2017 will run from November 1, 2016 through January 31, 2017.

Special enrollment periods apply in certain situations. For example, Native Americans are permitted to enroll at any time, as are persons who qualify for Medicaid. An individual may also qualify for a special enrollment period if he or she has experienced a qualifying event such as marriage, divorce, a change in citizenship status, or a change in the number of dependents.

If open enrollment has passed, short-term plans can be found outside of the Marketplace. However, these will not count as minimum essential coverage under the ACA, and the fee for being uninsured must still be paid.

Differences Between Marketplace and Off-Marketplace Plans

First, all qualified Marketplace and off-Marketplace plans cover the same basic benefits, count as minimum essential coverage, and offer identical rights and consumer protections. The chief differences between Marketplace and non-Marketplace individual plans lie in the cost and in the benefits offered above the minimum requirements.

Only Marketplace individual health insurance plans offer cost assistance through tax credits, subsidies, Medicaid, or the Children’s Health Insurance Program (CHIP), so getting an individual insurance plan from the Marketplace is generally the best choice if a person qualifies for assistance. Even if an individual is only eligible for a small amount of cost assistance, a Marketplace plan typically remains preferable because any given unsubsidized plan is still more costly than the most expensive subsidized plan.

If a person’s income is above $46,680 annually, it makes sense to shop around on and off of the Marketplace. This is because the cost of insurance includes more than just the monthly premium (for example – copayments, deductibles, etc.), and if an individual intends to use a lot of healthcare services in the upcoming year, it's wise to shop around for the best terms and conditions. Shopping outside the Marketplace will also provide a wider variety of plans. No agent or broker will have access to every plan available in each region, so those who wish to shop around will need to reach out to various sources to get a thorough view of the options.

Individual Health Insurance Wisconsin:


Purchasing individual health insurance does not have to be complicated – one only needs to begin the process of enrollment by going online or contacting an agent or broker. The choice to purchase a plan on the Marketplace mostly depends upon whether a person qualifies for cost assistance. If one can receive even a small subsidy, it will usually be more financially beneficial to buy a plan on the Marketplace.

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