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Medical Insurance in Wisconsin: An Overview

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Medical Insurance in Wisconsin

Medical Insurance in Wisconsin

Introduction: The medical insurance condition in Wisconsin is average, in comparison to overall health insurance situation of the United States. In accordance to a survey conducted by The Center for Disease Control, more or less 10% of the total Wisconsin individuals did not get any coverage under Wisconsin medical insurance for each year, between 2001 and 2003.

In the below-mentioned abstract we have discussed about some important Wisconsin medical insurance regulations and Wisconsin state-regulated alternative medical insurance options.

Regulations for Wisconsin Medical Insurance

  • Wisconsin individuals having access to state medical insurance policy through an employer or group can not be refused or restricted obtaining coverage under that employer or group Wisconsin medical insurance policy.
  • Wisconsin individuals asking for individual Wisconsin medical insurance can be refused or restricted access to coverage depending on age, health and other factors.
  • All Wisconsin medical insurance policies have a guaranteed provision for renewal. This guaranteed renewability provision lets a Wisconsin individual renew his or her existing medical insurance plan provided he or she should have disbursed all the premiums in time and provided no fake information, during the term of the plan.
  • Wisconsin medical insurance companies can implement elimination riders and pre-existing condition waiting periods.
  • Elimination riders can keep away certain medical conditions, body parts, body systems from coverage for an unlimited period of time or even permanently, for the entire duration of a policy.
  • A health condition, for which an individual was treated, diagnosed or received medical advice before beginning of new Wisconsin medical insurance plan can be considered as a pre-existing medical condition.
  • A pre-existing medical condition can last for a maximum of two years.
  • A policy holder is not entitled to get any coverage for particular pre-existing condition during the term of an exclusion period.
  • According to Wisconsin state health insurance law, pregnancy may be considered as a pre-existing medical condition for which an exclusion period may apply.
  • All newborns and adopted children should automatically get coverage under parent's individual Wisconsin medical insurance policy for the initial 60 days from the day of birth or adoption. However, the policy should offer coverage for dependants.
  • In certain cases, disabled and handicapped children should get coverage under parent's health insurance policy, even if they cross the decided upper age limit.
  • Wisconsin medical insurance rates differ on the basis of age and health status of an individual. The rate may go up at each renewal based on the type of plan and changing health and age of the policy holder.
  • Wisconsin individuals between jobs or insurance policies can apply for temporary Wisconsin medical insurance policy offered by some of the Wisconsin medical insurance companies.

Wisconsin Medical Insurance Alternative Options

Uninsurable Wisconsin individuals or those who are facing difficulties obtaining Wisconsin medical insurance can take advantage of Wisconsin state alternative medical insurance programs.

  • Wisconsin Health Insurance Risk Sharing Plan: This the high risk pool for the state. It helps uninsurable Wisconsin individuals to buy medical insurance under a state policy. Pre-existing health conditions may be applied.
  • BadgerCare: This is Wisconsin State Children's Health Insurance Program or CHIP. Wisconsin children below and up to the age of 19 as well as their parents qualify for the program provided they should be ineligible for Wisconsin Medicaid and unable to afford the cost of Wisconsin medical insurance.
  • Wisconsin Medicaid: The program is available to the Wisconsin individuals who meet all the qualifying including income and health-related criteria.

Wisconsin Insurance Commission

For more information on Wisconsin medical insurance, you can contact at the following address:

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


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