Each state has its own Department of Insurance, which means health insurance pricing, and regulations can vary based on a state’s current laws and economy. This means that some states are more flexible in terms of health plans than others. So before you begin searching for insurance policies, it’s best to know what the options and requirements are in your area.
Wisconsin has elected to use the Federally-facilitated Marketplace (FFM) for enrollment in qualified health plans (QHP). If you choose a qualified plan, you can enroll through HealthCare.Gov, or a private exchange like AHiX Marketplace. The advantage of using a private exchange like AHiX is that you can shop the same qualified plans at healthcare.gov, but also have access to the many non-qualified plans and supplemental coverages not offered at healthcare.gov.
Residents also have the option to opt for non-qualified alternatives, including temporary health insurance. For those who decide to go without coverage, note that Wisconsin does not implement the individual mandate requirement, which means that residents do not have to pay a fine for going uninsured.
Qualified plans are compliant with the Affordable Care Act, which satisfies the ten Essential Health Benefits, a set of benefits that are guaranteed to cover specific healthcare costs without discriminating against age, gender, location, or lifestyle choices.
Non-qualified plans are less expensive plans that provide coverage for individuals and families. These plans do not comply with the federal government’s health insurance requirements and do not cover maternity, mental health, substance abuse or pre-existing conditions.
These plans can help cover individual, family, and short term healthcare costs.
Wisconsin's individual health insurance is a type of coverage you purchase if you are only covering yourself or your family. You can choose to get insurance coverage through a private exchange like AHiX, directly from the insurance company, HealthCare.gov, your employer, or a social insurance plan like Medicare or Medicaid.
For ACA qualified plans, individuals can expect these average costs of premiums in Wisconsin (Age 40, Zip code 53201):
Alternatively, you could consider non-qualified plans. These plans still offer substantial coverage, with limits varying by the policy. Find out the lowest cost for non-qualified insurance near you.
Wisconsin family health insurance is ideal for families with at least one spouse and dependent. You can purchase qualified and non-qualified plans through AHiX Marketplace. You can also get coverage from your employer. Medicare is intended for seniors 65 years and older, so these are not viable options for families.
Here are the average costs of qualified premiums for Wisconsin families (Age 40) with children under 26 years old:
A married couple with one child
A married couple with two children
A married couple with three children
There are less expensive options to consider if you only need certain types of coverage. For example, non-qualified insurance has much lower premiums that can cover the whole family.
Short term health insurance is affordable, often less than half the cost of a qualified plan. These non-qualified plans are intended to provide temporary coverage until you're covered by an employer plan or a qualified plan. In Wisconsin, you can purchase coverage for up to 12 months (364 Days). When the coverage expires, you cannot buy another short term plan with the same carrier for 63 days. If you still need coverage, you will need to choose a different insurance carrier. AHiX.com offers easy online enrollment with multiple short term medical carriers in Wisconsin.
If you’re trying to stay within budget while finding the right coverage, then you already know that it can be an overwhelming process. The good news is that AHiX can do the work of searching for the right plan for you. AHiX Marketplace is an affordable exchange where you can browse for qualified and non-qualified plans so you can find the right coverage at the right price. Find your new policy today.