Wisconsin Health Insurance Marketplace 2025

Need health insurance in Wisconsin? This article is your go-to resource. It helps residents find and enroll in health plans with essential benefits, offering a range of options to fit different needs and budgets.

 

Key Takeaways

 

  • Various insurers provide Marketplace options in Wisconsin, ensuring at least three plans are available per county, and assistance resources are available to help individuals navigate their coverage choices.

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Understanding the Wisconsin Health Insurance Marketplace

Wisconsin health INSURANCE MARKETPLACE

The Health Insurance Marketplace is a federal government-guided system established under the Affordable Care Act to help individuals secure health insurance that meets their needs. This insurance marketplace is designed specifically for those who do not have health coverage through their employer or another source. It provides an avenue to buy health insurance independently while ensuring the plans include essential benefits such as preventive services, mental health care, and coverage for pre-existing conditions.

 

Eligibility for Wisconsin Marketplace Health Coverage

Individuals must be residents of Wisconsin to qualify for health coverage. This applies to the Wisconsin Health Insurance Marketplace. This residency requirement ensures that the marketplace serves the state’s population effectively. Additionally, applicants typically need to demonstrate that their income falls within specific thresholds set by the marketplace.

Eligibility for marketplace health plans may also depend on life events such as job loss, marriage, or the birth of a child. These circumstances can affect your ability to secure health insurance through the marketplace, so it’s important to understand all criteria before applying.

 

Open Enrollment Periods

The open enrollment period for the Wisconsin Health Insurance Marketplace is a key timeframe for securing health coverage. For 2024, it runs from November 1 to January 15. Enrolling by December 15 ensures coverage begins on January 1, while those applying between December 16 and January 15 will start coverage on February 1.

Open enrollment is the primary window for individuals to buy health insurance, make changes, or renew their current health plans. Missing this period means you might have to wait another year to enroll unless you qualify for a special enrollment period.

Enrollment deadlines and updates are regularly shared via emails and texts to keep you informed.

 

How to enroll in a plan

Special Enrollment Periods

Life’s unexpected changes are covered by the Special Enrollment Period (SEP), which allows for health coverage during crucial times. Qualifying life events like losing health coverage, marriage, or having a baby trigger a 60-day window for enrolling in a health plan.

Missing the open enrollment period but experiencing a significant life change allows you to apply for health insurance within the special window, ensuring major life transitions don’t leave you without coverage.

How to Enroll in a Wisconsin Marketplace Plan

Enrolling in a Wisconsin Marketplace plan is straightforward. Residents can apply for health coverage through multiple channels, including online applications using the zip code box on this website and phone assistance by calling 1-877-517-5357. These options cater to various preferences and comfort levels.

For those losing Medicaid or CHIP eligibility, acting quickly to secure a marketplace plan is essential to avoid coverage gaps. Get your needed support during this transition, ensuring a smooth process for accessing Medicaid services.

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1-877-517-5357

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Finding Affordable Health Insurance in Wisconsin

Affordable health insurance in Wisconsin is within reach with the right resources. You can find affordable health insurance through premium tax credits for qualifying incomes, which can significantly reduce monthly premiums, making health plans accessible even without employer-sponsored coverage.

This website provides free assistance, connecting individuals with licensed insurance agents who can help explore options and offer insurance to find a suitable health plan. These resources make securing affordable health insurance more manageable.

Health Insurance Premiums and Rate Changes

Health Insurance Premiums and Rate Changes

Health insurance premiums can change, and 2024 is no different. The average premium for non-Medicare participants in Wisconsin is expected to rise by 7.3%, while the Local Program may see an 11% increase. Medicare-enrolled retirees could face increases between 6% and 26%.

Factors contributing to these increases include lower-than-expected reserve balances, rising pharmacy and medical service costs, and higher administrative expenses. The Wisconsin Healthcare Stability Plan helps keep pre-subsidy premiums lower since its inception in 2019.

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Insurers Offering Marketplace Coverage in Wisconsin

The Wisconsin Health Insurance Marketplace provides various options, ensuring residents can find the best plan for their needs. In 2024, every county in Wisconsin will offer at least three insurers’ plans, making it easier to compare and select a suitable health insurance plan.

Insurers like Quartz, Common Ground Healthcare Cooperative, Molina Healthcare, and Health Partners Robin Oak, including Aurora Health Care, are among the options available. This ensures access to multiple health plans regardless of where you live in Wisconsin.

Compare Marketplace Health Insurance Plans

ENTER YOUR ZIP CODE BELOW

SPEAK WITH AN AGENT NOW!

1-877-517-5357

TTY users 711
Mon – Fri : 8am – 8pm EST

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Medicaid and CHIP Coverage Transition

Medicaid and CHIP coverage transition

 

Transitioning from Medicaid or CHIP to a Marketplace plan can be significant but necessary. If eligible for Medicaid or CHIP, you cannot keep a Marketplace plan with premium assistance, requiring a choice between the two coverages.

By April 2024, nearly 72,000 individuals transitioned from Wisconsin Medicaid to a Marketplace plan. For those losing Medicaid or CHIP, securing Marketplace coverage is vital to avoid gaps in health insurance. Understanding these transitions helps maintain continuous coverage.

Benefits of Choosing a Marketplace Plan

Choosing a Marketplace plan offers numerous benefits, including coverage for essential health services without lifetime or annual limits. This means your health insurance will cover critical services like preventive care, mental health services, and treatment for pre-existing conditions.

Marketplace plans offer various options, including dental and vision coverage, providing comprehensive healthcare solutions. Timely premium payments are essential to activate and maintain your coverage, ensuring access to these benefits whenever needed.

Signing Up for Updates

Staying informed about health insurance updates and deadlines is crucial. Signing up for email and text updates ensures you receive important reminders about enrollment periods and other critical information, helping you manage documents and deadlines more conveniently.

Call 1-877-517-5357 ensuring timely and accurate information. Stay ahead and never miss a crucial deadline.

Compare Marketplace Health Insurance Plans

ENTER YOUR ZIP CODE BELOW

SPEAK WITH AN AGENT NOW!

1-877-517-5357

TTY users 711
Mon – Fri : 8am – 8pm EST

agent

Summary

The Wisconsin Health Insurance Marketplace provides a valuable resource for those needing health coverage. From understanding eligibility and enrollment periods to finding affordable health insurance and navigating premium changes, this guide has covered all the essential aspects.

Taking action to secure health insurance is vital for your well-being. With the variety of options available and the support mechanisms in place, there’s no reason to delay. Ensure you and your family are protected by exploring the Wisconsin Health Insurance Marketplace today.

Compare Health Plans in your area

Enter Zip Code

 

Frequently Asked Questions

  • When can you enroll in or change health insurance plans?

You can enroll in or change health insurance plans during the open enrollment period, or if you experience qualifying life events such as changes in income, marriage, or the birth of a child. Consider reviewing your options regularly to ensure you have the best coverage for your needs.

 

  • What should you do if you lost Medicaid or CHIP?

If you’ve lost Medicaid or CHIP, consider obtaining coverage through the Marketplace. This will ensure you have access to health insurance options that suit your needs.

 

  • How can you receive important news and updates regarding health insurance?

To receive important news and updates regarding health insurance, sign up for email and text notifications for deadline reminders and essential information. This proactive approach ensures you’re always informed.

 

  • What are some benefits of choosing a Marketplace plan?

Choosing a Marketplace plan provides the advantage of comprehensive coverage for essential health benefits, including dental and vision, without lifetime or annual limits. This ensures you receive the necessary care while maintaining financial protection.

 

  • What happens if I miss the open enrollment period?

If you miss the open enrollment period, you may still be able to enroll in health coverage if you experience a qualifying life event like job loss, marriage, or the birth of a child. It’s important to act promptly to secure your options.