What is Considered to be Affordable Health Insurance (Wisconsin)?

  • April 24, 2016
  • |Quartz
|
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We’ve all been hearing about how the Affordable Care Act (ACA) has made health insurance affordable. But what exactly is considered to be affordable?
We’ve all been hearing about how the Affordable Care Act (ACA) helps make health insurance affordable. But what exactly is considered to be affordable health insurance in Wisconsin?

One way to view affordability is to compare Wisconsin health insurance premium costs from this year to last year.  An analysis1 by the Kaiser Family Foundation looks at premium costs for a silver level plan in Milwaukee. Silver level plans are in the middle of a five-tier system that runs from the lowest premium cost (Catastrophic) through Bronze, Silver, Gold and Platinum (highest premium cost).

 

Silver Level Monthly Premiums

 

Without subsidies

With Subsidies

Milwaukee, Wisconsin

2015

2016

2015

2016

$333

$326

$208

$206

Minneapolis, Minnesota

$183

$235

$183

$206

Chicago, Illinois

$215

$198

$208

$198

Cedar Rapids, Iowa

$246

$284

$208

$206

Detroit, Michigan

$230

$226

$208

$206

t’s interesting to see what people in neighboring states’ large cities pay for the same plan. It would be nice if we could buy a Chicago plan while we’re living in Wisconsin. Unfortunately, that’s not possible. By law, health plans can only offer their plans to those who live within a certain service area. In addition, you need to use the doctors, hospitals and clinics within a specific network. If you use out-of-network doctors, hospitals or clinics (except in the case of an emergency), you may be stuck with some or all of the bill.

The Other Side of Affordable Health Insurance in Wisconsin

Another aspect of affordable health insurance in Wisconsin is the cost related to getting health care services or prescriptions. Usually, the lower the premium, the more you have to pay out-of-pocket when you go to the doctor. For example, if you’re a non-smoker under 30 and have a catastrophic plan, your premiums will probably be less than $150 per month. However, you will have to pay $6,850 towards your medical costs before your catastrophic plan pays anything (except for certain no-cost preventive services). That may not be the most affordable plan for you.

However, if you meet the income requirements, you may be eligible for help paying for your premiums and even help paying for out-of-pocket costs. In 2016, you may qualify for help buying a silver plan if you earn less than $29,425 as a single person. If you qualify, your premium may be reduced and more of the cost will be covered when you go to the doctor.

See If You Qualify and Get a Quote

Finding affordable health insurance in Wisconsin depends on a variety of factors. If you have questions about what kind of plan is right for you and whether you can get subsidies, give our knowledgeable and helpful customer service representatives a call at 608.644.3430.

1. Cox, Cynthia; Gonzales, Selena; Kamal, Rabah; Claxton, Gary; Levitt, Larry: Analysis of 2016 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces.The Henry J. Kaiser Family Foundation,October 26, 2015. Accessed April 21, 2106.

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