What You Really Need to Know about Individual Health Insurance Wisconsin

  • May 04, 2016
  • |Quartz
This is a blog post. The information may not be up-to-date. If you have questions, please contact Customer Service.
Choosing an individual health insurance plan in Wisconsin can be overwhelming. It’s easier if you know what’s important and what’s not. Learn more.
Choosing an individual health insurance plan in Wisconsin can be overwhelming. It’s easier if you know what’s important and what’s not. Learn more.

It’s easy to get lots of information about individual health insurance plans in Wisconsin, but how do you know the facts from the myths?

Feature Myth or Fact Reality
The cheapest individual health insurance plans in Wisconsin have the lowest premiums. Fact-O-Meter150.png

This is only true if you don’t use health care services. Then your only cost is the premium.

However, if you go to the doctor or have an accident, you may be liable to pay up to $6,850 ($13,700 for a family) out of your own pocket before your individual health insurance plan will pay anything.  

The question is, how likely are you to need health care? The latest data1 shows that, for every 100 people, there were –

  • 41 hospital outpatient visits
  • 301 visits to the doctor’s office
  • 44.5 visits to the emergency room

Low deductible individual health insurance is best. Fact-O-Meter150.png

This may be true if you use a lot of health care services.

If you go to the doctor a lot, a low deductible plan means that you’ll pay a higher premium. However, your insurance will start paying sooner.

On the other hand, if you rarely see the doctor and don’t get sick or have an accident, a low deductible won’t mean much. It really depends on your specific situation.

I can buy individual health insurance in Wisconsin when I need it. Fact-O-Meter-Myth.png

You can’t buy an individual health insurance plan anytime in Wisconsin – or anywhere else in the country. Because of the Affordable Care Act (ACA), most people can only buy health insurance during open enrollment (in 2016, that’s November 1, 2016 through January 31, 2017).

Some people may qualify for a special enrollment period, or you may qualify to enroll in BadgerCare Plus or Medicare at other times during the year.

Further, you may be liable for a large fine if you don’t have health insurance.

It’s cheaper to just pay the fine than to pay for health insurance. Fact-O-Meter-Myth.png

This is usually only true if –

  • You rarely go to the doctor and don’t have a moderate or severe accident that requires medical attention
  • You aren’t eligible for subsidies to help pay for health insurance

Many times, people don’t buy health insurance because of the cost. Instead, they gamble that they’ll save money by paying the fee, rather than buying an individual health insurance plan. If you don’t have coverage, there is no limit to what you may owe for health care.

I can’t get health insurance because I have a pre-existing condition. Fact-O-Meter-Myth.png

This one is a myth! Nowadays, everyone can get health insurance, even if they’ve been denied coverage in the past. Further, you can’t be charged more for insurance if you have a pre-existing condition. The only factors that go into the price of an ACA-compliant plan are –

  • Whether or not you use tobacco
  • How many people are on the plan
  • How old you are
  • Where you live


See If You Qualify and Get a Quote

Many things have changes about insurance in the past few years. If you still have questions, just give us a call at 608.644.3430 and our knowledgeable and helpful customer service representatives will help.


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