Average Cost of Health Insurance in Wisconsin

  • September 13, 2016
  • |Quartz
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Find out the average cost of health insurance in Madison, Wisconsin.

The average cost of health insurance varies. It is based on –

  • your age
  • where you live in Wisconsin and
  • whether or not you use tobacco

You can’t be charged more based on your sex or your health condition. This stands true unless you use tobacco. Then you can be charged up to 50% more for coverage. Find out about Unity’s tobacco cessation program.

For example in 2016, the average monthly cost of health insurance premiums for a 40-year old non-smoker in Wisconsin is $326 without tax credits and $206 with tax credits.1

Of course, a premium is only one part of the cost of health insurance. Generally, the lower the premium, the higher the out-of-pocket costs when you receive care.

If you choose a plan with a low premium and a higher out-of-pocket cost, you should know what you may be charged if you need hospital services or clinic services. If you need to use the emergency room, for example, your average cost of health insurance can increase dramatically.


If you hurt your ankle and end up going to an emergency room in Dane county, the cost can range from $843 to $1,976, and you may be liable for a good part of that cost with a low-premium plan. It’s important to keep in mind that if you have an accident or illness that puts you in the ER, you will likely end up with follow-up visits, and a low-premium plan may pay less of those costs as well.2

In other words, the cost of health insurance varies widely depending on how much you use health care services.

If the cost of health insurance is too high, can I go without it?

Health insurance represents a cost that everyone has to pay one way or another. By law (the Affordable Care Act), you may have to pay a penalty if you do not have health insurance. Fortunately, there is assistance available for health care costs. See if you qualify for any of the subsidies, tax credits or other savings.

If you’re young and healthy, it might be tempting to pay the penalty and go without health insurance. This strategy is firmly rooted in luck. If you’re lucky enough not to get sick or have an accident that requires medical treatment, you may come out ahead financially. On the other hand, if you have one visit to the emergency room and additional follow-up visits, what might have been a financial benefit may turn into a liability very quickly.

It’s good to consider the average cost of health insurance in light of the benefit of having access to the doctors, hospitals and wellness programs that Unity offers its members. Your health is well worth the investment.

  1. http://kff.org/health-reform/fact-sheet/analysis-of-2016-premium-changes-in-the-affordable-care-acts-health-insurance-marketplaces/
  2. http://www.wipricepoint.org/Report_EDS.aspx


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