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What is Medical Insurance?

A basic understanding of what is it and what must be covered.

Medical insurance, also known as health insurance, is designed to protect people from large medical bills should they become injured, sick, or in need of extensive medical care. It works the way other insurance works – it manages risk by pooling the resources of a group to pay for the costs of those in the group who need to draw on those resources.

Because of the Affordable Care Act (ACA), most medical insurance has a stricter definition than in the past. In order to be ACA compliant, medical insurance must: 

  • Offer essential health benefits
  • Not cancel existing policies (except for non-payment of the premium or fraud)
  • Be offered to those with pre-existing conditions
  • Not charge women more for coverage (you can be charged more for coverage depending on your age, where you live, how many people are on the plan and if you use tobacco) 
Find a basic understanding of what medical insurance is and what must be covered in Wisconsin.

Can I buy a plan that is not ACA-compliant medical insurance?

You can find plans that offer limited health coverage or only cover certain things. Examples of this include: 

  • Coverage limited to vision care or dental care
  • Coverage limited to a specific disease or condition
  • Workers' compensation
  • Plans that offer only discounts on medical services 

Some people buy supplemental health insurance policies in addition to their ACA-compliant plans. Supplemental policies will provide money to live on if you are in the hospital, receiving rehab or other circumstances. If you are interested in this type of additional coverage, be sure to carefully review the plan to make sure it offers the extra coverage you want. 

Ready to find a plan? Shop medical insurance plans and get a quote now. Have questions about what kind of medical insurance is right for you? Talk to our knowledgeable and friendly customer service representatives at (800) 362-3310.