Best Health Insurance in Wisconsin 2024

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Best Health Insurance in Wisconsin

In Wisconsin, finding the best health insurance plan involves considering various factors such as coverage options, network availability, and affordability. Several insurance companies offer a range of plans tailored to meet the diverse needs of individuals and families across the state.

When choosing a health insurance plan in Wisconsin, individuals should prioritize comprehensive coverage for essential health services, including doctor visits, hospital stays, prescription drugs, and preventive care. Plans with low deductibles and copayments can help individuals manage healthcare costs effectively.

This comprehensive guide to help you find the perfect plan to meet your healthcare needs and budget.

Best Health Insurance in Wisconsin

How much does health insurance cost in Wisconsin?

The typical price for a Silver health insurance plan in Wisconsin stands at $583 per month for a 40-year-old. Your monthly expense is affected by various factors such as the plan tier you select and your age. Generally, higher-tier plans come with higher rates in comparison to lower-tier plans.

It’s crucial to bear in mind that with a higher-tier plan, you’ll incur lower costs when visiting the doctor or filling a prescription, unlike lower-tier plans.

Age significantly impacts health insurance expenses. In Wisconsin, the average health insurance costs rise by 28% from ages 21 to 40.

Health insurance costs escalate further as you reach middle age. On average, a 60-year-old in Wisconsin will pay over twice as much as a 40-year-old for identical coverage.

How much does health insurance cost in Wisconsin

Best Overall for Health Insurance in Wisconsin

In general, HealthPartners stands out as the top choice for health insurance in Wisconsin. This provider excels in affordability, claims processing, and plan adaptability. It boasts one of the most competitive premiums among the insurers compared, coupled with the highest rate of claims acceptance.

HealthPartners

HealthPartners offers the best health insurance in Wisconsin and offers 10 Silver PPO plans While PPO plans may come with higher costs, they boast expansive provider networks and eliminate the need for specialist referrals. This makes them an ideal choice for those prioritizing freedom of choice and convenience, even at a slightly costlier.

  • HealthPartners boasts a broad network of providers across Wisconsin giving you more flexibility in choosing your doctors and hospitals.
  • Offer various wellness programs and incentives.
  • High customer satisfaction
  • They offer a variety of Medicare Advantage plans with additional benefits.
  • Premiums can be on the higher end.
  • Deductibles and out-of-pocket costs can vary depending on the chosen plan.

Plan Recommendations

  • Robin Select $3,500 HSA Silver: $464 per month
  • Robin Oak $3,500 HSA Silver: $521 per month
  • Atlas $3,500 HSA Silver: $528 per month

Best Health Insurance in Wisconsin for Low Out-of-Pocket Costs

MercyCare Health Plans is Wisconsin’s leading health insurance provider for minimizing out-of-pocket expenses. Notably, MercyCare Health Plans stands out for its affordability, offering the most competitive premiums for Gold and Platinum plans in the state.

Additionally, the company maintains reasonable ratings for its claims denial rate and average maximum out-of-pocket costs (MOOP). With these attributes, MercyCare Health Plans proves to be a reliable choice for individuals seeking comprehensive coverage with minimal financial burden.

MercyCare Health Plans

MercyCare Health Plans offers two affordable Gold plans in Wisconsin, with an average monthly cost of $416 and an average maximum out-of-pocket (MOOP) expense of $5,850. Additionally, MercyCare Health Plans boasts a favorable claims denial rate of 10.04%, indicating high approval rates compared to competitors.

This provider’s Gold-tier plans are HMOs, offering lower monthly premiums but requiring you to use in-network providers for coverage and to get specialist referrals.

  • Competitive Bronze and Silver metal tiers- the best option for budget-conscious individuals.
  • Offer various wellness programs and incentives.
  • High customer satisfaction
  • Limited Platinum plan.
  • Limited Medicare Advantage options.

Recommendations Plan:

  • MercyCare HMO Gold HDHP: $429 per month
  • MercyCare HMO Gold Standard: $404 per month

Best Cheap Health Insurance in Wisconsin

MercyCare could be a great choice for individuals prioritizing affordability and in-network care within Wisconsin. In Wisconsin, MercyCare Health Plans offers three Silver HMO plans.

HMOs typically cost less than other plans but have limited provider choices. Opt for this plan if you’re okay with using network providers and need referrals for specialists.

MercyCare Health Plans

MercyCare Health Plans offers two affordable Gold plans in Wisconsin, with an average monthly cost of $416 and an average maximum out-of-pocket (MOOP) expense of $5,850. Additionally, MercyCare Health Plans boasts a favorable claims denial rate of 10.04%, indicating high approval rates compared to competitors.

This provider’s Gold-tier plans are HMOs, offering lower monthly premiums but requiring you to use in-network providers for coverage and to get specialist referrals.

  • Lowest premiums.
  • Fair average MOOP.
  • High customer satisfaction.
  • Reliable claims management reputation.
  • Has limited plan types.
  • Limited Medicare Advantage options.

Recommendations Plan:

  • MercyCare HMO Silver Standard: $441 per month
  • MercyCare HMO Silver HDHP: $450 per month
  • MercyCare HMO Silver Option A: $451 per month

Best Health Insurance for low-income in Wisconsin

MercyCare Health Plans is Wisconsin’s top choice for low-income individuals. We focused on affordable monthly premiums and included only companies offering Silver plans with cost-sharing reductions (CSRs). Across 33 EPOs, 82 HMOs, one POS, and 10 PPO plans, we evaluated options.

CSRs can cut deductibles and out-of-pocket maximums for households earning under 250% of the federal poverty level (FPL). While a standard Silver plan covers about 70% of eligible costs, CSR plans offer higher cost-sharing based on annual income.

MercyCare Health Plans

Low-income Wisconsin residents might prefer MercyCare Health Plans. Their health plans for those earning 201%–250% of the federal poverty level cost about $447 monthly, with a $6,217 maximum out-of-pocket. Plus, they approve more claims than many competitors in the state.

MercyCare Health Plans offers three Silver HMO plans with cost-sharing reductions (CSRs). These plans are ideal for low-income individuals seeking affordable monthly premiums and are okay with using in-network providers for covered healthcare services.

  • Lowest premiums.
  • Fair average MOOP.
  • Reliable claims management reputation.
  • Has limited plan types.

Recommendations Plan:

  • 201%–250% of the FPL: $441 per month
  • 151%–200% of the FPL: $441 per month
  • Up to 150% of the FPL: $441 per month

Best Health Insurance for Young Adults in Wisconsin

HealthPartners stands as the top health insurance provider for young adults in Wisconsin.

Offering Bronze or Catastrophic plans, they feature lower premiums but higher maximum out-of-pocket (MOOP) costs. Catastrophic plans, especially, are exclusive to individuals under 30 years old.

In Wisconsin, our analysis covered the following plan tiers and types:

  • Catastrophic: Eight EPO plans, nine HMO plans, and three PPO plans
  • Bronze: 13 EPO plans, 20 HMO plans, and one POS plan
  • Expanded Bronze: 36 EPO plans, 76 HMO plans, three POS plans, and nine PPO plans

HealthPartners

HealthPartners offers the top health insurance options for young adults in Wisconsin. With 12 Catastrophic, Bronze, and Expanded Bronze plans available, the average monthly cost is $295, with a maximum out-of-pocket (MOOP) limit of $8,675. HealthPartners boasts a claims denial rate of 6.57%, the best in Wisconsin.

Metal tiers show how much coverage a plan provides. Catastrophic, Bronze, and Expanded Bronze plans are good for young adults who want lower monthly payments and don’t expect to use many medical services.

  • A comprehensive network of providers across Wisconsin gives you more flexibility in choosing your doctors and hospitals.
  • Offer various wellness programs and incentives.
  • Offer a variety of plans to cater to different needs and budgets.
  • Affordable monthly premiums.
  • High MOOP costs.
  • Premiums can be on the higher end.

Plan Recommendations

  • Robin Select $7,500 HSA Bronze:
    • $254/month for 18 year olds
    • $285/month for 26 year olds
  • Robin Oak $7,500 HSA Bronze:
    • $285/month for 18 year olds
    • $320/month for 26 year olds
  • Atlas $7,500 HSA Bronze:
    • $289/month for 18 year olds
    • $324/month for 26 year olds

Cheapest health insurance in Wisconsin

The most affordable Silver health insurance option in Wisconsin is the Anthem Silver Pathway plan. It’s accessible to about 40% of Wisconsin’s residents, including those residing in the Milwaukee metro area.

Cheapest health insurance in WI
TierCheapest planMonthly cost
CatastrophicDean Focus Network Catastrophic Safety Net$215
BronzeDean Focus Network Bronze Standard$268
SilverAnthem Silver Pathway/Lean 5900/40% Standard$402
GoldDean Focus Network Gold$424
PlatinumGroup Health Cooperative-SCW Select Platinum$531
Monthly costs are for a 40-year-old.

Cheapest health insurance plan by Wisconsin county

The cheapest health insurance plan varies by location. Wisconsin offers 15 different cheapest Silver health insurance plans across its 72 counties.

Cheapest health insurance by WI county
CountyCheapest Silver planMonthly rate
AdamsDean Health Plan Dean Silver$498
AshlandSecurity Health Plan Select$606
BarronSecurity Health Plan Select$583
BayfieldMedica Essentia Choice Care$514
BrownCommon Ground CGHC Silver$460
BuffaloMedica Silver Standard$588
BurnettHealthPartners Atlas $3,800 HSA Silver$586
CalumetAnthem Silver Pathway$433
ChippewaSecurity Health Plan Select$586
ClarkSecurity Health Plan SimplyOne$540
ColumbiaAnthem Silver Blue Preferred$464
CrawfordDean Health Plan Dean Silver$516
DaneDean Focus Network Silver$427
DodgeCommon Ground CGHC Silver$439
DoorCommon Ground CGHC Silver$460
DouglasMedica Essentia Choice Care$514
DunnSecurity Health Plan Select$586
Eau ClaireSecurity Health Plan Select$586
FlorenceHealthPartners Robin Select Silver$481
Fond du LacCommon Ground CGHC Silver$439
ForestSecurity Health Plan SimplyOne$503
GrantDean Health Plan Dean Silver$516
GreenAnthem Silver Blue Preferred$464
Green LakeHealthPartners Robin Select Silver$481
IowaDean Silver$514
IronSecurity Health Plan Select$543
JacksonMedica Silver Standard$588
JeffersonAnthem Silver Blue Preferred$464
JuneauDean Health Plan Dean Silver$498
KenoshaAnthem Silver Pathway$446
KewauneeCommon Ground CGHC Silver$460
La CrosseMedica Silver Standard$588
LafayetteDean Health Plan Dean Silver$516
LangladeSecurity Health Plan SimplyOne$503
LincolnSecurity Health Plan SimplyOne$498
ManitowocCommon Ground CGHC Silver$460
MarathonSecurity Health Plan SimplyOne$498
MarinetteCommon Ground CGHC Silver$460
MarquetteHealthPartners Robin Select Silver$481
MenomineeHealthPartners Robin Select Silver$481
MilwaukeeAnthem Silver Pathway$402
MonroeMedica Silver Standard$588
OcontoCommon Ground CGHC Silver$460
OneidaSecurity Health Plan SimplyOne$503
OutagamieAnthem Silver Pathway$433
OzaukeeAnthem Silver Pathway$451
PepinSecurity Health Plan Select$586
PierceMedica Silver Standard$517
PolkMedica Medica Individual Choice Silver Standard$523
PortageSecurity Health Plan SimplyOne$498
PriceSecurity Health Plan SimplyOne$540
RacineAnthem Silver Pathway$446
RichlandDean Health Plan Dean Silver$498
RockAnthem Silver Blue Priority$446
RuskSecurity Health Plan Select$583
SaukDean Focus Network Silver$458
SawyerSecurity Health Plan Select$606
ShawanoCommon Ground CGHC Silver$460
SheboyganCommon Ground CGHC Silver$439
St. CroixMedica Silver Standard$517
TaylorSecurity Health Plan SimplyOne$540
TrempealeauMedica Silver Standard$588
VernonDean Health Plan Dean Silver$516
VilasSecurity Health Plan SimplyOne$503
WalworthMercyCare HMO Silver$453
WashburnMedica Essentia Choice Care$514
WashingtonAnthem Silver Pathway$451
WaukeshaAnthem Silver Pathway$451
WaupacaCommon Ground CGHC Silver$439
WausharaCommon Ground CGHC Silver$439
WinnebagoAnthem Silver Pathway$433
WoodSecurity Health Plan SimplyOne$498

FAQs About Health Insurance in Wisconsin

Is there a penalty for not having health insurance in Wisconsin?

The fee for not having health insurance ended in 2018. 

How many hours do you have to work to get health insurance in Wisconsin?

In Wisconsin, a small employer has 2 to 50 employees, and an eligible employee works at least 30 hours per week on a permanent basis according to state law.

Does Wisconsin have Obamacare?

Wisconsin residents use HealthCare.gov, the federally run health enrollment platform, to purchase ACA Marketplace plans.

What is Wisconsin state insurance called?

BadgerCare Plus

Does Wisconsin have mandatory insurance?

No, only Wisconsin drivers are required to have motor vehicle liability insurance.

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