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.
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.
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.
Pros
Cons
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.
Pros
Cons
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.
RecommendationsPlan:
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.
Pros
Cons
Lowest premiums.
Fair average MOOP.
High customer satisfaction.
Reliable claims management reputation.
Has limited plan types.
Limited Medicare Advantage options.
RecommendationsPlan:
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.
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.
Pros
Cons
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
Tier
Cheapest plan
Monthly cost
Catastrophic
Dean Focus Network Catastrophic Safety Net
$215
Bronze
Dean Focus Network Bronze Standard
$268
Silver
Anthem Silver Pathway/Lean 5900/40% Standard
$402
Gold
Dean Focus Network Gold
$424
Platinum
Group 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
County
Cheapest Silver plan
Monthly rate
Adams
Dean Health Plan Dean Silver
$498
Ashland
Security Health Plan Select
$606
Barron
Security Health Plan Select
$583
Bayfield
Medica Essentia Choice Care
$514
Brown
Common Ground CGHC Silver
$460
Buffalo
Medica Silver Standard
$588
Burnett
HealthPartners Atlas $3,800 HSA Silver
$586
Calumet
Anthem Silver Pathway
$433
Chippewa
Security Health Plan Select
$586
Clark
Security Health Plan SimplyOne
$540
Columbia
Anthem Silver Blue Preferred
$464
Crawford
Dean Health Plan Dean Silver
$516
Dane
Dean Focus Network Silver
$427
Dodge
Common Ground CGHC Silver
$439
Door
Common Ground CGHC Silver
$460
Douglas
Medica Essentia Choice Care
$514
Dunn
Security Health Plan Select
$586
Eau Claire
Security Health Plan Select
$586
Florence
HealthPartners Robin Select Silver
$481
Fond du Lac
Common Ground CGHC Silver
$439
Forest
Security Health Plan SimplyOne
$503
Grant
Dean Health Plan Dean Silver
$516
Green
Anthem Silver Blue Preferred
$464
Green Lake
HealthPartners Robin Select Silver
$481
Iowa
Dean Silver
$514
Iron
Security Health Plan Select
$543
Jackson
Medica Silver Standard
$588
Jefferson
Anthem Silver Blue Preferred
$464
Juneau
Dean Health Plan Dean Silver
$498
Kenosha
Anthem Silver Pathway
$446
Kewaunee
Common Ground CGHC Silver
$460
La Crosse
Medica Silver Standard
$588
Lafayette
Dean Health Plan Dean Silver
$516
Langlade
Security Health Plan SimplyOne
$503
Lincoln
Security Health Plan SimplyOne
$498
Manitowoc
Common Ground CGHC Silver
$460
Marathon
Security Health Plan SimplyOne
$498
Marinette
Common Ground CGHC Silver
$460
Marquette
HealthPartners Robin Select Silver
$481
Menominee
HealthPartners Robin Select Silver
$481
Milwaukee
Anthem Silver Pathway
$402
Monroe
Medica Silver Standard
$588
Oconto
Common Ground CGHC Silver
$460
Oneida
Security Health Plan SimplyOne
$503
Outagamie
Anthem Silver Pathway
$433
Ozaukee
Anthem Silver Pathway
$451
Pepin
Security Health Plan Select
$586
Pierce
Medica Silver Standard
$517
Polk
Medica Medica Individual Choice Silver Standard
$523
Portage
Security Health Plan SimplyOne
$498
Price
Security Health Plan SimplyOne
$540
Racine
Anthem Silver Pathway
$446
Richland
Dean Health Plan Dean Silver
$498
Rock
Anthem Silver Blue Priority
$446
Rusk
Security Health Plan Select
$583
Sauk
Dean Focus Network Silver
$458
Sawyer
Security Health Plan Select
$606
Shawano
Common Ground CGHC Silver
$460
Sheboygan
Common Ground CGHC Silver
$439
St. Croix
Medica Silver Standard
$517
Taylor
Security Health Plan SimplyOne
$540
Trempealeau
Medica Silver Standard
$588
Vernon
Dean Health Plan Dean Silver
$516
Vilas
Security Health Plan SimplyOne
$503
Walworth
MercyCare HMO Silver
$453
Washburn
Medica Essentia Choice Care
$514
Washington
Anthem Silver Pathway
$451
Waukesha
Anthem Silver Pathway
$451
Waupaca
Common Ground CGHC Silver
$439
Waushara
Common Ground CGHC Silver
$439
Winnebago
Anthem Silver Pathway
$433
Wood
Security 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.
ADVERTISEMENTS Finding the best and most affordable health insurance options in Arizona can be overwhelming. With so many providers, it’s hard to decide the best health insurance in Arizona. But fear not fellow Arizonans! We’ve compiled a comprehensive guide to help you find the perfect plan to meet your healthcare needs and budget. This comprehensive…
ADVERTISEMENTS Are you seeking the best health insurance options in Arkansas? Look no further. In this guide, we’ll explore the top health insurance providers in the state, their coverage options, and what sets them apart. From affordable premiums to comprehensive coverage, we’ll help you navigate the landscape of health insurance in Arkansas so you can…
ADVERTISEMENTS Offering health insurance is a significant choice for employers, particularly daunting for small businesses lacking an HR team or benefits expert to guide them through the process. Yet, investing the time and effort into establishing a structured health benefit plan is highly beneficial. There are numerous advantages to providing an employer-sponsored health insurance plan,…
ADVERTISEMENTS No matter who you are, having medical insurance will inevitably become essential at some stage in life. Whether it’s for routine check-ups or unexpected medical procedures, every individual requires coverage through an insurance policy. This is where the confusion begins. With numerous plans and companies available, it’s easy to become overwhelmed, particularly if you’re new…
ADVERTISEMENTS Are you on the lookout for the best health insurance options in Ohio? Whether you’re seeking coverage, a family in need of a comprehensive plan, or a self-employed individual exploring your options, finding the right health insurance plan is crucial. In this guide, we’ll explore Ohio’s top health insurance providers, including the cheapest options…
ADVERTISEMENTS In Hawaii, 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 Hawaii, individuals should prioritize comprehensive coverage…