Individual & Family Insurance
Individual & Family
- Comprehensive health plans.
- Offer choice of deductibles and optional benefits that enable you to build benefit levels around your specific needs.
- Good for the self-employed, early retirees or any individual that is not covered by a group sponsored health plan.
| Carrier | Link |
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Click for Anthem |
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Click for Assurant Health |
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Click for Golden Rule |
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Click for HumanaOne |
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Click for WPS |
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Click for WPS "Bridge65" |
Are you considering purchasing Individual Health Insurance?
Overview
The individual health insurance market is different than the employer-sponsored group health insurance. Please review the following information before you quote:
You MUST be honest in your application for health insurance. If medical conditions are not adequately disclosed, your policy could be rescinded back to the policy issue date or coverage could be denied. Your completed application becomes a permanent part of your insurance contract.
The underwriting guidelines for individual health insurance are very strict. More than half of all applicants are either declined outright or offered policies limited by exclusions or riders (meaning a carrier will deny coverage for a specified pre-existing condition). If you do get declined, or are offered a policy with riders/exclusions, and are a resident of Wisconsin, you may qualify for Wisconsin's Health Insurance Risk Sharing Pool (HIRSP).
If you are applying for a plan to cover yourself and dependents, the carrier does not have to accept the family as a whole. Carriers reserve the right to decline or rider any individual family member based on underwriting criteria.
Pre-Existing Conditions and Non-Covered Services
All individual insurance plans have a waiting period for certain pre-existing health conditions. This waiting period applies even when you go switch immediately from group coverage to individual coverage.
Most individual policies do not offer maternity or mental health benefits, but some carriers offer the benefits as an "add-on" for additional cost. You need to evaluate if an add-on is worth the additional premium you will be paying, since most add-ons have an extended waiting period.
Most individual policies issued with a drug card benefit do not cover drugs related to mental health (even if those drugs are being prescribed for a reason unrelated to mental health). For example, Buspar is a medication that can be used to treat a variety of conditions, including acne and mental health. If someone is taking Buspar for acne; this drug would likely not be covered under an individual plan even though it is not being dispensed to treat mental health. Many individual policies have a separate deductible associated with their drug card.
If you or your dependents are declined for coverage (or are offered a policy with riders/exclusions) and you are a Wisconsin resident, you can apply for a state government-run plan called HIRSP. For more details on how this plan works, go to www.hirsp.org.