Frett/Barrington Limited

Frett/Barrington Limited
21001 Watertown Rd.
Suite 301
Waukesha, WI 53186
(262) 780-5400

The Employee
Benefit Specialists

Individual & Family Insurance

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Read before you Quote:
Are you considering purchasing Individual Health Insurance? The individual health insurance market is different from employer-sponsored group health insurance, and some people are surprised by how it works. We want to help you be a better consumer of individual health insurance by describing the major differences before you start evaluating carriers. Here are some things to understand before you begin:

It is critical that you are 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 If medical conditions are not adequately disclosed, your policy could be rescinded back to the policy issue date or coverage could be denied.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 they will deny coverage for a specified pre-existing condition). If you do get declined, or are offered a policy with riders or exclusions, if you are a resident of Wisconsin, you can still qualify for HIRSP (see below).

If you are applying for a plan that includes yourself and dependents, the carrier does not have to accept the family as a whole. Carriers reserve the right to decline or rider any family member based on underwriting criteria.

All individual insurance plans have a preexisting waiting period for certain health conditions. This applies even when you go 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". 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 that are related to mental health, even if the drugs are being prescribed for a different reason. 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 the 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.