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Basic Plan — Premiums

All members must pay a monthly premium, per person, to enroll in the Basic Plan. Premiums may change, based on the costs of the plan. Your monthly  premium is due by the 5th of each month for coverage the next month. Late premium payments will not be accepted.

These premiums can be paid:

• Online with a credit card (MasterCard, Visa or Discover), debit card or electronic check. To pay online, go to access.wi.gov.
• By phone with a credit card (MasterCard, Visa or Discover), debit card or electronic check. To pay by phone, call 1-800-291-2002.
• By mail with a personal check, money order, cashier’s check or certified check. To pay by mail, please use a payment slip and send your payment to:

DHS Enrollment Services Center
P.O. Box 6590
Madison, WI 53716

You must include the premium payment slip you get each month with your payment. If you lose your premium slip, you can go to access.wi.gov and print one. If you print the slip from your MyACCESS account, you must be sure to include your seven digit account number in the space provided on the slip. This number can be found on your enrollment letter.

Late Payment/No Payment — To stay enrolled in the Basic Plan; you must pay the full premium amount by the due date on the payment slip.

Note: If your payment is not received in full by the due date, your coverage will end and you will not be able to enroll again in the Basic Plan.

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P-00148 (10/12)

Last Revised:  April 19, 2013