Paying for Health Care in Wisconsin

Finding and choosing insurance

• All Wisconsin residents have access to affordable health insurance. Some individuals and families can get health care coverage through Wisconsin's public health care program, BadgerCare Plus, while others will purchase it through the private market, their employer, or through the federal Health Insurance Marketplace (also known as HealthCare.Gov).
  • More information from HealthCare.gov.
  • Getting lower health care coverage costs at the Marketplace
  • Glossary of Health Coverage and Medical Terms (PDF)
  • Marketplace premium estimates
  • How to choose Marketplace insurance
  • Tips to help you enroll in health care coverage through the Marketplace
  • Getting health care coverage outside of Open Enrollment
  • The Value of Health Insurance (PDF)
  • The fee if you may have to pay if you don't have health care coverage
• Enrollment Wisconsin (EnrollWI.org): Provides resources for consumers (people needing to apply for health insurance using the federal Marketplace) as well as for organizations helping people to apply. An online Enrollment Directory is available on the site. It lists Wisconsin organizations that provide health insurance enrollment services, including organizations that are Certified Application Counselor Organizations - those who can assist with enrollment in the federal Marketplace.
• Information from the Wisconsin Department of Health Services: ForwardHealth: Wisconsin's Health Care and Nutrition Programs.
• The guide to finding and choosing insurance gives you information on what to consider as you search for an insurance plan.
• Here is information about long-term care insurance and paying for long-term care.
• The health plan quality page will help you find out how plans compare on a variety of quality measures.

Government programs

If you do not have access to private insurance, this section provides information about programs that might help you, including the following Wisconsin programs. (Specific eligibility requirements may vary in these programs. Please go to links for eligibility details.)

• ACCESS is a tool to help you determine if you are eligible for Wisconsin's health and nutrition assistance programs. You can check to see if you're eligible, apply for benefits, and find answers to common questions.
• BadgerCare Plus is a health insurance program available to all Wisconsin children, regardless of income. Others who may be eligible include pregnant women, parents and caretakers, young adults who are leaving foster care when they turn 18, farmers and self-employed people, and low-income adults with no dependent children. Find out if you are eligible for BadgerCare Plus and other health and nutrition programs by visiting ACCESS, or call 1-800-362-3002.
• Wisconsin Medicaid: A joint federal/state program that pays for medical services for residents of Wisconsin who are poor, aged, blind, or disabled. 
• SeniorCare: A Medicaid program that provides prescription drug assistance for those 65 or older.

Information on finding insurance and paying for care if you are:

• A college student: Insurance 101: A Guide to Insurance Basics for College Students from the Wisconsin Office of the Commissioner of Insurance (OCI).
• A young adult: Consult the Young Adults pages of Healthcare.gov, information from the U.S. Department of Health and Human Services.
• A farmer: Check A Guide to Health Insurance and Worker's Compensation Insurance for Farm Families from Wisconsin's Office of the Commissioner of Insurance (OCI). Also see information about the Farmers' Health Cooperative of Wisconsin.
• Medicare eligible or a senior: For those who are Medicare eligible, there are lots of things to consider such as buying supplemental insurance, joining a managed care plan, and how to get prescription drug coverage.
• Looking for health insurance as an individual: This guide helps you find and buy health insurance on your own if you do not have employer-based insurance.
• Unemployed or losing your group health insurance for other reasons: Turn here to find out what options and protections you have.
• Considering a health spending account.
• A small business owner.
• A veteran: There are several health insurance and health benefit programs available to veterans and their families.