Wisconsin Health Insurance

Health insurance regulations in the state of Wisconsin are particularly relaxed, so anyone who wants to buy new health coverage here would do well to learn about what they can and cannot expect from insurers in the current economic climate.  To get you started on the right foot, we offer the following overview of health insurance regulations in Wisconsin.

• As is common to most states in the U.S., Wisconsin legally requires all health insurance providers to include a guaranteed renewability provision in every policy they offer.  This means that, as long as you’ve kept to the terms of your policy, you may choose to renew your coverage each time it is due to expire.  Not only that, but insurance companies in this state are forbidden to cancel your coverage, or stop it from being renewed, when you have fallen ill.
• Every newborn or newly-adopted child in this state is considered to be covered under a parent’s health insurance automatically, assuming that the policy in question can be applied to dependents.  This applies for at least sixty (60) days, giving ample time to make other arrangements for any new family members.
• Wisconsin’s treatment of pre-existing conditions is unusually permissive to insurance companies, so this is something that should be of prime concern when applying for new coverage.  Any health issue for which you have ever been treated or diagnosed can be considered a pre-existing condition in Wisconsin, and there is no actual upper limit to how long such conditions can be excluded from your health coverage.  The standard practice is for the exclusion to expire within a matter of months or years, however.
• Another particularly “hands-off” issue in Wisconsin is the availability and cost of health insurance.  Insurers in this state are given free rein to deny any application for coverage for any reason, such as due to health or age concerns.  The cost of any health policy they do choose to provide can also vary dramatically for the same reasons.  Again, it is important for Wisconsin residents to read over any insurance contract carefully to ensure that the terms are fair.
• Small businesses operating in Wisconsin are automatically entitled to purchase group health coverage here.  As long as it has between 2 and 50 employees, a company is guaranteed access to any health plan that is already being offered to other Wisconsin-based companies.  The cost of this insurance may vary (within limits) based on typical risk factors like location and age, but can never take health status into account.
• Employers in this state may be required to meet a handful of conditions to maintain their employees’ group coverage.  Typically these obligations include ensuring that at least a certain percentage of the employees participate in the company health plan, paying a portion of each employee’s premiums, and so on.  Cancellation of the company’s health plan can potentially result if the specified conditions are not met.
• Self-employed residents of Wisconsin who have no other employees are not considered eligible to purchase group health insurance the way a larger enterprise could.  Purchasing individual health insurance is generally the only other option available, but on the bright side Wisconsin permits self-employed workers to deduct a large portion of the premiums for this coverage from their taxes.

Most of those who wish to buy health insurance in Wisconsin would be best off doing so as early in life as possible, as health coverage here only gets more expensive and harder to get as one gets older.  Fortunately, even those who are operating from a less-than-ideal position have a good chance of getting health coverage if they’re willing to take advantage of all resources and information at their disposal.

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