Last Updated: November 29, 2022
Printable version of publication: "Low Cost" Health Insurance
If you found health
insurance online or someone called with an offer that appears to be less costly, be sure to know what you are buying – including understanding
all out-of-pocket costs (expenses that aren't reimbursed by insurance such as
deductibles,
coinsurance,
copayments, and costs for services that aren't covered).
Before you buy that "low cost" health insurance, ask these questions first.
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Is it a Short-Term, Limited Duration plan, a Sharing Ministry plan, or other limited-coverage plan? Is it sold through an association that requires a membership fee? If so, it could cover less than Marketplace plans.
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Is the person selling the plan licensed in Wisconsin? To confirm, look up the agent using their name or license number. Visit oci.wi.gov/Consumers in our agent lookup portal.
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What is the
insurance company and is it licensed in Wisconsin? Insurance Company Look Up is also available.
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Does the plan cover your
preexisting conditions? Does it cover your medications?
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What are the
deductibles? There may be different deductibles for different services.
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What services
doesn’t the plan cover?
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For services that
are covered, how much will the plan
actually pay? Is there a limit on the total amount the plan will pay per person, per service, or per year?
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How long will the coverage last? Will you be able to keep or renew your coverage if you get sick?
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Does the plan have a provider
network?
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If yes, how do you access information about it? Is your doctor or hospital in the network?
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If not, will doctors and providers agree not to bill for amounts above what the plan pays?
Ask for a
written example of how coverage works if you visited a physician and needed diagnostic tests and follow-up care. Also ask for a
written example of how coverage works if you had a hospital stay for several days, had testing and scans, surgery, and saw several specialists.
Before you buy, always ask for the plan’s details in writing and take the time to review the materials carefully. Don’t feel rushed to make a decision.
Federal Insurance Marketplace
To buy
insurance that will cover a wide range of conditions and services, start with the federal Health Insurance Marketplace:
The Open Enrollment Period for 2024 coverage ended January 16, 2024. You may still be able to enroll in comprehensive coverage through the Marketplace after that date if you have a
qualifying life event
, like losing other health coverage, moving, getting married, or having a child.
If you have questions, visit HealthCare.gov or call the Wisconsin Office of the Commissioner of Insurance at 1-800-236-8517.
BadgerCare Plus (Wisconsin Medicaid)