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“Low Cost” Health Insurance

​​​​​​​​​​​​​​​​​​​Last Updated: January 23, 2025

Printable version of publication: "Low Cost" Health​ Insuranc​e​​​​​​​


If you found health ​​ insuranc​e 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-pock​et costs (expenses that aren't reimbursed by insurance such as deductibles, coinsurance, copayments, and costs for services that aren't covered).​​​​​

Be​​fore You Buy

Before you buy that "low cost" health insurance, ask the​​​se questions first:

  • 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 plan​s and leave you at risk of owning large balances to medical providers.

  • Is the person selling the plan licensed in Wisconsin? To confirm, look up the agent using their name or license number. V​​​isit ​our agent lookup portal​.

  • What is the name of the insurance company and is it licensed in Wisconsin? Insurance Company Look Up is also a​​vailable on Consumers page​.
      

  • Does the plan cover your preexisting conditions​? Does it cover your medications? 
     

  • What are the deductibles? There may be different deductibles for different services.

  • What services doesn’t the plan cover? 

  • For services that are covered,​​ how much will the plan pay for services? Is there a limit on the total amount the plan will pay per person, per service, or per year?

  • How long will the coverage last? Will you be able to keep or renew your coverage if you get sick?

  • Does the plan have a provider network​? 

    • If yes, how do you access information about it? Is your doctor or hospital in the network? 

    • 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. An agent should never pressure you into making a decision quickly.

Federal Insuran​​​ce 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 2025 coverage ended January 15, 2025. You may still be able to enroll in comprehensive coverage through the Marketplace after that date if you have a qual​ifying 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 (Wiscon​​sin Medicaid)

You might qualify for BadgerCare Plus if your income is below certain levels. Apply online at ACCESS ​  or visit the​ ​ Department of Health Services's BadgerCare Plus page ​​ for more information.​

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