Last Updated: January 21, 2021
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 reimbused 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.
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.
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 and click on Agent/Agency Lookup to be connected to our agent lookup portal.
What is the insurance company and is it licensed in Wisconsin?
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 actually pay? 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, and 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 2021 coverage has closed. But, you may still be able to enroll in comprehensive coverage if you have a
qualifying life event, like losing other health coverage, moving, getting married, or having a child.
If you have questions, call the Wisconsin Office of the Commissioner of Insurance at 1-800-236-8517.
BadgerCare Plus (Wisconsin Medicaid)