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How Wisconsin Realtors Should Compare Health Insurance Plans
Agents compare premiums and stop. Here's the order that actually protects you.
1. Out-of-pocket maximum
The most you can spend in a year on covered care. This is the number that matters in a bad year. Marketplace plans in Wisconsin cap around $9,200 individual; private PPOs commonly $6,000–$9,000.
2. Network — and where it works
Is your doctor in it? Is the hospital you'd actually go to in Milwaukee County in it? Does it work in another state? HMO vs. PPO decides this. Cigna, Aetna and PHCS PPO PPOs are national.
3. Deductible
How much you pay before the plan pays. Healthy agents usually do best with a mid-range deductible and lower premium, plus an HSA.
4. Premium
Only now. And compare net of subsidy if you qualify, net of the self-employed deduction either way. Wisconsin has a progressive state income tax, so the self-employed health premium deduction helps at both the federal and state level.
5. Enrollment flexibility
Marketplace: once a year. Private: any month. If your income is volatile, flexibility has value.
Wisconsin chose a partial Medicaid approach that stops at 100% of the poverty level, so there is a subsidy-eligible group just above that line — and a large self-employed farm, trade and small-business population above the subsidy range.
Our quoting tool shows every private plan in Wisconsin with deductible and out-of-pocket max side by side. Or check your options and we'll compare both markets for you.