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Overpaying for Health Insurance in Wisconsin? Here's What You Can Do
If your premium went up again and your coverage didn't, you're not imagining it. Here's the checklist we walk clients through.
Are you getting a subsidy you qualify for?
A surprising number of self-employed Wisconsinites buy full-price plans directly from a carrier and never apply through HealthCare.gov. If your income is under the 400% line, you're leaving money on the table.
Are you paying full price while healthy?
If you're above the subsidy line and in good health, you're paying a guaranteed-issue price for a risk you don't represent. Private shared-network PPOs on Cigna, Aetna and PHCS PPO price on health and are routinely hundreds less per month.
Is your network the one you use?
Many Wisconsin marketplace plans are HMOs centered on one hospital system. If you drive past in-network hospitals to reach your doctor, or travel, you're paying for a network you can't use. A national PPO fixes that.
Is your deductible matched to your usage?
Healthy people on low-deductible plans overpay every month for a deductible they never reach. Moving to a mid-deductible plan plus an HSA is often the right trade.
Wisconsin specifics
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. Wisconsin has no state individual mandate.
We do this review free, in 15 minutes, for anyone in Wisconsin. Check your options.