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PPO Health Insurance in Wisconsin for the Self-Employed: Where to Find It
Ask for a PPO on HealthCare.gov in Wisconsin and you'll mostly find HMOs and EPOs. Here's why, and where PPOs still live.
Why marketplace PPOs vanished
Guaranteed-issue plans attract the highest-cost members, and broad PPO networks are expensive to run for that population. Carriers like Anthem Blue Cross and Blue Shield, Quartz, Medica, Network Health, and Oscar responded by narrowing networks and dropping out-of-network benefits. The result: most individual plans in Wisconsin are built around one hospital system.
Where PPOs still exist
In the private shared-network market. Carriers lease the national Cigna, Aetna and PHCS PPO PPO networks — the same networks large employers use — and sell underwritten plans on them. No referrals, any in-network specialist, coverage in every state. For self-employed people who travel or want to choose their own doctors, this is usually the only way to get a PPO.
What a Wisconsin PPO costs
For healthy individuals, roughly $290–$600 a month depending on age and deductible; families roughly $800–$1,300. You can see live prices on our quoter.
Who qualifies
These plans are underwritten. Generally healthy applicants with no major pre-existing conditions. If that's not you, a marketplace plan is the right answer and we'll say so. 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.
Check your options to see the PPOs available in your ZIP.