Short-Term Health Insurance in Wisconsin

Short-term health insurance is temporary health insurance that’s meant to provide financial protection right away if you find yourself without coverage. As a resident of Wisconsin, it’s worth knowing that the state does have some restrictions on short-term insurance, so read on to determine whether this type of insurance is a good fit for you.

What You Need to Know

The state limits the coverage period of a short-term insurance policy to 364 days in a single coverage period, and you can enroll for as little as 30 days.

If you decide to purchase consecutive policies, the total coverage period cannot be more than 18 months in Wisconsin, and there must be at least 63 days from the end of the last short-term policy before you can enroll in a new one.

The state has a 10-day “free look” period, which means if you buy a short-term policy and change your mind, you have 10 days in which to cancel and receive a full refund.

Is Short-Term Medical Coverage in Wisconsin Right for You?

One of the primary benefits of short-term health plans is that they are flexible, allowing you to select your deductible, copayment and doctor network. You can enroll for just 30 days or up to 364 days if you need longer coverage. If you want the maximum (18 months) coverage allowed in Wisconsin, you can enroll in three 180-day plans.

Here are some other things to consider as you make your decision: 

Short-term health insurance typically costs less than an Affordable Care Act (ACA) plan on the federal or state Health Insurance Marketplace, provided your income doesn’t qualify you for a subsidy. (If you do qualify for a subsidy, you’d get help paying for your health insurance premiums.) The reason is that short-term plans don’t cover longer-term medical conditions like pregnancy or mental health disorders or preexisting conditions. 

Enrolling in temporary health insurance is easy and quick. Once you compare plans and decide on the one that’s best for you, you can apply online in five minutes or less. You first need to answer a handful of questions about your health and medical history to see if you qualify, but you’ll find out right away if you’re accepted or not. If you are, you’ll be insured by the next day.

Temporary health coverage is good for people who are pretty healthy. As mentioned above, preexisting conditions aren’t covered by short-term insurance, so if you’re managing a chronic condition and need regular medical care and/or prescriptions, this type of coverage probably isn’t right for you. But if you’re healthy and don’t plan to use your insurance much or at all and simply want some financial protection in the event of an accident or an unexpected diagnosis, short-term coverage could fill the bill.

When Short-Term Coverage Makes The Most Sense

Short-term health insurance helps if you are experiencing a new life situation. You are the best candidate for temporary medical insurance if:

• You lost your job and no longer have access to insurance and can’t afford COBRA. 
• You no longer qualify for Medicaid or other federal or state benefits.
• You no longer qualify for financial assistance to help pay for your ACA (aka Obamacare) plan.
• You turned 26 and aged off your parent’s health plan.
• You got divorced and lost your spouse’s health insurance.
• You retired early and no longer have access to group health insurance.
• You’re starting a new job but still in a waiting period for benefits to kick in.
• You’re a college student and your university requires health coverage for every student. 

How to Determine if Short-Term Health Insurance is Not Right for You

As mentioned above, if you have a preexisting condition or have been told by a doctor to have more tests for a medical problem, you won’t qualify for temporary insurance. Those who’ve had cancer, suffered a stroke or have a heart condition, for example, won’t qualify.

Also, if your income qualifies you for a financial subsidy on an ACA plan from the Marketplace, you can get more coverage at a lower rate by buying a plan there. According to Health Affairs, 87% of people who enroll in the ACA Marketplace qualify for a subsidy.¹ 

Even though the average Marketplace deductible is over $5,300, these plans must cover 100% of preventive care, cancer screenings, immunizations and more.² In fact, all ACA plans have to cover 10 specific health benefits.

How Much Do Short-Term Health Plans Cost in Wisconsin?

A 28-year-old woman living in Madison, for example, can pay between $56 to $307 per month in premiums for a short-term health insurance plan.³ The difference in how much you’d pay each month depends on the amount of your annual deductible, the coinsurance level you select, and whether or not you have copayments for doctor’s office visits or prescription drug coverage. The more coverage you want, the higher the monthly premium will be. 

Let’s break down the costs associated with every health plan:

Premium: This is the monthly cost of your short-term health insurance plan. You’ll pay your first premium right away when you enroll.

Deductible: This is the amount you’re responsible for paying before your insurer starts paying your medical expenses. The amount can range from $1,000 to $20,000 during the duration of your policy.³ Keep in mind that high-deductible health plans lower your monthly premium and a lower deductible raises the monthly cost of your premium. So it’s important to decide whether you’d prefer to pay less each month, knowing you’d need to pay more if a medical issue arises, and vice versa.

Coinsurance: This is the percentage of your medical bills you’re responsible for paying after you’ve met your deductible. In Wisconsin, you have the option of paying nothing in coinsurance, 20% or 30%. The health insurance plan pays the rest of the covered amount. If you have a low monthly premium, you’re likely to have a higher coinsurance and vice versa.

Copayment (copay): If you choose a short-term health plan with a copay option, you’ll pay a set amount for specific services, like doctor’s office or urgent care visits. It’s worth knowing that a copay is for each service, not multiple services like lab work. 

Out-of-Pocket Maximum: This is the most you’d be responsible for paying while you’re covered under your insurance policy. Once you reach that amount, your insurance company pays 100% of eligible expenses. In Wisconsin, the total amount could be a combination of your deductible and coinsurance or coinsurance alone. Be sure to review your policy carefully to understand what you are financially responsible for.

How Do I Buy Short-Term Health Insurance in Wisconsin? 

Before you purchase a short-term health plan, it’s important to compare plans and review the exclusions and limitations of the policy. Do your research to make sure the plan is right for both your budget and healthcare needs.

Once you’ve made a decision, the process of buying short-term medical insurance online is usually quick and easy:

Companies that advertise short-term health insurance available in Wisconsin include:

• Companion Life Insurance Company
• Everest
• Golden Rule Insurance Company
• National General Accident & Health

Can I Get Extra Coverage as a Wisconsin Resident?

If you aren’t confident that you’ll be able to cover your deductible and coinsurance if the unexpected happens, you can buy supplemental insurance in Wisconsin to provide an extra layer of financial protection. 

Supplemental insurance provides coverage for accidents and critical illnesses. Predetermined cash benefits are paid directly to you and you can use the money for whatever you choose. Or you can decide to assign the benefits to your provider.

In Wisconsin, you can purchase $2,5000 or $5,000 in coverage. A daily hospital benefit for any covered sickness or injury is included with the plan’s coverage. Plans are “guaranteed issue,” which means you don’t need to pre-qualify, and can be effective immediately. An accidental death benefit is also included.

Plans start at $29.95 per month for an individual and up to $99.95 per month for a family. The extra coverage could cost less than buying a low-deductible short-term health plan. 

Next Steps

If short-term health insurance feels like the best option for your situation, remember to do your research: Compare plan options, determine your budget and decide which benefits are most important to you. 

As a Wisconsin resident, you have a 10-day “free look” period, so if you buy a policy and have buyer’s remorse, you can cancel up to 10 days after purchase.