Short Term Health Insurance In Wisconsin

If you’re looking for medical coverage in Wisconsin, know that you have options beyond major medical policies. While comprehensive, these plans can be pricey and may afford more benefits than you need during times of transition. Recent college graduates, traveling volunteers, young adults exploring new plans outside of a family policy, or new employees waiting on job-based coverage to start might benefit from these temporary plans in the interim.

Short-term health insurance does not have to comply with the regulations stipulated in the Affordable Care Act (ACA). These plans are not required to cover pre-existing conditions, and some policies will exclude coverage for an illness or injury in the past five years if state law allows. Many do not cover pregnancy, preventive care, substance abuse treatment or mental health services. Short-term coverage also usually has higher deductibles and can cap benefit payouts, sometimes for the lifetime of the policy. Wisconsin requires short-term plans to cover some state-mandated benefits. The state also limits plan renewability.

Currently, plans in Wisconsin and the nation may not be issued for more than three months. Some insurers sidestep the issue by bundling four 90-day policies together so that you only have to apply once for the year. By issuing the policies all at once, insurers only need to rely on one period of medical underwriting to approve you for coverage. However, if you develop a medical problem during the term of one policy, treatment for that condition may not be covered in the next policy as it would likely be considered a pre-existing condition at that point.

In 2018, the Trump administration proposed changes that would allow consumers to purchase short-term plans for up to 364 days, a regulation that existed before 2017 when the Obama administration shortened the duration to three months. States would still be allowed to set their own duration limits. Right now, Wisconsin follows federal law regarding limits on short-term policies, which means that if the duration gets extended to 364 days, Wisconsin residents would likely be able to buy policies that last nearly a year.

There are concerns that expanding short-term health plans could lead to healthier people choosing those plans over more expensive ACA-compliant plans. The Urban Institute projects that if Wisconsin allows people to buy short-term policies under expanded guidelines, approximately 38,000 people with ACA-compliant policies would drop those plans, which represents about 14.6 percent of the state’s non-group insurance market.

The Wisconsin Department of Health Services cautions consumers to consider their options carefully when it comes to buying health insurance. Major medical isn’t the only option, but there are protections in place for these plans that don’t exist for short-term coverage. If you decide to buy a temporary policy, make sure the company you choose holds a valid license to sell these products in your state.

Carriers Offering Short-Term Policies in Wisconsin

Everest Prime

National General

Independence Holding Company (IHC Group)

Companion Life Insurance Company

Golden Rule Insurance Company (UnitedHealthcare)

Sources
https://www.urban.org/sites/default/files/publication/96781/2001727_0.pdf
https://nashp.org/states-face-short-deadlines-to-address-the-risks-of-short-term-health-insurance-plans/
https://www.dhs.wisconsin.gov/guide/insindividual.htm
https://www.npr.org/sections/health-shots/2017/01/31/512518502/sales-of-short-term-insurance-plans-could-surge-if-health-law-is-relaxed