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Wisconsin

Wisconsin Health Insurance

Wisconsin has fewer health insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes Wisconsin health insurance policy regulations

  • Lists rules Wisconsin health insurance companies must follow

Health insurance policies are regulated by each state's own health insurance laws. Wisconsin health insurance companies and policyholders alike must abide by established insurance laws.


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Do You Qualify For A Subsidy?


Find out if you qualify for a government subsidy under Obamacare. Millions of Americans will have their insurance rates reduced under the new health care law. Learn how much you could save with our simple calculator.

Wisconsin health insurance policy provisions

Some of the most important Wisconsin health insurance laws are the ones that influence the health insurance policy specifically.

For one, Wisconsin health insurance laws place no limitations on exclusion clauses for pre-existing medical conditions. This means Wisconsin health insurance policies can contain an elimination rider excluding any medical condition you've been diagnosed with previously from being covered for any length of time.

Sometimes medical conditions will be excluded permanently and other times the exclusion period will last only a few years. If you received medical attention for or were diagnosed with a condition before the beginning of the policy, it is considered to be pre-existing.

Wisconsin health insurance regulations do require all health insurance policies to contain a guaranteed renewability provision. This provision states that at the end of your Wisconsin health insurance policy's term, you always have the option of renewing it for another term.

Finally, newborns and adopted children are automatically included under any individual health insurance policy for 60 days if the policy already provides coverage for dependents.

Regulating Wisconsin health insurance companies

Understanding the laws limiting Wisconsin health insurance companies is especially important in making sure your health insurance company continues to honor your original contract.

For instance, Wisconsin health insurance companies can deny your application for health insurance if you are in poor health. Additionally, Wisconsin health insurance companies can charge you more for your health insurance because of poor health.

However, Wisconsin health insurance companies are not permitted to terminate a policy on the grounds of illness.

Since this is the case, it is advisable to purchase a good comprehensive Wisconsin health insurance while you are younger (now) and maintain it, thereby avoiding additional exclusion periods or, worse, being denied health insurance altogether.

Temporary Wisconsin health insurance

If you have breaks in your health insurance coverage, it is recommended that you purchase temporary health insurance. In Wisconsin, purchasing a conversion policy is an option if you are leaving a fully insured group policy. Acquiring conversion policies is relatively easy.

Your former Wisconsin health insurance company is required to offer either three standardized policies with varying degrees of coverage or a plan with coverage similar to your former Wisconsin health insurance. The premiums are often higher, but as far as temporary insurance goes, these plans offer competitive prices.

More WI health insurance help

If you want more help getting a good health insurance policy, read our guide to health insurance.

Also see the guide to Wisconsin small business health insurance.


To find out more about WI health insurance laws and regulations, visit the official website of the Wisconsin Office of the Commissioner of Insurance.





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This internet site provides information of a general nature for educational purposes only and is not intended to be legal advice. We make no guarantees as to the validity of the information presented. Your particular facts and circumstances, and changes in the law, must be considered when applying insurance law. You should always consult with a competent insurance professional licensed in your state with respect to your particular situation.