Currently have Medicaid? Changes are coming. Learn what you can do and sign up for alerts.

The Key To Accessing The Care You Deserve:

Health Insurance.

Explore Key Topics & Choice FAQs

  • There are many options for health insurance coverage depending on where you work, your income, your household size and many other factors. It can feel confusing and complicated, but it doesn't have to be. There are trained professionals to help you find the right insurance for you and your family.

  • Health insurance coverage is a type of insurance that helps you pay or lowers the cost of medical and health services.

  • Your health and wellness is important and health insurance can help you get the care you need in an affordable way. Every health insurance plan on HealthCare.gov covers these essential benefits: doctor visits, preventive care, hospitalization, prescriptions, pregnancy and newborn care, children’s dental care, mental health services, and more.

  • If you are under 26, you have the option to remain on your parent’s plan from their job or the Marketplace. But, there may be other options that save you more money.

    People of all ages are encouraged to view this guide

    If you are still not sure what option is right for you, dial 2-1-1 for free, local help.

    • First find out what options you have: Health Insurance Saver Tool.

    • You can sign up for health insurance online at Healthcare.gov (the Health Insurance Marketplace) during open enrollment.

    • You can apply for the state’s Medicaid, BadgerCare Plus at ACCESS.wi.gov at any time.

    • Free, expert help is available for you to sign up for and understand your health insurance coverage. Call now to find a health insurance enrollment assister near you:

      • You can call 2-1-1 anywhere in Wisconsin

      • In Milwaukee, call the Covering Wisconsin Navigator line at 414-400-9489

    • If you lose health insurance coverage or have another special life change, you can qualify for a special enrollment period to sign up on Healthcare.gov.

    • If you don’t have health insurance coverage and have low income, you can apply for health insurance on Healthcare.gov any time of the year.

    • You can apply for the state’s Medicaid program, BadgerCare Plus, at any time of the year.

    • If you are eligible for the state’s Medicaid program, BadgerCare Plus, the cost of insurance is free and copayments (co-pays) range from $0.50 to $3.00 depending on the service.

    • Depending on your income and household size, Healthcare.gov has financial help to lower the cost of health insurance. Most people can find plans with monthly premiums for $50 or less.

    • Open enrollment: The Healthcare.gov open enrollment period is November 1 to January 15

    • Copayment (co-pays): A fixed amount you pay for a health care service when you have insurance.

    • Premium: The monthly payment you make to the insurance company for your health insurance plan to be active.

    • Health insurance enrollment assister: A person trained and registered with the state of Wisconsin to help people sign up for health insurance for free, including a Navigator, Certified Application Counselor, agents, and brokers.

Not sure of the best health insurance option for you? Call a navigator for free help.

Getting Coverage Outside Of Open Enrollment (SEP).

Open enrollment is the time of year that you have the option to change and or renew your health insurance coverage. Outside of open enrollment, there are Special Enrollment Periods (SEP) and situations where you can get or change your coverage. Explore those situations below.

Lost your job-
based coverage.

  • You lost your job or you quit your job.

    Your hours were reduced, making you ineligible for your employer’s plan.

    Your employer stopped ordering coverage.

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov. CLICK HERE.

Job-based coverage
is too expensive.

  • Your employer stopped or reduced premium contributions for your plan, making premiums cost more than 9.78% of your projected income.

    Your family’s income falls, making your premiums more than 9.78% of your projected income.

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov CLICK HERE.

Were offered
COBRA.

  • You are still within 60 days of losing your job-based coverage, whether or not you enrolled in COBRA.

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov CLICK HERE.

 

Missed a SEP period
due to COVID-19.

  • You were affected by COVID-19 and it caused you not to claim your SEP, and you live in a state with a FEMA disaster declaration (as of 9.9.21 all states have a disaster declaration).

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov CLICK HERE.

Were previously
uninsured.

  • You experienced a change such as a permanent move or the birth of a child. Losing a job without also losing coverage does not result in an SEP.

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov CLICK HERE.

Have had a drop
in income.

  • You were enrolled in minimum essential coverage.

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov CLICK HERE.

Have low
income?

  • You have an income that is considered low.

  • Call a navigator and get free help at (414) 400-9489 or complete an application at HealthCare.gov CLICK HERE.

The lastest on health insurance…

Changes Coming to Special COVID-19 Rules for BadgerCare Plus and Medicaid. Stay informed about your health insurance to make sure you keep your coverage.

Special rules were put in place during the COVID-19 pandemic to allow more people to get and keep BadgerCare Plus and Medicaid benefits. In normal times, Wisconsin reviews member information and renews their Medicaid benefits if they still qualify. Right now, because of the pandemic Wisconsin has not been removing anyone from Medicaid programs, even if they have reported changes that mean they no longer qualify, or requiring people to renew their coverage.

The special rules will be ending in 2022, and the state of Wisconsin will resume the renewal process that was in place before COVID-19. But don’t worry - you will have plenty of time to renew or find new coverage.

Find out what can you do to prepare for Medicaid changes in 2022.

Find the plan for you.

More people than ever now qualify due to financial assistance, nearly 4 out 5 people in Milwaukee! Not sure if you qualify?

Our saver tool helps you find out in less than 2 minutes if you can go the rest of the year with savings or no out-of-pocket costs on health.