Best Health InsuranceWisconsinBest Wisconsin Health Insurance (2023 Plans)
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By , Content Manager
Updated: Aug 8, 2023
Best Health InsuranceWisconsinBest Health Insurance in Wisconsin
Best Overall in Wisconsin - HealthPartners
Best for Low MOOP - MercyCare Health Plans
Best Cheap - MercyCare Health Plans
Best for Low Income - MercyCare Health Plans
Best for Young Adults - HealthPartners
Best for HMO - MercyCare Health Plans
Best for PPO - HealthPartners
Best for EPO - Security Health Plan
Best for POS - Security Health Plan
Best Short-Term Insurance - National General Accident & Health
Best Overall for Health Insurance in Wisconsin
Overall, the best health insurance in Wisconsin is from HealthPartners, earning a MoneyGeek score of 77 out of 100. This insurer performs well in affordability, claims management and plan flexibility. It offers one of the lowest premiums in our comparison group while having the highest claims acceptance rate.
To determine our top pick for this category, we analyzed 47 Silver EPO (Exclusive Provider Organization) plans, 97 HMO (Health Maintenance Organization) plans, six POS (Point of Service) plans and 10 PPO (Preferred Provider Organization) plans in Wisconsin.
MoneyGeek Pick: HealthPartners
pros
Reasonable monthly premiums
Denies the fewest claims in Wisconsin
Many different plans available
cons
High MOOP costs
COMPANY HIGHLIGHTS
According to our study, HealthPartners offers the best health insurance in Wisconsin. This company offers 10 Silver PPO plans. Although PPOs can be expensive, they have wide provider networks and don’t need a referral to see a specialist. This plan type is ideal for those who want flexibility and are willing to pay a higher cost to get it.
With an average rate of $507 per month, HealthPartners has reasonable rates that run around the middle of the road compared to its competitors. However, its health plans have relatively high MOOP costs averaging $8,375. HealthPartners denies 6.57% of insurance claims, which is a better approval ratio than any other Wisconsin insurer we analyzed.
Plan Recommendations
Consider the following Silver PPO plans from HealthPartners:
- Robin Select $3,500 HSA Silver: $464 per month (MOOP $7,300)
- Robin Oak $3,500 HSA Silver: $521 per month (MOOP $7,300)
- Atlas $3,500 HSA Silver: $528 per month (MOOP $7,300)
Best Health Insurance in Wisconsin for Low Out-of-Pocket Costs
With a MoneyGeek score of 72 out of 100, MercyCare Health Plans is the best health insurance company in Wisconsin for low out-of-pocket costs. It offers the lowest premiums for Gold and Platinum plans in Wisconsin and has reasonable scores for claims denial rate and average MOOP.
We selected our category winner after analyzing 41 Gold EPO plans, 89 Gold HMO plans, three Gold POS plans, four Gold PPO plans, three Platinum EPO plans, 11 Platinum HMO plans and one Platinum POS plan.
MoneyGeek Pick: MercyCare Health Plans
pros
Ranked first out of 13 insurers for affordability
Reasonable MOOP costs
Strong claims management
cons
Limited plan types to choose from
COMPANY HIGHLIGHTS
MercyCare Health Plans sells two Gold plans in Wisconsin, which have an average cost of $416 per month — the cheapest among our comparison group. The average MOOP cost from these health plans is $5,850. MercyCare Health Plans has a claims denial rate of 10.04%, meaning this company approves more claims than most competitors in the state.
It’s worth noting that this provider’s Gold-tier plans are HMO plans. This plan type is preferable for affordable monthly premiums, but you’re required to stay within your provider network to have health care services covered. You also need a referral to see a specialist.
Plan Recommendations
We recommend these low-MOOP plans from MercyCare Health Plans:
- MercyCare HMO Gold HDHP: $429 per month (MOOP $3,000)
- MercyCare HMO Gold Standard: $404 per month (MOOP $8,700)
Best Cheap Health Insurance in Wisconsin
The best cheap health insurance in Wisconsin is provided by MercyCare Health Plans, which earned a MoneyGeek score of 86 out of 100.
Our study weighted plan costs more heavily to score providers in our comparison group. Health plans with lower monthly premiums usually have higher MOOP costs. This may be ideal for you if you don’t anticipate requiring much medical care.
We determined our winner by analyzing 47 Silver EPO plans, 97 Silver HMO plans, six Silver POS plans and 10 Silver PPO plans.
MoneyGeek also analyzed the cheapest health insurance in Wisconsin for those who just want the cheapest rates.
MoneyGeek Pick: MercyCare Health Plans
pros
Lowest premiums in Wisconsin
Reasonable average MOOP
Solid claims management reputation
cons
Has limited plan types
COMPANY HIGHLIGHTS
At an average of $447 per month, MercyCare Health Plans has the most affordable health insurance premium among the 13 providers in our study. Its health plans have an average MOOP cost of $7,800. MercyCare Health Plans has a 10.04% claims denial rate, meaning it is more likely to approve insurance claims and cover eligible health care services than many competitors.
In Wisconsin, MercyCare Health Plans offers three Silver HMO plans. HMOs are often cheaper than other plan types, but they don’t offer much provider flexibility. This plan type may be preferable if you don’t mind staying within your provider’s network for health care services and getting referrals for specialist visits.
Plan Recommendations
MercyCare Health Plans’ best affordable plans are:
- MercyCare HMO Silver Standard: $441 per month (MOOP $8,900)
- MercyCare HMO Silver HDHP: $450 per month (MOOP $5,400)
- MercyCare HMO Silver Option A: $451 per month (MOOP $9,100)
Best Health Insurance for Low Income in Wisconsin
MercyCare Health Plans provides the best health insurance in Wisconsin for those with low income, receiving a MoneyGeek score of 86 out of 100.
Our low-income analysis weighted low monthly premiums more heavily and only included health insurance companies that sell Silver plans with cost-sharing reductions (CSRs). We examined 33 EPO plans, 82 HMO plans, one POS plan and 10 PPO plans in The Badger State.
CSRs can lower your deductible and MOOP if your household income is below 250% of the federal poverty level (FPL). A standard Silver plan pays around 70% of eligible health insurance costs, while cost-sharing is higher for a CSR plan, depending on your annual income.
For example:
- An annual income between $27,180 and $33,975 (201%–250% of the FPL) qualifies you for a plan that covers 73% of health costs.
- An annual income between $20,385 and $27,180 (151%–200% of FPL) qualifies you for a plan that covers 87% of health costs.
- An annual income below $20,385 per year (up to 150% of the FPL) qualifies you for a plan that covers 94% of health costs.
These income brackets may shift based on the number of people in your household.
MoneyGeek Pick: MercyCare Health Plans
pros
Lowest premiums available
Relatively low MOOP costs
Good reputation for claims management
cons
Limited plan types to choose from
COMPANY HIGHLIGHTS
Low-income residents in Wisconsin may find MercyCare Health Plans as their best option for health insurance. This provider offers low-income health plans for those in the 201%–250% FPL bracket at an average of $447 per month, with a MOOP of $6,217. It also approves more claims than most competitors in Wisconsin.
MercyCare Health Plans has three Silver HMO plans with CSRs. This plan type is good for low-income individuals who want cheap monthly premiums and don’t mind staying in network to have health care services covered.
Plan Recommendations
MercyCare HMO Silver Standard is the best low-income health plan from MercyCare Health Plans. Based on your income bracket, you can get lower overall out-of-pocket costs for the same premium:
- 201%–250% of the FPL: $441 per month (MOOP $7,200)
- 151%–200% of the FPL: $441 per month (MOOP $3,000)
- Up to 150% of the FPL: $441 per month (MOOP $1,700)
Best Health Insurance for Young Adults in Wisconsin
Earning a MoneyGeek score of 73 out of 100, HealthPartners is the best health insurance provider for young adults in Wisconsin.
Our study found the best options for young adults by evaluating companies that offer Bronze or Catastrophic plans, which often have lower premiums in exchange for higher MOOP costs. Catastrophic plans are only available to those under 30 years old.
For this category, we analyzed the following number of plan tiers and types in Wisconsin:
- Catastrophic: Eight EPO plans, nine HMO plans and three PPO plans
- Bronze: 13 EPO plans, 20 HMO plans and one POS plan
- Expanded Bronze: 36 EPO plans, 76 HMO plans, three POS plans and nine PPO plans
MoneyGeek Pick: HealthPartners
pros
Many health plans to choose from
Ranked first out of 13 insurers for claims management
Reasonable monthly premiums
cons
High MOOP costs
COMPANY HIGHLIGHTS
HealthPartners provides the best health insurance for young adults in Wisconsin. It has 12 Catastrophic, Bronze and Expanded Bronze plans that average $295 per month and an $8,675 MOOP. This insurer has a 6.57% claims denial rate, which is Wisconsin’s best rate.
Metal tiers indicate how much coverage you’ll have. Catastrophic, Bronze and Expanded Bronze are ideal for young adults who want a lower premium and don’t anticipate needing much care.
Plan Recommendations
Our top picks for young adults from HealthPartners are:
- Robin Select $7,500 HSA Bronze: $254 per month for 18-year-olds and $285 per month for 26-year-olds (MOOP $7,500)
- Robin Oak $7,500 HSA Bronze: $285 per month for 18-year-olds and $320 per month for 26-year-olds (MOOP $7,500)
- Atlas $7,500 HSA Bronze: $289 per month for 18-year-olds and $324 per month for 26-year-olds (MOOP $7,500)
Best Health Insurance by Plan Type in Wisconsin
Health insurance companies often sell different plan types. The best providers for the plan types available in Wisconsin are:
- EPO: Security Health Plan (MoneyGeek score of 68 out of 100)
- HMO: MercyCare Health Plans (MoneyGeek score of 88 out of 100)
- POS: Security Health Plan (MoneyGeek score of 100 out of 100)
- PPO: HealthPartners (MoneyGeek score of 100 out of 100)
Note that our recommendations are limited to Silver plans. This metal tier balances premiums and out-of-pocket costs, making it ideal for buyers who want adequate coverage at an affordable price.
In Wisconsin, we analyzed 47 Silver EPO plans, 97 Silver HMO plans, six Silver POS plans and 10 Silver PPO plans.
MoneyGeek Pick for HMO: MercyCare Health Plans
COMPANY HIGHLIGHTS
For HMO plans, the best health insurance provider in Wisconsin is MercyCare Health Plans. It offers three Silver HMO plans at an average cost of $447 per month and a MOOP average of $7,800. It also has a claims denial rate of 10.04%, which is better than most competitors.
HMO plans tend to have low monthly premiums, but the trade-off is a limited provider network. Out-of-network services may only be covered during an emergency. This plan type also requires a referral to see a specialist.
Plan Recommendations
Our top picks for Silver HMO plans from MercyCare Health Plans are:
- MercyCare HMO Silver HDHP: $450 per month (MOOP $5,400)
- MercyCare HMO Silver Standard: $441 per month (MOOP $8,900)
MoneyGeek Pick for PPO: HealthPartners
COMPANY HIGHLIGHTS
HealthPartners is the best health insurance company in Wisconsin for PPO plans. It offers 10 Silver PPO plans, which have an average cost of $507 per month and a MOOP average of $8,375. This insurer has a 6.57% claims denial rate, meaning the chance of your claims getting denied is very low.
PPO plans may be ideal for you if you are willing to pay higher monthly premiums for provider flexibility. This plan type may cover health care services you receive from out-of-network providers. It also doesn’t require a referral to see a specialist.
Plan Recommendations
The following are the best Silver PPO plans from HealthPartners:
- Robin Select $3,500 HSA Silver: $464 per month (MOOP $7,300)
- Robin Oak $3,500 HSA Silver: $521 per month (MOOP $7,300)
MoneyGeek Pick for EPO: Security Health Plan
COMPANY HIGHLIGHTS
In Wisconsin, Security Health Plan is the best EPO plan provider. It sells nine Silver EPO plans averaging $561 per month with a MOOP average of $7,514. Out of the five EPO providers we rated, Security Health Plan has the second lowest claim denial rate at 10.97%.
Similar to HMOs, EPO plans offer lower monthly premiums in exchange for a limited provider network. However, EPOs may not always require a referral to see a specialist.
Plan Recommendations
Consider these Silver EPO plans from Security Health Plan:
- Reliance $4,000 - 20% HDHP: $580 per month (MOOP $5,500)
- Reliance $5,000 - 20% HDHP: $538 per month (MOOP $6,500)
MoneyGeek Pick for POS: Security Health Plan
COMPANY HIGHLIGHTS
The best POS plan provider in Wisconsin is Security Health Plan. It offers five Silver POS plans at an average rate of $644 per month with a MOOP average of $7,410. This insurer only denies 10.97% of insurance claims it receives, which is better than average.
With POS plans, you can get coverage for both in-network and out-of-network services, but the costs are often higher for the latter. This plan type may be ideal for you if you’re looking for provider flexibility and affordable in-network coverage.
Plan Recommendations
Security Health Plan’s best Silver POS plans are:
- Premier POS $4,000 - 20% HDHP: $680 per month (MOOP $5,500)
- Premier POS $5,000 - 20% HDHP: $632 per month (MOOP $6,500)
Best Short-Term Health Insurance in Wisconsin
National General Accident & Health provides the best short-term health in Wisconsin, earning a MoneyGeek score of 95 out of 100. Short-term health insurance should not replace health plans that are compliant with the Affordable Care Act (ACA) as they do not always cover pre-existing conditions or include essential health benefits.
National General Accident & Health
Our top pick for short-term health insurance in Wisconsin is National General Accident & Health, which offers a wide range of deductibles, co-insurance and benefits. Its short-term plans have coverage periods ranging from 30 days to a year, with options for renewal.
How to Find the Best Health Insurance for You in Wisconsin
The best health insurance for you depends on your budget and health care needs. We recommend determining how much you can afford for monthly premiums and how much you’re willing to pay out of pocket before buying health insurance.
Understand when a health insurance plan will cover you
HMO plans and EPO plans both have lower monthly premiums, but they won’t cover out-of-network services except in an emergency. Meanwhile, PPO plans and POS plans offer provider flexibility at a higher premium. Wisconsin has 148 EPO plans, 302 HMO plans, 14 POS plans and 26 PPO plans.
Weigh the cost of premiums vs. the cost of care
Plans with lower monthly premiums often come with higher out-of-pocket costs. For instance, Robin Select $3,500 HSA Silver may average $464 per month, but its out-of-pocket maximum is $7,300. This is the most you have to pay for health care services in a year before your insurer covers 100% of your eligible health costs.
Consider Wisconsin Medicare or Medicaid if You’re Eligible
Medicare is a federal health care program available for Wisconsin residents aged 65 or older and those with certain illnesses and disabilities. It provides national health coverage to eligible individuals.
Medicare is broken up into three parts:
- Part A (Hospital Insurance): Covers hospital stays, some home health care services, skilled nursing facility care and hospice care.
- Part B (Medical Insurance): Covers medical supplies, preventive services and doctors’ appointments.
- Part D (Prescription Drug Insurance): Covers prescribed drugs and vaccines.
Our resources can help you find the best Medicare Advantage plans in Wisconsin.
Residents in The Badger State may also qualify for Medicaid, which provides free or low-cost health care coverage. Eligibility for this government program depends on the state guidelines for low-income families and children, pregnant women and people with disabilities.
Frequently Asked Questions About Health Insurance in Wisconsin
You may wonder about costs and availability while buying health insurance in Wisconsin. Below, we answered some of your frequently asked questions.
About Brenna Kelly, Licensed Health Insurance Agent
