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Population: 5,556,506
(Source: U.S. Census Bureau)
Uninsured: 514,000
(Source: U.S. Census Bureau)
Health Benefits Direct is a licensed insurance broker for Wisconsin health insurance policies. Click here to view our registration with the Wisconsin Office of Insurance (We're listed as
"H B D C" - the spaces between the initials are required and capital letters must be used). |
Wisconsin has the 28th highest number of uninsured in the U.S.
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Health Insurance News in Wisconsin
Buying Individual Insurance Policies in Wisconsin
State regulation of individual health insurance differs greatly from state to state. For you, this means certain conditions or providers covered in one state may not be covered in another.
Each state has its own health insurance mandates. Those mandates require that insurance companies and health plans cover, or offer coverage for, certain conditions, benefits, providers and patient populations.
Here is a list of mandated and non-mandated conditions, covered persons and providers in Wisconsin:
(Source: Health Insurance Mandates in the States 2008¹, Council for Affordable Health Insurance. Last updated Jan 2008.)
| Mandated (Covered) Conditions |
Non-Mandated Conditions |
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- Alcoholism
- Ambulatory Surgery
- Anti-Psychotic Drugs
- Blood Lead Poisoning
- Breast Reconstruction
- Cleft Palate
- Clinical Trials
- Dental Anesthesia
- Diabetes Self Management
- Diabetic Supplies
- Drug Abuse Treatment
- Emergency Services
- Home Health Care
- Kidney Disease
- Mammogram
- Mental Health General
- Mental Health Parity
- Psychotic Drugs
- TMJ Disorders
- Well-Child Care
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- Alzheimer's
- Ambulance Services
- Autism
- Birthing Centers/Midwives
- Blood Products
- Bone Marrow Transplants
- Bone Mass Measurements
- Cancer Medications
- Cervical cancer/HPV Screening
- Chemotherapy
- Chlamydia
- Colorectal Cancer Screening
- Congenital Bleeding Disorders
- Contraceptives
- Early Intervention Services
- Habilitative Services
- Hair Prostheses
- Hearing Aid
- Hospice Care
- HPV Vaccine
- In Vitro Fertilization
- Long Term Care
- Lyme Disease
- Mastectomy
- Mastectomy Stay
- Maternity
- Maternity Stay
- Minimum Hysterectomy Stay
- Minimum Testicular Cancer Stays
- Morbid Obesity Treatment
- Neurodevelopment Therapy
- Newborn Hearing Screening
- Newborn Sickle-Cell Testing
- Off-Label Drug Use
- Orthotics/Prosthetics
- Ostomy Related Supplies
- Other Infertility Services
- Ovarian Cancer Screening
- PKU/Formula
- Port-wine Stain Elimination
- Prescription Drugs
- Prostate Cancer Screening
- Rehabilitation Services
- Second Surgical Opinion
- Smoking Cessation
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| Mandated Covered Persons |
Non-Mandated Covered Persons |
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- Adopted Children
- Continuation/Dependents
- Continuation/Employees
- Conversion to Non-Group
- Handicapped Dependents
- Newborns
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- Dependent Students
- Grandchildren
- Non-Custodial Children
- Domestic Partners
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| Mandated (Included) Providers |
Non-Mandated Providers |
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- Chiropractors
- Dentists
- Licensed Health Professional
- Nurse Practitioners
- Optometrists
- Psychologists
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- Acupuncturists
- Chiropodist
- Denturists
- Dieticians
- First Nurse Assistant
- Lay Midwives
- Marriage Therapists
- Massage Therapists
- Naturopaths
- Nurse Anesthetists
- Nurse Midwives
- Nurses
- Occupational Therapists
- Opticians
- Oral Surgeons
- Osteopaths
- Pain Management Specialist
- Pastoral Counselor
- Pharmacists
- Physical Therapists
- Physician Assistants
- Podiatrists
- Professional Counselors
- Psychiatric Nurse
- Public or Other Facilities
- Social Workers
- Speech or Hearing Therapists
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Although health insurance coverage for a particular condition or provider may not be mandated in your state, insurance carriers may still provide coverage for the condition or provider. Please keep in mind that major medical health insurance plans are subject to health underwriting and that mandates do not necessarily guarantee coverage. If you're not sure whether you could receive coverage, one call to Health Benefits Direct can help you determine if you're eligible to buy an individual health insurance policy in Wisconsin.
Health Benefits Direct provides free health insurance quotes on affordable health insurance plans for Wisconsin residents. We work with highly rated insurance carriers to deliver quality health insurance plans to families and individuals across Wisconsin.
¹Authors: Victoria Craig Bunce & JP Wieske
Please note that information contained on this page can change at any time. Consequently, while we seek to present as up-to-date information as possible, Health Benefits Direct in no way warrants the accuracy of the information.
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