New Health Insurance Option Available

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Jul 21, 2010 No Comments ›› admin

July 21, 2010

Do you know someone who has been without health insurance because they have pre-existing conditions? A new health insurance option may be able to help.

Enrollment for the new “HIRSP Federal Plan” opened last week. This plan is open to Wisconsin citizens who have a pre-existing condition and have been without health insurance for six months.

Wisconsin received $73 million dollars from the federal government to provide a health insurance option to help those facing the worst situation – serious health conditions with no health insurance.  The HIRSP Federal Plan offers very reasonable rates for comprehensive health insurance. For example, a person age 60 and over who chooses the highest deductible – $3,500 – will pay $398 a month. A person under 25 who chooses the lowest deductible – $500 – will pay $214 a month.

The plan’s benefits are similar to many health insurance plans and exclude such things as eye glasses, routine dental care and hearing aids. But the plan does offer a prescription drug benefit that includes generic and brand name drugs.

There are two important things to remember; the HIRSP Federal Plan benefits are not subject to any preexisting condition exclusions.  And the new federal plan does not replace Wisconsin’s existing HIRSP program which will continue to serve its current clients and accept new enrollees.

The new HIRSP Federal Plan adds to what can be a confusing array of options available to people who have trouble finding insurance. Earlier this month the Governor announced a low-cost public health insurance program called “Badger Basic”. Unlike BadgerCare – the state’s Medicaid program – this program is entirely funded by people’s premiums.

Badger Basic is inexpensive – $130 a month- but if is sounds to good to be true, remember this is really basic health coverage.  The benefits are severely limited with only ten doctor visits and limited hospitalization is covered before the $7,500 deductable kicks in. You must have income below about $1800 a month for a single person and about $2400 a month for a couple and have no children under age 20 living at home.

The purpose of this Basic plan is to provide some coverage for people waiting to get into the state’s BadgerCare ‘Core’ program, which is a Medicaid program that provides coverage for people without children at home but otherwise eligible for BadgerCare.

For people who have been without any health insurance for the past six months, the new HIRSP Federal Plan is a much better deal. It is more expensive than Badger Basic but the coverage is much closer to a commercial insurance plan.

Both Badger Basic and the new HIRSP Federal Plan are designed to be a bridge to real health care reform.  In 2014, states are required to create state-wide health insurance exchanges.

If you are interested in learning more about the new HIRSP Federal Plan, you can check the website of the state’s high risk pool – www.hirsp.org or toll free at 800-828-4777.

But finding your way through the maze of options is not easy and I strongly suggest people contact me. If you or someone you know does not have insurance, please call my office in Madison at 877-763-6636 (toll free) to help make sense of the confusing array of options and rules.


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