Updated: September 9, 2024
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Best Health InsuranceWisconsinBest Health Insurance in Wisconsin
Why Trust MoneyGeek? We downloaded plan data for Wisconsin directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.
Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.
MercyCare Health Plans offers the best health insurance in Wisconsin with a MoneyGeek rating of 80 out of 100. The provider has plan options that are more affordable and with low MOOPs. It also does not reject claims as often as other companies.
For this report, we checked 50 Silver EPO plans, 10 Silver POS plans, 75 Silver HMO plans and seven Silver PPO plans in Wisconsin.
Affordable premium rates
Low out-of-pocket maximum costs
Few claim denials
Limited plan types available
MoneyGeek's top pick for the best health insurance in Wisconsin is MercyCare Health Plans, which offers three Silver HMO plans. HMO plans generally require choosing a primary care doctor and getting referrals to see specialists.
MercyCare offers an average plan rate of $455 and a MOOP cost of $7,767. They also have a 10% denial rate, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following Silver plans:
Group Health Cooperative-SCW offers the best health insurance in Wisconsin for low out-of-pocket costs, with a MoneyGeek score of 75. The provider offers affordable plan options in the state, has low out-of-pocket costs and denies fewer claims than most.
For this category, five EPO plans and eight HMO plans were evaluated in Wisconsin.
Offers affordable premium rates
Low out-of-pocket costs
Very few claims denied
Offers limited types of plans
MoneyGeek's top pick for the best health insurance in Wisconsin for low out-of-pocket costs is Group Health Cooperative-SCW. They offer 10 Gold plans and four Platinum plans, metal tiers known for their lower out-of-pocket costs. These plans are all HMO, which means they have a network of doctors you can use.
Group Health Cooperative-SCW offers an average plan rate of $536 and an average MOOP cost of $5,300. They have a denial rate of about 7%, which is lower than most of the competition.
MoneyGeek recommends the following Gold and Platinum plans:
Plan Recommendations
MercyCare Health Plans is the best cheap cheap health insurance provider in Wisconsin, earning a score of 89 out of 100. MercyCare Health Plans offers the cheapest plan options, has lower average out-of-pocket expenses and denies claims less often than many other providers.
For this analysis in Wisconsin, MoneyGeek looked at 142 Silver plans. This included 50 Silver EPO plans, 10 Silver POS plans, 75 Silver HMO plans and seven Silver PPO plans. MoneyGeek placed more importance on plans with lower monthly premiums when deciding the best provider. Plans with lower premiums do tend to have higher out-of-pocket costs.
Affordable premium rates
Low out-of-pocket costs
Few denied claims
Limited variety of plan types available
MoneyGeek's top pick for the best cheap health insurance in Wisconsin is MercyCare Health Plans. They offer an average plan rate of $453 and an average MOOP cost of $7,767.
MercyCare Health Plans offers three different Silver plans to help you save money on health care. HMO plans often mean you may pay less out-of-pocket when you get medical care within the plan's network.
MercyCare Health Plans has a denial rate of 10%, which is lower than most of the competition.
Plan Recommendations
MoneyGeek recommends the following cheap Silver plans:
MercyCare Health Plans offers the best health insurance in Wisconsin for people with low income, scoring 87 out of 100. They have lower-than-average rates for plans, low out-of-pocket costs and a lower percentage of claim denials.
In Wisconsin, we looked at 30 Silver EPO plans, 60 HMO plans, five POS plans and seven PPO plans, all with cost-sharing reductions (CSRs). Plans were picked based on low monthly premiums that come with CSRs. These special plans can help you spend less when you go to the doctor or hospital compared with regular Silver plans, which already pay for 70% of healthcare costs. Based on how much money you make each year, you could be covered for more:
Keep in mind that these money amounts might change if you have more or fewer people living in your home.
Low premium rates
Low out-of-pocket costs
Few claims denied
Limited plan options available
MoneyGeek's top pick for the best health insurance in Wisconsin for people with low income is MercyCare Health Plans. The provider offers cost-effective plans for individuals earning below 250% of the FPL. MercyCare Health Plans provides three Silver CSR plans at an average cost of $455 per month and an average MOOP cost of $6,233.
While MercyCare Health Plans does not offer PPO or POS plans, EPO plans often have lower premiums. The company's denial rate is 10.37%, and it approves claims more frequently than competitors.
Plan Recommendations
MercyCare Health Plans' top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. Here are some of the lower overall out-of-pocket costs based on income levels:
HealthPartners offers the best health insurance in Wisconsin for young adults with a MoneyGeek score of 71 out of 100. They provide health plans with good rates, deny fewer claims than most other providers and are among the top providers for young adults.
For this analysis, we looked at 21 Bronze plans, 106 Expanded Bronze plans and 16 Catastrophic plans available in Wisconsin. Only young adults under 30 can purchase Catastrophic plans.
Offers affordable premium rates
Very low claim denial frequency
Diverse range of plan options
MOOP costs are higher compared with others
HealthPartners is MoneyGeek's top pick for the best health insurance in Wisconsin for young adults. The insurer offers two Catastrophic plans and six Expanded Bronze plans. They offer an average plan rate of $298 with an average MOOP cost of $9,075.
Young adults tend to choose lower coverage plans due to less medical service usage. HealthPartners provides these Catastrophic and Expanded Bronze plans as PPOs, which generally allow more flexibility, including coverage for medical services out of network.
The company has a 6% denial rate, which is a lower denial rate than most of the competition.
Plan Recommendations
MoneyGeek recommends the following plans for young adults:
Health insurance companies have different kinds of plans. The top providers in Wisconsin for all plan categories are:
In MoneyGeek's recommendations, only Silver plans were considered. Silver plans are a good choice for people who see the doctor occasionally. They generally have low montly premiums and low MOOP costs.
Wisconsin has many Silver plans available: 50 EPO plans, 10 POS plans, 75 HMO plans and seven PPO plans.
MoneyGeek's top pick for the best health insurance in Wisconsin for Silver PPO plans is HealthPartners. HealthPartners has seven Silver PPO plans available with an an average plan rate of $523 and an average MOOP cost of $8,650. The provider has a denial rate of about 6.4%, which is less than average.
Silver PPO plans give you more choice in picking your healthcare providers, and you don't need a referral to see a specialist. These plans are common but they may cost more than other types, like HMOs. They're good if you want flexibility and are okay with the higher cost.
Plan Recommendations
We suggest the following Silver PPO plans from HealthPartners:
In Wisconsin, MoneyGeek's top pick for the best health insurance in Wisconsin for Silver HMO plans is MercyCare Health Plans. They offer three Silver HMO plans with an average plan rate of $455 and an average MOOP of $7,767. The company has a denial rate of almost 0%, which is lower than average.
Silver HMO plans often cost less per month but require you to use doctors in the plan's network. To meet with a specialist, you must get a referral from your main doctor. These plans can be good if you want to pay less each month and the doctors in the network are close by.
Plan Recommendations
We suggest the following Silver HMO plans from MercyCare Health Plans:
MoneyGeek's top pick for the best health insurance in Wisconsin for Silver EPO plans is Security Health Plan. They offer nine Silver EPO plans. They offer an average plan rate of $598 and an average MOOP cost of $7,638. The provider has a denial rate of about 8.93%, which means they deny fewer claims than average.
One advantage of Silver EPO plans is that you may not always need a referral to see a specialist. This can make getting care easier. They are also the third most common plan type. But EPO plans require you to use doctors and hospitals in the plan's network except in an emergency. This can limit your choices for where you get care.
Plan Recommendations
We suggest the following Silver EPO plans from Security Health Plan:
MoneyGeek's top pick for the best health insurance in Wisconsin for Silver POS plans is Security Health Plan. They have five Silver POS plans available with an average plan rate of $699 and and an average MOOP cost of $7,540. The provider has a denial rate of about 9%, which is lower than that of most other insurance providers.
Silver POS plans give you a choice to see doctors both inside and outside of the network. However, going out of network usually costs more. These plans are not the most common but are good for people who want the chance to pick any doctor while still saving money when staying in-network.
Plan Recommendations
We suggest the following Silver POS plans from Security Health Plan:
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.
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.
Your budget and medical needs — including how much you're willing to spend each month versus when you receive care — will determine which health insurance provider in Wisconsin is right for you. The following pointers can be useful when planning to get health insurance.
Understand when a health insurance plan will cover you
Some doctors and hospitals are in your health insurance plan's network, and seeing them usually costs less. If you see doctors outside your network, it might cost you more, and some plans won't pay for care outside their network. Health plans in Wisconsin can have different rules for using in-network or out-of-network providers.
There are seven PPO plans, 50 EPO plans, 10 POS plans and 75 HMO plans in Wisconsin.
Weigh the cost of premiums vs. the cost of care
When you look for health insurance, you want to find the right mix of costs. Picking a plan with a low monthly cost might seem good, but it might have a high MOOP. If you can pay a bit more each month, your MOOP could be less. This could help if you need to see the doctor frequently.
For example, the MercyCare HMO Silver Option B costs $459 every month. Compared with Silver plans from MercyCare, this plan's monthly price is almost the same. But this same Silver Option B plan has a MOOP of $5,400, much less than the other plans. Finding a plan with a low monthly cost and a low MOOP is even better if the doctors and hospitals are rated highly.
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:
Our resources can help you find the best Medicare Advantage plans in Wisconsin.
Residents of Wisconsin 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.
You may wonder about costs and availability while buying health insurance in Wisconsin. Below, we answered some of your frequently asked questions.
Overall, MercyCare Health Plans offers the best health insurance in Wisconsin for 2023. That said, your best option may vary depending on your particular needs and situation.
Shop for health plans that offer the best blend of affordability and coverage. You’ll want to make sure the plan you choose is within your budget and can provide adequate coverage for your health needs.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
