What You Need to Know
Getting health insurance helps protect you in case of medical emergencies.
If you’re staying on your parents’ plan, make sure it offers in-network providers near your school.
You can buy limited plans that have lower premiums, but you risk major out-of-pocket costs if you need services they don’t cover.
Why Do Wisconsin Students Need Health Insurance?
You’re all set for college in Wisconsin: You’ve got your school supplies, new clothing, your class schedule, and a new laptop. But what about health insurance? Health insurance can be important even if you’re young and healthy. A sudden injury or illness can hit you hard financially.
Having health insurance means that your out-of-pocket costs will be much lower when you get medical treatment or prescription drugs. This is especially important because you may have little to no income as a student. If you have coverage, you’re also more likely to get preventive care, screenings and tests that can detect an emerging condition.
Although Wisconsin doesn’t have a state mandate that everyone have health insurance, some colleges do require it.
What Should You Consider When Searching for Student Health Coverage in Wisconsin?
There are several options for health insurance in Wisconsin. To decide which is best for you, consider these factors:
2021 Coverage Still Available
The federal government extended sign-ups for 2021 coverage until August 15, 2021, due to the coronavirus pandemic.
Will You Attend School In-State or Out-of-State?
If you’re an out-of-state student and you have health insurance already, make sure it covers services and providers near your school. You should also check if your plan is licensed to operate in Wisconsin.
If your plan has no network providers near your school, find out what is covered. Many cover just emergency room care, for example, if you go out-of-network. You’d have to pay out-of-pocket for any services following an emergency room visit.
Wisconsin doesn’t require health insurance, but some schools may require it for admission.
Can Someone Claim You as a Dependent?
Your parent or guardian can claim you as a dependent, but it might affect your eligibility for subsidies if you purchase a plan through the Marketplace.
Will You Stay on Your Parents’ Plan or Enroll in Your Own Plan?
You can stay on their plan until you turn 26, even if you’re not living with them. In Wisconsin, you can apply for a rider to stay on your parents’ plan until age 27, if you’re not getting coverage through an employer.
What Plans Are Cheaper?
BadgerCare Plus, Wisconsin’s public health care program, is an option if you have no or low income. Other low-cost options are catastrophic plans or short-term plans, but both offer more limited coverage.
What Plans Offer Better Coverage?
The most comprehensive plans typically meet Affordable Care Act (ACA) standards and cover preexisting conditions, emergency services and prescription drugs, among other things. They’ll likely have a higher premium. A plan with a lower premium will cost less per month, but might not cover as much, leaving you with high out-of-pocket costs.
What If You Skip Health Insurance?
Wisconsin doesn’t require you to have insurance, but your school might. If you don’t have coverage, you’d save on the monthly premium but risk big medical bills in an emergency or illness.
What Are Health Insurance Rules in Wisconsin?
Short-term health plans are limited to 364 days and can only be renewed up to 18 months. Wisconsin uses the federal Health Insurance Marketplace for ACA-compliant health plans.
Will the Plan Cover Services at the On-Campus Medical Facility?
Wisconsin campus student health facilities vary in the services they offer, their fee structure and whether they accept health insurance. Check with your school’s facility to get the details.
What Are Coverage Options in Wisconsin?
You or your parents can buy an ACA-compliant plan through the federal Health Insurance Marketplace. You can also get coverage through your or your parents’ employer-based plan. If your income is low enough (or you don’t have an income), you may be eligible for BadgerCare Plus.1
Many clinics and dentists’ offices in Wisconsin provide services for people with little or no insurance. They charge on a sliding scale, depending on income. The Wisconsin Association of Free & Charitable Clinics offers more information and a list of facilities.
Some colleges also offer their own health insurance plans.
Wisconsin allows you to buy a catastrophic plan if you’re under 30. The coverage is limited to emergency care and comes with a high deductible. You’ll have to pay out-of-pocket until you reach the deductible.
WIsconsin short-term plans offer basic, temporary health coverage. You might consider this if you’ve aged out of your parent’s or guardian’s plan, or missed the enrollment period for other plans. In Wisconsin, carriers who sell short-term plans can’t sell policies that last longer than 364 days. State law allows you to renew them up to 18 months.
Unlike ACA-compliant plans, short-term plans don’t have to cover preexisting conditions like diabetes or asthma. They also don’t have to cover all the essential health benefits required by the ACA.
Some colleges and universities offer student insurance plans.
How Do You Get Coverage Through the Affordable Care Act in Wisconsin?
Because of the American Rescue Plan Act, you may be eligible for a low-cost individual plan that meets ACA standards. The annual Open Enrollment Period for Health Insurance Marketplace coverage generally takes place from November 1 through December 15 of each year.
ACA-compliant plans offered by health insurance companies cover essential health benefits including hospitalization, mental health services, prescription drugs and maternity services.They can’t reject you or charge you more because of a preexisting condition.
In certain situations, such as losing previous coverage, you can qualify for a Special Enrollment Period. If you do qualify, you can enroll in a plan outside the Open Enrollment Period.
How Do You Get Covered Under Your Parents’ Plan in Wisconsin?
If your parents have health coverage through their employer or through an ACA plan, you can stay on their plan if you’re under 26 (or 27, with a rider). If you need to be added to their plan, they can do that during their plan’s annual Open Enrollment Period or during a Special Enrollment Period, if you qualify.
How Do You Get Covered Through Your School in Wisconsin?
Many colleges and universities offer their own insurance plan. The Wisconsin Office of the Commissioner of Insurance notes that student plans tend to cover less and have more exclusions than other insurance options.
Most school plans allow you to use your college loans to pay your premium.
Here are examples of what two Wisconsin schools offer:
The University of Wisconsin-Madison offers the Student Health Insurance Plan (SHIP), which costs $2,556 annually. It provides comprehensive coverage and a nationwide network of providers but requires that you use the on-campus facility, University Health Services (UHS), “for all available primary, urgent, and preventive care.”2 UHS is closed at night and on weekends and doesn’t offer emergency care, hospitalization or specialized services.
Lawrence University requires you to have health insurance, either your own or the school plan. The Lawrence University Insurance Plan, which is provided through Wellfleet Health Insurance, offers preventive and emergency care and prescription drug coverage. It costs $1,503 annually.
How Do You Get Covered Through Medicaid or CHIP in Wisconsin?
In Wisconsin, Medicaid, for people with low income or a disability, and the Children’s Health Insurance Program (CHIP), for children under 19, are combined in the BadgerCare Plus program. You can find out whether you qualify by applying anytime online. BadgerCare Plus covers a variety of services, including lab visits and X-rays, wellness visits, emergency room care, hospitalization, mental health, substance abuse and prescription drugs.
What Are Resources for Wisconsin Students?
Navigators at the Wisconsin Office of the Commissioner of Insurance can help you determine which plan fits your needs and budget.
The federal Health Insurance Marketplace site offers tips and information on health insurance to college students.
Check with the health services office at your college or university about what health coverage it offers and what services are available at the campus health facility.
If you’ve decided to get health insurance while you’re at school, compare the available plans to pick the one that best suits your health needs and your budget. Then make sure you’re ready to sign up before the semester starts.