Overview

The Health Insurance Risk-Sharing Plan (HIRSP) offers health insurance to Wisconsin residents who are unable to find adequate health insurance coverage in the private market due to their medical conditions or who have lost their employer-offered group health insurance. Applicants are required to meet HIRSP eligibility criteria to qualify.

HIRSP has a six-month waiting period for coverage of services related to pre-existing conditions. If you qualify for HIRSP because you lost your employer-offered group health insurance, Medicaid or BadgerCare Plus, Medicare or another state’s High-Risk Pool coverage, and you meet the requirements in this Outline of Coverage, this waiting period does not apply to you.(Refer to Six-Month Waiting Period for Coverage of Pre-existing Conditions in the Outline of Coverage.

HIRSP covers major medical and prescription drug expenses, subject to pre-existing condition limitations defined in this outline. Policyholders are responsible for paying premium, deductible and coinsurance amounts as indicated in the HIRSP policy.

HIRSP offers a variety of health insurance plans, including two plans that qualify you to open a health savings account (HSA) and a plan designed for policyholders enrolled in Medicare. This empowers you to choose the plan that best fits your health insurance needs.

Enrollment in HIRSP is not dependent upon your income or assets. However, if your total annual household income is less than $33,000, you may qualify for reductions in premiums, deductibles and drug out-of-pocket costs under the conditions defined in this outline.

This outline provides general information only. It does not provide a complete description of coverage and does not serve as a legal document. Only the terms of the HIRSP insurance policy constitute a binding agreement between the policyholder and HIRSP. Information contained in this outline is subject to change without notice.