HIRSP offers 3 plan options

  • The HIRSP Plan is for an individual who has recently been insured.
  • The HIRSP Federal Plan is for individuals who have not been insured for at least six months.
  • HIRSP Medicare Supplement Plan is for individuals who are on Medicare because of a disability or for current HIRSP members who turn 65 while enrolled in HIRSP.

Please use the link below to help you compare the plan options.

Compare Plans

BadgerCare Plus & HIRSP: How do they work together?
If you are no longer covered under a BadgerCare Plus program, you may still be eligible for HIRSP.
Learn more…

HIRSP and HIRSP Federal
Documents and Forms
HIRSP Enrollment HIRSP Federal Enrollment
PDF Icon HIRSP Application for Coverage PDF Icon HIRSP Federal Application for Coverage
PDF Icon Application for Reduced Premium, Deductible, and Drug Out-of-Pocket Maximum. No federal subsidy applicable.
PDF Icon Emergency Application For Reduced Premium, Deductible, And Drug Out-Of-Pocket Maximum No emergency application applicable.

Rate Information

HIRSP Federal Rate Information

PDF Icon HIPAA Authorization Form

HIRSP Coverage HIRSP Federal Coverage
Pharmacy Information

MedTrak Pharmacy Services

For formulary and pharmacy benefit information please visit the HIRSP Pharmacy Benefit Administrator's site:

>> MedTrak Pharmacy Services

Privacy Forms
PDF Icon HIRSP Notice of Privacy Practices
PDF Icon Your Right to an Independent Review
PDF Icon HIPAA Authorization Form
PDF Icon HIPAA Privacy Revocation of Authorization Form
PDF Icon HIPAA Privacy Restriction Request Form
PDF Icon HIPAA Privacy Access Request Form
PDF Icon HIPAA Privacy Accounting Request Form
PDF Icon HIPAA Privacy Alternative Communication Request Form
PDF Icon HIPAA Privacy Amendment Request Form
PDF Icon HIPAA Privacy Complaint Form


 
Please Note
HIRSP continues to reimburse agents $40 for approved applications.

Beginning in late 2011, HIRSP will be offering agent certification classes. All agents attending a certification class will be considered HIRSP certified. All HIRSP certified agents will recieve $100 for each approved application versus the current $40 referral fee.

In order to be reimbursed the agent must complete agent section of the HIRSP or HIRSP Federal Application.

About Privacy Forms
For agents to inquire on or track the status of an application, the applicant must first complete this authorization form: HIPAA Authorization Form (PDF)

Application and Privacy authorization forms should be submitted to:

HIRSP
P.O. Box 8961
Madison,WI 53708-8961