Eligibility Requirements for the HIRSP Federal Plan

Important Notice re: HIRSP Federal Applications.

Effective March 2, 2013 the HIRSP Federal Plan can no longer accept new applications due to Federal budget constraints. Any new HIRSP Federal Plan applications MUST be received by midnight on March 1, 2013 to be considered for coverage. This enrollment freeze DOES NOT impact the HIRSP state plans. The HIRSP state plans will continue to enroll new members. Existing HIRSP and HIRSP Federal Plan members are not affected by this change and their coverage continues to be in effect. Please contact us at (888) 253-2698 or email at HIRSPweb@wpsic.com with questions.

To qualify for the HIRSP Federal Plan, you must meet all of the requirements under A and at least one of the requirements under B:

A. Base Criteria

  1. A resident of Wisconsin
  2. A citizen or national of the United States, or lawfully present in the United States
  3. Have not had creditable coverage in the six months prior to the HIRSP Federal Plan effective date

B. Pre-Existing Condition Criteria

(must have received one of the following based on medical underwriting in the past nine months)

  • A letter from your physician dated within the last nine months confirming your diagnosis or treatment of one of the qualifying health conditions.
    OR
  • A notice of rejection from an insurer
  • A notice of reduction of limitation on coverage, including restrictive riders
  • A notice of an increase in premium of 50% or more
  • Two or more offers for insurance with premiums at least 50% higher than a standard risk would be charged for the coverage

If you do not meet the requirements in A and B, you may be eligible for Wisconsin HIRSP.

HIRSP Federal Plan Does Not Apply Preexisting Condition Exclusions: The HIRSP Federal Plan coverage will not be subject to any preexisting condition exclusions.

If you have any questions about the HIRSP Federal Plan, please call HIRSP Customer Service at:

1-888-253-2698
Monday through Thursday 7:00 a.m. to 5:00 p.m. and Friday 8:00 a.m. to 4:30 p.m. (CT).