Eligibility Requirements for the HIRSP Federal Plan

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.