HIRSP Federal FAQ's

Frequently Asked Questions HIRSP Federal Plan

How can I compare which plan is better for me?
The HIRSP Federal Plan will offer four deductible options. The deductible options will be $500, $1,000, $2,500 and $3,500. Premium rates for the HIRSP Federal Plans will be lower than current HIRSP plan rates. However, if your household income is below $33,000 per year, you may qualify for a premium subsidy under HIRSP. If you qualify for subsidy under HIRSP, your premium may be lower than the premium on the HIRSP Federal Plan. We will be updating the HIRSP website frequently with more details regarding the HIRSP Federal Plan premiums and plan details.
What are the benefits for the HIRSP-Federal plan?
The HIRSP-Federal plans will offer medical and drug benefits that are comparable to Wisconsin HIRSP. The HIRSP-Federal plans will not have a pre-existing waiting period. To view the benefits, various plan options and out of pocket costs available under the Wisconsin HIRSP plan, please visit this site again.
When can I enroll in the HIRSP-Federal plan?
Applications for the HIRSP Federal Plan will be available beginning July 15, 2010.
Is there a waiting list and how can I get on it?
The HIRSP-Federal applications will be available at the earliest starting in July 15, 2010. If a waiting list will need to be established, more information will be found on this web site.
When will applications be available?
The HIRSP Federal Plan applications will be available starting July 15, 2010.
Do I have to be uninsured for 6 months?
At a minimum to be considered for the HIRSP Federal Plan:
  1. you must be without creditable coverage* for 6 months, and
  2. be a citizen or national of the United States or be lawfully present, and
  3. have a preexisting medical condition.
The complete listing of requirements will be available soon on this Web site.

* Creditable Coverage: coverage under qualifying group health plans and insurance from any of the following:
  1. a group health plan.
  2. health insurance coverage.
  3. Medicare Parts A, B and D.
  4. Medicaid.
  5. TriCare, formerly the Civilian Health and Medical Plan of the Uniformed Services (CHAMPUS).
  6. Civilian Health and Medical Plan of the Veterans Administration (CHAMPVA).
  7. a medical care program of the federal Indian health service or of an American Indian tribal organization.
  8. a state health benefits risk pool.
  9. a federal employee health plan.
  10. a public health plan.
  11. a Peace Corps health plan.
What qualifies as a pre-existing condition?
The federal definition of a preexisting medical condition has not yet been determined. However, it is likely that it will require proof of uninsurability due to a pre-existing medical condition. Such proof would include a letter of rejection from an insurance carrier. It is recommended that you consider applying for individual insurance coverage as soon as possible. You can obtain a letter of rejection from a private insurance carrier up to 9 months prior to applying to the federal risk pool. More information will be available soon on the HIRSP web site, www.hirsp.org.
What are the eligibility requirements, other than those posted on the web site?
To be considered for the HIRSP-Federal, at a minimum, a person must:
  1. Be a citizen or national of the United States, or be lawfully present; and
  2. Be uninsured for at least 6 months before applying for coverage; and
  3. Have a preexisting medical condition. (Please note that the federal definition of a preexisting medical condition has not yet been determined.)
NOTE: If a person enrolls in any of the BadgerCare Plus plans or Wisconsin HIRSP, they will NOT be eligible for the HIRSP Federal Plan once it becomes available because they have to be uninsured for at least 6 months. More information will be available in the upcoming weeks.
Will plans be able to backdate for charges incurred in the past?
Applications will be available for the HIRSP Federal Plan on July 15, 2010. The earliest effective date available for the HIRSP Federal Plan will be August 1, 2010. Any services provided prior to the member's effective date will not be covered by the HIRSP-Federal plan.
Prescription drug coverage? More than just generics?
The HIRSP-Federal plans will offer a drug benefit, including generic and brand name drugs, that are comparable to Wisconsin HIRSP, with no waiting period for preexisting conditions. View the Wisconsin HIRSP benefits.
Can I apply over the internet?
PDF applications will be available on July 15, 2010. At that time, the application will be available to download. A notice will be posted on this site when an application can be completed online.
Will I lose my place on the BadgerCare Plus Core plan waiting list if I apply for this program?
You will not lose you place on the BadgerCare Plus Core plan waiting list if you enroll in the HIRSP-Federal plan. However, if you enroll in the BadgerCare Plus Core or Basic plan first, you will not be eligible for the HIRSP-Federal plan.
If I enroll in the BadgerCare Plus Basic plan, will this make me ineligible for the HIRSP-Federal plan?
If a person enrolls in BadgerCare Plus Basic or Core plan, they will NOT be eligible for the HIRSP-Federal plan when it becomes available. To be eligible for the HIRSP-Federal plan you must be uninsured for the past 6 months.