HIRSP Federal Plan - How to Apply

Please note: the HIRSP Federal application is currently being updated - effective immediately, you no longer need to meet these three requirements to be eligible for the HIRSP Federal Plan:

    1) Not eligible for employer sponsored group health coverage
    2) Not eligible for comprehensive Medicaid
    3) Not eligible for Medicare.

In other words, if you are currently eligible for coverage under one of the three types of insurance listed above, you may still be eligible for the HIRSP Federal Plan.

Save Time. Apply Online!

There are benefits to submitting enrollment applications using the online system, or by fax. The benefits include; expedited enrollment, improved accuracy (i.e. typed vs. hand written information), and reduced cycle time. You may enjoy the convenience and benefits the online system has to offer.

OR

HIRSP Certified Agent, if you would like assistance completing your application, you may want to work with a HIRSP Federal Certified agent in your county.

You can submit the completed paper application by mailing or faxing the application packet to:

HIRSP
1751 W. Broadway
P.O. Box 8961
Madison, WI  53708-8961

Fax:  1.608.243.6136

If you have questions, please call customer service:
1-608-221-5315 or 1-888-253-2698
Mon-Thurs: 7:00am - 7:00pm
Fri: 7:00am - 4:30pm

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.