You can apply for HIRSP using the HIRSP online application or contacting HIRSP directly or through an insurance agent licensed in Wisconsin. Parents or legal guardians may apply on behalf of dependents.
Adobe Reader will allow you to view the PDF documents below.
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.
Before applying, see if you qualify for Medicaid or BadgerCare Plus Standard Plan. If you qualify for BadgerCare Plus Standard Plan or Medicaid, you will be ineligible for HIRSP.
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.
Additional applications:
Mail or fax your completed application and relevant documentation to the address below.
If paying via direct bill please also mail your initial payment to the address below.
Mail to HIRSP
Attn: Member Services Administration
1751 W Broadway
PO Box 8961
Madison, WI 53708-8961
HIRSP Fax: (608) 243-6136
If you have questions about your application call HIRSP customer service at:
Phone:
1-800-828-4777 or 1-608-221-4551
Member Service Hours (CST):
Mon-Thurs: 7:00am - 7:00pm, Fri: 7:00am - 4:30pm
Where to Get an Application
Applications and information can be obtained from one of the following:
The new HIRSP Federal Plan may offer better health insurance options than HIRSP.
Enrolling in Wisconsin's HIRSP now will prevent you from enrolling in the Federal Plan. We want you to be aware of the Federal program so that you can make a fully informed decision before you enroll in HIRSP. Read more...