How to Apply
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.
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Save Time
If you qualify for BadgerCare Plus or Medicaid, you will be ineligible for HIRSP. To save time, see if you qualify for Medicaid or BadgerCare Plus before applying for HIRSP.
Applications
-
Apply
Online!
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HIRSP Application
- Additional applications:
-
Application for Reduced Premium,
Deductible, and Drug Coinsurance this subsidy application applies if your household income is
less than $33,000
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Emergency Application for
Reduced Premium, Deductible, and Drug Coinsurance
- HIPAA Privacy Authorization for Use or Disclosure Form
Mail your completed application, payment, and relevant documentation to:
HIRSP
Attn: Member Services Administration
1751 W Broadway
PO Box 8961
Madison, WI 53708-8961
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:
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HIRSP Customer Service by calling (800) 828-4777 or (608) 221-4551, or by writing to:
HIRSP, P.O. Box 8961, Madison WI 53708-8961
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this Web page
- Your insurance agent.
Please Note
The new HIRSP Federal Plan may offer better health insurance options than HIRSP. The HIRSP Federal Plan will begin accepting applications on July 15, 2010, for effective dates on August 1, 2010.
Enrolling in Wisconsin's HIRSP now will prevent you from using this new option. We want you to be aware of this new program so that you can make a fully informed decision before you enroll in HIRSP. Read more...