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Wisconsin Medical Insurance Coverage Facts

Wisconsin medical insurance plans must be renewed by a Wisconsin medical insurance company as long as the insured member submits true information and keeps current with their premium payments for their Wisconsin medical insurance policy. Additionally, an automatic 31 day coverage period for newborns and newly adopted children must be included in all Wisconsin medical insurance plan. After 31 days it is up to the child’s parents to add them to their policy. In some instances, Wisconsin medical insurance plans contain pre-existing exclusion periods. This occurs when an applying member has a medical condition which was treated or diagnosed before the effective date of a newly applied for Wisconsin medical insurance plan. These members may have a waiting period of time before any claims are paid by the Wisconsin medical insurance company for their pre-existing medical conditions. It is also possible that an Wisconsin medical insurance company includes a permanent exclusion period for a pre-existing medical condition. This means at no time during the policy effective period will specified pre-existing conditions be covered. If a woman is pregnant when applying for new coverage, most if not all Wisconsin medical insurance companies will deny coverage immediately. The question of how much exclusion time is at the sole discretion of the wisconsin medical insurance company.

If you decide to leave a group employer plan or Cobra, you should not cancel your active policy until you have been approved for an individual plan.  Those seeking to obtain a group health insurance plan for a business or self-employment, are responsible for contributing 50 percent of the total employee base monthly premium.  As an employer you can choose to contribute more than 50 percent.  Additionally, different laws apply for pre-existing conditions for group versus individual health insurance.  Before deciding to pursue a group plan, check the (HIPPA)  Health Insurance Portability and Accountability Act site ate www.cms.hhs.gov/hipaaGenInfo

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