Wisconsin health insurance questions, answered.

No. Wisconsin uses HealthCare.gov, the federal Marketplace. Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027, and you should enroll by December 15 if you want coverage to start January 1.

No. BadgerCare Plus covers adults with household income up to 100% of the federal poverty level, including adults without children. People above that level can get premium tax credits for Marketplace plans, so there is no gap between the two.

It is a state reinsurance program that started in 2019. It pays part of very large claims, which helps keep premiums lower for everyone in the individual market. For 2026 it covers 50% of a person's claims between $50,000 and $214,738, and it is approved through 2028. You do not need to sign up; it works in the background.

KFF reports the 2026 average benchmark Silver premium for a 40-year-old in Wisconsin is $611 a month before subsidies, up from $495 in 2025. Your price depends on your age, county, plan and income, and many people pay much less after premium tax credits.

For 2026 there is no premium tax credit above 400% of the poverty level because the enhanced subsidies expired. In one Milwaukee example, a 60-year-old earning $63,000 went from $261 to $1,029 a month for the cheapest plan. Managing taxable income can matter a lot, so it is worth planning with a tax adviser.

Yes, if household income is at or below 100% of the poverty level and other rules are met. BadgerCare Plus covers adults up to age 64 whether or not they have children at home. Income counts, not savings alone, so a low-income year in early retirement may qualify.

Yes. When you become eligible for Medicare, you generally move to Medicare and end your Marketplace plan, since premium tax credits stop for people who qualify for premium-free Medicare Part A. Plan the switch a few months ahead.

Wisconsin law allows a single term of up to 12 months, and up to 18 months of back-to-back coverage from the same insurer. A gap of more than 63 days starts a new count. Federal agencies have said they will not prioritize enforcing the 2024 federal 4-month limit.

A state-commissioned study of 2021 data found that none of the short-term plans covered maternity care and fewer than half covered mental health or substance use care. Insurers denied about one-third of claims. These plans can also exclude pre-existing conditions.

Not always. If you qualify for a premium tax credit, a Marketplace plan may cost about the same or less and cover much more. Without a credit, a short-term plan usually costs less up front, but you take on the risk of uncovered bills.

Molina and Chorus Community Health Plan stopped selling Marketplace plans after 2025. If you had one of those plans, you needed to choose a new one for 2026. Twelve insurers remain.

Anthem Blue Cross and Blue Shield, which sells under the name Compcare in Wisconsin, offers 2026 Marketplace plans in 53 of the state's 72 counties. Security Health Plan, Dean Health Plan and Medica follow. Many other insurers are regional, so check your county.

Pre-subsidy rates rose about 23% on average for 2026. Approved increases ranged from about 7% for Group Health Cooperative and MercyCare to about 35% for UnitedHealthcare. What you pay after subsidies depends on your income and the plan you pick.