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Basic Plan — Frequently Asked Questions

Basic Plan premiums are going up to $325 for coverage beginning with the November 2011 benefit month (premiums due October 5). Members will see the increase on their premium payment coupons sent out at the end of September. No benefit, coverage or deductible changes are taking place at this time.

  1. Why are the Basic premiums going up?

Under state law, Basic premiums have to support the cost of the program. Those costs have been much higher than planned.

  1. Why did the state stop taking new enrollment in the Basic Plan? 

The Basic Plan is required to be funded by member premiums. The current premium level is not meeting the requirement that the program be self-funded. Closing the program to new enrollment prevents further adverse selection that will help keep premiums more affordable for current members.

  1. Will you ever open up the Basic plan sign up again? 

There are currently no plans to re-open the Basic Plan for new enrollments. Before it could open up for new members, the premium cost would have to be self-sustaining. 

  1. What other options are available to people on the Core Plan Wait List? 

Other coverage and programs include: 

  • Individual plans in the private market
  • State Health Insurance Risk-Sharing Plan (HIRSP)
  • Federal Temporary High Risk Insurance Pool (To be in the federal high risk pool, you must be uninsured for six months.)
  • Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • Health Coverage Tax Credit 

For more information on these and other programs, go to dhs.wi.gov/forwardhealth/

For more information about Federal and State HIRSP programs, go to hirsp.org and click on the blue button to check on enrollment. Or, call 1-800-828-4777 for HIRSP Customer Service.

To qualify for HIRSP you must be rejected for coverage in the private insurance market because of a pre-existing medical condition. You will need to supply HIRSP with the letter of rejection from the private insurer as part of your application. You can apply for HIRSP directly on the HIRSP website at hirsp.org/plans/state-howtoapply.shtml or by calling the toll free number above.

You may also find insurance options available in Wisconsin by visiting healthcare.gov. Healthcare.gov provides general information on private and public insurance options, and other community resources.

Several insurance companies in Wisconsin offer low-cost health insurance plans. For more information, go to ehealthinsurance.com/wisconsin-health-insurance, type in your zip code and look over the plans offered in your area.

You may be able to receive care at one of Wisconsin’s free or low cost clinics or Federally Qualified Health Centers (FQHC). For a full list of these options, go to dhs.wisconsin.gov/ForwardHealth/clinics.htm.

You can also get help with prescription drug costs through one of several organizations. For a full list of these programs, go to dhs.wisconsin.gov/guide/spec/freeprescr.htm.

  1. I pre-paid my premiums. Do I have to pay more now? 

Your discounted pre-payment will last through the months for which you pre-paid. After that, you must pay the current monthly premium rate to continue in Basic.

 

P-00247 (09/11)

Last Revised:  September 16, 2011