The Health Insurance Risk-Sharing Plan (HIRSP), offers health insurance to Wisconsin residents who either are unable to find adequate health insurance coverage in the private market due to their medical conditions or who have lost their employer-sponsored group health insurance. Applicants are required to meet HIRSP eligibility criteria to qualify, including being under age 65 at time of application.
HIRSP covers major medical and prescription drug expenses, subject to pre-existing condition limitations. Policyholders are responsible for paying premiums, deductibles, and coinsurance amounts as indicated in the HIRSP policy.
HIRSP has a six-month waiting period for coverage of services related to pre-existing conditions. If a person qualifies for HIRSP because they lost their employer-sponsored group health insurance and they meet other eligibility requirements, the waiting period would not apply. However, if the policyholder who recently lost their employer sponsored coverage also has Medicare, they will serve a six-month waiting period.
HIRSP offers five plans:
- HIRSP $1,000 deductible plan
- HIRSP $2,500 deductible plan
- HIRSP $5,000 deductible plan
- HIRSP Health Saving Account - person can qualify to open a health savings account;
- HIRSP Medicare Supplement - specifically designed for policyholders who are eligible for Medicare. Beneficiary must have Parts A & B and also be enrolled in a Medicare Prescription Drug Plan (Part D). HIRSP will "wrap" around the Part D plan which could reduce out of pocket costs to the beneficiary.
Enrollment in HIRSP is not dependent upon income or assets. However, if total annual household income is less than $34,000, the enrollee may qualify for reductions in premiums, deductibles, and drug coinsurance.
For more information on HIRSP coverages, premiums, and reductions refer to www.hirsp.org or call HIRSP Customer Service at 1-800-828-4777.
Last Modified: 7/26/2016 1:46:45 PM