Most Affordable Health Insurance Providers in Wisconsin
We compared individual Silver plan premiums from major insurers on HealthCare.gov for a 40-year-old non-smoking adult. Wisconsin’s marketplace features strong regional carriers alongside national insurers, giving residents solid competition.
| Rank | Company | Monthly Premium | Annual Premium | vs. State Avg |
|---|---|---|---|---|
| 1 | Quartz Health Solutions | $365 | $4,380 | -14% |
| 2 | Common Ground Healthcare | $382 | $4,584 | -10% |
| 3 | Group Health Cooperative | $395 | $4,740 | -7% |
| 4 | Dean Health Plan | $410 | $4,920 | -4% |
| 5 | Molina Healthcare | $425 | $5,100 | 0% |
| 6 | Anthem Blue Cross | $448 | $5,376 | +5% |
| 7 | UnitedHealthcare | $470 | $5,640 | +11% |
| 8 | Aetna CVS Health | $495 | $5,940 | +16% |
*Wisconsin’s cooperative and regional insurers like Quartz and Common Ground keep premiums competitive. Rates shown are before subsidies—most HealthCare.gov enrollees qualify for premium tax credits that significantly reduce costs.
Wisconsin Health Insurance Rates by Age
Under the ACA, insurers in Wisconsin can charge older adults up to 3x what they charge younger enrollees (the 3:1 age band ratio). These are average Silver plan premiums before subsidies.
| Age Group | Monthly Premium | Annual Premium | vs. State Avg |
|---|---|---|---|
21–25 Individual Silver plan |
$284 | $3,408 | -33% |
26–29 Individual Silver plan |
$310 | $3,720 | -27% |
30–34 Individual Silver plan |
$340 | $4,080 | -20% |
35–39 Individual Silver plan |
$378 | $4,536 | -11% |
40–44 Individual Silver plan |
$425 | $5,100 | 0% |
45–49 Individual Silver plan |
$485 | $5,820 | +14% |
50–54 Individual Silver plan |
$574 | $6,888 | +35% |
55–64 Individual Silver plan |
$718 | $8,616 | +69% |
Subsidies Can Slash Your Premium
Most Wisconsin HealthCare.gov enrollees pay far less than listed rates. A 40-year-old earning $35,000/year could pay as little as $155/month after premium tax credits. Wisconsin’s partial Medicaid expansion also means adults earning up to 100% FPL qualify for BadgerCare Plus at no premium cost.
Wisconsin Health Insurance Rates by Plan Tier
HealthCare.gov plans in Wisconsin are organized into metal tiers. Lower tiers have cheaper premiums but higher out-of-pocket costs, while higher tiers cost more monthly but cover a greater share of your medical expenses.
| Plan Tier | Monthly Premium | Annual Premium | Avg. Deductible | vs. Silver Rate |
|---|---|---|---|---|
| Bronze | $310 | $3,720 | $7,000 | -27% |
| Silver | $425 | $5,100 | $4,500 | — |
| Gold | $498 | $5,976 | $1,300 | +17% |
| Platinum | $570 | $6,840 | $0 | +34% |
Which Tier Is Right for You?
Bronze works best for healthy Wisconsinites who rarely visit the doctor and want the lowest premium. Silver is the most popular tier and unlocks cost-sharing reductions for low-income enrollees. Gold and Platinum suit those with chronic conditions—especially in Milwaukee and Madison where access to UW Health and Froedtert is important.
What Affects Your Wisconsin Health Insurance Rate
Under the ACA, Wisconsin insurers can consider four factors when setting your premium: age, tobacco use, location, and plan category. Wisconsin allows tobacco surcharges up to 50%, which can substantially increase costs for smokers.
Age
| Age 21 rate: | $284/mo |
| Age 64 rate: | $718/mo |
| Difference: | +$434/mo |
Tobacco Use
| Non-smoker rate: | $425/mo |
| Smoker rate: | $638/mo |
| Extra cost: | +$213/mo |
Location / Region
| Cheapest (Madison): | $380/mo |
| Most expensive (northern WI): | $510/mo |
| Difference: | +$130/mo |
Key Wisconsin Health Insurance Dates
Wisconsin Health Insurance Regulations
Wisconsin uses the federal HealthCare.gov marketplace and took a unique partial approach to Medicaid expansion—covering adults up to 100% FPL through BadgerCare Plus without accepting ACA expansion funds.
Key Wisconsin Health Insurance Protections
Period
Expansion
Type
| Regulation | Requirement | Why It Matters |
|---|---|---|
| Marketplace | HealthCare.gov | Wisconsin uses the federal exchange. Residents shop, compare, and enroll through HealthCare.gov during open enrollment with strong insurer competition. |
| Medicaid Expansion | Partial (100% FPL) | Wisconsin expanded BadgerCare Plus to cover adults up to 100% FPL (~$15,060/year), avoiding the coverage gap without full ACA expansion to 138% FPL. |
| Tobacco Surcharge | Up to 50% | Wisconsin allows insurers to charge tobacco users up to 50% more. A $425/month Silver plan could cost $638/month for smokers. |
| Individual Mandate | None | Wisconsin does not have a state individual mandate. There is no penalty for being uninsured. |
| Short-Term Plans | Allowed (364 days) | Wisconsin permits short-term health plans up to 364 days. These plans are cheaper but lack ACA protections like pre-existing condition coverage. |
Wisconsin’s Unique Partial Expansion
Wisconsin is the only state that covers adults up to 100% FPL through its own Medicaid waiver (BadgerCare Plus) without accepting federal ACA expansion funding. This means there is no coverage gap in Wisconsin—adults below 100% FPL qualify for BadgerCare Plus, and those above 100% FPL qualify for marketplace subsidies. However, adults earning 100–138% FPL receive marketplace subsidies instead of free Medicaid, costing them more than in states with full expansion.
Health Insurance Plan Types in Wisconsin
Wisconsin’s HealthCare.gov marketplace offers several plan types from both regional cooperatives and national carriers. Understanding the differences helps you choose the right balance of cost, flexibility, and provider access.
HMO (Health Maintenance Organization)
Lowest CostHow it works: You choose a primary care physician (PCP) who coordinates your care. Referrals required for specialists. Care must stay in-network except for emergencies.
Average cost in Wisconsin: $355–$410/month for a Silver HMO plan (age 40).
Best for: Milwaukee and Madison residents near major health systems like UW Health, Froedtert, and Aurora. Ideal for families who want predictable costs.
Key feature: Quartz and Dean Health Plan offer integrated HMO models in south-central Wisconsin, while Group Health Cooperative serves the Madison market with a strong community focus.
PPO (Preferred Provider Organization)
Most FlexibleHow it works: See any doctor without a referral. In-network care costs less, but out-of-network care is partially covered too.
Average cost in Wisconsin: $460–$530/month for a Silver PPO plan (age 40).
Best for: Wisconsinites in rural areas or those who need out-of-network specialists. Good for residents near the Illinois or Minnesota border who see providers across state lines.
Key feature: Anthem Blue Cross offers Wisconsin’s broadest PPO network. Essential for northern Wisconsin residents who may need to travel for specialized care.
EPO (Exclusive Provider Organization)
Good BalanceHow it works: Similar to a PPO but without out-of-network coverage (except emergencies). No referrals needed for specialists.
Average cost in Wisconsin: $395–$450/month for a Silver EPO plan (age 40).
Best for: Wisconsin residents in metro areas who want specialist access without referrals but are comfortable staying in-network.
Key feature: Combines the flexibility of a PPO with the lower cost of an HMO. Molina and Common Ground offer competitive EPO options in Wisconsin.
HDHP with HSA
Tax AdvantagedHow it works: High-deductible plan paired with a Health Savings Account. You pay lower premiums but more out-of-pocket until the deductible is met.
Average cost in Wisconsin: $275–$340/month for a Bronze HDHP plan (age 40).
Best for: Healthy Wisconsinites who want the lowest premiums and tax-advantaged savings. Popular with self-employed workers, farmers, and small business owners.
Key feature: HSA contributions are tax-deductible at both the federal and Wisconsin state level, providing double tax savings for Badger State residents.
POS (Point of Service)
OptionalHow it works: Combines HMO and PPO features. You pick a PCP and need referrals like an HMO, but can see out-of-network providers at higher cost like a PPO.
Average cost in Wisconsin: $415–$480/month for a Silver POS plan (age 40).
Best for: Wisconsinites who want coordinated care through a PCP with occasional out-of-network flexibility.
Key feature: Less common on HealthCare.gov but available through some Wisconsin employers. Useful for those who want managed care with an escape valve.
How to Save on Health Insurance in Wisconsin
Wisconsin’s competitive marketplace and partial Medicaid expansion create opportunities to find affordable coverage. Here are proven strategies.
Check Subsidy Eligibility
Federal premium tax credits are available for Wisconsin households earning 100–400% FPL (enhanced subsidies extend beyond 400% FPL through 2025). A 40-year-old earning $35,000 could reduce a $425/month Silver plan to about $155/month. Check your eligibility on HealthCare.gov.
Explore BadgerCare Plus
Wisconsin’s BadgerCare Plus program covers adults earning up to 100% FPL (~$15,060/year for an individual) with no premiums. Unlike most non-expansion states, Wisconsin has no coverage gap. If your income qualifies, BadgerCare Plus is your most affordable option.
Consider Regional Cooperatives
Wisconsin’s co-op insurers (Quartz, Common Ground, Group Health Cooperative) often offer lower premiums than national carriers. They have strong local networks and community-focused care. Compare them alongside national options for the best rates.
Verify Your Doctors In-Network
Before picking a plan, confirm your doctors are in-network. Wisconsin’s regional insurers have strong but focused networks. If you need UW Health in Madison, Froedtert in Milwaukee, or Marshfield Clinic in central Wisconsin, verify which plans include your preferred providers.
Look Beyond Premiums
A cheap premium can mean high deductibles. Compare total expected costs: premiums + deductible + copays + coinsurance. A Gold plan at $498/month with a $1,300 deductible may cost less overall than a Bronze at $310/month with a $7,000 deductible if you have regular medical needs.
Quit Tobacco to Save Big
Wisconsin allows a 50% tobacco surcharge. A smoker could pay $213/month more for the same Silver plan—$2,556/year in extra costs. The Wisconsin Tobacco Quit Line (1-800-QUIT-NOW) offers free coaching and nicotine replacement therapy.
Best Health Insurance Companies in Wisconsin
Based on premiums, network size, and member satisfaction, these are the top health insurers for Wisconsin residents.
Quartz Health Solutions
A UW Health–affiliated insurer offering some of Wisconsin’s lowest premiums. Integrated care model with strong networks in south-central Wisconsin. Excellent for Madison-area residents who want access to UW Health providers.
Anthem Blue Cross
The broadest statewide PPO network in Wisconsin. Ideal for residents in rural northern counties or those who need provider access across the entire state. Strong national network for travelers.
Common Ground Healthcare
Nonprofit cooperative insurer focused on affordable, community-based healthcare in southeastern Wisconsin. Strong presence in Milwaukee and surrounding counties with competitive Silver plan pricing.
Molina Healthcare
Specializes in affordable plans for low- and moderate-income Wisconsinites. Competitive marketplace pricing with strong Medicaid managed care experience. Good option for budget-conscious families.
What Wisconsin Residents Are Saying
"When my brewery in Milwaukee hit a rough patch, I lost my employer coverage. Credit Haven helped me find a Common Ground Silver plan for $165/month after subsidies. I kept my doctors at Froedtert and saved nearly $400/month compared to COBRA. I couldn’t believe the savings."
"As a graduate student at UW-Madison, I was thrilled to find that Quartz plans included UW Health. Credit Haven showed me a Silver plan for just $95/month after subsidies. The integration with UW clinics makes scheduling and managing my care seamless. Best decision I made this year."
"My family runs a dairy farm near Green Bay and we needed affordable coverage for four of us. Credit Haven compared every option on HealthCare.gov and we found a Molina family Silver plan that saves us $6,000/year versus our old plan. The HSA on our old HDHP was nice, but the Silver savings are even better."
Frequently Asked Questions
How much does health insurance cost in Wisconsin?
The average cost of a Silver plan in Wisconsin is approximately $425 per month for a 40-year-old, about 2% above the national average. Most HealthCare.gov enrollees pay significantly less after federal premium tax credits. A 40-year-old earning $35,000/year could pay as little as $155/month.
Did Wisconsin expand Medicaid?
Partially. Wisconsin expanded BadgerCare Plus to cover adults up to 100% FPL (~$15,060/year) without accepting full ACA expansion funding. This avoids the coverage gap seen in non-expansion states, but adults earning 100–138% FPL must use marketplace plans instead of free Medicaid.
What is BadgerCare Plus in Wisconsin?
BadgerCare Plus is Wisconsin’s Medicaid program. It covers children, pregnant women, and adults earning up to 100% FPL with no premiums. Wisconsin’s unique partial expansion means there is no coverage gap, even though the state didn’t fully expand under the ACA.
When is open enrollment in Wisconsin?
Wisconsin’s open enrollment runs November 1 through January 15 on HealthCare.gov. Enroll by December 15 for January 1 coverage. Outside open enrollment, you need a qualifying life event to enroll.
What are the best health insurance companies in Wisconsin?
Quartz offers the lowest premiums with UW Health integration. Anthem has the broadest statewide network. Common Ground and Group Health Cooperative are excellent cooperatives. Molina provides strong value plans. The best choice depends on your location and priorities.
Does Wisconsin allow a tobacco surcharge?
Yes. Wisconsin allows health insurers to charge tobacco users up to 50% more. A smoker could pay $638/month for a Silver plan that costs non-smokers $425/month—an extra $2,556/year.
Are cooperative insurers a good choice in Wisconsin?
Yes. Wisconsin has some of the nation’s strongest health insurance cooperatives. Quartz, Common Ground, and Group Health Cooperative offer competitive premiums, strong local networks, and high member satisfaction. They’re often cheaper than national carriers.
Is it free to compare health insurance quotes on Credit Haven?
Yes, comparing health insurance quotes through Credit Haven is 100% free with no obligation. We help you see personalized rates from multiple Wisconsin-licensed insurers so you can make the best decision for your family.
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