Health Insurance Basics

Health insurance can be complicated! Take some time to learn about what the different types are and terms you should be familiar with when you select your own plan.

Wisconsin Insurance Commissioner’s Office (OCI), Definition of Insurance Terms

National Glossary:  Insurance terms definitions

What is the Health Insurance Marketplace?
The Marketplace is a new way to find and buy health coverage on the Internet that fits your budget and meets your needs. With one application, you can see all your options in Wisconsin and enroll. Visit the Healthcare.gov website to learn more.

What are Medicaid and BadgerCare+?
These are state-federal funded insurance plans for people with low-incomes, children, parents and caretakers,  pregnant women, people with disabilities and people over the age of 65.

Medicaid pays for care for people who are blind or elderly and have low incomes, including nursing home or community-based care.

BadgerCare+ is a Medicaid program that covers:

  • children under the age of 19 with household income below 300% of the Federal Poverty Level (FPL)
  • adults with income below 100% FPL
  • young adults who are leaving foster care when they turn 18 will be eligible regardless of income up to age 26; and
  • pregnant women will continue to be eligible if income is below up 300% FPL.

What is Medicare?
This is a health insurance program for people 65 or older and people with disabilities under age 65 who have insured status through the Social Security Administration.  Learn more at this federal government website.

How can I buy insurance in the private market, outside the new Marketplace?
The Wisconsin Office of the Commissioner of Insurance provides tips and a list of licensed insurance agents and brokers who can help you find a plan.

What if I have insurance through my job?
If you have insurance that you like and is affordable through your employer, you don’t have to change anything. Since employers review and may change the insurance they offer each year, it’s a good idea to talk to your employer about their plans for the upcoming year.

If your employer decides not to offer insurance at any time, or it costs you more than 9.5% of your income for a single plan, you will be able to purchase insurance on the Insurance Marketplace, and may be eligible for a discount on the cost depending on your income.