HMO Health Insurance Plans

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Health Insurance HMO Plans by WPS Health Plan

Individual Health Insurance Plans for Wisconsin Residents

A Health Maintenance Organization (HMO) plan is a cost-effective choice for individuals and families in Wisconsin. This type of managed care plan offers benefits in network only and uses a primary care practitioner (PCP) to coordinate your overall medical care. Choose from Gold, Silver, Bronze or, for those who qualify, Catastrophic plan options.

With the WPS Individual HMO Plan, you'll enjoy:
  • Comprehensive medical and hospital benefits, including telehealth services
  • Preventive care coverage with no calendar year maximums
  • Prescription drug coverage
  • The WPS Select Plus Network of health care providers
  • Optional dental insurance through Delta Dental
HSA-Qualified High-Deductible Health Plans Available

A high-deductible health plan can save you money on your premium. When you pair this type of plan with a Health Savings Account (HSA) that you own and control, you can maximize your health care spending! An HSA acts like a personal savings account, except the money is used exclusively for medical expenses. Plus, it allows you to pay for qualified medical expenses with tax-free funds. For more information, view our HSA FAQ.

Business owner

If you are a business owner purchasing your own individual plan, complete the Declaration of Employer Status form if you wish to pay using your company or business checking account.

The Centers for Medicare & Medicaid Services require Qualified Health Plans, such as WPS Health Plan, to post a notification online explaining the necessity of rate changes.

At WPS Health Plan, we do our best to control costs and provide our customers with the best value for their money. To continue providing top-quality health plans, rate adjustments are needed from time to time.

The primary factors impacting WPS Health Plan’s premium rate changes are:

  • The continued increases in the cost of medical care and prescription drugs.
  • An increase in health care service use by consumers.
  • The elimination of the individual mandate, which is expected to increase costs of the overall risk pool as healthier consumers drop out of the health insurance market.
  • WPS Health Plan is establishing premiums for 2022 assuming the Cost Sharing Reduction benefit subsidies are not funded and therefore need to be included in the premium development. A rate decrease has also been applied assuming the Wisconsin Health Care Stability Plan will be fully funded in 2022.

Rate adjustments were made to the renewing health plans and the individual HMO and POS products as a whole. Changes in cost sharing were made to maintain benefit offerings within the prescribed metal tiers.

   

  • Health Care Provider Networks

    High-quality health care providers and facilities

    Choose coverage for yourself or your family

    An individual health insurance plan from WPS provides the comfort of knowing that you’re protected so you can focus on the things that matter most to you.

    WPS Select Plus Network
    • Coverage in 50 Wisconsin counties
    • More than 7,000 health care providers
    • 49 hospitals
    First Health Network
    • Coverage in 49 states outside Wisconsin
    • More than 130,000 ancillary facilities
    • More than 6,000 hospitals

    Providers can leave or enter the network at any time. It is recommended that you check the network status of your provider on a regular basis.

    • Family at the clinic
  • Plan Materials

    View and download health plan information

   

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