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Clark Health Insurance

Facts and Figures

  • Insurance
    Carriers
    15
  • Number of
    General Doctors
    99
  • Number of
    Hospitals
    1

Insurance Carriers

State Government Insurance Programs Offered

Health Insurance Risk Sharing Plan (HIRSP) HIRSP Federal Plan Federal Program run by HIRSP


HIRSP: Offers five plan options. Covers hospital and physician care, prescription drugs and insulin, maternity care and other services. HIRSP-Fed: Covers broad range of benefits, including primary and specialty care, hospital care, and prescription drugs. Eligibility: HIRSP: Must be under age 65, a Wisconsin resident for at least 3 months, ineligible for employer- offered group health insurance or Medicaid or Badger Care Plus, and either: 1) Not eligible for Medicare, Lost your employer- offered group health insurance and did not voluntarily cancel coverage. In last 9 months was denied coverage due to health, or offered coverage with restricted benefits, or offered 2 coverages with premiums 50% or higher than a standard risk would be charged for the coverage, or diagnosed as HIV positive, or be eligible for Medicare due to disability. Or, 2) Be a HIPAA- eligible individual. HIRSP-Fed: Must be a U.S. citizen or legal alien, uninsured for 6 months prior to the HIRSP Federal Plan effective date, ineligible for employer-offered group health insurance or Medicaid or Badger Care Plus, and in last 9 months was denied coverage due to health, or offered coverage with restricted benefits, or offered 2 coverages with premiums 50% or higher than a standard risk would be charged for the coverage, or diagnosed as HIV-positive.

Badger Care Plus (BCP)


Coverage: BCP: Comprehensive care including but not limited to doctor visits, mental, dental, prescriptions, hospitalization and more (offers same as Medicaid). Eligibility: BCP: Must be U.S. citizen or legal alien and resident of Wisconsin. Must be children under 19 years old without access to health insurance; or pregnant women with incomes up to 300% FPL; or parents or caretakers earning up to 200% FPL. Children under 19 years old with income greater than 200%, then you will be transferred to the Benchmark plan.

Well Woman Program


Mammograms, Pap tests, certain other health screenings, and multiple sclerosis testing for women with high risk signs of multiple sclerosis

BadgerCare Plus Core & Basic Plans


BadgerCare Plus Core & Basic Plan has suspended enrollment due to lack of space. There is now a waitlist and those on the waitlist will be able to enroll as space becomes available. Those currently enrolled in the plans will continue to be covered provided they maintain eligibility. Limited plans with basic services such as Doctor visits, Hospital services, Emergency room and ambulance, Emergency dental services, Prescription drugs, Therapy (physical, occupational therapy, and speech), Cardiac rehabilitation, Durable medical equipment, Disposable medical supplies, Dialysis/kidney-related services. Eligibility: BadgerCare Plus Core: Must be Wisconsin resident and U.S. citizen or qualified immigrant, age 19 to 64 years old, have income at or below 200% FPL. Must NOT be or have the following: Be pregnant. Have children under 19 living with you. Be eligible for or have BadgerCare Plus, Medicaid, Medicare. Have private health insurance in the last 12 months before and during the date you request Core Plan, unless you lost your health insurance for a good reason. Have access to employer-based insurance in the month you apply or next three months. Had access to employer-based health insurance in the last 12 months. BadgerCare Plus Basic: Must be on the BadgerCare Core waitlist to have the option to enroll in BagerCare Plus Basic.

Wisconsin Chronic Disease Program (WCDP)


The Wisconsin Chronic Disease Program (WCDP) assists Wisconsin residents with chronic renal disease, hemophilia, and adult cystic fibrosis. It pays health care providers for disease-related services and supplies provided to certified patients in Wisconsin Chronic Disease Program after all other sources of payment have been exhausted.

Heath Care Reform

Immediate Benefits for Wisconsin

Small business tax credits. 89,000 small businesses in Wisconsin could be helped by a new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable.1 Small businesses pay, on average, 18 percent more than large businesses for the same coverage, and health insurance premiums have gone up three times faster than wages in the past 10 years. This tax credit is just the first step towards bringing those costs down and making coverage affordable for small businesses.
Closing the Medicare Part D donut hole. Last year, roughly 74,400 Medicare beneficiaries in Wisconsin hit the donut hole, or gap in Medicare Part D drug coverage, and received no extra help to defray the cost of their prescription drugs.2 Medicare beneficiaries in Wisconsin who hit the gap this year will automatically be mailed a one-time $250 rebate check. These checks will begin to be mailed to beneficiaries in mid-June and will be mailed monthly throughout the year as new beneficiaries hit the donut hole. The new law continues to provide additional discounts for seniors on Medicare in the years ahead and completely closes the donut hole by 2020.
Support for health coverage for early retirees. An estimated 71,600 people from Wisconsin retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time.3 Beginning June 1, 2010, a $5 billion temporary early retiree reinsurance program will help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and state and local governments are eligible for these benefits.
New consumer protections in the insurance market beginning on or after September 23, 2010.
Insurance companies will no longer be able to place lifetime limits on the coverage they provide, ensuring that the 3.6 million Wisconsin residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.
Insurance companies will be banned from dropping people from coverage when they get sick, protecting the 320,000 individuals who purchase insurance in the individual market from dishonest insurance practices.
Insurance companies will not be able to exclude children from coverage because of a pre-existing condition, giving parents across Wisconsin peace of mind.
Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care. This will protect the 3.3 million residents of Wisconsin with health insurance from their employer, along with anyone who signs up with a new insurance plan in Wisconsin.
Health insurers offering new plans will have to develop an appeals process to make it easy for enrollees to dispute the denial of a medical claim.
Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.
Extending coverage to young adults. Beginning on or after September 23, 2010, plans and issuers that offer coverage to children on their parents’ policy must allow children to remain on their parents’ policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. This provision will bring relief to roughly 14,700 individuals in Wisconsin who could now have quality affordable coverage through their parents.4 Some employers and the vast majority of insurers have agreed to cover adult children immediately.
Affordable insurance for uninsured with pre-existing conditions. $73 million federal dollars are available to Wisconsin starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the Federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the Federal government will administer the program for those residents.
Strengthening community health centers. Beginning October 1, 2010, increased funding for Community Health Centers will help nearly double the number of patients seen by the centers over the next five years. The funding could not only help the 81 Community Health Centers in Wisconsin but also support the construction of new centers.
More doctors where people need them. Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over five years) for scholarships and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 11% of Wisconsin’s population who live in an underserved area.
New Medicaid options for states. For the first time, Wisconsin has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.

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