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High Risk Pool

The mission of the HIRSP Authority is to provide access to high quality, affordable healthcare for all eligible Wisconsin residents.

If you have a medical condition that’s preventing you from getting health insurance or have lost your employer-sponsored coverage, you may still qualify for great benefits through HIRSP, the Health Insurance Risk Sharing Plan.

HIRSP is a Wisconsin non-profit that’s been helping people get health insurance for over 30 years.  If you’re eligible, you can choose from multiple health plans and select your own doctor from a vast statewide network.

How it Works

(HIRSP) is a health insurance program that helps the public maintain their health and well being. The Health Insurance Risk-Sharing Plan (HIRSP) was created in 1979 for Wisconsin residents. 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.

There are certain restrictions that you should be aware of when applying for (HIRSP):

1)    Medicare applicants under the age of 65 are only able to enroll in the HIRSP Medicare Supplement plan.

2)    Must be a resident of Wisconsin.

3)    Not eligible for employer-offered group health insurance coverage.

4)    You’re not eligible for comprehensive Wisconsin Medicaid services or BadgerCare Plus.

5)    There is a six month waiting period to obtain coverage for pre-existing conditions.

If you do not meet all of the above requirements, you are not eligible for HIRSP.

The following are HIRSP covered services:

* Medical-surgical services

* Anesthesia services

* Consultations

* Prescription drugs

* Home care

* Radiology services

* Laboratory services

* Pap test and pelvic exam

* Skilled nursing care

* Hospice care

* Yearly physical exam

HIRSP Outline of Coverage

The Health Insurance Risk-Sharing Plan (HIRSP) offers health insurance to Wisconsin residents who 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.

HIRSP offers a variety of health insurance plans, including a plan that qualifies you to open a health savings account (HSA) and a plan designed for policyholders enrolled in Medicare. This empowers you to choose the plan that best fits your health insurance needs.

Note: If you have been without healthcare coverage for six months, you may be eligible for the HIRSP Federal Plan which does not impose a waiting period for pre-existing conditions. Learn more…

Enrollment in HIRSP is not dependent upon your income or assets. However, if your total annual household income is less than $34,000, you may qualify for reductions in premiums, deductibles, and drug out-of-pocket under the conditions defined in this outline.

This outline provides general information only. It does not provide a complete description of coverage and does not serve as a legal document. Only the terms of the HIRSP insurance policy constitute a binding agreement between the policyholder and HIRSP. Information contained in this outline is subject to change without notice.