OCI PRESS RELEASE, AUGUST 5, 2026, BE AWARE OF ALTERNATIVE HEALTH INSURANCE PLANS

The following information was released by the Wisconsin Office of the Commissioner of Insurance:

Be Aware of Alternative Health Insurance Plans

Madison, Wis. The Wisconsin Offic e of the Commissioner of Insurance (OCI) advises Wisconsinites to use caution when considering the purchase of alternatives to comprehensive health insurance plans. These plans are often marketed to consumers as "non-Marketplace plans" or "private health insurance plans", and include health care sharing organizations, limited partnership health plans, and limited indemnity plans. Comprehensive health insurance will typically have a defined network. Sometimes, alternative health plans are marketed as "letting you see any provider" but the coverage is limited to a set amount paid to you after you receive and pay the provider for care up front.

Instability in the health insurance market has contributed to a rise in sales practices targeting consumers in need of affordable coverage. These alternative health plans market themselves to consumers by promising lower-cost premiums, but they may leave consumers responsible for significant unpaid medical bills or without access to health care. For example, limited indemnity health insurance is a supplemental plan that pays a set, fixed cash amount for specific medical events (such as $200 per hospital day), rather than covering the actual total cost of your medical care.

In recent years, more Wisconsinites have been targeted by companies offering limited partnerships or other multi-level-marketing arrangements to consumers for coverage as "owners" or "employees" of an entity for the purpose of obtaining the coverage. Consumers should be wary of any plan that requires them to become an employee or limited partner in an unfamiliar or unaffiliated company or organization.

Consumers should also closely review plans marketed as lower-cost alternatives to Affordable Care Act Marketplace coverage. Some products combine limited indemnity benefits with ancillary services such as prescription discount cards, gym membership discounts, or medical bill repricing or negotiating services. Others may be fraudulent schemes offered by companies illegally operating in Wisconsin and selling plans that have not been approved or do not comply with legal requirements. Legitimate health insurance products that provide limited benefits are required to include a disclaimer stating that the product is not major medical coverage and provides only limited benefits; these plans are designed to complement, not replace, comprehensive health insurance coverage.

Consumers unfortunately have to beware, as legitimate providers aren't the only ones targeting Wisconsinites. Scammers are also soliciting consumers by phone, text, and email to impersonate their current insurance provider, another health service company, and government agencies. These scammers pitch fake insurance and medical discount plans, offering great discounts if consumers act quickly.

Consumers should refrain from giving out personal information like your full name, subscriber number, bank account details, Social Security number, or other health insurance information in response to an unprompted solicitation. If you believe the offer is legitimate and are interested, ask to receive the full details in writing and take time to carefully read them. Contact your preferred healthcare providers to confirm whether they will accept a specific plan and contact the plan's seller with any other questions.

Protect yourself by taking detailed notes of any coverage promises made to you and requesting the license number of any insurance agent offering to sell you any health insurance plan. When you receive the plan documents, look for "ACA Compliant," coverage for pre-existing conditions, coverage for essential health benefits, and no lifetime or annual dollar limits on essential care. Confirm that your plan uses deductibles, copays, and coinsurance, not fixed cash-per-day payments.