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Direct individual & family plans

Health insurance off-Marketplace

MercyCare Health Plans offers plans directly through MercyCare.

These plans are the same plans and premiums offered on the Marketplace, however they do not offer financial assistance (reduced premium or cost sharing).

Eligibility

Must reside in one of the following counties: Rock or Walworth (Wisconsin) or Boone or Winnebago (Illinois).

Get a quote

Call: 800.895.2421, extension 7
Email: mercycaresales@mhemail.org

Apply for coverage

Pay first premium

Submit application

Option 1: Complete application and submit to mercycaresales@mhemail.org.

Option 2: Mail in requirements to MercyCare Health Plans, Attn: Sales Department, Janesville, WI 53547-0550

Make sure to include the following for a complete application:

  • Quote
  • Application
  • Premium payment receipt
  • Letter of Credible Coverage (LOCC) if applying outside of open enrollment (document that shows loss of coverage, allowing enrollment)

Applications, payment and quote provided must be received by the 15 of each month for the upcoming month. If the 15 falls on a holiday or a weekend, it must be submitted prior to then.

Plan information:

Note: Individuals purchasing insurance off-Marketplace are not eligible for tax credits or any cost-share reductions.

Pediatric dental coverage is not included in off-Marketplace plans or on-Marketplace plans. If you would like to purchase pediatric dental coverage, please contact Delta Dental at 800.236.3713 or visit deltadentalcoversme.com.

Outside of Open Enrollment: Individuals who qualify for special enrollment and are interested in purchasing a health insurance plan off-Marketplace, and directly from MercyCare Health Plans, please download the application below and deliver or mail it to:

MercyCare Health Plans
580 N. Washington St.
Janesville, WI 53547-0550

Applications, payment and quote provided must be received by the 15 of each month for the upcoming month. If the 15 falls on a holiday or a weekend, it must be submitted prior to then.

Health and wellness

Access to local care:

  • Heart and vascular care
  • Pain management
  • Comprehensive cancer care
  • Orthopedic surgery
  • Mental health and addictions treatment
  • Neurosurgery
  • Primary care (family medicine, internal medicine, OB-GYN)
  • Complementary medicine
  • Trauma services

Marketplace rate increase justification

The Centers for Medicare & Medicaid Services (CMS) requires all qualified health plans to post notification on their website explaining why rate increases are necessary for health plans offered on the health insurance marketplace.

Rate increase justifications for MercyCare HMO, Inc., marketplace plans can be found on ratereview.healthcare.gov by selecting Wisconsin, MercyCare Health Plans and searching the desired date range.

Frequently asked questions

Why should I have health insurance?

No one plans to get sick or hurt, but most people need medical care at some point. MercyCare Health Plans' individual plans cover many of your expected and unexpected health care costs and protect you from very high expenses.

Health insurance is a contract between you and MercyCare Health Plans. You buy a plan that best meets your needs, and MercyCare Health Plans pays part of your medical costs when you get sick or hurt.

There are other important benefits of health insurance. MercyCare Health Plan's individual plans provide free preventive care, vaccinations, screenings and checkups. We also provide prescription drug coverage.

What is the health insurance Marketplace?

Sometimes called the Exchange, the Marketplace is a new way to find health coverage that fits your budget and meets your needs. With one application you can see all your MercyCare Health Plan options and enroll.

When you use the Marketplace, you'll fill out an application and find out if you can get lower costs on your monthly premiums for private MercyCare insurance plans. You'll find out if you qualify for lower out-of-pocket costs through Medicaid or the Children’s Health Insurance Program (CHIP).

Can I keep my doctor?

If you currently see a Mercyhealth doctor, you can continue to see him/her by choosing a MercyCare plan. Please note that different plans have different networks and providers. Networks include health care providers that a plan contracts with to take care of the plan’s members. Depending on the type of policy you buy, care may be covered only when you get it from a network provider. When comparing MercyCare plans in the Marketplace, you will see a link to the list of providers in each plan’s network.

What do essential health benefits include?

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization
  • Maternity and newborn care (care before and after your baby is born)
  • Mental health and substance use disorder services, including behavioral health treatment (includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative services and devices (to help people with injuries, disabilities or chronic conditions gain or recover their mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services

Essential health benefits are minimum requirements for all MercyCare plans.

Customer Service

For questions about your health plan benefits or to speak to a customer service, please call MercyCare at 800.895.2421, Monday through Friday, from 8 am-5 pm.

580 N. Washington St., Janesville, WI 53548

Archived plan information