Individual/ Family FAQ’s

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?

Also 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 Mercy 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 8:00 am to 5:00 pm
580 N. Washington St, Janesville, WI 53548