Affordable Individual and Family Health Insurance Starts Here.

Looking for Fixed-rate Health Insurance from age 60 to Medicare?

Check out our Bridge65 Plans!

Thank you for your interest in individual and family health coverage from WPS Health Insurance, Wisconsin's leading not-for-profit health insurer.

To get free affordable individual health insurance quotes and family health insurance quotes with no obligation, please call 1-800-811-1670 Mon-Fri, 7 a.m. to 6 p.m., Sat, 9 a.m. to 5 p.m., or complete the form below. One of our knowledgeable, individual sales consultants will send you a quote with several options for you to consider.

Thank you again for considering WPS. We'd be delighted to serve you!
Note: Insurance plans advertised are only available to Wisconsin residents. This form is not intended for agent use.

Request a Free, No-Obligation Quote

* Required Fields
Quote Information (we need all fields filled so that we can provide you the most cost-effective options)

Product you would like a quote on?*

Short-term Health Insurance

Traditional PPO plan with copays
HSA-qualified high-deductible health plan

Medicare Supplement
Medicare Part D Drug Plan
Both Medicare Supplement and Part D Drug Plan

Type of Coverage*

Single
Family
Requested Policy Start Date*

Month

Day
 

Year

How Would You Like to Receive Your Quote?*

 E-mail
 Regular mail
 Telephone
Your Information

Your Name*

First:

Last:

E-mail Address*

Gender*

 Male
 Female

Date of Birth*

Month

Day
 

Year

Phone Number*

( )  -

Address*
Number & Street:
City:
 		 State:
 		 Zip:

County*

Does anyone being considered for coverage use tobacco products?*

 Yes
 No
Information About Dependents Seeking Coverage
Fill this section out only if you have dependents seeking coverage

Spouse's Name

First:

Last:

Spouse's Gender

 Male
 Female

Spouse's Date of Birth

Month
 

Day
 

Year

Number of Dependent Children

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