Frequently Asked Questions
What is happening?
Aspirus is working in good faith to reach a new contract with Anthem Wisconsin that more adequately covers the cost of the care we deliver to our patients.
When does the current contract end?
Our current contract ends December 31, 2025. We are being transparent with our communities, so people can make informed patient care and insurance decisions for 2026 in the event an agreement is not reached.
Can I still see my provider at this point?
Yes. Our existing agreement expires after December 31, 2025. For now, nothing changes for our patients.
What happens if a new agreement is not reached?
If both parties are unable to find common ground, effective December 31, 2025, Aspirus facilities – including our network of physicians, advanced practice clinicians, specialists, and affiliated ambulatory surgery centers – will be considered out of Anthem’s network. If Anthem forces Aspirus out of its network, patients may experience higher out-of-pocket costs when seeking care with their trusted Aspirus provider in 2026.
Why is this happening?
Our existing contract with Anthem does not reflect the cost of delivering sustainable, accessible, excellent care. Aspirus is simply seeking an equitable agreement with Anthem that reflects today’s reality: the cost of delivering excellent care is greater than it has ever been, and inflationary pressures and historic Medicaid cuts are significantly impacting our entire cost structure. Any contract must put patients first, or we cannot continue to improve the health of our communities.
Does this include Anthem Federal plans?
Our contracted plans are below and would include HMO/PPO and Federal:
- Anthem Blue Preferred
- Anthem Blue Preferred Plus
- Anthem Blue Access
- Anthem Blue Traditional/Indemnity/Standard products
Does this affect Anthem Medicare plans?
Anthem Medicare plans would be impacted in the same way as commercial plans, as they would be treated as out-of-network. This applies to coverage for any Anthem Blue Cross plans in Wisconsin.
Does this impact Excellus Blue PPO plan use of Aspirus in Wisconsin?
The Excellus product is not an Anthem product and is not in network/contracted. Anthem Blue Priority network plans are currently out-of-network.