Participating Payors & Plans
Aspirus Network contracts with most Payors in the region. These Payors include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and network only or "broker" arrangements. We also contract directly with employers and community business coalitions.
Please note coverage limitations are dependent on individuals and/or employer group contracts. To verify participation status in your health insurance plan, please refer to the information on the back of your health insurance identification card or check with your insurance carrier.
Aetna Health Plan
Aetna Medicare ESA, Extended Service Area Product (group retiree solution).
The Alliance Employer Cooperative
Regional self-insured employer coalition representiong mutiple employers located throughout the Aspirus Network geographical area, specifically Central Wisconsin and Dane County.
Anthem Blue Cross Blue Shield of Wisconsin
Wisconsin statewide health insurance plan; does include other national Blues Plans.
- Commercial HMO / POS / PPO
- Commercial Indemnity / Traditional / Standard
- Commercial Other State Specific
- Medicare Advantage HMO
- Medicare Advantage PPO
- Medicaid HMO BadgerCare Plus / Medicaid SSI
Aspirus Health Plan of Wisconsin
Wisconsin regional health insurance plan; promotes Aspirus Network, Inc. in North Central Wisconsin.
- Aspirus Health Plan Individual, Small, and Large Group Plans
- Aspirus Health Plan Medicare Advantage Plans
ChoiceCare
National PPO rental network offered to self-insured employers; health benefit plans administered by various TPAs
- Commercial PPO / POS / EPO
CIGNA
National health insurance plan with participation in PPO and Open Access Plus benefit plans; behavioral health services are not included in this contract.
First Health
National rental PPO network.
Group Health Cooperative of Eau Claire
Wisconsin regional health insurance plan: participation in the Medicaid HMO is an OPT-IN or voluntary basis only.
- Commercial HMO
- Medicaid HMO BadgerCare Plus / Medicaid SSI (including Compcare)
HealthPartners
Minnesota health insurance plan, licensed to sell plans in western and north central Wisconsin.
Humana
National health insurance plan.
- Commercial HMO / PPO / POS / EPO - Humana will be discontinuing Wisconsin commercial plans effective January 1, 2025.
- Medicare Advantage HMO / PPO / POS
- Medicare Network PFFS
- Traditional Plans (Indemnity) - Humana will be discontinuing Wisconsin commercial plans effective January 1, 2025.
MultiPlan, Inc.
National PPO rental network offered to self-insured employers; health benefit plans administered by various TPAs and includes other networks under this contract.
- Aetna - Commercial PPO
- HealthEOS - Commercial PPO (Wisconsin statewide)
- PHCS (including Beech Street) - Commercial PPO
OptumServe – VA Community Care Program
National partnership with the U.S. Department of Veterans Affairs through VA’s Community Care Network.
Security Health Plan (SHP)
Wisconsin regional health insurance plan; note ancillary DME, ancillary behavioral health providers.
- Commercial HMO
- Medicare Advantage HMO
- Medicaid - BadgerCare plus
UnitedHealthcare (UHC)
National health insurance plan: behavioral health services are not included in this contract.
- Commercial HMO / PPO / POS / EPO
- Medicare Advantage HMO / PPO
- Affordable Care Act (ACA) on/off Exchange Plans
- Medicaid HMO BadgerCare Plus / Medicaid SSI
Wisconsin Physician's Service (WPS)
Statewide health insurance plan.
- Traditional (Indemnity) - Plan will no longer be offered after July 1, 2024.
- PPO / POS / EPO
- FOCUS (exclusively offers Aspirus Network)
- Affordable Care Act (ACA) on/off Exchange Plan
Direct Employers
Regional self-funded employers offering health insurance plans that offer Aspirus Network as preferred providers; health benefits administered by various TPAs.
- Bone & Joint Clinic
- Forest County Potawatomi
- Medical College of Wisconsin - employer welfare benefit plan