HomeAspirus NetworkParticipating Payors & Plans

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).

  • Medicare Advantage HMO

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.

  • Commercial PPO

HealthSmart (formerly known as InterPlan Health Group)

National PPO rental network offered to self-insured employers; health benefit plans administered by various TPAs and includes other national networks under this contract.

  • Plans are no longer in network effective May 10, 2024. This is for all locations, including the Aspirus Divine Savior Hospital & Clinics location.

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