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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.

The Alliance Employer Cooperative 

Regional self-insured employer coalition representing multiple employers primarily located in Dane County; health benefit plans administered by various TPAs.

Anthem Blue Cross Blue Shield of Wisconsin

Wisconsin statewide health insurance plan; does include other national Blues Plans; participation in the Medicaid HMO is an OPT-IN or voluntary basis only.

  • 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 (formerly known as Aspirus Arise Health Plan of Wisconsin)

Wisconsin regional health insurance plan; promotes ANI providers exclusively in north central Wisconsin.

  • Aspirus Health Plan Exclusive Affordable Care Act (ACA) on/off Exchange Plans
  • Aspirus Health Plan Medicare Advantage Plans

WPS Arise Health Plan

Wisconsin regional health insurance plan; promotes ANI providers exclusively in north central Wisconsin.

  • Commercial HMO / POS

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. 

Humana

National health insurance plan.

  • Commercial HMO / PPO / POS / EPO
  • Medicare Advantage HMO / PPO / POS
  • Medicare Network PFFS
  • Traditional Plans (Indemnity)

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

Northcentral Employers Healthcare Alliance (NEHA)

Regional self-insured employer coalition representing employers primarily located in north central Wisconsin; health benefit plans administered by various TPAs.

  • PPO
  • Dual (two or more competing provider networks)
  • Limited (Aspirus Network Community Plan)
  • Workers Compensation (self-insured plans only)

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
  • Affordable Care Act (ACA) on/off Exchange Plans

UnitedHealthcare (UHC)

National health insurance plan; participation in the Medicaid HMO is an OPT-IN or voluntary basis only and 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 Educators Association Trust (WEA)

Statewide health insurance trust fund for Wisconsin-based teachers, government and local municipalities.

  • Standard (Idemnity)
  • POS
  • Trust Preferred (PPO)

Wisconsin Physician's Service (WPS)

Statewide health insurance plan.

  • Traditional (Indemnity)
  • 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