Insurance information

Insurance plans accepted

If you have insurance, it is important to verify that your plan is accepted by your providers and clinic, hospital or other health care facility. ProHealth Care contracts with the insurance plans listed below.

Be sure to contact your insurer directly to verify your specific coverage. Not all plans offered by an insurer may be accepted by ProHealth, and this list does not guarantee coverage.

Commercial insurance plans:

• Aetna
• Alliance
• Anthem
• Centivo (Broad (WI1B), Median (WI2M) and Value (WI3V))
• Chorus Community Health Plan
  • Formerly Children's Community Health Plan
• Cigna
• Coventry / First Health
• Dean Health Plan
• Health Payment Systems, Inc. (HPS)

• Humana
• Interplan Health Group (IHG) / HealthSmart
• MultiPlan (HealthEOS, PHCS, MultiPlan, PHCS Savility)
• ProHealth Care Employee Benefit Plan
• Quartz (Select plans only. Contact Quartz to to confirm access to ProHealth providers and sites)
• Trilogy Health Solutions
• UnitedHealthcare (UHC)
• WEA
• WPS

Medicaid and Medicaid HMOs:

• Anthem
• Chorus Community Health Plan (CCHP)
  • Formerly Children's Community Health Plan 
• Dean Health Plan

• Managed Health Services
• MyChoice Wisconsin Medicaid
• Network Health Plan
• Traditional Medicaid
• UnitedHealthcare Medicaid (UHC)

Medicare and Medicare Advantage plans:

• Aetna Medicare Advantage
• Anthem
• Care Wisconsin (My Choice Wisconsin)
• Community Care, Inc.
• Humana
• iCare (Independent Care)

• Managed Health Services (MHS)
• Network Health Plan Medicare Advantage
• Quartz Medicare Advantage
• Security Health Plan
• Traditional Medicare
• UnitedHealthcare Medicare (UHC)

Insurance approvals

To get coverage for certain procedures or care, you may need to ask your insurance company for approval first. This is called prior authorization or preauthorization. It’s your responsibility to find out what your insurance plan requires and to make sure you have any necessary approvals.

Billing your insurance

If you provide us with your health insurance information, ProHealth will bill your insurance for your care. Any part of your bill that’s not covered by your insurance is your responsibility.

If you have questions about payments made by your insurance, contact your insurance provider.