Aspirus Health Plan is a Wausau-based company that offers Wisconsinites a more cost-effective choice for health care coverage. Aspirus Health Plan is owned by Aspirus Health, a non-profit health system based in Wausau, Wisconsin.
Aspirus Health Plan’s Signature Network in north-central Wisconsin represents the full continuum of health care services, including more than 400 physicians and specialists. It is composed of Aspirus-employed physicians and independent physicians, many hospitals, ambulatory surgery centers, and other allied health care professionals and facilities.
As an integrated delivery system Aspirus Health Plan offers members Care Coordination to help simplify the healthcare system, a Welcome Center to help members establish an Aspirus Health primary care provider and quality initiatives to connect members to the right care at the right time.
The Aspirus Health Plan Signature Network is available to ETF members in the state of Wisconsin. Care needed outside of Wisconsin is only covered in the event of an emergency.
Referrals, Authorizations, Out-of-Network
Prior authorization is the process of obtaining written approval from Aspirus Health Plan for services or products before they are received. The prior authorization form is a document submitted to Aspirus Health Plan by your medical care provider. In reviewing a prior authorization request, proposed services are subject to all plan provisions, including medical necessity requirements and plan exclusions, among others. To learn more about prior authorization, visit the Aspirus website.
Emergency and Urgent Care
Emergency Care only is covered in and out of network with follow-up care required to be provided by an in-network (Aspirus Signature Network) provider.
If you need help selecting the right place for care, contact our 24-hour nurseline at 866-220-3138.
Mental, Behavioral Health and Substance Abuse
Aspirus Health Plan requires prior authorization for inpatient admissions or residential treatment centers. Members may self-refer for mental health services to the appropriate mental health provider using the Provider’s toll-free referral numbers. Members do not need a referral from their Primary Care Provider (PCP) to receive mental health services. Neither a referral from PCP nor prior authorization is required for a beneficiary to seek an initial mental health assessment from a network mental health provider.
Call a Vitals nurse at 866-220-3138.
MDLIVE is a convenient alternative to traditional health care. Board certified doctors can visit with you either by phone or secure video to help treat any non-emergency medical conditions such as fever, pink eye, rashes, or bladder infections. Licensed therapists offer online behavioural health care on you schedule from wherever you're located.
- MDLive: MDLIVE.com/AspirusHealthPlan
Major Health Systems
- Aspirus Health
- Ascension North & Central Wisconsin
- Bellin Health
- UW Health