Description
Aspirus Health Plan is a Wausau-based company that offers Wisconsin residents a cost-effective choice for healthcare coverage. Aspirus Health Plan is owned by Aspirus Health, a non-profit health system headquartered 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 comprised of Aspirus-employed physicians as well as independent physicians, multiple hospital systems, ambulatory surgery centers, and other allied health care professionals and facilities.
As an integrated delivery system Aspirus Health Plan offers members Care Coordination to simplify the healthcare system, a Welcome Center to help members establish with an Aspirus Health primary care provider, and quality initiatives to connect members to the right care at the right time.
Provider Directory
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.
See the Prior Authorization page on the Aspirus website for more information.
Emergency and Urgent Care
Should you require urgent or emergent care while outside of the network you may seek treatment at the nearest medical facility. Contact Aspirus Health Plan Member Services at 866-631-8583 with questions and to notify us that you were seen out of network. Follow-up care must be received from an in-network provider unless otherwise approved by Aspirus Health Plan.
If you are unsure if you should be seen, you can always contact our 24-hour nurseline at 866-220-3138.
Mental, Behavioral Health and Substance Abuse
Aspirus Health Plan encourages our members to take care of their mental health. Members do not need a referral from their Primary Care Provider (PCP) to receive mental health services or initial assessments with an in-network provider. Aspirus Health Plan does require prior authorization for inpatient admissions and residential treatment centers.
Behavioral health services are also available virtually through MDLive.
24-Hour Nurseline
Call a Vitals nurse at 866-220-3138.
Virtual Visits
MDLIVE is a convenient 24/7/365 alternative to traditional health care. Board certified doctors can visit with you by phone or secure video to treat non-emergency medical conditions such as fever, pink eye, rashes, bladder infections, etc. Visit the MDLive website for a full list of conditions. Additionally licensed therapists offer online behavioral health care that fits your schedule.
Major Health Systems
- Advocate Aurora Health
- Aspirus Health
- Bellin Health
- Children's Wisconsin
- ThedaCare
- UW Health