Insurance information

Protect your physical, mental and financial well-being. Make sure you have health insurance and understand what’s covered under your plan.

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)
  • Interplan Health Group (IHG) / HealthSmart
  • MultiPlan (HealthEOS, PHCS, MultiPlan, PHCS Savility)
  • Network Health
  • 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 Partnership, Family Care and Dual Advantage (formerly Care Wisconsin)
  • Network Health Plan
  • Traditional Medicaid
  • UnitedHealthcare Medicaid (UHC)

Medicare and Medicare Advantage plans:

  • Aetna Medicare Advantage
  • Anthem
  • MyChoice Wisconsin Partnership, Family Care and Dual Advantage (formerly Care Wisconsin)
  • Community Care, Inc.
  • Humana
  • iCare (Independent Care)
  • Managed Health Services (MHS)
  • Network Health Plan Medicare Advantage
  • Security Health Plan
  • Traditional Medicare
  • UnitedHealthcare Medicare (UHC)

Buying plans on the Health Insurance Marketplace

To learn about finding and choosing a health insurance plan, visit the Wisconsin Department of Health Services website or the Health Insurance Marketplace.

To find a plan that includes ProHealth Care providers and hospitals on the Health Insurance Marketplace, look for:

  • Anthem Pathway
  • Anthem Preferred/Broad
  • Dean Health Plan (HMO)
  • UnitedHealthcare (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.

Upcoming events

  • Dec
    5
    Friday
    6:30 PM - 9:00 PM
    Topics discussed: the birth process, pain management, comfort techniques, medical interventions, induction, epidurals, cesarean birth, and the basics of baby care
  • Dec
    6
    Saturday
    10:30 AM - 11:15 AM
    This complimentary tour is designed to familiarize you with the Birthing Centers at ProHealth Waukesha Memorial and ProHealth Oconomowoc Memorial hospitals.
  • Dec
    6
    Saturday
    11:15 AM - 12:00 PM
    This complimentary tour is designed to familiarize you with the Birthing Centers at ProHealth Waukesha Memorial and ProHealth Oconomowoc Memorial hospitals.

Contact us

Call 866-432-7855 or send an email message to our customer relations team if you have questions about a ProHealth hospital or physician bill.

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