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Insurance Plans and Networks

We accept many different insurance plans and provider networks.

Female provider and elder patient smile and look at each other Female provider and elder patient smile and look at each other

Insurance, Medicaid, and Family Care Contracts

To be certain of your specific insurance plan details, please contact your health insurance company (phone number on the back of your insurance card) to confirm your benefit structure and Provider and Hospital participation.

Commercial Insurance Contracts

Commercial Insurance Contracts

  • Anthem Blue Cross and Blue Shield (includes Blue Preferred Broad Marketplace Plan; excludes WI Blue Priority & WI Blue Priority X)
  • Centivo
  • Chorus Community Health Plan (formerly Children’s Community Health Plan)
  • Choice Care Network
  • CIGNA (excludes HealthPartners Robin)
  • First Health Network (excludes Aetna for HSHS St. Nicholas Hospital only)
  • Group Health Cooperative of Eau Claire
  • HealthEOS Network (excludes Aetna for St. Nicholas Hospital only)
  • Health Payment Systems
  • HealthSmart/Interplan Health Group
  • Humana (includes HPN Network for HSHS St. Nicholas Hospital only)
  • Live360 (HSHS Health Plan)
  • Molina
  • Multiplan Network
  • Network Health
  • North Shore Health Network (includes HSHS St. Vincent Hospital and HSHS St. Mary’s Hospital only)
  • Preferred Medical Claim Solutions (PMCS) (HSHS St. Clare Memorial Hospital only)
  • Prevea 360/Dean Health Plan (DHP) (excludes some DHP plans)
  • Security Health Plan (SHP) (excludes Affirm HMO/POS, Discover, Enrich, Inspire, 
  • Simplyone ACA/HMO/POS/SAS HMO)
  • Sheboygan Employer Health Network (SEHN)
  • The Alliance
  • Three Rivers Provider Network (SVG, SMG w/ Prevea East only)
  • Trilogy Health Network
  • United HealthCare (UHC)
  • Wheaton Health Network (HSHS St. Nicholas Hospital only)
  • WPS (excludes Select/Select Plus)
Medicaid Contracts

Medicaid Contracts

  • Anthem Blue Cross Blue Shield
  • Chorus Community Health Plan (formerly Children’s Community Health Plan)
  • Group Health Cooperative of Eau Claire (BadgerCare Plus and Medicaid SSI)
  • iCare
  • Managed Health Services (MHS) / Network Health Plan (BadgerCare Plus and Medicaid SSI)
  • Molina
  • My Choice Wisconsin (formerly Trilogy Medicaid)
  • Security Health Plan (SHP) (BadgerCare Plus and Medicaid SSI)
  • UnitedHealthcare Community Plan (BadgerCare)
 
Medicare Contracts
  • Anthem Blue Cross Blue Shield
  • Dean Health Plan/Prevea360
  • Humana 
  • iCare 
  • Managed Health Services (HSHS St. Clare Memorial Hospital only)
  • Molina
  • My Choice Wisconsin (HSHS St. Vincent Hospital and St. Nicholas Hospital only)
  • myNexus (Home care – HSHS St. Vincent Hospital and St. Nicholas Hospital only)
  • Network Health Plan
  • Security Health Plan (SHP) (excludes Promise RX, Surety RX)
  • Today’s Option/Universal American (HSHS St. Nicholas Hospital only)
  • United HealthCare (UHC)
Family Care Contracts

Family Care Contracts

  • My Choice Wisconsin (formerly Care Wisconsin First) (HSHS St. Vincent Hospital & HSHS St. Nicholas Hospital only)
  • Inclusa (formerly Community Link, Inc, Community Care Connections of Wisconsin, ContinuUs and Western Wisconsin Cares)
  • Lakeland Care, Inc. (HSHS St. Vincent Hospital only)
Health Insurance Marketplace - For Individuals
  • Anthem BCBS Blue Preferred Broad Marketplace
  • Chorus Community Health Plan (formerly Children’s Community Health Plan)
  • Dean Health Plan/Prevea360
  • Molina Healthcare
  • Security Health Plan (excludes Enrich (HMO/POS), Simplyone ACA/HMO/POS/SAS HMO)
SHOP Marketplaceā€‹ - For Small Businesses
  • Anthem BCBS Blue Preferred Broad Marketplace
  • Chorus Community Health Plan (formerly Children’s Community Health Plan)
  • Dean Health Plan/Prevea360
  • Molina Healthcare
  • Security Health Plan (excludes Enrich (HMO/POS), Simplyone ACA/HMO/POS/SAS HMO)
Worker's Compensation
  • CorVel (excludes HSHS St. Clare Memorial Hospital)
  • Coventry
  • Trilogy
Other
  • Cigna Behavioral Health (St. Vincent Hospital dba Libertas only)
  • Naphcare 
  • United Behavioral Health/Optum (Behavioral Health inpatient only)
  • Unity Hospice (HSHS St. Vincent and HSHS St. Nicholas Hospital only)
  • VA – Optum (medical and behavioral health with referral only) 
  • Vivent Health (formerly Aids Resource Center of WI)
  • Wisconsin Dept. of Justice Crime Victim
  • WI Well Woman Program

If you are an insurance company, third-party administrator, or insurance network and are interested in a contract with HSHS St. Mary's Hospital, contact the Managed Care Department at (715) 717-4240.