Health insurance providers

Understanding your health insurance coverage is crucial before receiving care, as your out-of-pocket costs can vary significantly depending on whether you use in-network or out-of-network providers. The total fee for a procedure typically covers the provider’s charges, facility fees, and may include certain ancillary services; however, coverage may be limited by the specifics of your insurance plan. To avoid unexpected expenses, always confirm your plan’s network status with both your insurance company and the provider, and request a detailed, itemized cost estimate in advance.

Insurance & Payment Advice

• Verify with your insurance provider whether Aurora Health Care is included in your network and whether your plan type is accepted.
• Be aware that limited benefit plans, sharing plans, and short-term health plans are generally not accepted.
• If you are insured through Centivo, Aurora is only in-network for the Wi-1 plan.
• For Devoted Health, in-network coverage is limited to specific regions in southern Wisconsin.
• Request a written, itemized estimate from your provider prior to your appointment.
• Review your insurance Explanation of Benefits (EOB) after the procedure to ensure charges match your expectations.

Associated Costs to Consider

• Deductibles and co-pays: Know your deductible status and anticipated co-payments for the visit.
• Ancillary services: Some lab work, imaging, or specialist referrals may not be included in the initial estimate.
• Out-of-network charges: Using an out-of-network provider can lead to significantly higher out-of-pocket costs.
• Follow-up care: Additional visits or procedures after your initial service may incur separate charges.

Frequently Asked Questions

• How do I find out if Aurora Health Care is in-network for my insurance? Check directly with your insurance provider or review your plan’s provider directory to confirm Aurora Health Care’s network status. You can also ask your Aurora clinic for assistance.
• What should I do if I have a limited benefit or short-term health plan? These plans are generally not accepted at Aurora Health Care. Contact your insurer to discuss your coverage options or consider obtaining a plan that offers broader coverage.
• Will I receive a bill for services that are not covered by my insurance? Yes, you are financially responsible for any services not covered under your insurance plan. Always request a detailed estimate and clarify coverage beforehand.
• What are common extra costs beyond the base procedure fee? Extra costs may include facility fees, lab tests, imaging, anesthesia, and any follow-up visits or treatments.
• How can I minimize my out-of-pocket costs? Use in-network providers, confirm your coverage, ask for an itemized estimate, and understand your deductible and co-pay obligations before your visit.
• What if my insurance plan only offers regional in-network coverage? If your plan has regional limitations, ensure your location and provider are included in the covered area to avoid unexpected charges.
• Can I appeal if insurance denies coverage for my procedure? Yes, you can file an appeal with your insurance company. Gather all supporting documentation and work with your provider’s billing office for assistance.
• What steps should I take if I receive an unexpected bill? Contact the provider’s billing office to clarify the charges, review your insurance EOB, and verify whether all discounts and insurance payments have been applied.
• How soon will I receive my bill after the procedure? Bills are typically issued after insurance processes the claim, which can take several weeks. Contact your provider if you have not received a bill within a month.

Before you visit us for care, it’s important to understand the health insurance coverage you have and how much you’ll pay – you may be able to save money by seeing an in-network provider, for example.

Check with your insurance provider to make sure your benefit plan includes Aurora Health Care, or call your local Aurora clinic at 888-863-5502. We’ll help answer questions about insurance.

These companies typically cover Aurora Health Care primary care services. This list was revised on April 14, 2023.

• Aetna
• Anthem (Elevance Health)
• Anthem Blue Priority
• Anthem Medicaid
• Arise Health Plan
• Aspirus
• Aurora Employee Plan (UMR)
• BayCare Clinic Employee Plan
• Blue Cross Blue Shield of IL PPO
• Chorus Community Health Plan – Medicaid (CCHP)
• Cigna Healthcare
• Centivo** In Network for Wi-1 plan only
• Cofinity
• Common Ground Healthcare

• Community Care Inc (CCI)
• Devoted Health***
• Everpointe Network
• First Health Network/Coventry Health Care
• Fond du Lac Area Businesses On Health (FABOH)
• Health Finest Network (HFN)
• Health Management Network (HMN)
• Health Payment Systems (HPS)
• HealthEOS*
• HealthPartners – Robin Product
• HealthSmart
• HSTechnology
• Humana

• Independent Care (iCARE)
• Managed Health Services (MHS)
• Molina Healthcare
• PHCS*
• Prime Health Services
• Quartz
• Three Rivers Provider Network (TRPN)
• Tricare
• Trilogy
• UHC Community Plan
• United HealthCare (UHC)
• Wisconsin Physicians Service (WPS)

*Limited Benefits or Specific coverage plans including, but not limited to, Physician only, Ancillary only, Hospital only, sharing plans, and short-term health plans are not accepted.

**Centivo: In Network for Wi-1 plan only, Aurora is Out of Network for Wi2 & Wi3.

*** Devoted Health is only in-network regionally on the south end of WI (3 hospital & 1 surgery center).