CMS

Health Insurance Coverage in Wisconsin

Health Plan Overview

Insurance CompanyCMS
StateWisconsin
Websitecms.gov
Number of Hospitals in Network75
Number of Plans Offered3

Network Hospital Locations

Hospitals in Network (75)
Aspirus Stevens Point HospitalAscension NE Wisconsin - St. Elizabeth HospitalMarshfield Medical Center-Rice LakeAspirus Rhinelander HospitalSSM Health Monroe HospitalAspirus Wausau HospitalAspirus Wisconsin Rapids HospitalMarshfield Medical CenterAspirus Divine Savior Hospital & ClinicsEmplify HealthAscension Columbia St. Mary's Hospital - Milwaukee CampusSSM Health St. Clare Hospital - BarabooMarshfield Medical Center-Beaver DamAscension St. Francis HospitalSSM Health St Mary's Hospital - MadisonEmplify HealthSt Agnes Hospital Hospice HopeHoward Young Medical CenterAscension All Saints HospitalBeloit Health SystemMile Bluff Medical CenterAscension SE Wisconsin Hospital - St. Joseph CampusOrthopaedic Hospital of WisconsinOakLeaf Surgical HospitalMarshfield Medical Center-WestonMidwest Orthopedic Specialty HospitalSSM Health St. Mary's Hospital - JanesvilleMarshfield Medical Center - Eau ClaireMarshfield Medical Center - MinocquaAscension Wisconsin Hospital - Menomonee FallsMarshfield Medical Center-River Region at Stevens PointAspirus Eagle River HospitalGundersen St. Joseph's Hospital and ClinicsAdventHealth DurandEmplify HealthAspirus Stanley HospitalAspirus Tomahawk HospitalGundersen Tri-County Hospital & ClinicsAscension Calumet HospitalOsceola Medical CenterEdgerton Hospital and Health ServicesSSM Health Ripon Community HospitalMarshfield Medical Center-NeillsvilleAspirus Medford Hospital & ClinicsMarshfield Medical Center-Park FallsSSM Health Waupun Memorial HospitalEssentia Health St. Mary's Hospital-SuperiorCrossing Rivers HealthBurnett Medical CenterBlack River HealthTamarack Health Hayward Medical CenterSaint Croix Regional Medical CenterAspirus Merrill HospitalIndianhead Medical CenterStoughton HealthGundersen Boscobel Area Hospital and ClinicsWestern Wisconsin HealthVernon Memorial HealthcareAspirus Langlade HospitalReedsburg Area Medical CenterUpland Hills HealthSouthwest HealthBellin Health Oconto HospitalTamarack Health Ashland Medical CenterChildren's WisconsinChildren's Wisconsin-Fox Valley HospitalBrown County Community Treatment CenterNorth Central Health CareRogers Memorial HospitalNorwood Health CenterFond du Lac County Acute Psychiatric UnitWaukesha County Mental Health CenterBellin Psychiatric CenterWillow Creek Behavioral HealthMiramont Behavioral Health

Available Plans

Medicare Plan

3 plans

Plan Details
Plan NamePlan Type
NAMedicare Plan
NAMedicare Plan
NAMedicare Plan

Recent News

2025-06-25
CMS announced enforcement discretion and clarification of personnel regulations, detailed in QSO-25-21-CLIA, which affects CLIA Laboratories. The Wisconsin Department of Health Services disseminated this bulletin, noting that CMS is exercising enforcement discretion in limited circumstances regarding certain personnel qualification requirements that went into effect on December 28, 2024, due to stakeholder feedback.
2025-04-10
A Consumer Guide for Wisconsin Medicare provides information about the program run by CMS, including details on supplemental insurance (Medigap), Medicare Advantage plans, and prescription drug coverage (Part D). The guide serves as a resource for Wisconsin residents navigating their Medicare options.
2025-04-07
The Wisconsin Department of Health Services outlines the requirements for hospitals regarding State Licensure and Medicare/Medicaid Certification by CMS. Hospitals in Wisconsin must be licensed by the state and CMS to provide certain services, with specific application steps detailed, including submitting the CMS-855 Medicare Enrollment Application.
2025-03-12
The CMS (Centers for Medicare & Medicaid Services) published an emergency preparedness rule for health providers participating in Medicare and Medicaid, affecting over 1,200 providers across Wisconsin. This rule aims to establish consistent emergency preparedness policies and procedures to increase patient safety during emergencies and create a better coordinated response to disasters.
2025-01-21
Information on Local Coverage Determinations lists Medicare Administrative Contractors (MACs), including National Government Services, Inc. which serves Wisconsin. MACs are private health care insurers that have been awarded a geographic jurisdiction to process Medicare Part A and Part B medical claims.

State Leadership

Pam L. Thomas

Regional Administrator, CMS Chicago (Region 5)

Leads and coordinates local external engagement efforts with stakeholders and customers in Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Provides administrative and operational support to CMS Chicago employees. Previously worked in the Center for Medicaid & CHIP Services and the Division of Survey and Certification.