Wisconsin Commercial Health Plans

The following commercial health plans are offered in Wisconsin. Open any section below to view more information.

Bind administers an innovative personalized health plan. It accesses UnitedHealthcare provider contracts through its partnership with UnitedHealthcare. While Bind leverages the UnitedHealthcare network, members must present a Bind ID card. The plan features no deductible and no coinsurance, providing members with fewer barriers to care. With the Bind plan, members are covered across numerous common conditions and events. They can also activate coverage during the year for less common, plannable treatments if and when they need them.

All claims for Bind members must be sent directly to the Bind Payer ID 25463 or the address listed on the member ID card. Claims sent to a different address or Payer ID for UnitedHealthcare will be denied.

To check member eligibility, call 844-368-6661, or visit uhss.umr.com and enter the subscriber ID when prompted. For additional information, visit yourbind.com/providers.

The UnitedHealthcare Choice and Choice Plus health plans allow members to choose a physician or specialist from the UnitedHealthcare Choice networks but do not need a referral to receive benefits.

  • UnitedHealthcare Choice members must receive care from network care providers for benefits to be covered. There is out-of-network coverage for emergency services only.
  • UnitedHealthcare Choice Plus members are covered at a lower benefit level for services provided by out-of-network care providers.

Preventive care, including immunizations and preventive exams and health screenings, is covered at 100 percent in our UnitedHealthcare Choice and UnitedHealthcare Choice Plus networks.

UnitedHealthcare EDGE health plans allow members to choose a network physician or specialist but don’t need a referral (open-access).

Some UnitedHealthcare EDGE plans provide access to network and non-network care providers so members can seek care from any care provider they choose, but at a lower co-insurance/deductible level for network care providers.

By seeking care from Tier 1 care providers, members can maximize their in-network benefits based on UnitedHealthcare’s evaluation.

UnitedHealthcare EDGE plans provide medication benefit coverage through a four-tier pharmacy plan. UnitedHealthcare EDGE plans include health and wellness programs, services and discounts from UnitedHealth Wellness®.

UnitedHealthcare Options PPO health plans allow members to choose a network physician or specialist without a referral (open-access).

  • It is the member's responsibility to obtain prior approvals for both network and non-network services. No referral is required to see a specialist.
  • If a non-network physician is chosen, out-of-pocket member costs will be higher and it is the member’s responsibility to obtain approvals and submit claims.

UnitedHealthcare Options PPO offers two levels of coverage: a higher level of benefits for in-network services, and a lower level of benefits for non-network services, with somewhat higher deductibles and coinsurance.

For information on UnitedHealthcare Tiered Benefits Plans (Passport Connect from Medica – Providers) please visit medica.com/providers.