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Available Plans

Find out more

To learn more about available NHIC plans and decide which one is best for you, click on the plan names below for additional information. If you still have questions, feel free to contact us at any time. We're always happy to help.

Network Health Insurance Corporation is pleased to offer area residents with Medicare a choice of six affordable Medicare Advantage Preferred Provider Organization (PPO) plan options.

Three plans provide combined medical and Medicare Part D prescription drug benefits:

  • Network PlatinumSelect PPO Plan

    Medical and prescription drug coverage combined in one easy-to-use plan with a $0 monthly plan premium. Learn more

  • Network PlatinumPlus Pharmacy PPO Plan

    Provides the same health care benefits as Network PlatinumPlus, including $0 in-network hospital stays and Medicare Part D prescription drug coverage with NO deductible, plus generic coverage through the gap. Learn more

  • Network PlatinumPremier Pharmacy PPO Plan

    Provides the same health care benefits as Network PlatinumPremier with NO copayments for many preventive services. Also provides Medicare Part D prescription drug coverage with NO deductible, plus generic coverage through the gap. Learn more

Two plans provide medical coverage only:

  • Network PlatinumPlus PPO Plan

    Medical only coverage for health care services both in- and out-of-network. NO copayments for in-network hospital stays. Learn more

  • Network PlatinumPremier PPO Plan

    Medical only coverage for health care services both in- and out-of-network, with NO co-payments for in-network doctor visits and hospital stays. Learn more

One plan provides combined medical and Medicare Part D prescription drug benefits for people who have both Medicare and Wisconsin Medicaid:

  • NetworkCaresPPO Special Needs Plan offers health care services, prescription drug coverage, and supplemental benefits including routine eyeglass benefits and dental care. There is a $0 monthly plan premium. Learn more

How do these plans differ

Our wide range of plan options ensures there is a plan that fits your needs and your budget.

Local service, powerful national reach

A respected company right here in your community, Network Health Insurance Corporation (NHIC) provides a "local" advantage and a firm commitment to personal service. As part of Network Health Plan and Affinity Health System, NHIC also delivers national coverage. You'll enjoy more choices, greater flexibility, generous provider and pharmacy selections all across the country, and value-added benefits.

What's the difference between these plans?

Network PlatinumSelect is a $0-premium Medicare Advantage Preferred Provider Organization (PPO) plan. It offers combined comprehensive medical and prescription drug coverage in one easy-to-use plan. There is no monthly plan premium. You simply continue to pay your Medicare Part A, if applicable, and Part B premiums. For most covered services, you pay low copayments such as a $15 copayment for a primary care doctor visit.

Network PlatinumPlus Pharmacy and Network PlatinumPremier Pharmacy offer additional coverage for Medicare Part D prescription drugs. This will save you considerable expense if you currently take prescription drugs on a regular basis, or need to in the future. And, with over 50,000 pharmacies in our pharmacy network, getting your medication is always convenient.

Network PlatinumPlus and Network PlatinumPremier are Medicare Advantage Preferred Provider Organization (PPO) plans. They both offer rich benefits, including a $0 copay for in-network hospital stays, skilled nursing care, and primary care doctor visits. Please see the Network PlatinumPlus or Network PlatinumPremier Summary of Benefits on this website for more information.

Network PlatinumPlus and Network PlatinumPremier allow you to choose doctors and hospitals, either in or outside of the preferred provider network. However, if you see a doctor or obtain services outside of the network for non-emergency care, your share of the cost may be higher.

NetworkCares is our Medicare Special Needs Plan. It is a Medicare Advantage Preferred Provider Organization (PPO) plan designed for people who have both Medicare and Medicaid. You must meet specific enrollment criteria, and all cost sharing is based on your level of Medicaid eligibility. There is no monthly plan premium. When you join NetworkCares, you get all your Medicare Part A, Part B, and Medicare Part D prescription drug coverage through this plan. As a member you also receive supplemental benefits — including extensive dental services — tailored to keep you healthy. Please see the NetworkCares Summary of Benefits on this website for more information.

For more information from the State of Wisconsin on Medicaid, please visit the Wisconsin Department of Health Services (by clicking on this link, you will be leaving the Network Health Medicare-specific web pages).

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Preventive Care

Enjoy coverage for important preventive services, such as:

  • Bone Mass Measurement
  • Prostate Cancer Screening Exams
  • Pap Smears
  • Pelvic Exams
  • Colorectal Screenings
  • Immunizations
  • Mammograms
  • Diabetes Supplies (new for 2012)
  • X-ray and lab work (new for 2012)
  • And more

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H5215_Website12 CMS Approved 12152011
Last Updated: 5/11/2012

Notice of Privacy Practices (2012)

Quality Initiatives (by clicking on this link, you will be leaving the Network Health Medicare-specific web pages)
Financial Information | Site Map | Network Health Plan (by clicking on this link, you will be leaving the Network Health Medicare-specific web pages)

Network PlatinumPlus, Network PlatinumPremier and Network PlatinumSelect are Medicare Preferred Organizations (PPO) plans offered by Network Health Insurance Corporation, a Medicare Advantage plan with a Medicare Contract. Benefits, formulary pharmacy network, premium and /or copayments and co-insurance may change on January 1, 2013.The Network Health Insurance Corporation Contract is renewed annually, so enrollment in a plan cannot be guaranteed.

We also offer NetworkCares PPO SNP, a $0 premium full dual eligible Special Needs Plan. NetworkCares is a Coordinated Care Plan with a Medicare Advantage contract and contract with the Wisconsin Medicaid Program. This plan is available to anyone who has both Medical Assistance from the State and Medicare. You must continue to pay your Part B premium unless otherwise paid for by Medicaid or by another third party. For information about this Special Needs Plan, please contact us at 1-800-983-7587 or 1-800-947-3529 Monday through Friday 8 a.m. - 8 p.m. For the hearing impaired, call TDD/TTY 1–800–947–3529.

Network Cares has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2013/2014. NCQA’s approval is based on a review of NetworkCares Model of Care and is an indicator of compliance with CMS requirements. NCQA’s approval is not an endorsement by CMS and/or NCQA of NetworkCares or the quality of services provided by NetworkCares. NetworkCares will still need to be approved each year by CMS in order to operate. If you have any questions regarding our approval by the NCQA, please contact us at 1-800-378-5234.

You may be eligible for extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

  • 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week.
  • The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m. Monday through Friday. TTY users should all 1-800-325-0778; or
  • Your State Medicaid Office.

The benefit information provided here is a brief summary, not a comprehensive description of benefits. For more information, please contact the plan.

Network Health Insurance Corporation (NHIC) contracts with a network of providers within the 14 county service area to provide Medicare-covered benefits. Our Network Medicare Advantage plans are open to Medicare beneficiaries eligible by age or disability in the plan’s service area. Our Network Medicare Platinum Plans provide reimbursement for all covered benefits regardless of whether they were received in-network, as long as they are medically necessary. With the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers.

Individuals must have both Medicare Part A and Part B to enroll and continue to pay their Part B premiums, unless otherwise paid for by Medicaid or by another third party. Plan benefit maximum limitations, copayments and restrictions may apply. To qualify, you must be a resident of the service area and not have End Stage Renal Disease (ESRD).

Members may enroll only during certain times of the year. If you enroll in one of our Medicare Advantage Pharmacy plans, you must receive your Medicare prescription drug benefit through the plan. Eligible members must use network pharmacies to access their prescription drug benefit except under non-routine circumstances; quantity limitations and restrictions may apply. Our Network Medicare Advantage Pharmacy plans use a formulary, which is a list of preferred drugs covered by the plan.