Plan Documents and Information
Welcome to Aspirus Health Plan. We’re committed to serving central Wisconsin, and we’re always here to support you.
2026 Plans
Pharmacy resources
Formulary (list of covered drugs)
Part D prescription drug coverage
Search Pharmacy Network
Medicare Prescription Payment Plan
Dental and hearing resources
Dental Overview (PDF)
TruHearing Hearing Aid Benefit (PDF)
Health and wellness resources
Health and Wellness Program
Healthy Benefits+ card
Mental Health and Substance Use Disorder
Medication Therapy Management (MTM) for plans with a Part D component
Member resources
Member Guide (PDF)
Member Release of Information Form (PDF)
Statement of Representative Form (PDF)
Power of Attorney Short Form (Fillable PDF, external link)
Member Reimbursement Form (PDF)
Automatic Payment Form (PDF)
Instructions for Appointing a Representative (PDF)
Advanced Directive (PDF)
Quality Improvement Program
2025 Plans
Pharmacy resources
Formulary (list of covered drugs)
Part D prescription drug coverage
Search Pharmacy Network
Medicare Prescription Payment Plan
Dental and hearing resources
Dental Overview (PDF)
TruHearing Hearing Aid Benefit (PDF)
Health and wellness resources
Health and Wellness Program
Rewards and incentives
Healthy Benefits+ card
Mental Health and Substance Use Disorder
Medication Therapy Management (MTM) for plans with a Part D component
Member resources
Member Guide (PDF)
Member Release of Information Form (PDF)
Statement of Representative Form (PDF)
Power of Attorney Short Form (Fillable PDF, external link)
Member Reimbursement Form (PDF)
Automatic Payment Form (PDF)
Instructions for Appointing a Representative (PDF)
Advanced Directive (PDF)
Quality Improvement Program
Annual Notice of Changes (PDF)
Annual Notice of Changes - Spanish (PDF)
Evidence of Coverage (PDF)
Evidence of Coverage - Spanish (PDF)
Summary of Benefits (PDF)
Choice Dental Certificate (PDF)
Plan Comparison Chart (PDF)
Provider and Pharmacy Directory (PDF)
Provider and Pharmacy Directory - Spanish (PDF)
Annual Notice of Changes (PDF)
Annual Notice of Changes - Spanish (PDF)
Evidence of Coverage (PDF)
Evidence of Coverage - Spanish (PDF )
Summary of Benefits (PDF)
Choice Dental Certificate (PDF)
Plan Comparison Chart (PDF)
Provider and Pharmacy Directory (PDF)
Provider and Pharmacy Directory - Spanish (PDF)