Last Updated: July 27, 2021
Health insurance is an important part of taking care of your health and safeguarding yourself against costly expenses. A managed care health plan is a type of health insurance that is involved in the choice of medical care providers and the choice of medical treatments.
- Health Maintenance Organizations (HMO) An HMO is a health insurance plan providing comprehensive medical care when services are provided by a plan provider.
- Limited Service Health Organizations (LSHO) An LSHO is the same as an HMO except it provides a limited range of health care services. For example, a dental LSHO provides only specific dental services.
- Preferred Provider Plans (PPP) A PPP pays a specific level of benefits if certain providers are used and a lesser amount if non-PPP providers are utilized.
This guide explains the different managed care health plans in Wisconsin, how they differ, what benefits are covered, frequently asked questions, and the process to follow if you have a grievance.
GLOSSARY TIP: To more easily view a glossary term in a PDF within your internet browser, simply hold the CTRL (control) key (or ⌘ key on a Mac) while clicking on the
dotted-underlined term. This will open the glossary in a new window, allowing you to hold your spot within the consumer guide.
Request a Copy by Mail
If you wish to receive a printed version of this guide by mail, click here or call 1-800-236-8517 to request a copy.
File a Complaint
If you have a specific complaint about your insurance, refer it first to the insurance company or agent involved. If you do not receive satisfactory answers, contact the Office of the Commissioner of Insurance (OCI).
-
Reach out to OCI (1-800-236-8517, ocicomplaints@wisconsin.gov) to speak with our staff. If sending an email, please indicate your name and phone number.
-
File a complaint with OCI. You can file a complaint online by clicking here. If you would like to file your complaint by mail, you can download a complaint form in English or Español.