Understanding HMO Plans and Networks for Individual Plans
The HMO Network focuses on integrated care from trusted providers in 20 counties, with your primary care provider (PCP) serving as your first point of contact for all aspects of your health care. This means health insurers and health care providers work together to provide a comprehensive benefit plan that’s easy to use.
The HMO Network is a good choice on an Individual Plan if:
- You live in the Dean HMO Service Area: the geographic area included within the boundaries of Adams, Columbia, Crawford, Dane, Dodge, Fond du Lac, Grant, Green, Green Lake, Iowa, Jefferson, Juneau, Lafayette, Marquette, Richland, Rock, Sauk, Walworth, Waukesha and Vernon counties in the State of Wisconsin.*
- You want the full breadth of coverage in 20 counties, including more than 2,000 doctors to choose from for routine through specialty care.
- You want highly directed care from a team of physicians working together.
Find HMO providers
HMO Provider Network Map
The Focus Network
The Focus Plan is a budget-friendly choice that works like an HMO, but features a narrower network of designated providers in Dane, Rock and Sauk Counties. Except in the case of an emergency, medical services must be obtained from a Focus Plan network provider in these counties to ensure coverage. This plan provides access to St. Mary’s Hospital in Madison, St. Mary’s Janesville Hospital, St. Clare Hospital in Baraboo and Stoughton Hospital.
The Focus Network is a good choice on an Individual Plan if:
- You live in the Focus Plan Service area of Dane, Rock or Sauk Counties and receive your medical services in those areas.*
- You want a lower-cost option but still want to see doctors in your community.
- You like the comfort of knowing all your care is carefully coordinated through your primary care physician and a select number of providers.
Find Focus providers
Focus Plan Provider Network Map
*Service areas vary depending on plan type. If you have an Employer Group Plan please check with your company benefit administrator to understand provider networks and service areas.