To the Editor;
Did you know…There is a critical issue affecting health care access for residents in northern Wisconsin. My recent experience with Aspirus Healthcare highlights policies that prioritize corporate interests over patient care, creating unnecessary barriers for those who depend on their services.
As of January 1, 2025, my employer-sponsored health insurance transitioned to Network Health Medicare Advantage. This plan treats in-network and out-of-network claims the same, meaning I can see any doctor without incurring higher costs. However, Aspirus has chosen not to bill out-of-network claims, leaving patients like me with two limited options: becoming self-pay or seeking care at a different facility.
Aspirus informed me that as a self-pay patient, I would need to pay 50% of the full, undiscounted cost up front, with the remainder due afterward. They explicitly stated that no discounts could be offered because I have insurance, even though Aspirus refuses to bill my insurance.
This policy forced me to transition my care to Marshfield Healthcare, which, thankfully, is willing to bill out-of-network.
Aspirus’ refusal to bill out-of-network claims appears to be an attempt to monopolize health care in northern Wisconsin while dictating how patients can use their services. This approach leaves patients with fewer choices and creates unnecessary hardships for those with complex medical needs. It also highlights broader systemic issues:
• The lack of accessible providers accepting new patients in rural areas.
• The impact of corporate health care policies on patient choice and continuity of care.
• The need for stronger regulations to ensure fair and equitable health care access, particularly for those with Medicare Advantage or other nontraditional insurance plans.
As a resident of northern Wisconsin, I am deeply concerned about how these policies are affecting the health and well-being of our community. This issue affects not only me but countless others in our region who depend on fair and accessible health care.
Debbie Ryan
Phelps
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