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How Network Health Is Different From Other Health Plans

If you’re looking for the largest, most widespread health plan in the country, that’s not us. If you’re looking for informed people you can reach in person or on the phone, who answer questions directly – that’s us. We take a different approach to health insurance, providing personalized service while treating you with courtesy and respect. From our headquarters in Menasha to our office in Brookfield, we work to meet the needs of our members throughout Wisconsin.

Network Health hats at the Timber Rattlers

We Live In Your Community

Being local allows us to focus on our mission of creating healthy and strong Wisconsin communities. We care about making our home a better place to live.
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We Are Provider-Owned

Network Health is locally owned by Froedtert ThedaCare Health. We collaborate with our provider-owners to give members access to high-quality coordinated care.
a couple of Medicare age

We Speak Your Language

When you call us, we don’t bombard you with health insurance jargon. We talk like people, not insurance dictionaries.

5-Star Customer Service

In 2027, Network Health Medicare Advantage PPO plans earned a 5 Star Rating for customer service for the 6th consecutive year. For 2027, Network Health earned an overall 4 out of 5 Star Rating for its Medicare Advantage Prescription Drug PPO plans from the Centers for Medicare & Medicaid Services (CMS).**
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We Embrace Diversity

To accomplish our mission, we value and celebrate diversity across Wisconsin. We do our best by embracing diversity, inclusion and social justice as part of our value.
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We Focus On Healthy Living

We believe in helping people lead healthy lives, not just helping out when they get sick. As a member, you’ll have access to programs that help you improve or maintain your health.
new to Network Health member meeting

We Assess Your Needs

Network Health provides guidance to all our members with complex conditions to ensure they receive the necessary services. Each year, we assess the demographics of our members to ensure we meet their needs.
Network Health at Capri Communities

Quality That Matters

When you choose Network Health, you have a plan that shines at serving its members and keeping them healthy. The Centers for Medicare & Medicaid Services also rewards high-rated plans with bonus payments to be spent on extra member benefits.

Quality You Can Trust

Quality is engrained within the culture of Network Health and the work of each employee. Our commitment to quality isn’t about our awards, excellent quality ratings or accreditations. Yes, we continue to exceed the industry’s highest standards, but at Network Health we put the spotlight on you.

Our quality department focuses on improving the health care services you receive every day, ensuring your experience with Network Health exceeds expectations. And our members appreciate our level of service and coverage. That’s why 98 percent stayed with us last year.*

For more information about Network Health’s Quality Improvement Program, email us at QI@networkhealth.com


Network Health’s Rating With the National Committee for Quality Assurance (NCQA)

NCQA rates Medicare insurance plans based on their combined Healthcare Effectiveness and Data Information Set (HEDIS®) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and NCQA Accreditation standards scores. Accreditation status is as of September 16, 2026.

Network Health’s NCQA ratings for 2026 are below. Please click on the arrow to expand each section.

Measure Rating
Getting Care 5
Getting Care Easily 5
Getting Care Quickly 5
Satisfaction with Plan Physicians
Coordination of Care 5
Satisfaction with Plan and Plan Services 4
Rating of Health Plan 4
Rating of Care 4

Measure Rating
Cancer Screening 4.5
Breast Cancer Screening 4
Colorectal Cancer Screening 5
Description of Membership 5
Race and ethnicity of members 5
Language preferences of members 5
Other Preventive Services
Influenza immunizations for adults 4
Td/Tdap immunizations for adults 5
Zoster immunizations for adults 5
Pneumococcal immunizations for adults 5

Measure Rating
Respiratory 4
Appropriate antibiotic use for acute bronchitis/bronchiolitis 4
Diabetes 4.5
Patients with Diabetes - Blood Pressure Control (140/90) 5
Patients with Diabetes - Eye Exams 4
Patients with Diabetes - Glycemic Status 5
Patients with Diabetes - Received Statin Therapy 4
Patients with Diabetes - Statin Adherence 80% 4
Patients with Diabetes - Kidney Health Evaluation 4
Heart Disease 4.5
Patients with Cardiovascular Disease - Received Statin Therapy 3
Patients with Cardiovascular Disease - Statin Adherence 80% 4
Controlling High Blood Pressure 5
Behavioral Health - Care Coordination 4.5
Follow-up After Hospitalization for Mental Illness 5
Follow-up After ED for Mental Illness 4
Follow-up After ED for Substance Use Disorder 4
Behavioral Health - Medication Adherence
Adherence to Antipsychotic Medications for Individuals with Schizophrenia 5
Behavioral Health - Access, Monitoring and Safety
Substance Use Disorder Treatment Engagement 2
Patient Safety and Treatment for Older Adults 3.5
Avoiding High-Risk Medications for Older Adults 4
Managing Risk of Falls 2
Managing Osteoporosis in Women After Fracture 3
Screening for Osteoporosis in Women 5
Care Coordination 4.5
Follow-up After ED for Multiple High-Risk Chronic Conditions 4
Transitions of Care - Notification of Inpatient Admission 5
Transitions of Care - Receipt of Discharge Information 5
Transitions of Care - Patient Engagement After Inpatient Discharge 5
Transitions of Care - Medication Reconciliation Post-Discharge 4
Advance Care Planning 3
Risk-Adjusted Utilization 4.5
Plan All-Cause Readmissions 5
Emergency Department Utilization 3
Acute Hospital Utilization 5
Hospitalization for Potentially Preventable Complications 5

Stars Rating Information

The Centers for Medicare and Medicaid Services (CMS) uses a five-star quality rating system to measure Medicare patients' experiences with their health plans and the health care system. This rating system applies to Medicare Advantage (MA) plans throughout the nation. For 2027, Network Health earned a 4 out of 5 Star rating for our Medicare Advantage PPO plans, while also receiving the following ratings for key individual measures.**

Getting appointments and care quickly - 5
Member experience with health plan - 5
Ease of getting needed care and seeing specialists - 5
Coordination of members' health care services - 5

Network Health Medicare PPO Star Ratings for 2027 are listed in full in the tables below. Please click on the arrow to expand each section.

(5 is the highest performance)

Measure Rating
Breast Cancer Screening 4
Colorectal Cancer Screening 5
Yearly Flu Vaccine 4
Improving or Maintaining Physical Health 2
Improving or Maintaining Mental Health 2
Monitoring Physical Activity 2

Measure Rating
Members whose plan did an assessment of their health needs and risks 4
Yearly review of all medications and supplements being taken 5
Osteoporosis Management 3
Eye exam to check for damage from diabetes 4
Plan members with diabetes whose blood sugar is under control 5
Kidney health evaluation in patients with diabetes 4
Controlling Blood Pressure 4
Reducing the risk of falling 1
Improving bladder control 3
Readmission to a hospital within 30 days of being discharged (more stars are better because it means fewer members are being readmitted) 4
The plan makes sure members with heart disease get the most effective drugs to treat high cholesterol 4
After hospital stay, members receive information and care they need 5
Members with 2 or more chronic conditions receive follow-up care within 7 days after an emergency department visit 4
Yearly assessment of how well plan members are able to do activities of daily living 5

Measure Rating
Ease of getting needed care and seeing specialists 5
Getting appointments and care quickly 5
Health plan provides information or help when members need it 5
Members' rating of health care quality 4
Members' rating of health plan 5
Coordination of members' health care services 5

Measure Rating
Complaints about the health plan (more stars are better because it means fewer complaints) 5
Members choosing to leave the plan (more stars are better because it means fewer members choose to leave the plan) 5
Improvement (if any) in the health plan's performance 3

Measure Rating
Health plan makes timely decisions about appeals 3
Fairness of the health plan's appeal decisions, based on an independent reviewer 2
Availability of TTY services and foreign language interpretation when prospective members call the health plan 4

Measure Rating
Availability of TTY services and foreign language interpretation when prospective members call the drug plan 4

Measure Rating
Complaints about the drug plan (more stars are better because it means fewer complaints) 5
Members choosing to leave the plan (more stars are better because it means fewer members choose to leave the plan) 5
Improvement (if any) in the drug plan's performance 4

Measure Rating
Members' rating of drug plan 4
Ease of getting prescriptions filled when using the plan 4

Measure Rating
Plan provides accurate drug pricing information for this website 5
Taking diabetes medication 3
Taking blood pressure medication 5
Taking cholesterol medication 4
The plan makes sure members with diabetes take the most effective drugs to treat high cholesterol 3
Concurrent Use of Opioids and Benzodiazepines (more stars are better meaning fewer plan members took these two drugs together, decreasing the risk of adverse events) 4
Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (more stars are better meaning fewer older adult plan members took two or more anticholinergic medications at the same time, decreasing the risk of cognitive decline) 4
* Based on the percentage of Network Health Medicare Advantage (PPO) members who stayed on the plan for 2026, for coverage starting January 2026.
** See our 2027 Star Rating Information for Network Health PPO Medicare Advantage Plans, Network Health Medicare Explore (HMO) and Network Health Prime (MSA) plans. (Medicare evaluates plans based on a Five-Star rating system. Star Ratings are calculated each year and may change from one year to the next).