My Choice Wisconsin
My Choice Wisconsin is a Wisconsin-based Managed Care Organization and HMO, now part of Molina Healthcare, delivering Medicaid-funded Family Care, Partnership, and Medicare Dual Advantage programs to frail elders, adults with disabilities, and dual-eligible members across up to 44 Wisconsin counties.
- Company typePrivate
- Founded2000
- HeadquartersMilwaukee, United States
- Headcount11–50
- GTM typeB2C
- OfferingServices
What My Choice Wisconsin does
My Choice Wisconsin is a Wisconsin-based Managed Care Organization (MCO) and Health Maintenance Organization (HMO) that contracts with Wisconsin Medicaid and the federal Medicare program to deliver long-term care, health services, and dual-eligible coverage. Originally founded in 2000 (previously known as Care Wisconsin following an internal merger), the company is now a subsidiary of Molina Healthcare Inc. (NYSE: MOH) following a 2025 operational integration that combined MCW and Molina systems.
The organization runs three core programs: Family Care, a Medicaid-funded program coordinating home and community-based long-term care for frail elders and adults with intellectual, physical, or developmental disabilities; Partnership, a PACE-style program for members with higher care needs that integrates medical, behavioral, and long-term care services with Medicare drug coverage; and Medicare Dual Advantage, an HMO Special Needs Plan for individuals eligible for both Medicare and Medicaid. Each member is supported by a dedicated care team consisting of a Care Manager and a Registered Nurse, with access to self-directed supports (the ability to hire one's own caregivers), employment support, and supplemental benefits including dental, vision, hearing, and Over-the-Counter allowances administered through NationsBenefits. Quality performance is validated by annual HEDIS compliance audits, External Quality Review by Metastar, Inc., and a 4-out-of-5 CMS Star Rating achieved in plan year 2023.
The underlying technology platform is a healthcare managed-care stack rather than a software product: care coordination systems, Electronic Visit Verification (EVV) for Medicaid-covered personal care services, provider network management tools, and integrations with TriZetto (Cognizant) for claims processing, EnvisionRx for pharmacy benefit administration, NationsBenefits for OTC benefits, ForwardHealth for Wisconsin Medicaid enrollment, and CAQH ProView for provider credentialing. A new web-based Provider Network Management Portal (ProviderTrak) is scheduled to launch in July 2026. Revenue is generated through capitation payments from Wisconsin Medicaid and CMS for covered lives; member outreach runs through Aging and Disability Resource Centers (ADRCs), community advocacy partners, and a statewide network of 90+ hospitals, 1,900+ primary care providers, and nearly 10,000 facility locations across 34 to 44 Wisconsin counties depending on the program.
My Choice Wisconsin firmographics
Firmographics- Name
- My Choice Wisconsin
- Legal name
- My Choice Wisconsin
- Website
- https://mychoicewi.org
- Company type
- Private
- Founded year
- 2000
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- My Choice Wisconsin is a Wisconsin-based Managed Care Organization and HMO, now part of Molina Healthcare, delivering Medicaid-funded Family Care, Partnership, and Medicare Dual Advantage programs to frail elders, adults with disabilities, and dual-eligible members across up to 44 Wisconsin counties.
- Ownership category
- akta.pro rank
My Choice Wisconsin industry classification
Industry- Product category
- Managed Care Services (Medicaid and Medicare)
- NAICS
- HMO Medical Centers (621491), Services for the Elderly and Persons with Disabilities (624120), Nursing and Residential Care Facilities (623)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Medicaid Managed Care HMOs (HLAEAMAI)
- akta.pro secondary industry
- Benefits, Insurance & Long-Term Care Planning Navigation (Medicare/Medicaid/LTC) (HLADALAI)
Keywords
Where My Choice Wisconsin is headquartered
LocationHeadquarters
- HQ city
- Milwaukee
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
My Choice Wisconsin business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure
Revenue model
- Government Healthcare Programs: My Choice Wisconsin operates as a Managed Care Organization (MCO) receiving capitated payments from Wisconsin Medicaid and Medicare programs to provide long-term care and health services to eligible members including frail elders, adults with disabilities, and dual-eligible beneficiaries.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Monthly | Family Care - Medicaid funded long-term care |
| Other | Monthly | Partnership - For members with higher care needs |
| Other | Monthly | Medicare Dual Advantage (HMO SNP) - Dual eligible support |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels5 records
My Choice Wisconsin product offering
Product offeringCore offering
My Choice Wisconsin is a Managed Care Organization and HMO that operates three government-funded programs in Wisconsin: Family Care (Medicaid long-term care coordination for frail elders and adults with disabilities), Partnership (a PACE-style program for higher-need members coordinating medical, health, and long-term care with Medicare drug coverage), and Medicare Dual Advantage (an HMO SNP plan for dual-eligible beneficiaries providing coordinated healthcare with supplemental benefits and no premiums). The organization receives capitated payments from Wisconsin Medicaid and Medicare to deliver care plans managed by dedicated Care Managers and Registered Nurses, supported by self-directed supports, an extensive provider network across 90+ hospitals and roughly 10,000 facility locations, and integrated pharmacy and supplemental benefits.
Product overview
My Choice Wisconsin is a Managed Care Organization (MCO) and Health Maintenance Organization (HMO) offering three core programs: Family Care (Medicaid-funded long-term care for frail elders and adults with disabilities), Partnership (PACE-style program with higher care needs including Medicare drug coverage), and Medicare Dual Advantage (HMO SNP for dual-eligible individuals). The organization is part of Molina Healthcare and operates across Wisconsin counties. Core programs include Self-Directed Supports (allowing members to hire their own caregivers), Employment Support, Care Team coordination, and pharmacy services. Medicare Dual Advantage and Partnership include supplemental benefits such as dental, vision, hearing, and Over-the-Counter allowances managed through NationsBenefits.
Differentiator
Problem solved
Functional benefit
Brands
- Family Care: A Medicaid-funded program helping frail elders and adults with disabilities coordinate their home and community-based long-term care needs.
- Partnership
- Medicare Dual Advantage
Products and services
- Family Care Medicaid-funded managed care program helping frail elders (65+) and adults (18+) with intellectual, physical, or developmental disabilities coordinate their home and community-based long-term care needs through dedicated care teams, self-directed supports, employment support, and care planning.
- Family Care Partnership (Partnership) PACE-style integrated program for frail elders and adults with disabilities who have higher care needs, coordinating their medical, health, and long-term care services along with Medicare drug coverage through dedicated care teams and an extensive provider network.
- Medicare Dual Advantage HMO SNP Medicare Advantage plan for individuals who qualify for both Medicaid and Medicare, offering coordinated healthcare with no monthly premiums or deductibles plus supplemental benefits including prescription medications, dental, vision, hearing, OTC allowance, PERS, Silver&Fit fitness, and readmission-prevention meal services.
Quantifiable outcome
- 4 out of 5 stars in CMS Medicare Star Ratings (2023)
- +1 more outcomes
Companies that use My Choice Wisconsin
Customer profileSegments3 records
Ideal customer profiles3 records
My Choice Wisconsin technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration9 records
Feature2 records
My Choice Wisconsin partnerships and signals
Strategic signalPartnerships
Ten partnerships are on record, tiered minor and core.
- Best BuddiesminorAdvocacy organization partnership providing opportunities for people with intellectual and developmental disabilities through friendship, employment, and leadership development programs.
- GiGi's PlayhouseminorDown syndrome achievement center partnership providing educational, therapeutic, and career preparation programs for individuals with Down syndrome.
- Association for the Rights of Citizens with handicaps (ARCh)minorAdvocacy organization partnership focused on promoting rights and independence for individuals with disabilities.
- The Arc WisconsinminorState chapter of national advocacy organization working to promote and protect the rights of people with intellectual and developmental disabilities.
- Wisconsin BPDDminorWisconsin Board for People with Developmental Disabilities partnership supporting self-advocacy and inclusion.
- DSAminorDown syndrome advocacy organization partnership providing resources and support for individuals with Down syndrome and their families.
- Molina HealthcarecoreParent company relationship. My Choice Wisconsin is now part of Molina Healthcare Inc. Medicaid SSI and BadgerCare Plus services transitioned to Molina in 2025. Medicare Dual Advantage products combined onto MCW systems.
- EnvisionRxcorePharmacy benefit management partnership providing pharmacy directory locator services and prescription drug coverage administration for Partnership and Medicare Dual Advantage members.
- NationsBenefitscoreOver-the-counter benefits administration partnership providing OTC card and catalog services for Medicare Dual Advantage and Partnership members.
- Cognizant (TriZetto)coreClaims processing platform partnership providing electronic claims submission portal and electronic funds transfer capabilities for providers.
Scale indicators7 records
Recent moves7 records
Expansion highlights4 records
My Choice Wisconsin competitors and assessment
Company assessmentDirect peers
- Molina Healthcare: Parent company (NYSE: MOH) and the most direct comparable as a national Medicaid managed care operator. MCW is a Wisconsin subsidiary of Molina following the 2025 integration.
- Chorus Community Health Plans: Wisconsin-based nonprofit MCO offering BadgerCare Plus, Medicaid SSI, and Medicare Advantage plans. Direct competitor for the same Wisconsin Medicaid and dual-eligible populations MCW serves.
- Network Health: Wisconsin-based health plan owned by Froedtert Health offering Medicare Advantage and Medicaid plans in eastern Wisconsin. Competes with MCW for dual-eligible and Medicaid members in the Milwaukee metro.
- Security Health Plan: Wisconsin-based HMO offering Medicare Advantage and Medicaid plans. Regional peer competing for dual-eligible beneficiaries across central and western Wisconsin.
- iCare (Independent Care Health Plan): Wisconsin-based MCO specializing in Medicaid SSI and BadgerCare Plus members, particularly those with complex needs. Direct competitor in the same Wisconsin Medicaid SSI market that MCW transitioned to Molina.
Broad incumbents
- Centene Corporation: One of the largest U.S. Medicaid managed care operators (NYSE: CNC), operating multiple state Medicaid plans including Wisconsin. Broad incumbent competing for the same dual-eligible and Medicaid populations at a national scale.
- Elevance Health (Anthem): National managed care company (NYSE: ELV) operating Blue Cross plans including in Wisconsin with Medicare Advantage and dual-eligible Special Needs Plans. Large incumbent with overlapping products and broader portfolio.
- Humana: National leader in Medicare Advantage (NYSE: HUM) with Dual-Eligible Special Needs Plans (D-SNPs). Comparable in dual-eligible focus but at a national scale across a much broader portfolio.
- UnitedHealth Group (Optum): Largest U.S. health insurer (NYSE: UNH) operating Medicare Advantage plans including D-SNPs nationwide. Provides broad competitive context for the dual-eligible SNP segment MCW serves.
Emerging players
- CareSource: Nonprofit Medicaid-focused MCO operating across multiple states with a strong dual-eligible focus. Comparable in mission and product mix, though not currently a major Wisconsin presence.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
My Choice Wisconsin social profiles
Digital presenceMy Choice Wisconsin compliance and trust
Trust signalCompliance6 records
My Choice Wisconsin financial estimates
Financial estimateRevenue estimate
Valuation estimate
My Choice Wisconsin leadership team
Management profileNumber of profiles
Profiles3 records
My Choice Wisconsin funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
My Choice Wisconsin M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about My Choice Wisconsin
What does My Choice Wisconsin do?
My Choice Wisconsin is a Managed Care Organization and HMO that operates three government-funded programs in Wisconsin: Family Care (Medicaid long-term care coordination for frail elders and adults with disabilities), Partnership (a PACE-style program for higher-need members coordinating medical, health, and long-term care with Medicare drug coverage), and Medicare Dual Advantage (an HMO SNP plan for dual-eligible beneficiaries providing coordinated healthcare with supplemental benefits and no premiums). The organization receives capitated payments from Wisconsin Medicaid and Medicare to deliver care plans managed by dedicated Care Managers and Registered Nurses, supported by self-directed supports, an extensive provider network across 90+ hospitals and roughly 10,000 facility locations, and integrated pharmacy and supplemental benefits.
Is My Choice Wisconsin a public or private company?
My Choice Wisconsin is a private company. It is classified as corporate owned and is currently operating.
When was My Choice Wisconsin founded?
My Choice Wisconsin was founded in 2000. It employs 11 to 50 people.
Where is My Choice Wisconsin based?
My Choice Wisconsin is headquartered in Milwaukee, United States, in the North America region.
How does My Choice Wisconsin make money?
One revenue line is on record: government Healthcare Programs.
Who are My Choice Wisconsin's main competitors?
Direct peers on record are Molina Healthcare, Chorus Community Health Plans, Network Health, Security Health Plan and iCare (Independent Care Health Plan). Broad incumbents are Centene Corporation, Elevance Health (Anthem), Humana and UnitedHealth Group (Optum). CareSource is listed as an emerging player.
Does My Choice Wisconsin have an API?
No public API is recorded for My Choice Wisconsin.
What industry is My Choice Wisconsin in?
My Choice Wisconsin's product category is Managed Care Services (Medicaid and Medicare). Its primary akta.pro industry code is HLAEAMAI, Medicaid Managed Care HMOs, with a secondary code of HLADALAI, Benefits, Insurance & Long-Term Care Planning Navigation (Medicare/Medicaid/LTC). Its NAICS code is 621491 and its SIC code is 6324.