For information on the coronavirus vaccine and your benefits as a Network Health member, click here.

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Coronavirus Information for Commercial Members

Information Specific to Commercial Group and Individual and Family Plan Members

Below you will find useful information about the virus specific to commercial members.

If you have any questions feel free to reach out using the contact information listed throughout this page. You can also contact our member experience team.

For frequently asked questions about the coronavirus vaccine, please visit our coronavirus vaccine page by clicking the link below.

Information on the coronavirus vaccine and Network Health

 Medical Plan Information About the Coronavirus

Yes, the coronavirus test is covered by your Network Health plan, in accordance with the Families First Coronavirus Response Act.

You will pay $0 out-of-pocket to receive this test at in- and out-of-network facilities. 

You can contact your personal doctor, Wisconsin Department of Health Services at dhs.wisconsin.gov/outbreaks/index.htm, Ascension, Froedtert or visit the CDC’s website at cdc.gov/coronavirus/2019-ncov/index.html.

If you are feeling mildly ill, call your doctor before seeking medical treatment.

  • He or she may be able to give you advice on how to treat your symptoms at home, which would reduce the number of people you expose.
  • If you or someone you’re caring for is short of breath, minimally responsive, looks blue or ashen call 911.

Providers will prioritize who is tested. Here is some of the criteria that will be used.

  • Patients with signs and symptoms of the coronavirus (such as fever, cough and difficulty breathing) and no other explanation for symptoms.
  • High risk patients (individuals with underlying health conditions such as asthma, diabetes, cancer or heart disease, age = 65, residing in a long-term care facilities, etc.).
  • Patients with known or suspected contact (direct contact with a known case of the coronavirus, travel history to a high-risk geographic area or healthcare worker with known exposure) within the past 14 days.

If your provider determines you need a test, they will work with you on what to do next. Typically, that means your doctor will collect a sample via swabbing the nose and throat before sending to a state-regulated lab.

Yes, all Network Health members can get a 90-day supply of their medications if the following conditions are met.

  • The prescription order has sufficient refills remaining. If needed, ask the pharmacist to request additional refills from your prescriber.
  • The requirements for taking these medications imposed by the medication prescriber are met.
  • This applies to our entire pharmacy network, including states outside Wisconsin.

Commercial members can get their refills via retail location or mail order.

Health Insurance Exchange members must use mail order to get a 90-day supply of medication.

During the coronavirus health crisis, members may reach out to their pharmacy to ask about delivery options. Many pharmacies are delivering free of charge while Wisconsin is under the safer at home order.

At this time, no changes are anticipated to member medical or pharmacy benefits. We are monitoring the situation closely and will update our information and policy if the situation changes.
Yes, hydroxycholorquine is on our drug list. Our pharmacy benefits manager is putting an anti-hoarding algorithm into their system to monitor supplies because we understand how important this drug is for chronic disease management.

 Health Insurance Exchange (Marketplace) Members

If you’ve lost your job or had a change in income, go to healthcare.gov and update your income to see if you qualify for additional subsidies.
Contact your broker with any questions.

Information for Employer Groups

Network Health is here to help. We are here to support you even though our physical offices are closed. We will be handling business a little differently to ensure we’re continuing to provide you with the same superior service you’ve come to expect. For employer groups that may have unique circumstances, please contact your client manager. Below is an overview of some changes we’re making effective immediately.

Effective immediately, through July 1, 2021, Network Health will have relaxed eligibility guidelines for employer groups. Groups that have reduced hours for staff, have furloughed employees, or have employees that have been laid off will be considered actively at work for eligibility purposes if monthly premiums are paid.  

Groups no longer meeting participation requirements due to the public health crisis will not be termed. Groups impacted will be handled on a case by case basis at the time of renewal.

We expect renewal timing to remain unchanged. For groups that may see their participation change more than 10 percent, Network Health will not re-rate groups due to these changes through July 1, 2021.
Effective immediately, through July 1, 2021, Network Health is offering a special enrollment period for group business that allows employees, who may have waived coverage at open enrollment, to join Network Health. State eligibility guidelines will apply.
For employer groups that wish to pay the group monthly premium by credit card, please call 920-720-1350 and press option 3. We will be happy to process this one-time payment at no additional costs.

Telehealth Services

To give our members access to the care they need, effective March 20, 2020, Network Health will cover all coronavirus telehealth services for a $0 copayment, including MDLIVE® virtual visits and telephone and virtual face-to-face visits with in-network providers.

All coronavirus telehealth services will be covered at a $0 copayment until July 19, 2021. We will continue to evaluate this date as well.

In addition to coronavirus telehealth services, telehealth services performed by primary care, behavioral health and OBGYN providers are covered with no member cost share. Other visits are subject to your plan’s deductible, copayment and/or coinsurance. Telehealth services from out-of-network providers for HMO members will not be covered.

No. To increase access to appropriate care, all coronavirus telehealth visits will be covered at $0 per visit until July 19, 2021, even before members have met their deductible.

No, primary care telehealth services are not subject to your plan’s deductible, copayment and/or coinsurance until July 19, 2021.

Virtual visits limit your exposure to illness from others and limit the spread of any illness you may have. Getting medical advice using a virtual visit provides many benefits if you are experiencing non-emergency symptoms. For more information on MDLIVE, including the illnesses they treat and instructions for logging in, visit our Getting Care Quickly page.

Please note, due to increased activity, MDLIVE wait times are longer than usual. If you prefer not to wait on hold, MDLIVE gives you the option to receive a call back

Yes, all coronavirus and primary care telehealth services are covered for a $0 copayment. This applies to all telehealth providers for point-of-service (POS) plans and in-network providers for health maintenance organization (HMO) plans. HMO plans do not cover telehealth services with out-of-network providers.

Below is a list of providers that have telehealth services available online. This list will continue to grow as we get more information.

Yes, this list will continue to grow as we get more information.

  • Froedtert 414-805-2000
  • Ascension 833-978-0649
  • Agnesian 844-225-0147
  • Bellin Health 888-330-3524
  • Bellin Telehealth 920-445-7313
  • Holy Family 920-320-3333
  • Primary Care Associates of Appleton 920-996-1000
  • ProHealth 262-928-4499

That is at the discretion of the provider. Typically, providers will only see existing patients virtually.

No, the coronavirus must be diagnosed through a lab test. Telehealth providers can let their patient know whether a lab test is warranted.

No, any labs that are ordered by the telehealth provider will be subject to your plan’s deductible, copayment and/or coinsurance. The exception is the coronavirus lab test – that is fully covered by your Network Health plan.

This depends on the pharmacy, so the member will want to call the pharmacy to confirm. During the coronavirus health crisis, many pharmacies are delivering free of charge while Wisconsin is under the safer at home order.

In addition, many pharmacies have drive-up windows that customers can use if they don't want to enter the store.


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.