State of Wisconsin Group Health Insurance Program
It's Your Choice – Choose Network Health
At Network Health, we understand the importance of quality health care and believe it should be convenient. As a member of the State of Wisconsin Group Health Insurance Program, you can choose your plan based on your health insurance needs. We appreciate your choice to be a Network Health member.
Major Health Systems
Network Heath’s provider network is combined across northeast and southeast Wisconsin. Our network includes the following high-quality health systems.
- Froedtert & the Medical College of Wisconsin (Froedtert, Community Memorial, St. Joseph’s Hospital – West Bend)
- Children’s Hospital of Wisconsin
- Ascension Wisconsin (Affinity Health System, Ministry Health Care, Columbia St. Mary’s, Wheaton Franciscan Healthcare)
- Prevea Health
- Bellin Health
New for 2019 – Redesigned Member Portal
Network Health has gathered and incorporated customer feedback to deliver a new member portal that’s centered around you. The new portal is easier to navigate to find information regarding your plan, benefits, claims and more. Plus, it's mobile responsive and viewable from any device at any time. The first time you access the new portal, you will need to create a new account.
Visit login.networkhealth.com to get started today. See our How to Register cheat sheet for step-by-step instructions.
Once you are logged in, you'll find all this and more:
- Benefits and coverage overview
- Out-of-pocket expenses tracker
- Claims detail and status
- Your mobile ID card
- Find a Doctor search and ability to select your personal doctor
- Secure messaging with our local customer service team
Local Customer Service
The State of Wisconsin Group Health Insurance Program has a dedicated customer service line located in Menasha, WI. To speak with a specially trained Network Health representative call 844-625-2208 or 920-720-1811. Our representatives are available Monday through Thursday 7:30 a.m. to 5 p.m. and Fridays 7:30 a.m. to 4:30 p.m. You can email us a question by using our Contact Us form. We can also provide Language Assistance.
Provider Directory
To find an in-network provider, follow these steps.
- Go to our Find a Doctor search tool.
- Choose State of Wisconsin employees/members from the Choose a Plan menu.
- Follow the steps and enter in your search criteria then select Search.
- You can also view a PDF of the provider directory.
- If you would like a printed directory mailed to you, please call 844-625-2208.
Prior Authorizations and Referrals
At Network Health, we believe in empowering you to control your health care decisions. You can see any in-network doctor without a referral, although select services require prior authorization.
Care Outside the Service Area
If you are traveling outside the network service area and have a medical emergency that requires a visit to the emergency room or urgent care, get the medical care you need without worrying about your health insurance. Network Health will cover the cost of your visit, excluding any required deductible, coinsurance, or copayment. Follow-up care must be received from an in-network provider unless otherwise approved by Network Health.
Go to urgent care if your symptoms are moderate, but not severe or life-threatening. You may receive urgent care services from a nonparticipating facility, however you will only receive in-network benefits if one of the following is true:
- You receive the services in the emergency department of a hospital or in a hospital-based urgent care facility, or
- You receive the services in a nonhospital-based urgent care facility and you provide Network Health notification within 48 hours of receiving the services. Call the Network Health Care Management Department at 800-236-0208 (TTY 800-947-3529) to provide that notification.
- Call Network Health at 844-625-2208 or contact your personal doctor if you need help determining the appropriate level of care.
24-Hour Care
If you experience a medical emergency, seek medical care at the emergency room. Sometimes, you may have a non-emergency question or illness when your personal doctor is unavailable. When this occurs, you have two options for non-emergent care that is available 24 hours a day.
Network Health Nurse Line
Our free nurse advice line gives you access to a registered nurse that can help answer your specific medical problems–any time of the day or night. The nurse advice line can be accessed by calling 888-879-8960 (TTY 888-833-4271).
Call the nurse line when you:
- Have a symptom like a sore throat, muscle pain or a fever.
- Have questions about your medications or are prescribed a new medicine and want to know more about it.
- Want more information on a health issue.
- Need help determining where to go for care when it's not an emergency.
MDLIVE® Virtual Visits
Virtual visits, brought to you through MDLIVE®, are a great way to save time and money when you experience non-emergency symptoms. By using your phone, smartphone, tablet or computer, you can connect with a board-certified physician or pediatrician for treatment of a wide range conditions. You can also get prescriptions filled, if needed.
MDLIVE can assist with these conditions and more.
|
|
You can activate your Network Health MDLIVE account one of three ways.
- Text NETWORK to 635483 or visit MDLIVE.com/networkhealth.com.
- Download the MDLIVE app on your smartphone or tablet. Open the application and follow the instructions to create an account.
- Call 877-958-5455 and an MDLIVE customer service representative will walk you through the process of setting up an account.
Mental and Behavioral Health Treatment
We require prior authorization for autism treatment and all inpatient services for mental health, behavioral health or substance abuse services. For assistance, please contact Network Health’s Care Management Behavioral Health Department at 800-555-3616. After hours, call your practitioner or the Network Health Nurse Line.
2019 Summary of Benefits and Coverage
- 2019 State of Wisconsin It's Your Choice (IYC) High Deductible Health Plan
- 2019 State of Wisconsin IYC Health Plan
- 2019 IYC Local Deductible
- 2019 IYC Local High Deductible Health Plan
- 2019 IYC Local Health Plan
- 2019 IYC Local Traditional
2020 Summary of Benefits and Coverage
- 2020 State of Wisconsin It's Your Choice (IYC) High Deductible Health Plan
- 2020 State of Wisconsin IYC Health Plan
- 2020 IYC Local Deductible
- 2020 IYC Local High Deductible Health Plan
- 2020 IYC Local Health Plan
- 2020 IYC Local Traditional
Other Forms
Frequently Asked Questions
- Visit login.networkhealth.com Once signed in, select your name in the upper right corner to view your profile. Select Change my Personal Doctor and follow the steps that appear to select or change your doctor.
- Call our customer service department at 844-625-2208.
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Diabetes
- Heart Disease
- Stroke
Premium- The monthly payment you make for your health plan.
Deductible - The amount you must pay for covered health care services before Network Health begins to pay
Copayment - A set fee you might pay for a type of health care or a prescription drug. For example, your copayment for a doctor visit could be $20. Once your deductible is met, Network Health pays the rest.
Coinsurance - A set percentage you might pay for a type of health care or a prescription drug. For example, 10 percent coinsurance means you pay 10 percent of the cost. Network Health pays the rest.