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Member Resources

We handle customer service a little differently at Network Health. Our member experience team provides solutions to your concerns, and best of all—they are just a phone call away at 800-378-5234 (TTY 800-947-3529) Monday–Friday, from 8 a.m. to 8 p.m. October 1–March 31, they’re here every day, from 8 a.m. to 8 p.m. 

For details about nondiscrimination or getting assistance in another language, view this multi-language and nondiscrimination document. 


Need to Change Your Plan?
As a member, you can make changes to your plan in the following situations.

  • It's during the annual enrollment period (October 15–December 7).
  • You lose coverage through your employer.
  • You move outside of your plan’s service area.
  • Your current Medicare Advantage plan is discontinued.
  • Your income has changed, and you now qualify for the subsidy program, Extra Help

Change Your Plan


Member Extras

Member Referral Program

Love your Network Health Medicare Advantage coverage? Have friends or family members looking for a Medicare Advantage plan that goes above and beyond? As a member, we are rewarding you for telling others about Network Health.  

To refer somebody, they must meet the following criteria.  

  • Have Medicare Part A and Medicare Part B (original Medicare)
  • Not currently be a member of a Network Health Medicare Advantage plan
  • Live in our service area

If you know somebody who meets the above criteria and is looking for a Medicare Advantage plan with benefits like a travel benefit, an integrated health care team and local member service, have them call 844-850-5284 (TTY 800-947-3529) to let us know you referred them. You can earn one $15 gift card for each member you refer, up to four gift cards, for a variety of stores each year. Once your referral calls us, we will contact you to choose the gift card you prefer. 

Member Newsletter

Our Medicare Advantage member newsletter, Concierge, includes helpful tips and advice for your life, health and wellness, events in your community, as well as a member feature story. You’ll also find highlights on the best ways to use your plan, save money and get the most from your coverage. 

 

Concierge 2024 Newsletter

cover of 2024 concierge magazine showing CEO coreen dicus-johnson


Additional Wellness Benefits

As a member, you also have access to many programs to help you stay well. Because we care about your well-being, these programs are available to you at no cost.

Member Wellness 
One-on-one support to help you achieve and maintain a healthy lifestyle.

Care Management
Support for our members that are dealing with a short-term illness or a more complex medical condition.

Condition Management
One-on-one health coaching is available at no cost for our members with a chronic condition (asthma, chronic obstructive pulmonary disease (COPD), diabetes, heart disease, stroke or heart failure).

Community Workshops  
Available workshops to teach members how to best manage common symptoms of chronic conditions.

Breathe at Ease
A proactive program designed to help members with chronic bronchitis, emphysema and chronic obstructive pulmonary disease (COPD) avoid flare-ups, control symptoms and potentially improve their lung conditions. 

Medication Therapy Management
This program helps you and your doctor ensure your medications are working to improve your health.


Evaluating New Technologies 

Network Health evaluates new technologies and new applications of existing technologies on a regular basis. This includes the evaluation of medical procedures, drugs and devices.

New technologies are reviewed by a group of participating physicians and health plan staff who make recommendations for inclusion as a covered benefit. The review process also includes evaluation of information from government regulatory bodies and published scientific evidence.

Forms

Payment Option Form 
Set up recurring premium payments for the year using your bank account or credit card. 

Advance Care Planning/Power of Attorney for Health Care Forms
Use this resource to give someone permission to make health care decisions on your behalf. For questions about advance directives, contact the Wisconsin Department of Health Services at 608-266-1251 or contact Network Health at 800-378-5234 (TTY 800-947-3529).

Appointment of Representative Form
This form names a relative, friend, advocate, doctor or someone else to act on your behalf for an appeal or complaint. Send the completed form to Network Health, Attn: Medicare Advantage Plans, PO Box 120, Menasha, WI 54952.

Dilated Retinal Eye Exam Form
This form is used to document the results of your dilated eye exam and should be placed in your medical record with your personal doctor.

Express Scripts PharmacySM Mail Order Form
Sign up for convenient home delivery of your prescriptions.

Medicare Appeals Form
This form initiates the appeal process on your behalf, asking Network Health to consider a coverage or benefit decision that has been made. The use of this form ensures complete information is sent to Network Health for timely and accurate processing of your appeal request.

Member Reimbursement Form
If a provider is unable to send a claim this form can be used to submit charges to Network Health.

Personal Health Information Consent Form
This form allows a specified person (a spouse, relative, friend, advocate, attorney, doctor or someone else) to call to discuss your coverage and plan information if it’s ever needed.

Request for Access Form
This form requests a copy of the protected health information Network Health has about you in a designated record set.

Prescription Drug Claim Form
To request reimbursement for a self-administered drug, use this form.

Preventive Health Checklist
Use this form to keep track of your preventive care and screenings.

Request for a Drug Coverage Determination 
You have the right to request coverage for a particular prescription drug. This can be done online, or by mailing or faxing this form.

Request Redetermination Form
You have the right to ask us to reconsider a coverage decision made for a particular prescription drug.


Additional Resources

How to Make a Complaint or Appeal 
Learn more about how to file a complaint (also called a grievance) or an appeal.

How Health Plans Make Decisions
Find out how decisions are made about your care. You can also view our medical policies for certain treatments here.

How to Protect Yourself from Fraud
Tips, contact numbers and what you should know about Medicare and billing fraud.

Medicare Disaster Policy
Find out how Network Health Medicare Advantage members get the benefits and medical care they need if the President, Governor or Secretary of Health and Human Services declares an emergency, major disaster or a public health emergency.

Member Rights and Responsibilities
As a member, you have certain rights and responsibilities.

Clinical Practice Guidelines
Visit this page for our clinical practice guidelines that include U.S. Preventive Services Task Force recommendations for preventive care, like certain screenings, shots and vaccines that can help you stay healthy and avoid getting sick.

Notice of Privacy Practices
Our policies to ensure that your privacy and information is protected.

For accommodations of persons with special needs at meetings call 800-378-5234 (TTY 800-947-3529).