It's Your Choice 2016
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
ACA: Patient Protection Disclosure
The State of Wisconsin and Wisconsin Public Employers (local government) Group Health Insurance Program offered by the HMOs and PPOs generally require the designation of a primary care provider. You have the right to designate any primary care provider (PCP) who participates in the health plan’s network and who is available to accept you or your family members. If you do not choose a PCP or primary care clinic (PCC), some health plans will designate a PCP or PCC for you automatically. For information on how to select a primary care provider and for a list of the participating primary care providers, contact the health plan. You can find contact information on Health plan Contact pages.
For children, you may designate a pediatrician as the PCP.
For women, you do not need prior authorization from the health plan or from any other person (including a PCP) in order to obtain access to obstetrical or gynecological care from a health care professional in-network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the health plan. You can find contact information on Health plan Contact pages.
This page was last modified on: 9/11/2015 7:53:12 PM