It's Your Choice 2016
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
Group Health Cooperative of Eau Claire1-888-203-7770 or 715-552-4300
What’s New for 2016
Group Health Cooperative of Eau Claire is pleased to serve counties throughout Northern and Central Wisconsin.
Members of the Cooperative now have unlimited FREE access to a doctor through Teladoc. A Teladoc doctor is always just a call or click away. The service is available 24 hours a day, 7 days a week and can treat many common medical conditions including flu symptoms, sinus problems and bronchitis. To learn more about this new and exciting benefit for members of Group Health Cooperative of Eau Claire, visit https://www.group-health.com/Members/Teladoc.aspx.
Go to group-health.com to access a provider directory. Use https://www.group-health.com/Directories/Providers.aspx as a direct path or visit www.group-health.com, choose “Members,” then “My Plan” and “State of WI Employees.” To request a printed directory be mailed to you, call Member Services at 1-888-203-7770.
Referrals, Prior Authorizations, Out-of-Network Care
Referrals are not needed when receiving care from in-network providers. You must get a prior authorization before receiving care from an out-of-network provider, for all admissions and for select outpatient services. You will receive written notification of the approval or denial for the prior authorization. Members with low back pain are required to participate in a shared decision making tool to review information on options, outcomes and to clarify personal values. For further information regarding authorization guidelines, please visit group-health.com or call 1-888-203-7770 to speak with Member Services.
Qualified: Ashland, Burnett, Clark, Douglas, Langlade, Lincoln, Marathon, Oneida, Price, Sawyer, Taylor and Washburn counties.
Emergency and Urgent Care Outside Service Area
If you require emergency or urgent care while outside the network, seek care at the nearest medical facility. Use the FirstCare Nurseline listed on your ID card if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise authorized by the Cooperative.
Mental, Behavioral Health and Substance Abuse
No referral is needed to see a provider in the Cooperative’s network. Prior authorization guidelines may apply for certain services; please contact Member Services at 1-888-203-7770 for additional information. Please refer to the provider directory for a listing of mental health providers in the Cooperative’s network.
FirstCare Nurseline: 1-800-586-5473
This page was last modified on: 9/29/2015 12:04:06 PM