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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2016 State of Wisconsin Group Health Insurance Program
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Wisconsin Department Of Employee Trust Funds

It's Your Choice 2016


State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)

MercyCare Health Plans

1-800-895-2421
mercycarehealthplans.com

What’s New for 2016

Our website has also been revised to better manage your healthcare needs. Visit our newly enhanced, user friendly website at mercycarehealthplans.com. You can still hold your place in line at a Mercy emergency room or urgent care facility by using Mercy Health System’s website at mercyinquicker.org.

Provider Directory

Go to mercycarehealthplans.com to access a provider directory. On the right side of the page, in the interactive center box, click “State of Wisconsin Members” then under provider directories click “State of WI 2015 Provider Directory.” To request a printed directory be mailed to you, call 1-800-895-2421.

Referrals, Prior Authorizations, Out-of-Network Care

MercyCare Health Plans requires referrals from the member’s Primary Care Physician for all specialist visits, both in- and out-of-network. 

Service Area

Qualified: Jefferson, Rock and Walworth counties.

Not Qualified: Green

Emergency and Urgent Care Outside Service Area

If you require emergency or urgent care when outside of the network, seek care at the nearest medical facility. Contact MercyCare Health Plans at 1-800-895-2421 within 48 hours of receiving care, if possible. Follow-up care must be received from an in-network provider unless otherwise approved by MercyCare Health Plans.

Mental, Behavioral Health and Substance Abuse

No prior authorization or referral is required for outpatient services from an in-network provider. Prior authorization and referral is required for inpatient services and transitional care out-of-network. For other services, contact 1-800-895-2421.

24-Hour Nurseline

Healthline: 608-758-5770 or 1-888-756-6060

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 9/23/2015 3:36:41 PM