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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

Local High Deductible Health Plan
Insurance for Employees
and Retirees

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.

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: 9/11/2015 7:53:12 PM