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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
(PO7)


Arise Health Plan

1-888-711-1444 toll free or 920-490-6900
WeCareForWisconsin.com

What’s New for 2016

The Arise Health Plan is consolidating our Northern and Southeastern plans in order to better align with our network affiliations. Providers will be available in the 23 counties listed below. Southeastern counties will now be served by Arise Health Plan - Aspirus Arise.

The Arise Health Plan service area will no longer include Jefferson and Marquette counties. If you are a current member of Arise Health Plan Northern in Clark, Florence, Forest, Langlade, Lincoln, Marathon, Oneida, Portage, Taylor, Vilas or Wood counties you will automatically be moved to the new Arise Health Plan - Aspirus Arise plan. Members in all other counties covered by Arise Northern and Southeast will automatically be enrolled in the Arise Health Plan. All Arise members should confirm their current providers will be available in 2016.

We are excited to offer telehealth services through Teladoc, formerly StatDoctors. Now you can get 24/7/365 access to board-certified physicians – by phone or the Internet. Teladoc can diagnose and treat most minor medical conditions and even prescribe medication at a reasonable cost.

Provider Directory

Go to WeCareForWisconsin.com to access a provider directory. Select “Members” or “Visitors” and then “Find A Doctor.” To print a provider directory, scroll to the bottom of the “Find a Doctor” page and select the link below the search options. To request a printed directory be mailed to you, call 1-888-711-1444.

Referrals, Prior Authorizations, Out-of-Network Care

Referrals are not needed when receiving care from in-network providers. Prior authorization is required before the services are rendered for certain services, all non-participating providers, and tertiary-care specialists and facilities. You will receive written notification of the approval or denial for the prior authorization. If you are unsure if a service, test or procedure requires prior authorization or a referral, contact 1-888-711-1444 before the appointment or visit WeCareForWisconsin.com for complete list.

Service Area

Qualified: Brown, Door, Fond du Lac, Kenosha, Kewaunee, Manitowoc, Marinette, Milwaukee, Oconto, Outagamie, Ozaukee, Shawano, Sheboygan, Walworth, Washington, Waukesha, Waupaca and Winnebago counties.
Non-qualified: Calumet, Dodge, Green Lake, Racine and Waushara counties.

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 1-888-711-1444 toll free or 920-490-6900 if assistance is needed to determine the appropriate level of care. Follow-up care must be received by an in-network provider unless otherwise approved by Arise.

Mental, Behavioral Health and Substance Abuse

Outpatient mental health and alcohol and drug abuse (AODA) services do not require a pre-service authorization, but a participating provider is required. Inpatient and transitional mental health and AODA services require a pre-service authorization and use of a participating provider.

24-Hour Nurseline

Not available.

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: 9/30/2015 9:18:07 AM