It's Your Choice 2017
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
MercyCare Health Plans1-800-895-2421
What’s New for 2017
Due to several expansions through MercyCare’s parent company, MercyHealth, State of Wisconsin Group Health Insurance Program participants will have a much larger service area and number of physicians in their network.
MercyCare’s service area now includes Boone and Winnebago counties in Illinois. Services available in the additional counties brings not only a larger volume of primary care physicians and specialists, but also many other subspecialties such as pediatric cardiology and gastroenterology. This expansion has also allowed MercyCare to add an additional hospital to our network that is home to a level 1 trauma center, the regions only level III neonatal intensive care unit, and the regions only pediatric intensive care unit.
Go to mercycarehealthplans.com to access a provider directory. In the middle of the page under, “Live well. We’ll Insure you do,” Click on the box. Then in the drop down box under select your plan choose W9 HMO PRIME State of Wisconsin Group Health Insurance Program and select if you would like to search by practitioner or facility/clinic. Once you are there you can narrow your search if you would like by city, last name, etc., or you can print a full directory by clicking "View the printable directory here"
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.
Jefferson, Rock and Walworth 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 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.
Healthline: 608-758-5770 or 1-888-756-6060
This page was last modified on: 9/7/2016 11:23:35 AM