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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 Local Deductible Health Plan Insurance Program
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2017 It's Your Choice - Local Deductible Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds It's Your Choice 2017


Local Deductible Plan
Insurance for Employees
and Retirees
(PO4, PO14)


IYC Medicare Advantage PPO

Administered by Humana
1-855-STOFWIH or 1-855-786-3944
humana.com

About IYC Medicare Advantage PPO

If you retire and are currently a Humana member enrolled in Medicare Parts A & B, you will automatically be enrolled in Humana’s Medicare Advantage Preferred Provider Organization (PPO) plan. Retirees enrolled in Medicare Parts A & B and enrolled in another Medicare plan, including Original Medicare, may choose to switch to Humana’s Medicare Advantage plan during open enrollment. This plan is available if you live anywhere in the United States or Puerto Rico.

For 2017, Humana’s Medicare Advantage Plan will provide the same Uniform Benefits in-network and out-of-network. Members can use any provider that accepts original Medicare and agrees to bill Humana. Additional benefits and services are also available, such as enhanced preventive benefits covered at 100%, no-cost SilverSneakers Fitness basic membership, and 24-hour nurse helpline. To get more information, including an enrollment kit with a provider directory, call Humana Group Medicare Enrollment at 1-855-STOFWIH or 1-855-786-3944 and indicate you are a State of Wisconsin retiree. Call 1-800-824-8242 for information on the SilverSneakers Fitness Membership. Participants of Humana’s Medicare Advantage are not eligible to receive the Well Wisconsin Incentive.

Provider Directory

To request a printed directory, call 1-855-STOFWIH or 1-855-786-3944, or visit https://our.humana.com/stateofwi. You can also use the online physician finder tool available at www.humana.com. Select "Medicare/Medicaid" when you begin your search.

Referrals, Prior Authorizations, Out-of-Network Care

Members in the Humana Medicare Advantage plan do not need a referral when receiving care from providers. Prior authorization is required for some services, if you are unsure whether a service, test, or procedure requires prior authorization, contact 1-855-STOFWIH prior to your appointment. You will receive written notification of the approval or denial for the prior authorization.

Service Area

This plan is available throughout every county in Wisconsin and available nationwide.

Emergency and Urgent Care Outside Service Area

If you require emergency or urgent care when outside the network, seek care at the nearest medical facility. Additional, separate, benefits are available world-wide.

Mental, Behavioral Health and Substance Abuse

Prior to seeking mental, behavioral health or substance abuse services, contact 1-855-STOFWIH or 1-855-786-3944 between 8 a.m. and 5:30 p.m. for assistance from a behavioral health specialist.

24-Hour Nurseline

HumanaFirst Nurse Advice: 1-800-622-9529

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: 9/19/2016 5:36:53 PM