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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)


UnitedHealthcare of Wisconsin

Open Enrollment Information: 1-866-873-3903 or welcometouhc.com/state
1-800-357-0974
myuhc.com

What’s New for 2017

Covered subscribers will continue to have access to online tools out on myuhc.com to assist them with making important healthcare decisions. Healthcare Cost Estimator (myHCE) allows members to compare common medical procedures cost before receiving services. Know the 4 Ps when shopping for health care – Procedure, Provider, Price, Place.

Virtual Visit – Access to care online at any time, members can see & speak with a doctor from their mobile device or computer for non-emergency medical conditions. Great for kids away at college or if a family member becomes ill while traveling.

Provider Directory

Go to welcometouhc.com/state, click on “Find a Doctor/Hospital” and then select the “State of WI employee Provider Directory” link. For a print version, call Customer Service at 1-800-357-0974 (current member) or 1-866-873-3903 (non-current member). A full directory or ZIP code search may be requested. If you are currently enrolled, you will be able to register on myuhc.com for your personal search criteria.

Referrals, Prior Authorizations, Out-of-Network Care

You do not need a referral to see a physician/hospital in the network. If a specific covered health service is not available from a network physician/hospital, your network physician must notify UnitedHealthcare (UHC) Care Coordination to request a “Network Gap Exception.” You are responsible for notifying UHC’s Care Coordination before obtaining services for dental/oral. Certain tests and procedures, including high tech radiology and low back surgery, require prior authorization. You and your physician will be notified in writing of UHC's decision and coverage determination.

Service Area

Brown, Calumet, Dodge, Door, Fond du Lac, Green Lake, Jefferson, Kenosha, Kewaunee, Manitowoc, Marinette, Milwaukee, Oconto, Outagamie, Ozaukee, Racine, Rock, Shawano, Sheboygan, Walworth, Washington, Waukesha, Waupaca, Waushara and Winnebago counties.
Limited provider availability in: Marquette County.

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 Customer Service at 1-800-357-0974 or your primary care physician if assistance is needed to determine the appropriate level of care. Follow-up care must be completed with your local participating provider or one of our national HMO contracted providers unless approved by UHC.

Mental, Behavioral Health and Substance Abuse

Prior to seeking mental, behavioral health or substance abuse services, contact Optum Behavioral Health at 1-800-851-5188 for assistance from a behavioral health specialist, 8 a.m. - 5 p.m. CST. 24-hour service outside standard business hours are for emergency assistance only.

24-Hour Nurseline

Care24: 1-888-887-4114

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.

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