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


Local High Deductible Health Plan
Insurance for Employees
and Retirees
(PO7, PO17)


Humana – Eastern

1-855-STOFWIH or 1-855-786-3944
humana.com

What’s New for 2017

Humana's service area is expanding to include Green County. Humana continues to support our members health and well-being through innovation. We've added telemedicine services for our members, which saves you time and money. We've also enhanced our customer service by adding Chat features as well as continuing to provide assistance through email. Visit humana.com to explore our services.

Humana’s robust online tools help you choose a provider, see claim status and more. For additional information, go to our.humana.com/stateofwi.

Humana continues to offer a dedicated team trained specifically on the State of Wisconsin health insurance program.

For Members on Medicare: Medicare Advantage

If you retire and are currently a Humana member enrolled in Medicare Parts A and B, you will automatically be enrolled in Humana’s Medicare Advantage PPO plan. Retirees enrolled in Medicare Parts A and B and enrolled in another Medicare plan may choose to switch to Humana’s Medicare Advantage plan. This plan is available if you live anywhere in the United States or Puerto Rico and if you use providers that have accepted the terms of the Medicare Advantage plan.

For 2017, Humana’s Medicare Advantage will provide the same Uniform Benefits for in-network and out-of-network services. Additional benefits and services are also available, such as enhanced preventive benefits which covers 22 services at 100% including bone mass measurement, depression screening and Humana’s 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. Participants of Humana's Medicare Advantage are not eligible to receive the Well Wisconsin incentive.

Provider Directory: Non-Medicare Members

You are required to have a Wisconsin based primary care provider. Go to https://our.humana.com/stateofwi to request a provider directory.
To request a printed directory be mailed to you, call 1-855-786-3944.

Referrals, Prior Authorizations, Out-of-Network Care: Non-Medicare Members

Referrals are needed when receiving care from in-network providers for certain services. Please call 1-855-STOFWIH for more details. Prior authorization is required for some services, and for out-of-network providers before you receive care. 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 1-855-STOFWIH prior to your appointment.

Service Area: Non-Medicare Members

Brown, Calumet, Dodge, Door, Fond du Lac, Green, Green Lake, Jefferson, Kenosha, Manitowoc, Marinette, Milwaukee, Oconto, Outagamie, Ozaukee, Racine, Rock, Shawano, Sheboygan, Walworth, Washington, Waukesha, Waupaca, Waushara and Winnebago counties.
Limited provider availability in: Kewaunee 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. If possible, contact 1-855-STOFWIH within 48 hours of receiving care or if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise approved by Humana.

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 4:36:53 PM