It's Your Choice 2018
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
MercyCare Health Plans1-800-895-2421 Option 5
What’s New for 2018
Since Mercyhealth System and Rockford Health System merged to form Mercyhealth in January 2016, we have integrated services and grown to meet the ever expanding needs of the region. We have hired over 165 new primary and specialty care physicians, and added new and unique services such as the region’s only Small Baby Unit, a special unit to care for babies born at less than 27 weeks gestation or weighing less than 2.2 pounds. In June 2016, we broke ground on a new women’s and children’s hospital and medical center in Rockford, Illinois. In preparation for the women’s and children’s hospital opening in late 2018, we have formed a partnership with Anne and Robert H. Lurie Children’s Hospital of Chicago to bring highly specialized pediatric services, such as pediatric cardiovascular surgery, plastic surgery and hematology/oncology care, to Rockford to serve Mercyhealth patients throughout northern Illinois and southern Wisconsin. MercyCare’s service area continues to serve Rock, Walworth, Jefferson and Green Counties in Wisconsin as well as Boone and Winnebago Counties in Illinois.
We have also remodeled and expanded a variety of facilities, and received approval to build a 13-bed hospital and clinic in Crystal Lake, Illinois. Currently underway is a new Mercyhealth Alpine facility, which will house a new family medicine residency program that will allow Mercyhealth to recruit, train and retain qualified primary care physicians in the wake of a growing shortage.
Go to mercycarehealthplans.com to access a provider directory. In the middle of the page click on the box "Find a doctor/facility". 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 2018 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 Option 5 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 Services
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 Option 5.
Healthline: 608-758-5770 or 1-888-756-6060
This page was last modified on: 9/27/2017 3:20:49 PM