Prevea360 Health Plan is brought to you by Dean Health Plan, a member of SSM Health. Prevea360 Health Plan believes that health insurance is about more than just helping people when they’re sick. That’s essential, but so is helping to keep you well! That’s why we work so hard at prevention and enhancing your overall well-being. When you choose Prevea360 Health Plan, you benefit from having insurance that’s integrated with your medical care. It’s a different kind of health care model that combines physicians and coverage to better care for you.
Prevea360 Health Plan offers a comprehensive network of hospitals, physicians and specialists throughout northeastern and western Wisconsin. Prevea360 offers the best of three worlds – a strong network of providers, innovative hospitals and comprehensive insurance coverage – all working for you. Prevea360 coordinated care integrates all key elements of personalized health care into a single efficient system. A powerful network of providers. A comprehensive collection of care facilities.
What’s New for 2021
It’s more important than ever to get care quickly and safely. That’s why Prevea Virtual Care is such an important option. Virtual Care – personalized care from a local Prevea Health provider straight from your smart phone or computer. A Virtual Care Visit, which has a zero copay, is intended for limited non-urgent health care needs. This treatment option covers more than 24 conditions. Visit prevea360.com/virtualcare 24/7 for conditions we treat and/or to answer a brief questionnaire and get started with care.
If complex specialty care is required, Prevea360 Health Plan is ready to help with personalized assistance. Prevea360 Health Plan has a special team at the ready, helping you navigate the health care system so you can get the care you need without the added stress of figuring out how to get it. Complex Case Management is available for any member in need.
Go to prevea360.com/wi-employees to access a provider directory. Select “Online Provider Directory” or “2021 Printable Provider Directory” under "Quick Links." To request a printed directory be mailed to you, call 1-877-230-7555.
Referrals, Authorizations, Out-of-Network
Referrals are not needed when receiving care from in-network providers. Prior authorization is required for certain services, procedures and for out-of-network providers before you receive care. You will receive written notification of the approval or denial for the prior authorization. You may check the status of your request at MyPrevea.com. If you are unsure if a service, test or procedure requires prior authorization or a referral, contact 1-877-230-7555 prior to the appointment.
Emergency and Urgent Care
If you require emergency or urgent care when outside of the network, seek care at the nearest medical facility. Contact the Customer Care Center at 1-877-230-7555, if possible, when you receive emergency care. If assistance is needed to determine the appropriate level of care outside of normal working hours, contact Prevea Care After Hours at 1-888-277-3832. Follow-up care must be received by an in-network provider unless otherwise approved by Prevea360.
- Save My Spot allows you to make a reservation at the Prevea Urgent Care of your choice from the comfort of your home. You choose one of the available times and have the option of receiving a text message reminder.
- Online scheduling makes primary care clinic appointments a snap. Simply visit prevea.com and select the medical service you need. Then click Schedule Online Now and follow the prompts to select a time with your doctor.
Most often primary care providers (PCP) should be your first choice for care both because they are familiar with your medical history and because a scheduled office visit is the most cost-effective method of care.
When a more immediate need arises, you do have other options. Visit prevea360.com/RightCare for assistance in making the right choice when it comes to your need for care, ensuring that you receive the right care in the right place at the right cost.
Mental, Behavioral Health and Substance Abuse
A prior authorization is required for the following mental health and substance use services:
- Partial Hospitalization/Day Treatment
- Intensive Outpatient
- In-home therapy
For members with mental health and substance use disorders, Prevea360 Health Plan's behavioral health and substance use case management provides an individualized approach. The goal is to help you manage your health and live your best life. Learn more by visiting Behavioral health and substance use.
With Prevea Virtual Care, we make it simple to get care on your schedule. No appointment. No waiting rooms. Accessible 24/7. Complete an online health interview (5-15 minutes) from your smart phone, tablet or computer. A Prevea Health provider reviews your responses and creates a treatment plan, which may include a prescription if necessary. Visit prevea360.com/virtualcare 24/7 for conditions we treat and/or to get started with care. Virtual Care/Virtual Visit is a non-face-to-face and non-real-time communication-based technology service.
Major Health Systems
- HSHS WI Division Hospitals
- Prevea Clinics
- Door County Medical Center
- Holy Family Memorial Hospital and Clinics
- Oakleaf Clinics