The State of Wisconsin and Wisconsin Public Employers (local government) Group Health Insurance Program offered by the HMOs and PPOs requires the designation of a primary care provider (PCP) or primary care clinic (PCC). You have the right to designate any PCP or PCC who participates in the health plan’s network and who is available to accept you or your family members. If you do not choose a PCP or PCC, health plans will designate a PCP or PCC for you automatically. For information on how to select a PCP or PCC and for a list of the participating PCPs and PCCs, contact the health plan. You can find contact information on Health plan Contact pages.
For children, you may designate a pediatrician as the PCP.
For women, you do not need prior authorization from the health plan or from any other person (including a PCP) in order to obtain access to obstetrical or gynecological care from a health care professional in-network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the health plan. You can find contact information on Health Plan Contact pages.