Description

When it comes to providing access to local providers and health systems, Network Health is a smart choice. We’re a Wisconsin-based company co-owned by two high-quality health systems – Froedtert Health and Ministry Health Care, part of Ascension Wisconsin. We are the only insurer contracted with the State of Wisconsin that has Froedtert and the Medical College of Wisconsin, Ascension and Children’s Hospital Health Systems in our network. For more than 37 years Wisconsinites have trusted us with their health care needs and we continue to offer innovative health insurance solutions that put our members first. 

Network Health’s mission is to create healthy and strong Wisconsin communities. Our employees are from your hometowns. You are our neighbors, friends, and family and so we make sure to get things right, the first time. That’s why we go above and beyond to provide you with exceptional service. We are your health and wellness partner, helping you flourish in every stage of life. That is the Network Health Hometown Advantage™.

What’s New for 2021

Introducing SilverCloud

SilverCloud is a leading mental and behavioral health online platform. It provides access to over 30 digital cognitive behavioral therapy solutions. It supports the treatment of such conditions as depression, anxiety, dealing with chronic disease, insomnia, stress related to higher education, chronic health, and general well-being. You can access these programs independently or at the recommendation of your providers.

Pilot Programs
Network Health is always looking for ways to improve the health of our members. For State of Wisconsin members, we offer several “Pilot” programs aimed at specific conditions. These pilot programs are not part of uniform benefits and are subject to change without notice.

Prevent T2 Pilot Program

Our Prevent T2 Lifestyle Change Program is a yearlong program designed for people with prediabetes and who are at high risk for type 2 diabetes and want to lower their risk. The program follows CDC Guidelines. To be eligible for Prevent T2, you must have a fasting glucose of 100 – 125 mg/dL and a Body Mass Index (BMI) greater than 25. If you’d like to learn more about Prevent T2, please email NHpreventT2@networkhealth.com.

Evidence Based Integrated Care Plan (EBICP) Pilot Program 

Network Health, in partnership with Delta Dental, provides access to enhanced dental benefits for members who are diabetic or are experiencing a high-risk pregnancy. Your Uniform Dental Benefit coverage allows for an additional cleaning as part of its Evidenced Based Integrated Care Plan (EBICP). If you have any questions or need help coordinating your health care, please call our care management team at 1-800-236-0208.

Acupuncture Services Pilot Program

Network Health will cover 12 acupuncture visits with no cost sharing to you for the treatment of chronic headaches, chronic neck pain, chronic low back pain, and osteoarthritis of the knee. Prior authorization and a medical necessity review are required for coverage. If you have demonstrated improvement of your condition, we will cover an additional eight sessions. The additional visits will also need prior authorization. Please contact our member experience team with questions about the acupuncture benefit at 1-844-625-2208. For prior authorization requests, contact our utilization management department at 1-800-236-0208.

Provider Directory

Go to networkhealth.com/find-a-doctor to access an easy-to use provider and facility search. Choose State of Wisconsin employees/members as your plan. Or, view a PDF of the Provider Directory. To request a printed directory be mailed to you, call 1-844-625-2208.

Referrals, Authorizations, Out-of-Network

As a State of Wisconsin member of Network Health, you can see most in-network doctors without a referral. Orthopedic and neurology specialists require a referral for lower back pain. Prior authorization (or prior approval) is required for certain services, procedures, and for out-of-network providers before you receive care. A list of services requiring prior authorization is available here. You can also find the list in your member portal account at login.networkhealth.com under My Materials. An in-network provider will request a prior authorization for you. We will provide you and your provider with written notification of its approval or denial. To determine if a service, test, or procedure requires prior authorization or a referral, call 1-844-625-2208 prior to your appointment.

Emergency and Urgent Care

If you require emergency or urgent care when outside the Network Health service area, seek care at the nearest medical facility. Contact your primary care physician if you need help determining the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise approved by Network Health.

Mental, Behavioral Health and Substance Abuse

Prior authorization is required for all inpatient services for mental health, behavioral health, or substance abuse services. Prior authorizations are not required for outpatient mental health services. For assistance accessing mental health or behavioral health services, please contact Network Health’s Care Management Behavioral Health Department at 1-800-236-0208. After hours, call your personal doctor.

24-Hour Nurseline

If you have health care questions during normal business hours, you can contact your personal doctor's office. Health care questions that arise outside normal business hours can be directed to one of our provider nurse lines that can be found on the Getting Care Quickly page of our website.

Virtual Visits

Virtual visits, brought to you through MDLIVE, are a convenient and affordable alternative to urgent care or a doctor visit when you experience a non-emergency illness. By using your phone, smartphone, tablet or computer, you can connect with a board-certified physician or pediatrician for the treatment of a wide range of behavioral and physical health conditions.

You can activate your Network Health MDLIVE account one of three ways.

  1. Text NETWORK to 635483 or visit MDLIVE.com/networkhealth.
  2. Download the MDLIVE app on your smartphone or tablet. Open the application and follow the instructions to create an account.
  3. Call 1-877-958-5455 and an MDLIVE customer service representative will walk you through the process of setting up an account.

Member Portal

Your member portal is the gateway to secure information about your Network Health plan. In it, you’ll find links that are unique to you. Tools, tips, and important information to help you enhance your life, health, and wellness are also available here.

When you sign in, you’ll see a customized dashboard specific to you and your plan. You can view benefit information, view out-of-pocket expenses, reorder an ID card, access plan materials, and more.

Dedicated Customer Service Line

You will have access to our member experience team through a dedicated phone line. By calling 1-844-625-2208 or 920-720-1811, you'll be connected with Network Health representatives who are specially trained to answer State of Wisconsin and Wisconsin Public Employer Group Health Insurance Program questions. The member experience team can be reached Monday, Wednesday–Friday from 8 a.m. to 5 p.m. and Tuesday from 8 a.m. to 4 p.m.

Major Health Systems

  • Froedtert & the Medical College of Wisconsin Health System
  • Children’s Hospital of Wisconsin - with locations in Milwaukee, Green Bay and Neenah
  • Ascension Wisconsin
  • Prevea Health
  • Bellin Health
  • Agnesian Healthcare

Full Service Areas

Brown County, Calumet County, Dodge County, Door County, Fond Du Lac County, Green Lake County, Kenosha County, Kewaunee County, Manitowoc County, Marinette County, Milwaukee County, Oconto County, Outagamie County, Ozaukee County, Portage County, Racine County, Shawano County, Sheboygan County, Washington County, Waukesha County, Waupaca County, Winnebago County

Limited Service Areas

Marquette County, Menominee County, Waushara County

Limited Hospital Access

Kewaunee County
Was this page helpful?