The State Maintenance Plan, or SMP, is a health plan that offers Uniform Benefits. SMP is designed to provide a health plan option for members who live or work in areas without adequate access to in-network providers or hospitals.
What’s New for 2021
SMP will be offered in Buffalo, Crawford, Florence, Jackson, La Crosse, Monroe, Pepin, Pierce, Polk, Rusk, St. Croix, and Trempeleau counties. It will no longer be offered in Forest County.
Our improved online provider search tool makes it easy to find doctors by network, location, provider name, specialty and more. Now it’s easier and faster than ever to find the right care and the right doctor. Visit www.weatrust.com/findadoc to start searching.
Go to weatruststatehealthplan.com/providers to search for providers or to access a SMP directory. To request a printed directory be mailed to you, call 1-866-485-0630.
Referrals, Authorizations, Out-of-Network
You must get a referral approved by WEA Trust before getting care outside the WEA Trust SMP network. Your provider must request the referral. It is ultimately the member’s responsibility to make sure the referral is submitted and approved prior to receiving services.
Prior authorization is required for certain services and procedures before you receive care. Without an approved prior authorization, WEA Trust may deny payment. A list of services requiring preauthorization can be found at weatrust.com/preauthorization. You will receive notification of the approval or denial for the prior authorization.
Emergency and Urgent Care
If you require emergency or urgent care when outside of the network, seek care at the nearest medical facility.
Contact 1-866-485-0630 or your primary care physician if assistance is needed to determine the appropriate level of care. Follow-up care must be performed by a network provider to receive network benefits.
Mental, Behavioral Health and Substance Abuse
No prior authorization is required for outpatient services from a network provider, except for psychiatric and neuropsychiatric testing. Prior authorization is required for in-patient and transitional care. A list of services requiring preauthorization can be found at weatrust.com/members/preauthorization-information. For other services, contact 1-866-485-0630. Review the Uniform Benefits certificate for details.
WEA Trust contracts with a variety of health care provider systems that offer their own nurselines. A list of those nurselines can be found at weatruststatehealthplan.com/nurseline.
With WEA Trust’s virtual service, powered by Amwell, health care is delivered to you, on your terms, in the safety and comfort of your own home.
Use Amwell to have a video visit with a doctor or therapist on your smartphone, tablet, or computer. In 2021, psychiatry will be added to the platform. Providers on Amwell treat, diagnose and even prescribe—helping you feel better faster. You’ll get quality care from your own home, for a more affordable price than in-person visits.
Visit weatrust.com/amwell or call 1-800-SEE-DOCS for more information or to get started.
Care Outside the Service Area
SMP, offered by WEA Trust, will reimburse for covered services at 50% of our maximum allowable fee, subject to a $5,000 individual, $10,000 family deductible.
Major Health Systems
Available in select counties. See provider directory.