Description

Network Health partners with high-quality health systems and local health care providers to provide care for your whole family right around the corner. No matter your age or stage of life, Network Health will be your partner in health and wellness. For nearly 40 years Wisconsinites have trusted us with their health care needs and we continue to offer innovative health insurance solutions that put our members first. 

We are the only insurer contracted with the State of Wisconsin that has Froedtert and the Medical College of Wisconsin, Ascension Wisconsin and Children’s Wisconsin hospital and clinic locations in our network.

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, 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.

What’s New for 2022

Network Health provides you access to convenient, affordable care close to home. You can receive medical services from our network of high-quality local health care providers or use one of our many digital and telehealth options to connect with care providers from the comfort of your home.

Pilot Programs

Network Health is dedicated to improving the health of our members. For State of Wisconsin members, we offer several “Pilot” programs to help members access the care they need to be well. These pilot programs are not part of uniform benefits and are unique to Network Health. Pilot programs 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. 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 866-709-0019.

     
  • 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. If you have demonstrated improvement of your condition, we will cover an additional eight sessions. Prior authorization and a medical necessity review are required for coverage. Please contact our member experience team with questions about the acupuncture benefit at 844-625-2208. For prior authorization requests, contact our utilization management department at 866-709-0019.

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. If approval is required for your medical services, your 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. You are responsible for obtaining required prior authorizations or you may be financially responsible for the services. To determine if a service, test or procedure requires prior authorization or a referral, call 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 with participating providers. 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 866-709-0019. After hours, call your personal doctor.

As a Network Health member, you have access to SilverCloud, a leading mental and behavioral health online platform. Access over 30 digital cognitive behavioral therapy solutions for  depression, anxiety, dealing with chronic disease, insomnia, stress related to higher education, chronic health and general well-being. To access SilverCloud, log into your Network Health member portal at login.networkhealth.com. Once you sign in, select the My Wellness link in the top right of the page and then select SilverCloud from the dropdown menu.

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. Virtual Visits through MDLIVE give you access to nurses, doctors, dermatologists and behavioral health practitioners from the comfort of your own home.

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 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 - Friday from 8 a.m. to 4:30 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
  • Holy Family Memorial

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, Marquette County, Milwaukee County, Oconto County, Outagamie County, Ozaukee County, Portage County, Racine County, Shawano County, Sheboygan County, Washington County, Waukesha County, Waupaca County, Waushara County, Winnebago County

Limited Service Areas

Menominee County