Description

A Group Health Cooperative of Eau Claire health plan in partnership with Common Ground Healthcare Cooperative.

Common Ground Healthcare Cooperative (CGHC) is a non-profit insurance cooperative which serves the people of Wisconsin and gives the public a voice in their health insurance. In many ways, cooperatives behave much like any other health insurance company. We meet the same laws and regulations, and we provide medical insurance and prescription drug coverage. What makes us different is that we answer to our members, not corporate shareholders, so we have absolutely no motivation to raise prices simply to make more money. We are pleased to provide coverage throughout Eastern Wisconsin with high quality care at lower costs.

What’s New for 2023

The Cooperative continues to urge members to utilize our telehealth service, Teladoc. Teladoc provides access to a doctor through the convenience of a phone or video consult for treatment of many minor conditions, such as cold and flu symptoms, from the comfort of your home. If necessary, you can even receive a prescription. Visit group-health.com/members/alternative-care-options/teladoc for more information.

In 2023 CGHC is excited to provide coverage in the following counties throughout Eastern Wisconsin: Brown, Fond du Lac, Green Lake, Kewaunee, Manitowoc, Marinette, Milwaukee, Outagamie, Ozaukee, Shawano, Sheboygan, Washington, Waukesha, Waupaca, Waushara, and Winnebago.

Provider Directory

Go to our partner’s website group-health.com to access the provider directory. Use group-health.com/directories/providers.aspx as a direct path or visit group-health.com, choose “Members,” then “Find a Doctor.” In the drop-down menu under “Select A Plan,” choose State of Wisconsin Employee. To request a printed directory be mailed to you, call Member Services at 1-888-203-7770.

Referrals, Authorizations, Out-of-Network

Referrals are not needed when receiving care from in-network providers. All out-of-network requests require an approved referral by CGHC. Certain in-network services and all admissions require a prior authorization as well. You will receive written notification of the approval or denial for the prior authorization. Members with low back pain are required to participate in a shared decision-making tool to review information on options, outcomes, and to clarify personal values. For further information regarding authorization guidelines, please visit our partner’s website at group-health.com or call 1-888-203-7770 to speak with Member Services.

Emergency and Urgent Care

If you require emergency or urgent care while outside the network, seek care at the nearest medical facility. Use the Teladoc number listed on your ID card if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise authorized by the Cooperative.

Mental, Behavioral Health and Substance Abuse

No referral is needed to see a provider in the Cooperative’s network. Prior authorization guidelines may apply for certain services; please contact Member Services at 1-888-203-7770 for additional information. Please refer to the provider directory for a listing of mental health providers in the Cooperative’s network.

24-Hour Nurseline

Teladoc: 1-800-835-2362

Virtual Visits

Members of the Cooperative have 24/7/365 access to telehealth services through Teladoc. Through the convenience of phone or video consult, this service allows you to discuss your medical concerns with a doctor and, if necessary, receive a prescription from the comfort of your home. It is cost-effective and convenient. Visit our partner’s website at group-health.com/members/alternative-care-options/teladoc for more information.

Major Health Systems

  • Advocate Aurora Health Care
  • ThedaCare
  • BayCare Clinic

Full Service Areas

Brown County, Fond Du Lac County, Green Lake County, Kewaunee County, Manitowoc County, Marinette County, Milwaukee County, Outagamie County, Ozaukee County, Shawano County, Sheboygan County, Washington County, Waukesha County, Waupaca County, Waushara County, Winnebago County