Description

Prevea360 Health Plan, brought to you by Wisconsin-based Dean Health Plan, is a better kind of  health care coverage. Unlike most health care providers, Prevea360 offers the best of three worlds—a strong network of providers, innovative hospitals and comprehensive insurance coverage—all working for you. This means we're all on the same page, and when it comes to your health care, that’s pretty important.

What’s New for 2023

New networks:  For 2023, we are optimizing the structure of our Prevea360 provider network offerings, adding a second comprehensive provider network option for State of WI Group Health Insurance Program members to select – giving you the right option for your care needs whether you’re in eastern or western Wisconsin.

  • Dean Health Plan – Prevea360 East
  • Dean Health Plan – Prevea360 West with Mayo Clinic Health System

If you prefer to get primary care in eastern Wisconsin, then select Dean Health Plan – Prevea360 East.

New Prevea Health Clinic at 3750 N. Investors Court, Grand Chute opened for patient care in late July.  This new clinic location features the latest in design, technologies and amenities for exceptional patient care and experience.  This location will offer the following primary and specialty medical care services:

  • Corporate health and wellness
  • Pediatric neurology
  • Podiatry (foot and ankle)
  • Family medicine
  • Pediatric orthopedics
  • Urgent care
  • Lab and pathology
  • Pediatric rheumatology
  • Urology
  • Mammography
  • Physiatry and pain management
  • Women’s care
  • MRI
  • Physical therapy
  • X-ray

Provider Directory

Go to prevea360.com/wi-employees to access a provider directory.  Select “Search Provider Directory” or “Provider Directory (PDF)”.  To request a printed directory to mailed to you, call 1-877-230-7555.

Referrals, Authorizations, Out-of-Network

Referrals are not needed when receiving care from in-network providers. Prior authorization is required for certain services, procedures and for out-of-network providers before you receive care. You will receive written notification of the approval or denial for the prior authorization. You may check the status of your request at MyPrevea.com. If you are unsure if a service, test or procedure requires prior authorization or a referral, contact 1-877-230-7555 prior to the appointment.  

Emergency and Urgent Care

If you require emergency or urgent care when outside of the network, seek care at the nearest medical facility. Contact the Customer Care Center at 1-877-230-7555, if possible, when you receive emergency care. If assistance is needed to determine the appropriate level of care outside of normal working hours, contact Prevea Care After Hours at 1-888-277-3832. Follow-up care must be received by an in-network provider unless otherwise approved by Prevea360.

  • Save My Spot allows you to make a reservation at the Prevea Urgent Care of your choice from the comfort of your home. You choose one of the available times and have the option of receiving a text message reminder.
  • Online scheduling makes primary care clinic appointments a snap. Simply visit prevea.com and select the medical service you need. Then click Schedule Online Now and follow the prompts to select a time with your doctor. 

Most often primary care providers (PCP) should be your first choice for care both because they are familiar with your medical history and because a scheduled office visit is the most cost-effective method of care.

When a more immediate need arises, you do have other options. Visit prevea360.com/Members/Right-Care for assistance in making the right choice when it comes to your need for care, ensuring that you receive the right care in the right place at the right cost.

Mental, Behavioral Health and Substance Abuse

A prior authorization is required for the following mental health and substance use services:

  • Detox
  • Inpatient
  • Residential
  • Partial Hospitalization/Day Treatment
  • Intensive Outpatient
  • In-home therapy

For members with mental health and substance use disorders, Prevea360 Health Plan's behavioral health and substance use case management provides an individualized approach. The goal is to help you manage your health and live your best life. Learn more by visiting Behavioral health and substance use.

More Ways to Access Mental Health

If you or someone you know is struggling, you are not alone. Prevea360 Health Plan offers many supports, services and treatment options within our network. Visit prevea360.com/Wellness/Behavioral-health for additional information.

Telemedicine continues to grow every day and more specialties are finding ways to provide virtual options for patients. Find out what telepsychiatry means and how it works. You can find an in-network provider at prevea360.com/doctors.

Learn more about Prevea360 Health Plan telepsychiatry at prevea360.com/News/What-is-telepsychiatry.

24-Hour Nurseline

Prevea Care After Hours: prevea360.com/Members/Care-after-hours

Prevea Care After Hours is a free telephone service for Prevea360 Health Plan members. It's available 24 hours a day, 365 days a year. If you're not sure you need to see a doctor—or you're wondering if you have a problem—give us a call. Call 888-277-3832 or 920-496-4700 anytime to speak with a registered nurse.

Experienced registered nurses at Prevea Care After Hours are always available to answer your questions and concerns. When responding to your call, they draw on years of clinical experience in many medical specialties.

Virtual Visits

E-visit - $ the lowest-cost option

You can get care from the comfort of your own home. In 60 minutes or less during regular business hours, you can reach a trusted provider when you need them most. You will get a diagnosis, treatment plan and any needed prescriptions. Virtual care is available to members through age 75. To ensure members receive the highest quality of care, those age 76 and above should be seen at a clinic or doctor's office. Try virtual care for:

  • coronavirus (COVID-19)
  • upper respiratory infections
  • urinary tract infections
  • lice
  • yeast infections
  • pink eye/conjunctivitis
  • acid reflux/GERD
  • and more

Visit prevea.zipnosis.com 24/7 for conditions we treat and/or to get started with care.

Major Health Systems

  • Prevea Health Clinics
  • HSHS WI Division Hospitals
  • Door County Memorial Hospital & Medical Center
  • Holy Family Memorial Hospital and Clinics

Full Service Areas

Brown County, Calumet County, Door County, Kewaunee County, Manitowoc County, Menominee County, Oconto County, Outagamie County, Pepin County, Sheboygan County

Limited Service Areas

Marinette County, Shawano County