Description
Network Health partners with high-quality health systems and local healthcare providers to provide care for your whole family right around the corner. No matter your age or stage of life, Network Health is your partner in health and wellness. For more than 40 years Wisconsinites have trusted us with their healthcare needs and we continue to offer innovative health insurance solutions that put our members first.
We are the only plan to have Froedtert Health, Children’s Wisconsin, ThedaCare, and Ascension Wisconsin hospital and clinic locations all in our network, to help ensure the best care possible is available to you – right around the corner.
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. We take the extra steps to make insurance understandable so you can make the most of your coverage. We’re honest and hardworking – just like you.
Network Health is one of the top-rated plans for quality in the Group Health Insurance Program, and scored #1 in the ratings for health plans, comprehensive diabetes care, and hospitalization follow-up care for mental health.
What’s New for 2025
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.
As of January 1, 2025:
As of January 1, 2025, ThedaCare will be a participating in-network provider for Network Health State of Wisconsin Group Health Insurance Program members. This addition to our high-quality provider network will allow members to access eight more hospitals and nearly three dozen more clinics and care centers throughout the Network Health service area.
A new pilot program for Remote Patient Monitoring (RPM) visits and devices for managing obesity, hypertension, sleep apnea, and atrial fibrillation. The program reduces member cost-share to $0 for RPM visits and devices, helping members manage their condition more efficiently and effectively.
Provider Directory
Visit our Find a Doctor, Facility or Clinic webpage 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.
Please note – Both provider and the provider facility must be in-network and located in Network Health’s service area for medical services to be covered by your Network Health benefits plan.
If you receive services from an out-of-network provider at a facility that is in-network, the services will not be covered. The same is true if you receive services from an in-network provider at a facility that is out-of-network or out of our service area.
Both provider and provider facility must be in-network and located in Network Health’s service area.
Referrals, Authorizations, Out-of-Network
As a State of Wisconsin member of Network Health, you can see most in-network doctors without a referral. 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 after logging in, 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 for services provided by Out-of-Network providers or you may be financially responsible for the services. 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 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 1-866-709-0019. After hours, call your personal doctor.
As a Network Health member, you also have access to telehealth services through MDLIVE®. MDLIVE licensed therapists and board-certified psychiatrists can help you get back to feeling your best if you’re feeling overwhelmed, stuck, or not like yourself – in the privacy of your own home. Common reasons to seek care include the following:
- New relationships
- Divorce or separation
- Parenting challenges
- New job or stress at work
- Job loss or retirement
- Loss of a loved one
- Experiencing a traumatic event
- LGBTQ+ support
- And more
See the Virtual Visits section below for instructions about setting up your MDLIVE account.
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.
- Text NETWORK to 635483 or visit our MDLIVE page.
- Download the MDLIVE app on your smartphone or tablet. Open the application and follow the instructions to create an account.
- 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 1-920-720-1811, 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 Health
• Children’s Hospital of Wisconsin - with locations in Milwaukee, Green Bay and Neenah
• ThedaCare
• Ascension Wisconsin
• Bellin Health
• Prevea Health
• SSM Health