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 is your partner in health and wellness. For 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 plan to have Froedtert and the Medical College of Wisconsin, Ascension Wisconsin, and Children’s 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.
What’s New for 2023
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.
Breathe at Ease Program
Breathe at Ease is Network Heath’s proactive condition management program designed to help members and participants avoid flare-ups, control symptoms, and potentially improve their lung conditions. It’s intended to supplement a physician’s care of chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD).
How does the program work?
- Enroll by contacting one of the Breathe at Ease respiratory therapists to schedule an appointment or ask your doctor for a referral to Breathe at Ease.
- Schedule and attend a one-on-one appointment with a Breathe at Ease respiratory therapist. You’ll receive an assessment, discuss your health history, and develop an action plan.
- Schedule monthly follow-up calls with your respiratory therapist. These phone calls help address any concerns as they arise.
Breathe at Ease Locations and Contacts
Robyn West, RRT
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Ascension St. Elizabeth Hospital 1506 S. Oneida St., Appleton, WI 54915 Phone 920-831-1498 Email Robyn.West@ascension.org |
Ascension NE Wisconsin St. Elizabeth 500 S. Oakwood Rd, Oshkosh, WI 54904 Phone 920-831-1498 Email Robyn.West@ascension.org
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Ascension Medical Group at New London 1420 Algoma St., New London, WI 54961 Phone 920-831-1498 Email Robyn.West@ascension.org |
Prevent T2 Condition Management Program
Our Prevent T2 Lifestyle Change Program is a year long program designed for people with prediabetes and who are at high risk for type 2 diabetes and want to lower their risk. The program follows the Centers for Disease Control and Prevention (CDC) Guidelines.
Prevent T2 empowers individuals by focusing on the following lifestyle and risk-mitigation strategies.
- Dietary changes – You’ll learn the foods that can help you avoid diabetes Type 2 as well as get great recipes and enjoy community discussion around such foods.
- Physical activity – Find an exercise or exercises that works with your schedule and desired activity types.
- Behavior change strategies – Certain behaviors put us at greater risk of developing diabetes Type 2. Similarly, adopting other behaviors can help us in our quest to prevent the condition. Learn the difference and the most efficient ways to change or implement these behaviors.
To be eligible for Prevent T2, you must have a fasting glucose of 100 – 125 mg/dL and a body mass index (BMI) greater than 25.
If you’d like to learn more about Prevent T2, please email NHpreventT2@networkhealth.com.
Pilot Program
For State of Wisconsin members, we offer a “Pilot” program to help members access the care they need to be well. This program is not part of uniform benefits and is unique to Network Health. Pilot programs are subject to change without notice.
- 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
Visit 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 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. Orthopedic and neurology specialists require a referral for lower back pain. If referred to a bariatric surgeon, members will need to acquire prior authorization from Network Health before receiving services. 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. This virtual care platform provides on-demand support, programs, and clinically appropriate care for conditions including the following.
- Depression
- Anxiety
- Chronic disease
- Insomnia
- Stress related to higher education
- Chronic health conditions
- General well-being
To access SilverCloud, log in to your Network Health member portal at login.networkhealth.com. Once you sign in, select the My Wellness link at 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.
- Text NETWORK to 635483 or visit MDLIVE.com/networkhealth.
- Download the MDLIVE app on your smartphone or tablet. Open the application and follow the instructions to create an account.
- 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
- SSM Health
- Holy Family Memorial