You've selected this plan
Our Health Care Concierge Team
Our health care concierges are just a phone call awaySee More
Questions? Need to Change Your Plan?
If you have any questions about your plan, call a health care concierge at 800-378-5234 (TTY 800-947-3529). We're available Monday through Friday, 8 a.m. to 8 p.m. From October 1 - February 14, we're here every day, 8 a.m to 8 p.m.
You can change your plan at certain times of the year, like during the Annual Enrollment Period from October 15 to December 7.
Sign Up for Less Mail
Make your selection for email by September 1 to receive your Annual Notice of Change materials by email in September. If you and your spouse are on the same plan, you can also choose to get one copy of materials instead of two (called householding). It takes less than five minutes to sign up. A health care concierge can also assist you at 800-378-5234 (TTY 800-947-3529).
Advance Care Planning/Power of Attorney for Health Care Form - The State of Wisconsin recognizes living will forms and health care power of attorney forms as advance directives. Use this resource to find forms that make it possible for you to give someone permission to make health care decisions on your behalf, should you become unable to express your wishes. If you have questions about advance directives, contact the Wisconsin Department of Health Services at 608-266-1251 or you can call Network Health at 800-378-5234.
Personal Health Information Consent Form - When completed and signed by both parties, this form, allows the specified person (a spouse, relative, friend, advocate, attorney, doctor or someone else) to call to discuss your coverage and plan information if it’s ever needed. By filling out this form when it’s convenient, you can protect yourself and your loved ones from headaches later.
Appointment of Representative Form - You can use this form to name a relative, friend, advocate, doctor or someone else to act on your behalf for an appeal or complaint. To name a representative to act for you, complete this form (sign it and have the representative you're naming sign it) and send it to Network Health Insurance Corporation, Attn: Medicare Advantage Plans, PO Box 120, Menasha, WI 54952.
Correction: The Fall 2016 Concierge newsletter incorrectly stated that a completed Appointment of Representative Form can help family, friends or an appointed representative discuss your personal health information (PHI) with members of our health care concierge team. The correct form is the Personal Health Information Consent Form above.
Submit a Request for a Drug Coverage Determination - You have the right to request coverage for a particular prescription drug.
Redetermination Request Form - You have the right to ask us to reconsider a coverage decision made for a particular prescription drug.
Prescription Drug Claim Form - If you need to get reimbursed for a self-administered drug, use this form.
Your Primary Care Physician (PCP) - Learn how Network Health designates PCPs.
Clinical and Preventive Guidelines - Visit this page for our clinical practice guidelines that include U.S. Preventive Services Task Force recommendations for preventive care, like certain screenings, shots and vaccines that can help you stay healthy and avoid getting sick.
Your 2017 Plan Policy, Called Your Evidence of Coverage
Annual Notice of Changes for 2017
If you're currently enrolled, this document explains the changes to your plan for 2017.
Find news, healthy tips and feature stories in our member newsletter, Concierge.