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Online Learnings

Education and tips on ways to stay healthy and well

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Benefits for Better Health

SilverSneakers® Fitness benefit, virtual visits and preventive care

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Member Extras

News, discounts and access to our member newsletter

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Help with Health Conditions

Condition and care management programs available at no cost

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Need to Change Your Plan?

If you're an existing member you can make changes to your plan in the following special situations.

  • You lose coverage through your employer.
  • You move outside of your plan's service area.
  • Your current Medicare Advantage Plan is discontinued.
  • Your income changes and you qualify for a low-income subsidy.
Change Your Plan

Questions?

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–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.

Medicare Diabetes Program Effective Date Change

All Medicare health plans were recently notified that the effective date of the Medicare Diabetes Prevention Program has been delayed by the Centers for Medicare and Medicaid Services. Instead of the program being effective January 1, 2018, it will launch April 1, 2018. This change has been made to all of our Evidence of Coverage documents found at NetworkHealthMedicare.com. Beginning April 1, 2018, services for this program will be covered for eligible Medicare beneficiaries under all Medicare health plans.

The program is a structured health behavior change intervention that provides practical training in long-term dietary change, increased physical activity, and problem-solving strategies for overcoming challenges to sustaining weight loss and a healthy lifestyle.

Receive Plan Materials by Email

Make your selection by September 1 to receive your Annual Notice of Change materials by email in September. 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).

Receive Plan Materials by Email

Forms

Advance Care Planning/Power of Attorney for Health Care Forms - 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 (TTY 800-947-3529).

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.

Medicare Appeals form - When completed by a member (not required) or completed and signed by your doctor, this form will initiate the appeal process on your behalf asking Network Health to consider a coverage or benefit decision that has been made. The use of this form ensures complete information is sent to Network Health for timely and accurate processing of your appeal request.

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.

Express Scripts PharmacySM Mail Order Form – Sign up for convenient home delivery of your prescriptions. 

Member Reimbursement Form – This form can be used to submit charges to Network Health, if a provider is unable to send a claim.

Resources

Your Personal Doctor (also referred to as a Primary Care Practitioner or PCP) - Learn how Network Health designates PCPs.

Preventive Health Checklist

Your Rights and Responsibilities

Help with Multiple Medications

How to Protect Yourself from Fraud

How to Make a Complaint or Appeal

How Health Plans Make Their Decisions

See Quality and Member Satisfaction Ratings (HEDIS/CAHPS Performance Results)

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.

NetworkCares (PPO SNP) Plan Services

A Quick Summary of the Delta Dental Rider Benefit

Delta Dental of Wisconsin Provider Search for Medicare Advantage Plan Benefits

Your 2018 Plan Policy, Called Your Evidence of Coverage

Network PlatinumSelect (PPO)

Network PlatinumChoice (PPO)

Network PlatinumPlus (PPO)

Network PlatinumPlus Pharmacy (PPO)

Network PlatinumPremier (PPO)

Network PlatinumPremier Pharmacy (PPO)

Network Health Medicare Go (PPO)

Network Health Medicare Anywhere (PPO)

NetworkCares (PPO SNP)

NetworkPrime (MSA)

Annual Notice of Changes for 2018

If you're currently enrolled, this document explains the changes to your plan for 2018.

Network PlatinumSelect (PPO)

Network PlatinumPlus (PPO)

Network PlatinumPlus Pharmacy (PPO)

Network PlatinumPremier (PPO)

Network PlatinumPremier Pharmacy (PPO)

Network Health Medicare Go (PPO)

Network Health Medicare Anywhere (PPO)

NetworkCares (PPO SNP) 

NetworkPrime (MSA)

Your 2018 Delta Dental Plan Policy, Called Your Certificate of Coverage

Delta Dental Coverage Included with Most Plans
(*Not included with Network PlatinumSelect (PPO) or Network Health Medicare Go (PPO)

Delta Dental Rider Coverage – Optional Supplemental Dental Program Available to Add on to All Plans

Delta Dental Coverage for NetworkCares (PPO SNP)

Find a Doctor

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Read the Latest

Find news, healthy tips and feature stories in our member newsletter, Concierge.

Research Rx

Visit our Research Rx Center to find local pharmacies where you can get prescriptions, which medications are covered, what they cost and more.

Find a Pharmacy Look Up Medications Go to Research Rx Center