Medicare Plans

Member Resources

We handle customer service a little differently at Network Health. Our health care concierge team provides solutions to your concerns, and best of all—they are just a phone call away at 800-378-5234 (TTY 800-947-3529) Monday–Friday, from 8 a.m. to 8 p.m. October 1–March 31, they’re here every day, from 8 a.m. to 8 p.m. Or, if you’d prefer, you can stop into our Menasha office and speak face-to-face.

Need to Change Your Plan?

As a member, you can make changes to your plan in the following situations.

  • It's during the annual enrollment period (October 15–December 7).
  • You lose coverage through your employer.
  • You move outside of your plan’s service area.
  • Your current Medicare Advantage plan is discontinued.
  • Your income has changed and you now qualify for Extra Help. 

Change Your Plan


Additional Wellness Benefits

As a member, you also have access to lots of programs to help you stay well. Because we care about your well-being, these programs are available at no cost.

Member Wellness 
One-on-one support to help you achieve and maintain a healthy lifestyle.

Care Management
Support for our members that are dealing with a short-term illness or a more complex medical condition.

Condition Management
One-on-one health coaching is available at no cost for our members with a chronic condition (asthma, chronic obstructive pulmonary disease (COPD), diabetes, heart disease, stroke or heart failure).

Community Workshops 
Available workshops to teach members how to best manage common symptoms of chronic conditions.

Breathe at Ease
A proactive program designed to help members with chronic bronchitis, emphysema and chronic obstructive pulmonary disease (COPD) avoid flare-ups, control symptoms and potentially improve their lung conditions. 

Medication Therapy Management

This program helps you and your doctor ensure your medications are working to improve your health.

Member Extras

Experience Network Health Member Events

Each year, Network Health hosts special events throughout our service area, called Experience Network Health. We invite you to learn about your plan and any upcoming changes for next year. We give benefit presentations, provide materials and resources and you can get your annual flu shot. Plus, you're welcome to bring a friend. Watch for your invitation to arrive this September. Reservations are reccommended, so sign up for an event today.

RSVP Today

Member Newsletter

Our Medicare Advantage member newsletter, Concierge, includes helpful tips and advice for your life, health and wellness as well as a member feature story. You’ll also find highlights on the best ways to use your plan, save money and get the most from your coverage. 

Concierge Spring
2018 Newsletter
Northeast Concierge Fall 2018 Newsletter Southeast Concierge
Fall 2018 Newsletter
NetworkPrime (MSA) Concierge Fall 2018 Newsletter
concierge-spring18_cover.png NE Concierge Newsletter SE Concierge Newsletter Concierge for NetworkPrime

Fox Cities Performing Arts Center and Marcus Center Ticket Discounts

Network Health offers ticket discounts for select performances at these venues. Offers are highlighted in Network Health’s Concierge member newsletter.

Fox Cities Performing Arts Center – Appleton, Wisconsin

FIDDLER ON THE ROOF – December 2 at 1 p.m.

Tickets on sale now. Offer expires November 12, 2018. Subject to availability.

Visit www.foxcitiespac.com/onlineoffers, click on Network Health Medicare Advantage Plan Member to access the discount offers and use promo code MEDICARE.  

 

Marcus Center – Milwaukee, Wisconsin

HOW THE GRINCH STOLE CHRISTMAS – November 23 at 2 p.m. and November 24 at 5 p.m.

Priority Seating – Tickets on sale now. Offer expires November 18, 2018. Subject to availability.

Visit www.marcuscenter.org/mcaccess and either login or create an account using the Group Code: network.

 

THE PHANTOM OF THE OPERA, ANDREW LLOYD WEBBER’S NORTH AMERICAN TOUR – March 7 at 2 p.m. and March 17 at 6:30 p.m. Priority Seating – Tickets on sale now. Offer expires March 1, 2019. Subject to availability.

Visit www.marcuscenter.org/mcaccess and either login or create an account using the Group Code: network.

Forms

Payment Option Form

Set up recurring premium payments for the year using your bank account or credit card. 

Advance Care Planning/Power of Attorney for Health Care Forms
Use this resource to find for you to give someone permission to make health care decisions on your behalf. For questions about advance directives, contact the Wisconsin Department of Health Services at 608-266-1251 or contact Network Health at 800-378-5234 (TTY 800-947-3529).

Appointment of Representative Form
This form names a relative, friend, advocate, doctor or someone else to act on your behalf for an appeal or complaint. Send the completed form to Network Health, Attn: Medicare Advantage Plans, PO Box 120, Menasha, WI 54952.

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

Medicare Appeals Form
This form initiates 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.

Member Reimbursement Form
If a provider is unable to send a claim this form can be used to submit charges to Network Health.

Personal Health Information Consent Form
his form allows a 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.

Prescription Drug Claim Form
To request reimbursment for a self-administered drug, use this form.

Preventive Health Checklist
Use this form to keep track of your preventive care and screenings.

Request for a Drug Coverage Determination 
You have the right to request coverage for a particular prescription drug.

Request Redetermination Form
You have the right to ask us to reconsider a coverage decision made for a particular prescription drug.

Additional Resources

How to Make a Complaint or Appeal 
Learn more about how to file a complaint (called a grievance) or an appeal.

How Health Plans Make Decisions
Find out how decisions are made about your care.

How to Protect Yourself from Fraud
Tips, contact numbers and what you should know about Medicare and billing fraud.

Member Rights and Responsibilities
As a member, you have certain rights and responsibilities.

Clinical Practice 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.

Notice of Privacy Practices
Our policies to ensure that your privacy and information is protected.

Provider Medicare Manual
Find all of our Medicare processes, policies and procedures in one reference manual. 

For accommodations of persons with special needs at meetings call 800-378-5234 (TTY 800-947-3529).


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.