We're excited to have you as a member. To help you, we've created this guide to help you learn how to use your health plan.
Getting Started
As a new member, we want to make it as easy as possible for you to understand and start using your health plan. To help you, we've created this member kit to provide everything you need to know all in one location.
-
Online Tools: Learn more about Unity’s online tools including MyChart and Health Topics.
-
Using Your Health Plan: Find out about your benefits and services including any copayments, coinsurance or charges you are responsible for, any benefit restrictions, how to submit claims and how to voice a complaint or appeal a decision.
-
Accessing Health Care: Discover the large network of providers available to you and how to access primary or specialty care, behavioral health care, hospital services, care after normal office hours, emergency care and care when you’re away from home or outside of your network.
-
Dental & Rx Benefits: Obtain information about your prescription medication coverage through Navitus and your dental benefits.
-
Rewards for Staying Healthy: Read about the rewards you can earn for participating in healthy activities.
-
Managing Your Health: Learn about the programs and tools available to help you manage your health.
Online Tools
|
MyChart
MyChart gives you access to UW Health medical and Unity insurance information through one secure portal.
As a MyChart member you can:
|
Sign up today!
|
|
MyChart members with a UW Health provider can:
- Receive test results
- Schedule, cancel, and view appointments
- Send secure electronic messages to your UW Health care team
- View and print selected health issues, medications, allergies and immunizations
|
- View your benefit information
- Check claims status
- Check eligibility
- Review prior authorizations
- Receive electronic communications from Unity
- Take a health risk assessment
- Request ID cards
- Change your Primary Care Physician
- Update your demographic information
(Please note: report these changes to your Benefits/Payroll office.)
- Ask customer service a question through Ask an Expert within MyChart
|
|
Health Topics
The Healthwise® Knowledgebase is an online encyclopedia that allows you to research symptoms, diagnoses, treatments and obtain helpful tips on self-care.
|
Using Your Health Plan
1.
ID Card
Review your ID card to make sure your information is correct. Keep it in your wallet and show it each time you receive care. To order replacement ID cards, click here.
2.
Explanation of Benefits (EOB)
Your explanation of benefits informs you of what Unity has paid and what you might owe after receiving care. Learn more about your EOB and sign up to receive electronic EOBs on MyChart.
3. It's Your Choice Book
This document contains your benefit information.
To view your benefit information online, visit MyChart. Here you'll find Uniform Benfits, claim information and authorizations, EOBs, Determining Costs Form and more.
You'll find other important plan information in the Using Your Plan section of the website, such as:
• How to submit a claim
• How to voice a complaint or appeal a decision
• Member Rights & Responsibilities
• Privacy Practices & Policies
• Utilization Management
Accessing Health Care
Unity wants you to receive the care you need, when you need it. Find A Doctor provides a search feature for participating practitioners and providers. You can search by Primary Care Physician, Specialist, Location, or Facility.
If you are looking for a primary care physician at a UW Health Clinic and need help selecting one, visit the UW Health Welcome Center, a concierge service available to help new Unity members select primary care physicians and transition their care to UW Health.
Below is a summary of how to access care depending on your needs:
|
TYPE OF CARE
|
WHAT TO DO
|
|
Routine care
|
Contact your Primary Care Physician's (PCP) clinic
|
|
Specialty Care
|
Contact your PCP clinic, they will tell you how to get appropriate care
|
|
After-hours care
|
Contact your PCP clinic, they will tell you how to get appropriate care
|
|
Urgent Care
|
Go to a participating urgent care center if your injury is not life-threatening but you need prompt attention
|
|
Emergency care
|
Go to the nearest hospital or call 911
|
|
Care away from home
|
Contact your PCP clinic or if it's an emergency go directly to the nearest hospital
|
|
Behavioral Health Care
|
• If your PCP is located in Dane County (excluding Black Earth and Cambridge), contact UW Behavioral Health at 800-683-2300 for mental health services. For alcohol and other drug abuse (AODA) services, contact Gateway Recovery at 608-278-8200
• If your PCP is located outside of Dane County (including Black Earth and Cambridge) contact UW Behavioral Health at 800-683-2300
|
Dental & Rx Benefits
Dental Benefits
Covered benefits for diagnostic, preventive, and basic restorative services are paid at 100% up to $1,000 per member each calendar year with NO annual deductible. Orthodontic care for dependent children up to 19 years is covered at 50% of the first $3,000 in covered services for a lifetime maximum payment of $1,500. Your dental benefits are administered by either Momentum Insurance Plans, Inc. or Delta Dental based on the provider network you have selected:
|
UW Health Network Members
|
Community and Unity Network Members
|
|
Momentum Insurance Plans, Inc. administers dental benefits for members who have selected a PCP in the UW Health Network. To find out if your dentist is in the Momentum network please access their website at momentumplans.com/unity or call toll-free 855-729-6569 or locally
608-729-6569.
|
Delta Dental administers dental benefits for Community Network members. Through Delta Dental you have access to either the Delta Dental PPO network or the Delta Dental Premier network. To find out if your dentist is a Delta Dental provider please access Delta's website at deltadentalwi.com and select either Delta Dental Premier or Delta Dental PPO as your dental plan or call 800-236-3712.
|
Pharmacy Benefits
As a participant in the State of Wisconsin health insurance program, your prescription medication coverage is through Navitus Health Solutions, LLC, a pharmacy benefit manager. You receive an identification card directly from Navitus Health Solutions, LLC and you must use this when filling prescriptions. Your Unity ID card should not be used for pharmacy benefits. For questions about your prescription drug benefit call Navitus Health Solutions, LLC at 866-333-2757 or visit navitus.com.
Rewards for Staying Healthy
How you can earn your rewards/reimbursements through Fitness First & More:
| |
Fitness First
|
|
Fitness First, Health Education,
Integrative Medicine, CSA
and Weight Watchers®
|
|
Health Education,
Integrative Medicine,
CSA and Weight Watchers®
|
Maximum Reimbursement
|
|
Single Coverage
|
$200
|
or
|
$100 for Fitness First and
$100 for all other activities
|
or
|
$100
|
$200
|
|
Family Coverage
|
$200
|
or
|
$200
|
or
|
$200
|
$200
|
Fitness First for Kids is an exercise reward program for kids between the ages of 5 and 18 who are insured dependents of a Unity subscriber. Kids can earn prizes for being physically active.
Health First is a discount program in which members can show their Unity ID cards to participating vendors to receive savings on a variety of wellness products and services.
Managing Your Health
|
Unity offers several programs to help you manage your health.
Preventive Health Care Guidelines
provide preventive service recommendations for infants, children, adolescents, adults and pregnant women.
Complex Case Management— Experienced Registered Nurses work with both you and your health care practitioner to coordinate, monitor, and evaluate the options and services available to help you meet your health care needs. Please call 888-829-5687 to get started.
Unity's Health Management Programs provide condition-specific education, resources and assistance for individuals with certain conditions. Materials members receive include care guidelines, educational mailings, helpful resources, and more. Visit any of the pages listed to the right for more information.
Health Assessment Tools
These tools can help you make smart decisions about your health.
|
Health Management Programs
|
Contact Us
Unity Customer Service
- Send a message through Ask an Expert within MyChart.
- Call 800-362-3310 Monday through Friday from 7am to 5pm (CST).
- 24-Hour Call Back Program- Call and leave a message and we will return your call when it's convenient for you.
UW Health Welcome Center
If you would like help selecting a UW Health Clinic Primary Care Physician, contact the UW Health Welcome Center at 608-821-4819 or 800-552-4255 Monday through Friday from 8am to 5pm. You can also send an email to patient.resources@uwmf.wisc.edu.
Printed Materials
If you would like printed materials, complete the Request Materials form in MyChart, or Ask an Expert. You can also contact Unity Customer Service at 800-362-3310. Printed materials you can request include:
| • Provider Directory |
• Member Guide |
| • Notice of Privacy Practices |
• Fitness First & More Flyer |
| • Preventive Health Care Guideline |
|
