| Welcome to Humana --
Hello ETF Health Plan Participants, and Thank You for choosing Humana!
When it comes to your health and your medical coverage, you need information that helps you understand and manage your benefits. Humana makes it easy to find the facts you need to get the most from your benefits by offering this interactive Web page created just for you!
- State of Wisconsin Member Handbook and Directory - Significant Network Change in Western Region
This is the most comprehensive document on Humana's administration of the State of WI Uniform Benefit plan. It has been developed with considerable input from DETF and key employer groups, so please become familiar with it. The handbook is printed with the Humana Provider Directory, and included in the Dual Choice/New Hire enrollment kits. The electronic version has the added feature of a search function, which can speed up your finding the answers to your service questions.
- Provider Directories
The custom web page will give you access to 3 different provider directories. These are large files that will take a considerable time to open. Below is an outline of what each directory offers so you only need to open the directory most helpful for you.
- 2008 Directory for State of Wisconsin Members
This directory includes network information for both the Humana Eastern and Western 'Premier HMO and POS' network. Please view this directory for a list of participating providers in both the Eastern and Western regions. If your current provider is not listed, you will not have benefits payable under the Humana plan. A Humana-approved referral is required for benefits for services from providers outside of the 'Premier HMO and POS' network.
- 2008 Directory with updated index
- 2008 Premier Network Provider Additions:
Durand Medical Clinic
Kenneth Rucker, MD, Internal Medicine
1250 3rd Avenue W
Durand, WI 54736
715-672-5233
Castleberg Clinic
Robert Dohlman, MD, Family Practice
Joseph Elsner, MD, Family Practice
905 7th Avenue W
Durand, WI 54736
715-672-5981
- HealthPartners Provider List
- Humana Western: There are significant network changes in the Western region for 2008.
- The PreferredOne network will no longer be offered in 2008. The network in 2008 will be the Premier HMO and POS network.
- Mayo Clinic and Hospitals and Minnesota providers will NOT be participating in the Premier network.
- River Falls Hospital in Pierce County was inadvertently dropped off the directory. River Falls Hospital is a network provider in 2008.
- Referral status can be viewed online after January 1, 2008. You may also call Humana directly at 1-800-626-2698.
- 2007 Premier Directory: This directory lists network providers for Humana Eastern only.
Humana Western network information will be available in this directory after January 1, 2008. Please see the 2008 Directory for State of Wisconsin members for a list of participating Western providers. In addition to the providers listed in the Plan Description Pages of the "It's Your Choice" booklets, Humana has contracted with marshfield clinic and Abbot-Northwestern Hospital for tertiary services.
- EyeMed Directory: This lists the EyeMed providers for Wisconsin and Minnesota.
- Humana Group Medicare PFFS
New for 2008: Humana is offering a Group Medicare Private Fee For Service (PFFS) plan to the State of Wisconsin's retirees enrolled in Medicare Parts A & B. Please see the attached materials for more information, or call 1-800-396-8810 7:30 a.m. - 4 p.m. Central time, Monday through Friday.
- Correspondence
A library of communications such as Student Verification Letters.
- Reading the Humana Explanation of Benefits
Humana is a network model HMO, which means that all physicians are essentially independent contractors reimbursed on a Fee-For-Service basis. Every service usually generates a claim for Humana to pay. Thankfully because of Humana's technology investment, 70% of all claims are processed electronically, with an average processing time that is under 5 days. On each claim, Humana will produce an explanation of benefits, or EOB. The link will walk you through the components of the EOB. To help reduce the paper involved, you can receive your EOB via email by registering on My Humana.
- MyHumana
Register for your own customized and secure web page, MyHumana. This powerful web tool will help you track your own health expenses as well as access the monitor a wide range of issues:
- Condition Centers to learn symptoms, treatment and tests. There are tools to assist you in tracking your condition and preparing questions for your doctor.
- Health Assessment to share with your doctor.
- View claims records
- Order replacement Humana Identification cards.
- Receive secure emails from Humana, including health and money-saving tips and guidance in using benefits wisely.
- Report cards: national data on provider cost and quality, including Leapfrog reporting.
- Health and wellness programs.
- Download the PlanProfessor guide to MyHumana
- SpecialtyRX form
Some physicians will prefer to have Humana order and pay directly for a range of high cost medications that are not covered under your Navitus pharmacy plan. The SpecialtyRX order form is a convenient method for physicians to order medications with payment handled directly by Humana.
- Humana Dental Additional information of the supplemental dental plan that Humana has added to the Uniform Benefits of your medical plan.
- EyeMed provides discount options to all Humana members.
- Find a Provider
Humana now offers the 'Premier HMO and POS' network to State of Wisconsin members in the Eastern and Western region. Please choose 'Premier HMO and POS' to find a participating provider in your area. - View the directory
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