Coreen Dicus-Johnson
Network Health President and CEO
Do You Have a Child Turning 26? Approaching 65? We’ve Got a Plan for You.
Getting to Know Your Health Plan
Froedtert ThedaCare Health, Inc. Sole Owner of Network Health
Froedtert ThedaCare Health, Inc. is now the sole owner of Network Health. Froedtert Health and Ascension Wisconsin signed a definitive agreement in which Froedtert Health purchased Ascension’s interest in Network Health. Prior to this agreement, each provider system owned 50 percent of Network Health. On January 1, 2024, Froedtert Health and ThedaCare finalized their agreement to come together as one organization called Froedtert ThedaCare Health, Inc.
We believe the new ownership structure will foster closer strategic planning with Froedtert ThedaCare Health, Inc. and enable Network Health to provide even better support for our communities and members, presenting further opportunity for us to grow and deliver an exceptional health insurance experience.
This ownership change will not disrupt your access to our provider network. Ascension is still an in-network provider.
Froedtert ThedaCare Health, Inc.’s strategy is consistent with their mission to advance the health of the people of the diverse communities they serve through exceptional care enhanced by innovation and discovery. We look forward to exploring new opportunities in our continuing partnership with Froedtert.
Great things are on the horizon for Network Health and our members. We look forward to serving you for years to come.
ED ITORIAL STAFF
Chief Administrative Penny Ransom Officer
Strategic Marketing Julie Heinzel and Communications Jon Race Coordinators
Supervisor
Creative Design Debra Sutton
EDITORIAL BOARD
Jeanne Wittig, Angela Keenan, Devon Lor, Carisa Satorius, Romi Norton, Theodore Regalia, Laura Schneider
Balance is published by Network Health. The health information contained in Balance is meant to supplement, not replace, the advice of health care professionals.
© 2024 Network Health. No portion of this newsletter may be reproduced without written permission from Network Health.
HAVE A QUESTION?
Call our member experience team.
HOURS
Monday-Friday from 8 a.m. to 5 p.m.
PLANS THROUGH AN EMPLOYER
800-826-0940
PLANS FOR INDIVIDUALS AND FAMILIES
855-275-1400
STATE OF WISCONSIN
EMPLOYEES/MEMBERS
844-625-2208
Monday–Friday: 8 a.m. to 4:30 p.m.
TELL US YOUR STORY
If you have questions or suggestions or would like to tell us how Network Health improved your life, send us an email at marketing@networkhealth.com
YOU CAN ALSO WRITE TO US AT:
Network Health
Attention: Julie Heinzel
16960 W. Greenfield Ave., Suite 5, Brookfield, WI 53005
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Your Member Portal
Our goal at Network Health is to make it easy for you to manage your health plan. We work hard to ensure you understand and are comfortable with your plan. That’s why we created the Network Health member portal.
Access your portal at login.networkhealth.com by scanning this QR code with your smartphone camera or type the address into your favorite browser.
Mailing Preferences
Choose which information you want to receive in the mail and which information you want to receive via email. You can go paperless and receive communications via email. Or, if there are communications you’d rather receive as hard copies through the mail, you can select that preferen is yours.
To select your preferences, simply log in to the portal, click your name in the upper right corner and select Change My Communication Preferences. From there, you can choose email for some or all the available categories. Make sure to click Next to save your choices.
Plan Information
The member portal is your personalized online account where you can find information specific to your health insurance plan. It is a secure, passwordprotected account that keeps you well informed and provides plan information at your fingertips.
• Benefits and coverage overview
• Claims detail and status
• Access your mobile Network Health ID card (or request replacement hard copies)
More Resources
The member portal also provides seamless connections to other valuable resources.
• Pharmacy benefits and claims information*
• Your health questionnaire
• Out-of-pocket expenses tracker
• Monthly explanation of benefit (EOB) statements
• Select or update your personal doctor
• Virtual visits
• Wellness programs and tools*
The portal works great on your mobile phone and is built to be viewed on any smart device. That means you have access to your important information wherever you go – the pharmacy, doctor’s office or even on vacation. Just visit login.networkhealth.com.
*Not all Network Health plans have a wellness program or pharmacy benefits. Check your plan documents for details.
New Search Functionality on networkhealth.com
The Find a Doctor and Find a Pharmacy search functionalities on networkhealth.com have been updated.
Like our old search tool, this new enhanced version allows you to find in-network providers and provider and facility information. However, the look and feel has been updated, making it easier to find the information you need for the insurance plan you have.
The new tool also allows for scheduling access for Froedtert doctors.
You can start using Network Health’s enhanced search by visiting networkhealth.com and clicking on the Find a Doctor or Find a Pharmacy buttons in the middle of the page. You can also download an informational how-to document at networkhealth.com/newsearch
Know Your Numbers
By Sam Clark, community wellness supervisor
When reviewing lab results, it’s common to wonder which are the most important numbers to review. Knowing your numbers can help prevent the onset of chronic diseases. Keep in mind, your numbers do not define who you are, however, they give you an opportunity to understand your physical health and decide what course of action you need to take to improve.
Cholesterol
Cholesterol is a waxy substance found in your blood that’s needed to build healthy cells, however, high levels can increase your risk of heart disease. With high cholesterol, you can develop fatty deposits in your blood vessels that can grow and make it difficult for blood to flow through your arteries. Sometimes, these deposits break away and form a clot, which can cause a heart attack or stroke.
HDL Cholesterol
60 mg/dL and higher HDL Cholesterol
40-59 mg/dL (male)
50-59 mg/dL (female)
HDL Cholesterol
Under 40 mg/dL (male)
Under 50 mg/dL (female)
Recommendations – According to the Cleveland Clinic
Blood Pressure
Blood pressure is the force of blood against the walls of the arteries and is made up of two numbers. The top number is your systolic blood pressure which looks at how your heart beats. The bottom number is your diastolic blood pressure which is how your heart relaxes between beats. Over time, high blood pressure may lead to a stroke or heart attack.
Body Mass Index (BMI)
BMI uses a formula that includes a person’s weight and height. A person’s ideal body weight varies by gender, age, height and frame. Your BMI and waist circumference provide good indicators of whether you are at a healthy weight. A high BMI can be an indicator of high body fat.
High Blood Pressure
Hypertension stage 1
There are two types of cholesterol. Your low-density lipoprotein (LDL), or “bad” cholesterol, transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow. Then there is your high-density lipoprotein (HDL), known as your “good” cholesterol, which picks up excess cholesterol and takes it back to your liver.
High Blood Pressure Hypertension stage 2 140 mm Hg or higheror90 mm Hg or higher
Hypertension Crisis
Consult your personal doctor immediately Higher than 180 mm Hg and/or Higher than 120 mm Hg
Recommendations – According to the American Heart Association
30 and above
Recommendations – According to the Centers for Disease Control and Prevention (CDC)
lif e. health. wellness.
Fasting Blood Sugar
Blood sugar is the amount of sugar (glucose) in the blood. This blood test is typically a fasting test. Blood sugar can also be measured by the amount of hemoglobin in your blood. This is called an A1c test and can determine an average blood sugar for the past three months. The A1c test can give you a better idea of how well you are managing your blood sugar levels.
Diabetes 6.5% or above
126 mg/dL or above200 mg/dL or above200 mg/dL or above
Prediabetes 5.7%-6.4% 100-125 mg/dL 140-199 mg/dL N/A
Normal Below 5.7%
Recommendations – According to the CDC
99 mg/dL or below140 mg/dL or belowN/A
What’s the Difference Between Emergency Care, Urgent Care and Virtual Visits?
Virtual Visit
Emergency Care
An emergency is an illness, injury, symptom or condition so serious, that a reasonable person would seek care right away to avoid serious harm. You typically receive emergency care at the emergency room. Emergency care conditions include the following.
• Chest pain
• Trouble breathing
• Sudden numbness in an arm or leg
• Head or neck injury
Urgent Care
Urgent care is for an unexpected injury or illness that is not life threatening, but still needs attention quickly so it doesn’t develop into a serious problem. Urgent care is available at your personal doctor’s office, a walk-in clinic or an urgent care facility. Areas of urgent care include the following.
• Fever
• Pink eye
• Cuts requiring stitches
• Vomiting
• Sinus infections
• Allergic reactions
Another option if you are sick is a virtual visit with MDLIVE®. A virtual visit is a convenient way to get care through your computer, smartphone or tablet. All Network Health plans offer virtual visits as an alternative to urgent care visits for non-emergency medical conditions. Appointments with behavioral health counselors, psychologists and psychiatrists are also available through MDLIVE. Areas of virtual care include the following and more.
• Behavioral health services
• Headache
• C old and flu
Always Remember
• Pink eye
• C ough
• Nausea and vomiting
• Diarrhea
• Respiratory problems
• Fever
• Urinary problems or UTI
If you or a loved one is hurt or ill, panic and confusion can make it difficult to know what to do. If you feel you’re experiencing a medical emergency, it’s important to get to the nearest emergency room or call 911. If it’s not an emergency, many times your personal doctor, a virtual visit, an urgent care or walk-in clinic can provide the care you need at a lower cost.
Getting to Know Your Health Plan
How it all began
It was 41 years ago, in November of 1982, when a small group of like-minded physicians came together around the idea of caring for the communities in which they lived. That’s how Network Health got started. These doctors saw a need in the community for a more personalized form of health care coverage and felt compelled to address it.
The start of Network Health is really that simple.
The idea of being locally focused was the driving force and at the foundation from the beginning. That small group of physicians recognized that they knew the people in their communities better than any large company ever could. And who better to help provide the care and services their friends and neighbors needed than people who live in the very same communities?
At Network Health, we do what’s right, even when it isn’t easy. We take the extra steps to make health plans affordable and understandable, so our members can make the most of their coverage. We offer a different kind of health plan that puts members first.
As a trusted expert in health care coverage, Network Health takes a different approach as a health plan and provides personalized service and treats members with courtesy and respect. As a member, you may already know that. But following is some information you may not yet know about us.
And the mission of Network Health was born – to create healthy and strong Wisconsin communities.
Fast forward four decades, and nothing has changed. Network Health continues to be a locally focused health plan, with its leaders, decisionmakers and the entire organization, located in Wisconsin; all striving to help our members receive the best, and right, care at the right time.
The growth of Network Health
When Network Health first opened its doors, there were a handful of people working in just one building in Menasha. Since then, the organization has grown to over 450 employees between two offices and remote employees.
To support members in the Fox Valley and Milwaukee, our two largest service areas, we expanded to the southeast Wisconsin area in 2015 with an office located in Brookfield. Now, with these two offices, Network Health has an accessible presence in all the communities we serve.
When Network Health first started out, they were strictly a Health Maintenance Organization, or an HMO. It was just one type of plan and
By Jon Race
one group client. Now, including Medicare, Network Health provides dozens of different types of plans to over 120,000 members. Currently, our provider network has grown to include more than 2,400 personal doctors, over 18,800 specialists, over 60 hospitals and more than 2,300 ancillary services providers.
And, as the saying goes, the more things change, the more they stay the same … in a good way. Although we have a lot more members than 40 years ago and our provider network has grown, Network Health still manages to keep our local-community focus.
That will never change.
Network Health in the community
One of the greatest advantages of being headquartered in Wisconsin is that we are deeply connected to the communities where we serve, live and work. At Network Health, we strive to for excellence in everything we do and making a positive impact in our communities is no different.
Over the past year, Network Health has supported over 200 different member and community engagement events with over 16,458 members of the community. Choosing which community partnerships to support is a relatively easy task. We just look for organizations that share our same passion for building healthy and strong Wisconsin communities.
Photographs by Blake Badtke
Over 2,600 Volunteer Hours in 2023
Community impact highlights
At Network Health, we show up and integrate ourselves in our communities. All employees are encouraged to get involved and are given eight hours of paid volunteer time per year.
51% of employees volunteered 172 organizations supported value of hours over $77,000
In January, Network Health participated in the 27th annual Dr. Martin Luther King Jr. celebration, that recognizes work of local non-profit organizations dedicated to serving others.
This year Network Health employees hand-made over 2,000 personalized Valentine’s Day cards for veterans in our community. The cards shared heartwarming messages of gratitude for those who have dedicated their lives to protecting our nation.
In 2024, Network Health partnered with Gold Cross Ambulance Service-HeartStart Foundation to donate an AED to St. Vincent de Paul Food Pantry in Neenah. This gift will help save lives.
We offer members complimentary memberships at the Museum of Wisconsin Art (MOWA). Network Health partners with MOWA to offer educational programming to the community.
Health equity requires access to healthy foods. That’s why we support St. Joseph Food Program and Grow a Row in Menasha every year. In Milwaukee, Network Health helps support over 800 families, including partnerships with local community-based organizations to donate 300 Thanksgiving meals to families in our urban communities.
For decades Network Health employees have donated a steady blood supply to The Community Blood Center and Versiti Blood Center of Wisconsin to ensure our neighbors have access to the lifesaving blood needed. Our Menasha office hosted five blood drives, donated 71 pints of blood in 2023 and helped save 213 lives with their whole blood donations.
In 2023 we returned over $1,152,779 to the community by spending with our own clients.
In 2023 Network Health partnered with Waukesha County Community Foundation (WCCF) and distributed $405,799 to 61 501c3 charitable organizations from the Network Health Hometown Advantage Fund.
The leaders behind Network Health
Any organization is only as good as the people who work there. Network Health is no exception. The leadership team is comprised of individuals who truly believe in the mission to create healthy and strong communities. That belief travels from the top down and is embraced by all Network Health employees.
Moving forward
To learn more about Network Health's leadership team, visit networkhealth.com/ media-kit .
Network Health serves the people of Wisconsin by providing exceptional service, high-quality solutions and exceptional value to our community.
We continue to grow and support the changing needs of our community. It is who we are as individuals and as a team, working to ensure we help create healthy and strong communities.
Why is Proper Drug Disposal Important?
By Anna Peterson Sanders, PharmD, BCGP, pharmacist
Proper disposal of your medications helps minimize the risk of accidental poisoning, overdose and abuse. Improper disposal, such as flushing medications or throwing them in the trash, can contaminate the water supply and soil, harm wildlife or be found and illegally sold or abused.
Fast Facts
• Abuse of prescription or illegal drugs often starts with misuse of prescription drugs, which typically come from family or friends, including situations where medications are stolen from the home.
• In Wisconsin, drug deaths are not region-specific, they are seen statewide. Between 2015 and 2022, 8,272 opioid overdose deaths occurred in Wisconsin.
• Nationally, more than 105,000 deaths related to drug-induced overdose occurred in 2021.
• The problem continues to worsen. Tracking since 1999 has seen an upward trend nearly every year with rapid increases seen in the past five years.
How Do I Dispose of My Medications?
The National Prescription Drug Take Back Day aims to provide a safe, convenient and responsible means of disposing prescription drugs. The April 2024 Take Back Day collected 670,136 pounds, or 335 tons, of medications.
The next National Prescription Drug Take Back Day is scheduled for October 26, 2024. You can find a convenient drug take back location by using the interactive map located at dhs.wisconsin.gov/opioids/drug-take-back-day.htm.
Other options to consider
• To find a permanent drug drop box near you, visit dhs.wisconsin.gov/opioids/permanent-drug-drop-boxes.htm.
• Check to see if your local pharmacy or police department has a drop box at their facility.
• Ask your pharmacy if they have DisposeRx, a medication disposal packet. Visit disposerx.com to learn more.
• Certain drugs for cancer or other chronic diseases may be donated to the Wisconsin Drug Repository to be given to uninsured or underinsured individuals. To find out more about this program, visit dhs.wisconsin.gov/guide/ cancer-drugrepo.htm.
*nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
Required Information
There are several organizations that exist to help improve the quality of health care across the United States, including the National Committee for Quality Assurance (NCQA), the Wisconsin Office of the Commissioner of Insurance (OCI) and the Centers for Medicare & Medicaid Services (CMS). They use a variety of performance measurement tools and regulations to help ensure consumers are protected and receive quality health care services. These organizations also require health insurance companies to provide information to their members on these specific topics.
• Access to Network Health Care Management Employees and Services
• Evaluating New Technologies
• How Do Health Plans Make Decisions?
• Member Rights and Responsibilities
• Submitting a Claim for Reimbursement
• What’s the difference between emergency care, urgent care and virtual visits?
• Ensuring You Receive the Service You Deserve
• Falls/Osteoporosis
• Keep Yourself Safe from Medicare Fraud
• Network Health’s Focus on Quality
• The Importance of Exchanging Information
• What is Population Health Management?
You can find a downloadable PDF of this information at networkhealth.com/required-info. If you do not have access to the internet and need a hard copy, please call our member experience team at the number located on the back of your Network Health ID card.
Network Health Diabetes Prevention Program
By Sam Clark, community wellness supervisor
Network Health has been working with our members to expand our prevention efforts for Type 2 diabetes through the Prevent T2 diabetes prevention program.
This program consists of a one-year series of facilitator-led group sessions for individuals with prediabetes or a predisposition for developing Type 2 diabetes. The program is part of the National Diabetes Prevention Program, which is led by the Centers for Disease Control and Prevention (CDC) and has been proven to prevent or delay Type 2 diabetes.
The program focuses on dietary changes, increased physical activity and behavior change strategies. Prevent T2 classes are designed to help individuals make small changes that lead to big differences in their overall health. Program participants may also learn to manage other conditions like high cholesterol or high blood pressure with fewer medications.
The Network Health Prevent T2 program drives incredible results. To be included in future classes, email NHpreventT2@networkhealth.com or pre-register at networkhealth.com/wellness/prevent-t2 and a Network Health wellness coordinator will follow up with you.
Know someone who is enrolled in Medicare and could benefit from this program?
Network Health recently launched the Medicare Diabetes Prevention Program (MDPP). We are the first health plan in Wisconsin to offer this free program, which is part of the National Diabetes Prevention Program, led by the CDC. Classes are offered every other month. To learn more, visit networkhealth.com/wellness/prevent-t2-ma
CANCER PREVENTION Human Papillomavirus (HPV) Vaccine Is
Why does my child need the HPV vaccine?
The HPV vaccine protects against cancers caused by HPV infection. HPV is a common virus that infects teens and adults. About 14 million people, including teens, become infected with HPV each year. HPV infection can cause cervical, vaginal and vulvar cancers in women and penile cancer in men. It can also cause anal cancer, cancer of the back of the throat (oropharynx) and genital warts in both men and women.
When should my child be vaccinated?
All children who are 11 or 12 years old should get two shots of the HPV vaccine six to twelve months apart. Getting vaccinated on time protects preteens long before ever being exposed to the virus. People get HPV from another person during intimate sexual contact.
Some children may need three doses of the vaccine. For example, adolescents who receive their two shots less than five months apart will need a third dose for the best protection. Also, children who start the vaccine series on or after their fifteenth birthday need three shots given over six months. If your teen hasn’t received the vaccine yet, talk to their doctor about getting it as soon as possible.
HPV vaccination is recommended at ages 11-12 to protect against cancers caused by HPV infection.
Is the HPV vaccine safe for my child?
The HPV vaccination provides safe, effective and long-lasting protection against cancers caused by HPV. The vaccine has a reassuring safety record backed by ten years of monitoring and research.
Like any vaccine or medicine, the HPV vaccine can cause side effects. The most common side effects are mild and include pain/redness/swelling in the arm where the shot was given, dizziness, fainting, nausea and headache. Fainting after any vaccine, including the HPV vaccine, is more common among adolescents.
It is important to tell the doctor or nurse if your child has any severe allergies, including an allergy to latex or yeast. The HPV vaccine is not recommended for anyone who is pregnant.
Where can I learn more?
Talk to your child’s doctor or nurse to learn more about HPV vaccination and the other vaccines that your child may need. You can also find out more about the HPV vaccine at cdc.gov/hpv
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Finding Lower-Co$t Medications
By Anna Peterson Sanders, PharmD, BCGP, pharmacist
Seems like we’ve been stuck in a cycle of ever rising prices and it feels as though nothing is immune to inflation – housing, food, gas, you name it. If you’ve been to your pharmacy, you likely noticed how prices have crept up over time.
Fortunately, there are several tools at your disposal that can help to bring down your cost at the pharmacy register.
1. Know your formulary
A formulary is a list of prescription drugs covered by your insurance and includes important information such as tier placement, quantity limits and prior authorization requirements. Review this list with your doctor so they can help you choose a lower-cost product in a medication class that has options. The lower the tier, the lower the cost.
2. Use your Network Health member portal to price drugs
Sign in at login.networkhealth.com and enter in your medication and zip code. Local, in-network pharmacies will display your coinsurance or copayment for each store. This is a great way to quickly see which pharmacies near you may have the best cost options.
3. Websites like GoodRx.com and SingleCare.com
Search your medications to see if you discover a better price than what you find in your member portal. If you do, print the coupon from the website or use a QR or barcode from your smart phone app to present to your pharmacist when picking up your medication in person. Please note that this option does not count toward your deductible since it is a program that works outside of your health insurance.
4.
Mark Cuban Cost Plus Drug Company (Cost Plus
Drugs)
Cost Plus Drugs is a lower cost alternative for prescriptions and is available online only as a mail order pharmacy option at costplusdrugs.com. While this pharmacy doesn’t offer every drug, the ones they include are at a fantastic savings. To keep costs low, registration and communication are done online through Cost Plus Drugs. You must pay the full cost initially out-of-pocket and submit a claim to Express Scripts for reimbursement and credit toward meeting to your deductible. Prescription reimbursement claim forms can be found at networkhealth.com/employer/ pharmacy-information.
5. Are you on insulin?
We have a patient assurance program offering preferred insulins for $25 per month. No need to sign up for the program, it will automatically process for this copayment at the pharmacy. Contact a Network Health pharmacist for information regarding the insulins that are part of this program.
6. Call your local Network Health pharmacist
Reach out to us Monday–Friday from 8 a.m. to 5 p.m. at 888-665-1246 or pharmacist@networkhealth.com. We can help you look at alternative therapies, price out costs and seek assistance.
Do You Have a Child Turning ?
If you, your child or someone you know is turning 26 soon and won’t be enrolling in an employer’s group plan, make sure you review Network Health’s Individual and Family Plans. We offer a variety of plans to ensure excellent coverage, along with the high-quality service you’ve come to expect.
We understand that health insurance isn’t always the easiest item to shop for. This is true for those who have purchased and used it for years, and it can be even more complicated if you’re shopping for the first time.
That’s where Network Health can help. For over 40 years, we have been a trusted expert in health insurance, offering a different kind of health plan that puts members first.
Our plans are easy to understand and affordable. We can provide the information needed to help you choose the plan that’s best for you. Making sure you keep up on your preventive medical tests, appointments and procedures, as well as dental care, is vital in maintaining a healthy "you".
If you or someone you know is turning 26 and will be shopping for health
or someone
You will receive the same exceptional one-on-one service you’ve experienced for years and we make enrolling in a Medicare plan easy.
As good as Original Medicare is, it will not cover all your health care expenses. Most people who are eligible for Medicare choose to get their benefits through private health insurance companies to help cover costs. With a Network Health Medicare Advantage Plan, you’ll get extra benefits that Original Medicare doesn’t cover.
