Spirit Rx (HMO-POS) Essence Rx (HMO-POS)
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2021 Ascend Rx (HMO-POS) Esteem Rx (HMO-POS) Assurance Rx (HMO-POS) Spirit (HMO-POS) Essence (HMO-POS) Spirit Rx (HMO-POS) Essence Rx (HMO-POS) This directory is current as of Aug. 20, 2020. This directory provides a list of Security Health Plan’s Ascend-Assurance-Essence-Esteem- Spirit HMO current network providers. This directory is for the plan’s Ascend-Assurance-Spirit and Essence-Esteem-Spirit service areas, which include 49 counties in central, south central, southeastern, northern and northwestern Wisconsin as described in detail on pages iii-iv. It also includes providers in some adjacent areas in Minnesota, Michigan, Illinois and other states. To access Security Health Plan’s Ascend-Assurance-Essence-Esteem-Spirit HMO online provider directory, you can visit www.securityhealth.org/directory. For any questions about the information contained in this directory, please call our Customer Service Department at 1-877-998-0998 or 715-221-9897. We are open 7 days a week, 8 a.m. to 8 p.m., Oct. 1-March 31; and Monday through Friday, 8 a.m. to 8 p.m., April 1-Sept. 30. TTY users should call 711. Security Health Plan of Wisconsin, Inc., is an HMO-POS, MSA and D-SNP plan with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in Security Health Plan depends on contract renewal. This document may be available in alternate formats; call Customer Service at the numbers above. Y0117_MC-778-0188-C-09-20_C Table of Contents Section 1 – Introduction.................................................................................................. ii What is the service area for Ascend-Assurance-Essence-Esteem-Spirit HMO plans? .................................................................................................................... iii How do you find Ascend-Assurance-Essence-Esteem-Spirit HMO providers in your area? ............................................................................................... iv Discrimination is against the law ............................................................................. iv Language assistance services..................................................................................... v Section 2 – List of network providers ......................................................................... vi Primary care providers ................................................................................................. 1 Specialty care providers ............................................................................................77 Behavioral health providers .................................................................................. 319 Family planning clinics ........................................................................................... 356 Dental providers ....................................................................................................... 357 Ambulatory surgery centers .................................................................................. 358 Hospitals ..................................................................................................................... 361 Urgent care centers .................................................................................................. 369 Other plan providers ............................................................................................... 375 - Durable medical equipment .......................................................................... 375 - Hearing aid providers ...................................................................................... 386 - Home health agencies ..................................................................................... 392 - Medicare diabetes prevention program suppliers ................................... 397 - Orthotics/prosthetics ....................................................................................... 397 - Skilled nursing facilities (SNFs) ..................................................................... 400 Pharmacies ................................................................................................................. 413 Providers listed alphabetically ............................................................................. 469 i SECTION I - INTRODUCTION This directory provides a list of Security Health If you have a medical emergency: Plan’s Ascend-Assurance-Essence-Esteem-Spirit HMO network providers. To get detailed Get help as quickly as possible. information about your health care coverage, Call 911 for help or go to the nearest please see your Evidence of Coverage (EOC). emergency room, hospital or urgent care center. Call for an ambulance if you need it. You will have to choose a provider to be your You do not need to get approval or a Primary Care Provider (PCP). Generally, you will referral first from your PCP. get most of your health care services from your PCP. As soon as possible, make sure that our plan has been told about your The network providers listed in this directory emergency. We need to follow up on your have agreed to provide you with your health emergency care. You or someone else care services. Because your plan includes should call to tell us about your emergency point-of-service coverage, you may receive care, usually within 48 hours. Call Customer covered services from any of our network Service at providers listed in this directory or may choose 1-877-998-0998 (TTY 711). We are open 7 to use any Medicare-certified provider who has days a week, 8 a.m. to 8 p.m., Oct. 1-March not opted out of Medicare and is located in the 31; and Monday through Friday, 8 a.m. to 8 United States. If you have been going to one p.m., April 1-Sept. 30. provider, you are not required to continue going to that same provider. For more You may get covered urgent and emergent information on point-of-service coverage, see medical care whenever you need it, anywhere your Evidence of Coverage booklet. in the world. Our plan covers ambulance Certain services require prior authorization services in situations where getting to the from Security Health Plan. You may be emergency room in any other way could responsible for obtaining prior authorization endanger your health. For more information, whether from an in-network or out-of-network see your Evidence of Coverage booklet. provider. The Security Health Plan medical If you have an emergency, we will talk with the director must authorize the service before you doctors who are giving you emergency care to receive care for the service to be covered by help manage and follow up on your care. your plan. For more information on services Theywill decide when your condition is stable that require prior authorization, see your and the medical emergency is over. You are Evidence of Coverage booklet. responsible for contacting Security Health Plan There may be times when you get a bill from a to notify us of the emergency once your provider for the full cost of medical care you condition has stabilized. Your follow-up post- have received. In many cases, you should send stabilization care will be covered according to this bill to us so that we can pay our share of Medicare guidelines. the costs for your covered medical services. ii What is the service area for Security Health Plan’s Ascend- Assurance-Essence-Esteem-Spirit HMO-POS plans? The counties in our service area are shown on this map. Ascend-Assurance- Essence-Esteem- Spirit HMO-POS 2021 Service Area Ascend-Essence- Esteem-Spirit plans Assurance-Essence-Spirit plans iii The counties in our service area are listed below: Adams Eau Claire Lincoln Sauk Ashland Florence Marathon Sawyer Barron Forest Marquette Shawano Bayfield Green Monroe Taylor Buffalo Green Lake Oneida Trempealeau Burnett Iowa Pepin Vernon Chippewa Iron Pierce Vilas Clark Jackson Polk Washburn Columbia Jefferson Portage Waukesha Crawford Juneau Price Waupaca Dane La Crosse Richland Waushara Douglas Langlade Rusk Wood Dunn How do you find Security Health Plan Ascend-Assurance- Essence-Esteem-Spirit HMO providers in your area? Please review the Primary Care and Specialty Care sections of this directory to find a provider in your area. The state, county and city names divide each section so that it is easy for you to locate plan providers near your home or place of work. If you have questions about Security Health Plan’s Ascend-Assurance-Essence-Esteem-Spirit HMO plans or require assistance in selecting a primary care provider, please call our Customer Service Department at 1-877-998-0998 or 715-221-9897. We are open 7 days a week, 8 a.m. to 8 p.m., Oct. 1-March 31; and Monday through Friday, 8 a.m. to 8 p.m., April 1-Sept. 30. TTY users should call 711. Or, visit www.securityhealth.org/medicareadvantage. Discrimination is against the law Security Health Plan of Wisconsin, Inc., complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. Security Health Plan of Wisconsin, Inc., does not exclude people or treat them differently because of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status. Security Health Plan of Wisconsin, Inc.: Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information