Out-of-area Coverage

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Coverage for out-of-area dependents

green icon of a book  What you need to know

Do you have dependents who live outside of the Prevea360 Health Plan service area? If your dependents (up to age 26) are college students or children living in communities outside our service area, Prevea360 Health Plan is committed to helping them get the health care and coverage they need when they need it.

This coverage is available under large employer group plans. To find out if you have this coverage, see your member certificate or check with our Customer Care Center at 877-230-7555.

green icon of a clip board with a checkmark  Notify us

Be sure to notify us of your out-of-area dependent by completing and submitting an out-of-area dependent form.

View Form
 


Green icon of the state of Wisconsin  If your dependent needs services

Outside of Wisconsin

To find a provider for your dependent living outside of Wisconsin, use our vendor to find covered out-of-area services. Go to MultiPlan's site, click the Select Network button, then PHCS network to search.

PHCS logo

Search MultiPlan Providers

 

Inside Wisconsin, but out of the service area

If your dependent lives in Wisconsin, but outside the service area, use our vendor to find covered out-of-area services. Go to MultiPlan's site, click the Select Network button, then HealthEOS network to search.

HealthEOS logo

Search MultiPlan Providers


green icon of an ambulance  In case of emergency

If your dependent needs urgent or emergency care outside the service area and is unable to get to a plan provider, he or she should go to the nearest urgent care or emergency center for treatment.

It is important to notify Prevea360 Health Plan as soon as possible by calling the Customer Care Center at 877-230-7555.

All follow-up care should be done by a plan provider. If your dependent is out of the area and unable to see a plan provider, call your primary care practitioner for a referral to an out-of-area provider. These services require approval by Prevea360 Health Plan.

two women hiking up a mountain

Traveling? You've got coverage

Traveling and find you need health care? Prevea360 Health Plan members are covered for urgent and emergency care worldwide. Regardless of where you travel, you don’t need to take health care coverage worries with you on vacation. We have you covered.

green icon of an airplane  Find a provider while traveling

HMO/POS members outside the Prevea360 Health Plan service area or Wisconsin:

Search Providers Now

If you reside outside of the Prevea360 network area, you will fall under the PPO product design and need to select that option in our provider directory to see providers. This section is intended only for those on a network or POS product when traveling out of the area or having a dependent out of the area for a period of time.
 

green icon of a dollar sign with an arrow  Your coverage

You do not need a referral or prior authorization for urgent or emergency services — no matter where you travel:

  • Prevea360 Health Plan covers urgent and emergency services while you are outside of our service area (subject to policy copays, coinsurance, deductibles and maximum allowable fees).
  • The amount charged for these services received from an out-of-network provider may exceed the maximum allowable fee, in which case you will be responsible for paying the difference between the amount charged and the maximum allowable fee.
  • If you require urgent or emergency care outside the service area and are unable to get to a plan provider, please go to the nearest urgent care or emergency center for treatment. It is important to notify Prevea360 Health Plan as soon as possible by calling the Customer Care Center at 877-230-7555.
  • All follow-up care should be done by a plan provider. If you are out of the area and unable to see a plan provider, call your primary care practitioner for a referral to an out-of-area provider. These services require approval by Prevea360 Health Plan.