Use these tools to manage your health coverage. Hello there, how can we help? Everything you need to take full advantage of your WPS plan is right here at your fingertips. Log in to your customer account or register online to get started. If your WPS ID card has this logo, log in here: Don’t have an account? Register now . Customer Account Guide If your WPS ID card has this logo, log in here: Don’t have an account? Register now . Customer Account Guide It’s easy to stay connected to your health coverage and more. Connect with us Questions? To contact our friendly customer care center, please call the number on your ID card. Activate your WPS portal account to easily manage and track your plan details. Keep your WPS ID card in your wallet for easy access. Programs and services to support better health. Pharmacy services Learn how to access and save on prescription medications. Note: If you receive your pharmacy service through a different provider other than WPS and Express Scripts, Inc., please contact your HR Benefit Team for more information. Telehealth services Connect with board-certified doctors by phone or video 24/7. Preventive care services Take advantage of a wide range of covered services from in-network providers. Gym membership savings Enroll today to save on gym memberships and more. Care management services Get support throughout your healthcare journey with help from our care managers. WPS plan forms and documents Simply click below to see more: Authorized representative form for grievance/appeal Customer authorization form Instructions for completing customer authorization form Confidential communications form Consent to unsecure email communications Request to access PHI Request to amend PHI Privacy complaint form Attestation regarding use or disclosure of reproductive healthcare records Domestic partner declaration Domestic partner dissolution WPS Powered By Auxiant forms and documents Simply click below to see more: Customer authorization form Confidential communications form Request to access PHI Request to amend PHI Medicaid and the Children’s Health Insurance Program (CHIP) Medicaid y el Programa de Seguro Médico para Niños (CHIP) Member rights and responsibilities Women’s Health and Cancer Rights Act and Newborns’ and Mother’s Health Protection Act Notice Aviso de la Ley de Derechos sobre la Salud y el Cáncer de la Mujer y de la Ley de Protección de la Salud de los Recién Nacidos y las Madres Your rights and protections against surprise medical bills Frequently asked questions (FAQs) You have access to fitness, vision and hearing programs. To see all your perks, click here . Whether you’re ready to kick-start your exercise routine or just looking to level up, you’ll have access to the Active&Fit Direct ™ program. You can choose from 12,700+ participating fitness centers and select YMCAs nationwide for $28 a month (plus a $28 enrollment fee and applicable taxes). The program offers: Online directory maps and a locator for fitness centers (available on any device) A guest pass to try out a fitness center before enrolling (where available) The option to switch fitness centers to make sure you find the right fit Online fitness tracking from a wide variety of popular wearable fitness devices, apps, and exercise equipment To sign up or learn more about the Active&Fit Direct ™ program, log in to your WPS customer account. Once logged in, click on the link for Customer Resources, then click on Active&Fit Direct. This program is not available to our WPS Medicare Supplement Insurance customers. It is your responsibility to ensure that a claim is submitted to us. You may request that the provider of services file the claim on your behalf. Claims should be itemized and state the provider of the service, diagnosis, date of service, services provided and amount charged for the services. Claims may be submitted to the address on your ID Card. Under Sec. 111 in the H.R. 133, the Consolidated Appropriation Act, health plans are required to send patients an Advance Explanation of Benefits (AEOB) after receiving a good faith estimate notification from a provider or facility that an individual is scheduled to receive an item or service. In addition, 2009 Wisconsin Act 146 requires hospitals, insurance plans, and healthcare providers to disclose information about the cost and quality of healthcare services. If you have a WPS plan, complete the request form to obtain an estimate of out-of-pocket expenses Request form Information on form If you have a plan through WPS Powered By Auxiant, you can use the estimated out-of-pocket costs tool found in your member portal. If you have a WPS plan and you need to file a complaint, please use this form . If you have a plan through WPS Powered By Auxiant please go here to file a complaint. The language of health insurance can be hard to understand. We think you’ll agree that a little knowledge will go a long way toward helping you make sense of it all—so you can make smart decisions that will benefit you and your family, today and for years to come. Learn basic terms .

Your ID card categorizes your information into manageable, easy-to-read tabs. The front of the card includes your ID number and group number, as well as pharmacy information, network choices and any dependents also on your plan. Be ready to show your ID card each time you visit a doctor or specialist. If your health plan has an office visit copay, you will be asked to pay that amount at the time of service. Important tips to remember: Carry your ID card with you at all times Present it when you receive any services Notify customer service if your ID card is lost or stolen Do not let anyone who is not specified on your plan use your ID card—it’s illegal! To request a new or additional ID card, please log in to your online account and fill out an ID card request. You can also call customer service at the number shown on your card. Get more tips . Yes. You will need to use providers that are in your network. Your network can be found on your ID card. We recommend you see an in-network provider. That way, your preventive care services will be covered. If you choose a provider who is out of network, your out-of-pocket costs will be higher. You can use our Find A Doctor tool to search for a provider or hospital in your network. Providers can leave or enter a network at any time; it is recommended that you check the network status of your provider on a regular basis. A prior authorization is the process of receiving written approval from WPS for certain services or products prior to services being rendered. The prior authorization is a written form submitted to us by a participating provider. Services are still subject to all plan provisions including, but not limited to, medical necessity and plan exclusions. See our WPS Explains Videos for more information on prior authorizations. Get more helpful tips . It is ultimately the customer’s responsibility to make sure prior authorization requests are submitted and approved by WPS prior to receiving services. If you have any questions, please call the customer service number on the back of your ID card. Please call the customer service number listed on your ID card. Our helpful team will direct you to the prior authorization list based on your coverage. Calling your primary care physician to describe your symptoms is always a good first step. Many doctors can rearrange their schedules to squeeze patients in for needs which are not emergencies but need medical attention. Consider how serious your symptoms are. For life threatening issues, call 911 or go to the emergency room. For illnesses or injuries that need quick attention but aren’t emergencies, urgent care is usually the best option. If you have a minor illness, need follow up care or have questions about your health, your primary care provider or virtual care visit can help. Choosing the right level of care can save time, reduce costs and get you the right treatment faster. For example, if your coverage includes Teladoc Health®, you can connect with a board-certified doctor 24/7 via phone or video for certain urgent care services and more. Please use this tip sheet [LINK] to help you decide where to go for care. Continuity of care is a relationship with your primary care practitioner (PCP) that is ongoing over time, during periods of illness and health. When your healthcare provider knows you as a whole person, he or she can understand your specific needs for information and care related to your illness. Continuity of care reduces the risks of unnecessary testing and the potential for medical errors. Your provider already knows your past medical and personal history as well as the circumstances of your daily life. So, any decisions made are the best ones for you. At times, patients may need to seek care from medical specialists and behavioral healthcare providers. In these situations, continuity of care relates to the accurate transfer of medical information between your health provider and the medical or behavioral health specialist. With advances in technologies, many patients believe that their medical record is available to all providers at any time, but this is not always true. To assure your healthcare providers are communicating effectively with each other, you will be required to sign a release of medical information. This release allows you to specify which information may be shared and with whom it will be shared. To be certain your healthcare providers share necessary information, ask if a release of information needs to be signed. Continuity of care is not a substitute for active involvement in your own care, especially if you see more than one healthcare provider. If you have received care from medical or behavioral health specialists, be sure to share that information with your primary care practitioner (PCP). Knowing your health history and which medications you take will help your provider give you safe, quality medical care. Behavioral health focuses on behaviors, habits, thoughts, and actions that directly impact your mental and physical well-being. Professional services can include individual, group and family counseling, as well as treatment for substance use. Behavioral health professionals have specialized training to help you understand your problems with an objective, independent viewpoint. They can help identify why you may feel unhappy, depressed, anxious, fearful or in need of emotional help. They can also prescribe medicine—or connect you with someone who can determine if you need medication. Coverage for behavioral health care services depends on your health plan benefits. You can login to your customer account or call the number on the back of your member ID card to determine your eligibility for specific services. Specific services can include outpatient services, partial hospitalization, intensive outpatient, residential and inpatient levels of care. A provider must confirm pregnancy, then coverage begins with your next prenatal visit. Prenatal visits include weight, blood pressure, fetal heart tones, history, physical exam and routine chemical urinalysis. Breast pumps are typically covered in full by your health plan. To learn more about your coverage, please call the customer service number on your member ID card. You may receive your pump through the mail or at a durable medical equipment (DME) supplier. Suppliers may carry different brands of pumps. If you are looking for a particular pump, it is recommended to call several suppliers. If you would like to know what DME suppliers are in your network, please call the customer service number on your customer ID card or search for a supplier online using our Find A Doctor search tool. Featured online option: If Edgepark is a covered DME provider in your network, you can order online and receive the pump by mail. Order at any time and you will receive it one month before you are expected to give birth. Visit edgepark.com , select the state you live in, then select WPS as your insurance provider. You will then be able to browse their products. Have your insurance card and healthcare provider information handy at checkout. Order at any time and you will receive it one month before you are expected to give birth. Visit edgepark.com , select the state you live in, then select WPS as your insurance provider. You will then be able to browse their products. Have your insurance card and healthcare provider information handy at checkout. Search on our Find a Doctor tool to search for doctors and facilities in your network. Log in to your member portal. View your Schedule of Benefits and other information including your claims history. You will want to add your newborn as soon as possible to your insurance plan. If your coverage is through your employer, work with your Human Resources department to obtain coverage. Access your Explanations of Benefits (EOBs) and policy materials Check your claims processing status Verify plan benefits Active customers and eligible dependents (generally dependents over the age of 18 can register for an online account). For WPS members, your user ID must be at least six characters, and no more than 20. Spaces cannot be used. For WPS Powered By Auxiant members, your user ID has no limitations or requirements. For WPS members, your password must be: At least nine characters long (no more than 20), and must contain at least: One letter One number One of the following special characters: (pound signs (#), dollar signs ($), percent signs (%), ampersands (&), underscores (_), or hyphens (-). One of the following special characters: (pound signs (#), dollar signs ($), percent signs (%), ampersands (&), underscores (_), or hyphens (-). It may help you remember your password if you think of the numerical and special characters as letter symbols or use a short sentence as the password. Example: MyPa$$w0rd. (Do not use this specific example). This example uses 10 characters, has lowercase and uppercase letters, includes two special characters (two dollar signs) and a number (zero). For WPS Powered By Auxiant members, your password must be: At least five characters long, and must contain at least: One letter One number When you are registering, review the registration form to make sure your name and date of birth are correct. If this is not the issue, it could be your effective date. If your effective date has not yet occurred, you will need to wait until your effective date before you can be considered an active customer and can register for online access. If none of the above apply, please contact customer service: 888-915-5477 or 888-915-2493 (for WPS Powered by Auxiant customers only), 7:30 a.m.–5 p.m. CT (M-F). When you call, please be at your computer with the WPS site on screen. You will have had to register to set up your user ID and login for access to your customer account. If this is the case, and you are still experiencing problems, please contact customer service: 888-915-5477 or 888-915-2493 (for WPS Powered By Auxiant members only), 7:30 a.m.–5 p.m. CT (M-F). When you call, please be at your computer with the WPS site on screen. Please click the "Forgot your password" link on the login page or call 888-915-5477 for assistance, 7:30 a.m. - 5 p.m. CT (M-F). WPS Powered By Auxiant members call: 888-915-2493. Please call 888-915-5477 for assistance, 7:30 a.m. - 5 p.m. CT (M-F). WPS Powered By Auxiant members call: 888-915-2493. When you call customer service, please have this information ready: Customer (or Subscriber) number At this time, only subscribers can access their online Member Guide. After you log in to the customer portal, navigate to Customer Resources > Document Center > Search your Documents. Select the Document Type of Member Guide/Benefit Booklet from the drop-down listing and change the from date to a date before your effective date and click Search. For WPS Powered By Auxiant members: Your member guide is referred to as the Plan Document. After you log in to the customer portal, navigate to Deductibles and Benefits > Benefit Information. Select the Summary of Plan Document. We display the most current eligibility data on file. Just log in to your customer account, select Benefit & Claim Information, and then select the Plan Benefits link. The policy effective date is located under the Benefits section of the page. For WPS Powered By Auxiant members: Navigate to Enrollment Information on your dashboard and select View Your Enrollment Info. Your effective date will be listed under Original Effective. It could be that you have a future effective date. You will need to enter that date (or a later date) when using your online account tools. For WPS Powered By Auxiant members: You will not be able to log in to your customer account until after your effective date. The drug benefit will display as Not Applicable (N/A) because it is covered under your medical benefit. For WPS Powered By Auxiant members: Navigate to Prescription Benefits in your customer account. This will refer you to your Pharmacy Benefit Manager to contact with questions on your benefit. Please contact the customer service line listed on your customer ID card to resolve your questions on benefit information. Monday-Friday, 7:30 a.m.-5 p.m. (CT). Understanding health plan benefits can be confusing—that’s why we have a helpful resource to help you walk through your EOB. Click here for more information . For Powered By Auxiant members: Click here for more information.