Network Health Services

Network Health Services Insurance Review

Network Health is a Wisconsin-based health insurance provider with a four-decade history of serving the state's communities. Dedicated to building healthy communities, they partner with high-quality local healthcare systems and providers to offer comprehensive insurance solutions. This in-depth review will examine Network Health's offerings, strengths, and potential areas for improvement, helping you determine if it's the right fit for your healthcare needs.

Overview

Established in 1982 as Nicolet Health Plan, the company began as a group HMO formed by the Physicians of Nicolet Clinic. A pivotal moment arrived in 1986 when it rebranded as Network Health Plan, setting the stage for substantial growth and expansion. Key milestones throughout its history include the establishment of a new management team in 1991, strengthening their operational capabilities across various departments. Changes in ownership structure in 1994 led to the formation of Network Health System, involving St. Elizabeth Hospital and Wheaton Foundation. The acquisition of an amended certificate of authority in 1995 enabled them to offer a broader range of insurance products. The launch of Medicare Advantage PPO plans in 2005 signified a key strategic move, and 2012 saw an increased emphasis on fostering a positive employee culture. Their commitment to quality was further solidified by achieving 4.5 out of 5 stars from the NCQA in both their Medicare and commercial plan ratings in 2021.

Regulatory Compliance and Licenses

Network Health operates under the full regulatory compliance and licensing requirements of the state of Wisconsin. Their commitment to quality is further evidenced by their accreditation as one of only four accredited health plans in Wisconsin, a testament to their high standards as verified by consistently high ratings from the NCQA for both their Medicare and commercial plans. This demonstrates a strong track record of adhering to strict regulatory standards and maintaining exceptional quality of care.

Insurance Products and Services

Main Insurance Products

Network Health provides a diverse range of health insurance options catering to various needs. These include:

• Health Insurance: They offer a wide selection of health insurance plans, encompassing both Medicare Advantage and commercial plans. These plans provide extensive coverage, including hospitalization, doctor visits, and essential preventive care. The depth and breadth of their offerings ensure a suitable plan for most individuals and families.
• Coverage Options and Policy Details: Network Health goes beyond simply offering basic plans. They offer point-of-service (POS) plans, preferred provider organization (PPO) plans, and various ancillary products, providing members with greater choice and flexibility to tailor their coverage to their specific healthcare requirements. Their Medicare Advantage PPO plans have achieved the highest rating of 5 out of 5 stars from Medicare, underscoring their dedication to exceptional quality.

Additional Services

Network Health enhances its core offerings with additional services designed for improved member experience and convenience:

• Telehealth Services: Recognizing the importance of accessible care, Network Health integrates digital and telehealth services, allowing members to connect with providers remotely, promoting convenience and potentially reducing barriers to care.
• Claims Assistance: Dedicated customer service representatives assist members with claims processing and related inquiries. This proactive approach aims to minimize frustration and ensure efficient claim resolution.

Premiums and Pricing

Pricing Structure

The premium rates for Network Health’s plans are dynamic, reflecting factors such as coverage type and member age. Detailed premium information for different plans is readily available on their website. Although direct comparison data with industry averages isn't readily provided, Network Health's focus on affordability and clarity suggests competitive pricing within the market. Transparency in pricing is crucial for consumers to make informed decisions.

Discounts and Special Offers

While Network Health doesn't explicitly list specific discounts on their website, their commitment to affordability implies that they may offer various incentives or promotional deals. It is recommended to check their website regularly or contact customer service for the latest updates on any available discounts or limited-time offers.

Customer Service and Support

Contact Methods

Network Health strives to provide comprehensive customer support through multiple channels:

• Available Customer Service Channels: They offer phone support at 1-844-625-2208 or 920-720-1811, along with email and live chat access through their member portal. This multi-channel approach ensures accessibility for members.
• 24/7 Support and Multilingual Assistance: While 24/7 support isn't explicitly stated, their commitment to customer service suggests they strive to provide timely assistance. They do offer multilingual support, acknowledging the diverse linguistic needs of their membership.

Pros and Cons of Network Health Services Insurance

Pros

• Comprehensive Coverage: Their plans provide extensive coverage encompassing a wide range of medical services, ensuring members have access to comprehensive healthcare.
• High-Quality Providers: Network Health partners with reputable and high-quality healthcare providers and systems, providing members with access to leading medical professionals and facilities.
• Innovative Solutions: Their commitment to innovation manifests in their efforts to make health insurance more affordable and understandable for members, simplifying the often-complex process.

Cons

• Limited Geographic Coverage: Primarily serving Wisconsin limits their accessibility to individuals residing outside the state.
• Complex Claims Process: Some members may find the claims process somewhat complex, though customer service is available to help navigate this.

Conclusion

Network Health is a respected health insurance provider known for its dedication to Wisconsin communities and its commitment to quality healthcare. They offer comprehensive plans, partner with leading healthcare providers, and strive to make health insurance more accessible. Their strong NCQA ratings further validate their commitment to high standards. Their focus on affordability and innovative solutions makes them a strong contender in the Wisconsin health insurance market.

Network Health is a particularly suitable option for Wisconsin residents seeking comprehensive, high-quality health insurance coverage. Their robust provider network and user-friendly approach make them an attractive choice for those who value reliable healthcare access.

Frequently Asked Questions about Network Health Services Insurance

1. What types of insurance does Network Health offer? Network Health offers a diverse range of health insurance plans, including Medicare Advantage and various commercial plans designed to cater to a wide spectrum of individual and family needs.
2. How can I contact Network Health customer service? You can reach Network Health customer service via phone (1-844-625-2208 or 920-720-1811), email, or through their member portal's live chat feature.
3. What is the process for filing a claim with Network Health? While the claims process might seem complex to some, dedicated customer service representatives are available to guide you through each step. Detailed information is available on their website.
4. Are there any waiting periods for coverage? Specific waiting periods will depend on the chosen plan and coverage type. It's recommended to review your policy details or contact customer service for clarification.
5. What types of doctors are included in their network? Network Health partners with a wide range of doctors and specialists. Their website or member portal should list participating providers in your area.
6. How do I change my plan? The process for changing your plan will be outlined in your policy documents or available on their website. Contacting customer service is recommended for guidance.

References

• [1] https://networkhealth.com/about/2021-media-kit.pdf
• [2] https://etf.wi.gov/its-your-choice/2024/network-health
• [3] https://networkhealth.com/__assets/pdf/media-kit.pdf