WPS Health Insurance

How to Obtain Care

Step 1: Know Your Health Plan

Read your Certificate of Insurance and Member Guide. Make sure you understand them, especially the information on benefits, coverage, and limits. Reference our glossary of terms if words are unfamiliar. If you have questions, please contact Member Services. Always carry your Member ID card.

Step 2: Learn About Your Health History

By learning more about your health history, habits and risks you take a vital step toward living a healthy life. View valuable health information resources in the WPS Health Center.

Step 3: Find a Doctor in Your Network

When you have questions about your health, ask your physician for advice and insist on clear answers. View a list of specific questions to ask your doctor. Don't have a regular doctor? Use the WPS Find a Doctor tool to locate a doctor in your network.

Step 4: Know When to Call WPS

Unless it is a medical emergency, you need to contact WPS at 1-800-333-5003 to obtain advance approval (pre-certification) if you need to go to the hospital. Otherwise, the cost of your hospital care may not be covered.

Medical Service When to Call WPS
Scheduled in-patient hospital stay — not including OB or in-patient hospital stays for mental health/chemicaldependency treatments unless required under your plan. However, if not required, we strongly recommend getting pre-certification for mental health/chemical dependency treatment. Read more... At least 3 business days in advance
Emergency in-patient hospitalization — not including in-patient hospital stays for mental health/chemical dependency treatments under your plan. Within 2 business days after admission
Pregnancy
Learn about the WPS Great Beginnings Pregnancy Program
During the first trimester is recommended, although not required
Out-patient surgery or services (only if required by your plan) At least 3 business days in advance