Description
Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a non-profit, member-owned health plan providing high-quality health care services, including primary care and specialty care to over 79,000 members living in south central Wisconsin.
When your health care and your health plan work together, the result is the superb care and impeccable service you've come to expect from GHC-SCW.
You will enroll in one of two plans, depending on where you want to primarily receive care: the GHC-SCW Dane Choice Plan or the GHC-SCW Neighbors Plan. Regardless of where you live or work, you will have the option to select either plan.
The GHC-SCW Neighbors Plan includes the following healthcare systems and clinics: Aspirus Health, Emplify Health, Fort HealthCare, Grant Regional Health Center, High Point Family Medicine, Lafayette Hospital & Clinics, Mile Bluff Medical Center, Reedsburg Area Medical Center Physicians Group, Sauk Prairie Healthcare, Southwest Health, Three Oaks Health, Upland Hills Health, and UW Health (Fort Atkinson and Portage locations).
If you primarily receive care at one of the healthcare systems or clinics listed above in Columbia, Grant, Iowa, Jefferson, Juneau, Lafayette, or Sauk County, select the GHC-SCW Neighbors Plan.
Please note that there are also clinics outside of these counties in the GHC-SCW Neighbors Plan that you may choose from: Sauk Prairie Health Care's Wisconsin Heights Clinic in Mazomanie, Upland Hills Clinic in Mount Horeb, and Aspirus Health Clinic in Oxford.
You will still be able to visit urgent care facilities, emergency rooms, and UW-Health Hospitals and specialists located in Dane County.
Note: All dependents on the subscriber's plan will automatically be enrolled within the same plan the subscriber selects. Subscribers and their dependents cannot be enrolled in different plans.
What's New for 2025
Plan Changes
GHC-SCW has partnered with Emplify Health to offer more provider options in the Neighbors Plan. Locations include primary care clinics in Boscobel, Fennimore, and Muscoda, and a hospital in Boscobel.
Memorial Hospital of Lafayette County (MHLC) is building a brand new hospital which will replace the old location. The opening is expected in January 2025. Coinciding with the opening, MHLC will change their name to Lafayette Hospital & Clinics.
Foundations Virtual Intensive Outpatient Program
GHC-SCW is pleased to introduce our Foundations Virtual Intensive Outpatient Program (VIOP), which allows you to receive behavioral health care from the comfort of your own home. Our VIOP provides the same high-quality, evidence-based therapy as our in-person sessions, and brings the support you need directly to you.
Autism Spectrum Treatment Program
GHC-SCW is proud to introduce our focused Autism Spectrum Treatment Program! The Autism Spectrum Treatment Program helps school age children who have trouble making and keeping friends, or who experience difficulty managing their emotions.
Member Engagement Program
We are excited to announce our new Member Engagement Program. Through this program, we listen to what members have to say about GHC-SCW. Through surveys and focus groups, we get to hear everyone's voice. We want our members to help guide our health care services. By working together, we ensure all different views and experiences help us make better decisions.
Virtual Care
GHC-SCW is introducing a new option via the KeyCare platform, called E-Visits. Members can now send messages and photos to a licensed provider to review and help treat non-emergency medical conditions. Virtual Urgent Care Visits via KeyCare and Virtual Therapy visits via MDLive are still available.
Members can visit our Virtual Care page for virtual care needs.
Provider Directory
Go to our Government Employees page and scroll down to the "Wisconsin Public Employer Group Health Insurance Program Members and State of Wisconsin Group Health Insurance Program Directories" section. The current provider directories are available under the plan year. To request a printed directory to be mailed to you, call Member Services at 800-605-4327.
Referrals, Authorizations, Out-of-Network
Your primary care provider will submit a referral request to GHC-SCW Care Management Department when you need to receive services outside of a GHC-SCW clinic or through a specialty care area that requires a prior authorization. Certain procedures or tests also require a prior authorization for medical necessity review. You will receive a letter from GHC-SCW, as well as notification in your GHCMyChartSM account letting you know if the referral/prior authorization has been approved.
Emergency and Urgent Care
If you require emergency or urgent care when outside of the plan, seek care at the nearest medical facility. Contact GHC-SCW Member Services at 800-605-4327 if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise approved by GHC-SCW.
Mental, Behavioral Health and Substance Abuse
When seeking Behavioral Health services, please visit the Behavioral Health page. This page will provide helpful information about your options and contact information for securing care. A prior authorization is not required when seeking individual psychotherapy or psychiatry care.
24-Hour Nurseline
GHCNurseConnect: 608-661-7350 or 855-661-7350
Virtual Visits
GHCMyChartSM Video Visits
Looking for a video visit? GHC-SCW members can schedule video appointments through GHCMyChart for routine visits and select specialty visits (PT/OT, Dermatology, and Behavioral Health). Video visit appointments through an active GHCMyChartSM are a simple option to see your health care provider while still getting the exceptional care you expect from GHC-SCW.
Virtual Urgent Care, E-Visits and Virtual Therapy Visits
Members can virtually access a doctor or therapist from their own home or office, on-the-go, 24/7, 365. Licensed providers and therapists are available either by phone, secure video, or messaging to help treat any non-emergency medical or behavioral health condition. Visits are free for most members. Members with Medicare or HSA-Eligible plans have restrictions or limitations.
Visit our Virtual Care page to learn more.
Major Health Systems
- Aspirus Health
- Fort HealthCare
- Grant Regional Health Center & Southwest Health
- Lafayette Hospital & Clinics
- Mile Bluff Medical Center
- Sauk Prairie Healthcare