WPCP Enrollment Application

WPCP Enrollment Application
Eligibility Guidelines
Enrollment Process
New Member Information

Eligibility Guidelines

If you satisfy these enrollment requirements, you may be eligible to enroll in the Wisconsin Personal Care Plan.

• Currently enrolled in a Wisconsin Medicaid Program and receive full benefits
• Be entitled to Medicare Part A and enrolled in Medicare Part B
• Continue to pay your Medicare Part B premium
• Do not have ESRD (End Stage Renal Disease, except for current commercial members or individuals affected by the non-renewal of another Medicare Advantage Plan after December 31, 1998)

Also, you must live within our service area, which includes the following Counties:

• Buffalo
• Jackson
• La Crosse
• Monroe
• Trempealeau
• Vernon

Enrollment Process

Enrolling in Wisconsin Personal Care Plan is easy. You can select any of these three enrollment options:

1. Enroll by appointment. Call us at 1-715-552-4300 or 1-888-203-7770 (toll free). Our normal business hours are Monday through Friday, 8:00 am - 5:00 pm; a voice mail system is available for all after hour calls from 5:00 pm - 8:00 pm, and during weekends and holidays. (TDD/TTY 1-800-947-3529). We will schedule an appointment with you to discuss how to enroll in Wisconsin Personal Care Plan.
   
   
2. To request enrollment information by mail, please write us and ask for an enrollment packet. The address is:
   
        Group Health Cooperative of Eau Claire
        Attn: Wisconsin Personal Care Plan
        P.O. Box 3217
        Eau Claire, Wisconsin 54702-3217
   
   
3. Print a copy of our Enrollment Application from our website. (See the link at the top of this page.) Then mail the completed Enrollment Application to the address listed above.

New Member Information
Here's a list of things to expect as a new Wisconsin Personal Care Plan member:

1. New Member Packet
   As a new member of Wisconsin Personal Care Plan, you will receive a New Member Packet in the mail within a few weeks of your enrollment. This packet contains important information including:
   
   • Member Identification (ID) Card
     Keep your ID Card in your wallet and be sure to show it whenever you need medical care or get prescriptions filled. Keep your original Medicare Card in a safe place.
   • Annual Notice of Change/Evidence of Coverage
     This is a booklet that describes your benefits, membership, covered and non-covered services, member rights and responsibilities, changes from last year’s plan and other important plan information.
   • Advance Directives
     Allows you to select someone to make medical decisions on your behalf if you become unable to make these decisions on your own.
   • Notice of Privacy Practices
     Describes how medical information about you may be used and disclosed and how you can get access to this information.
     
     
2. New Member Enrollment Call:
   After we receive your Enrollment Application you will get a call from us to:
   
   • Verify that the information on your enrollment form is correct
   • Answer any questions you have about Wisconsin Personal Care Plan

   After your enrollment has been approved, you will receive a welcome call from us. You will also receive a written letter to confirm your enrollment in Wisconsin Personal Care Plan and the date your coverage begins. We will help you select a Primary Care Clinic (if you haven’t done so already), review your benefits and covered services, and review the medical services available to you in your service area.

3. Health Assessment Call:
   You will receive a call from one of our nurses to ask questions about your health and medical needs. This is called a Health Assessment call. This is done so that we can help you find the best care to meet your medical needs. You may also be eligible for voluntary programs that will help you manage your prescription drug treatments.