HMO, State of Wisconsin and Local Government Members
Most Unity members do not need to get a Prior Authorization from their doctor (PCP) or nurse for in-network specialty care.*
If your PCP wants to send you to a doctor or nurse who is not in the Unity network, a Prior Authorization Form must be filed out. These Prior Authorizations are only approved if Unity’s network does not offer the service. (Learn more about Prior Authorizations.)
To learn about your benefits, login to MyChart and check your –
- Schedule of Benefits or Summary of Benefits and Coverage
- Certificate of Coverage
- State and Local government participants should refer to the It's Your Choice book
POS, Choice, Choice Plus, My Choice or PPO
POS and PPO plans offer members the choice to stay in-network or go out-of-network for services.
Behavioral Health and AODA Services
For assistance coordinating your behavioral health services, including alcohol and drug treatment services, please contact UW Health – Behavioral Health Care Management at 608.233.3575 or toll free at 800.683.2300.
Mental Health and Substance Abuse Services for BadgerCare Plus (Medicaid) Members
Unity Health Insurance provides mental health and substance abuse (drug and alcohol) services to all members. Where you get these services depends on –
- the location of your doctor
- if you have dependent children living with you
For elective (non-emergency) services where you will be admitted to the hospital, the doctor who will admit you must contact Unity for approval and precertification. If the hospital is not in Unity’s network, please notify Unity Customer Service at 800.362.3310.
Please access your plan's prior authorization list to see if the service requires prior authorization.
Learn about your Pharmacy Benefits.
Hearing Aid Benefits
Learn more about hearing aid benefits.
Get in touch with Unity Customer Service by sending a message.
*Exception: State of Wisconsin and Local Government members must get a referral from their PCP to visit or be treated by a neurosurgeon or orthopedic surgeon for low back pain.
Estimate Your Out-of-Pocket Costs
Determine costs you may incur prior to receiving health care services using the Determination of Benefits Form. To complete the form, you will have to ask your provider for certain medical coding information including procedure codes, procedure modifiers and unit codes for the services.