Understanding Member Coverage

Pharmacy

GHC-SCW offers a variety of pharmacy benefits to employers wishing to purchase benefits for their employees. These benefits typically place medications into different co-pay tiers, corresponding to different co-pay levels.

You can determine the co-pay tier for your patient’s medications by reviewing GHC-SCW formularies. The formulary lists medications by drug class according to the copay tier they are covered under.

If you are not able to obtain the necessary co-pay information for your patient with the above tools please feel free to call the GHC-SCW Pharmacy Administration at (608) 828-4811.

Important Note

This information is not applicable to members covered under the State of Wisconsin health insurance program or the BadgerCare Plus program. State of Wisconsin members should contact Navitus Solutions and BadgerCare Plus members should call the State Medicaid Program.

Plan Coverage

MyPlanFinder is an online tool to help you view our wide selection of insurance plans so you can find the right match for your needs. If you are an existing GHC-SCW member, use MyPlanFinder to find details about the plan you currently have. Your current plan number is located on your membership card. Summary of Benefits Coverage documents are available to help you better understand your coverage by summarizing key features of insurance plans.

Using MyPlanFinder 

• Select MyPlanFinder.
• Choose the plan by number or select sear​ch by individual or group plans.
• View a Benefits Summary and a detailed Summary of Benefits and Coverage for the plan(s) selected.