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Better Together HMO

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Better Together HMO
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Welcome to Better Together HMO!

The Better Together HMO plan gives individuals and employer groups of any size their choice of our five full-service, high-quality primary care clinics in and around Madison. Plus, they’ll access specialty care close to home through our world-class specialty partners at UW Hospital and Clinics.

GHC-SCW has been among the highest rated plans in the country for over nearly three decades.

Find a Provider

You can easily find a Better Together HMO primary or specialty care provider by clicking the button below.

Our Provider Search tool allows you to filter and customize your search based on your specific needs. Then you can view and choose from available providers.

If you need specialty care, you may visit an in-network Specialty Care Provider*. To verify that the specialist is an in-network Specialty Care Provider, use the button below to search by name or location.

 

*Prior Authorization or a referral may be required for Specialty Care Services, depending on your plan. 

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Virtual Care

Members with Better Together HMO insurance plans have access to virtual care benefits, which are handy when you’re having unusual symptoms and need some peace of mind or just need a quick follow up with your provider to go over new medications you’ve been recently prescribed. Our virtual care options are a convenient and safe way to get the care you need at home or on the go.

  • GHC NurseConnect
  • Video Visit Using GHCMyChartSM
  • Virtual Urgent Care powered by KeyCare
  • E-Visits powered by KeyCare
  • Virtual Therapy powered by MDLIVE®
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Emergency Care

In the event of a life-threatening emergency, visit one of the hospital emergency rooms participating in the Better Together HMO plan network. If that is not possible, proceed immediately to the nearest hospital emergency room. In both situations, contact the GHC-SCW Care Management Department at (608) 257-5294 or toll-free at (800) 605-4327, and request Care Management within 48 hours of receiving emergency services or as soon thereafter as reasonably possible.

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Prior Authorization

Prior Authorization is the process by which GHC-SCW provides prior written approval for coverage of specific benefits, treatments, Durable and Disposable Medical Equipment (DME), Prescription Drugs and supplies. The purpose of Prior Authorization is to determine and authorize the following:

  • The specific type and extent of care, Durable and Disposable Medical Equipment, Prescription Drug or supply that is necessary.
  • The number of visits, or the period of time, during which care will be provided.
  • The Provider to whom the Member is being referred.
  • Whether the Member should receive coverage for the services from an out-of-network Provider because necessary services are not available from an in-network Provider.

If Prior Authorization is not received prior to the date of service and/or receipt of supplies, your Provider should contact GHC-SCW’s Care Management Department for a determination of Medical Necessity. The Prior Authorization lists may differ depending on your health plan. Please contact Care Management at (608) 257-5294.

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Better Together HMO Frequently Asked Questions

The Better Together HMO plan offers high-quality primary care clinics and providers from GHC-SCW as the exclusive choice for primary care. Specialty care will continue to be offered through the UW Hospital and Clinics.

The Better Together HMO plan is available to the following:

  • Individual plan members in Dane County through the Health Insurance Marketplace at healthcare.gov or directly through GHC-SCW.
  • Small Employer Groups who choose an ACA-compliant plan.
  • Businesses in Dane County can offer this plan to all employees.
  • Businesses outside of Dane County can offer this plan to those employees who live or work in Dane County.

The Better Together HMO product is available for HMO ACA compliant plans only. POS/PPO/Medicare
plans are not eligible for this product.

You can only choose a Primary Care Provider (PCP) at a GHC-SCW clinic. Through this plan, you can’t choose a PCP in the broader Partners HMO plan.

No. The Better Together HMO plan offers primary care only through GHC-SCW clinics and Primary Care Providers.

For specialty care outside of GHC-SCW-owned clinics, members with the Better Together HMO plan will have access to specialty care through the UW Hospital and Clinics and UW Health Clinics.

Care must be received at University Hospital and Clinics or UnityPoint Health – Meriter Hospital.

Where to Go For Care

Primary Care Primary care services, including lab and radiology, must be received at:

  • Capitol Clinic
  • East Clinic
  • Hatchery Hill Clinic
  • Madison College Community Clinic
  • Sauk Trails Clinic
Specialty and Ancillary Services at GHC-SCW Clinics Services should be received at GHC-SCW-owned clinics for:

  • Chiropractic Services
  • Clinical Health Education
  • Dermatology
  • Eye Care
  • Occupational therapy
  • Physical Therapy
  • Sports Medicine
Specialty Care Outside of GHC-SCW Clinics Prior authorization may be required for these services. Specialty care outside of GHC-SCW-owned clinics must be provided by contracted providers at University Hospital and Clinics, Unity-Point Health – Meriter Clinics or UW Health Clinics (special cases only). This excludes Behavioral Health.
Urgent and Emergency Care If you need medical care after hours, call the GHC-SCW Urgent Care Clinic at (608) 257 9700 to schedule an appointment. Our urgent care providers will be there for you in your time of need. Most urgent care providers may not be selected as a primary care provider.
Inpatient Care Care must be received at University Hospital and Clinics or UnityPoint Health – Meriter Hospital.
Inpatient Labor & Delivery Care Care must be received at UnityPoint Health – Meriter Hospital.
Call To Action

Still have questions about what is covered under your Better Together HMO Plan?

Call GHC-SCW Member Services at (608) 828-4853 or toll-free at (800) 605-4327.