We provide most of the medical & mental health services available under BadgerCare Plus (Standard, Benchmark, Core) through the Medicaid program. We also have extra benefits and services. All services must be medically necessary.

Some services may:

• Have coverage limits
• Have copays
• Need a doctor’s order
• Need prior approval

Some members may not have all the benefits listed. This is also true for members in the Benchmark and Core plans under BadgerCare Plus.

Primary Care Provider

We want you to grow healthy and stay healthy. Making sure you are in good health is very important. We offer you the choice of a primary care provider (PCP) to help you maintain your health. Women can have both a PCP and an OB/Gyn.

Your PCP can be a doctor, a nurse practitioner or a physician’s assistant. It is easy to choose a PCP. We have a lot of doctors to choose from. Just click on the Find a Doctor tab, or call our member services at (888) 713-6180 for help.

Selecting your PCP within the first 30 days of enrollment:

Once you have enrolled in your MHS health plan you will have thirty (30) days to select a PCP.  If after 30 days, you have not selected a PCP, MHS will select one for you.  You may change your PCP at anytime by calling Member Services at (888) 713-6180.

New Technology

MHS has a committee that evaluates new technology and new uses of technology for possible inclusion as covered services. Our Medical Director and Medical Management can identify procedures or devices for review.

If a new technology that has not yet been reviewed then our Medical Director will make a one-time determination. The new technology will be reviewed at the next meeting of the committee. Your provider can request a determination by calling our provider line.