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Children's Health

We know providing the best life possible for your child is important to you. Yet, knowing how to care for your child can be confusing at times. We are here to help! Below are some of the topics of most interest by parents.

If you have medical questions about your child, always reach out to your child’s doctor.

It is important to choose a primary care provider (PCP) to manage your child’s overall health. A primary doctor gets to know you and your child over time. They can help you to keep your child healthy and take care of them when they are sick.

Regular child check-ups are important. These doctor visits should occur on a set schedule based on age.

  • The American Academy of Pediatrics has preventive health visit schedule for children. 
  • Teens may not need checkups as often as young kids do, but they should see their primary doctor at least once a year. Regular visits will help them stay up to date on vaccines.
    • It’s very important that your teen child who has diabetes or asthma keep seeing their primary doctor.
  • Your child will may need to change to an adult doctor when they are around 18 years old. Ask your child’s doctor when to an adult doctor should be made.
  • Your child can keep their family medicine doctor as an adult.
  • You can even earn rewards for healthy activities.

Learn about My Health Pays rewards for pregnancy, newborn, and child wellness.

You should get all your health care from doctors and hospitals in the MHS Health network. You can find the list of providers in our visit our Find a Provider online directory.

We can help you choose a primary doctor for your child. Just call us at 1-888-713-6180.

You may also call us at 1-888-713-6180 to learn more about a provider, like their medical school and residency information.

If you need a paper copy of the directory, please call us at 1-888-713-6180.

Your child may see different doctors when they are growing up. Below are some descriptions of these doctors.

Primary Care Provider

A primary care provider (PCP) is a person you may see first for checkups and health problems. PCPs can help manage your overall health.

A PCP is a doctor who has a medical degree, either an MD or DO.

Types of primary care doctors

  • Pediatrician (cares babies, children, and teens)
  • Family Medicine (cares for all ages)
  • Adult (Internal) Medicine (cares for those over age 18)

Types of providers who can provide primary care but are not doctors.

  • Advanced Practice Nurse Prescriber (APNP) is a registered nurse with graduate training. APNPs are also known as nurse practitioners (NP).
  • Physician Assistant (PA) is someone with advanced schooling and clinical training who provides services like a doctor but works under the direction of a doctor.

Nurse practitioners and physician assistants can work in clinics or in the hospital.

In Wisconsin, APNPs can take care of their own patients. PAs can care for patients under the supervision of a medical doctor.

Both APNPs and PAs can prescribe medicines.

You can find a list of primary care providers in the MHS Health network in the Find a Provider directory.


Obstetrics-Gynecology (OB/GYN)

The American College of Obstetricians and Gynecologists (ACOG) recommends teens start seeing an OB/GYN between the ages of 13 and 15.  Your teen daughter can choose a primary doctor and an OB/GYN. You do not need a referral to an OB/GYN.

You can find a list of OB/GYNs the MHS Health Network in the Find a Provider directory.

Behavioral Health Providers

  • Psychiatrists are licensed medical doctors who specialize in behavioral health. They can prescribe medication and may do counseling.
  • Psychologists are qualified to provide counseling and order tests. Psychologists cannot prescribe medication.
  • Mental Health Advanced Practice Nurse Practitioners (APNP) are trained to diagnose and treat behavioral health concerns. They can prescribe medication. Some may do counseling.
  • Therapists are qualified to provide counseling. Therapists cannot prescribe medication.

You can find a list of behavioral health providers in the MHS Health Network in the Find a Provider directory.


Specialists/Specialty Care

  • A specialist is a doctor who has extra training in a specific area of medicine or surgery.
  • Specialists practice in areas such as orthopedics (bone and joint), cardiology (heart), and allergy (allergies/asthma).
  • Your PCP will help you decide if you need to see another doctor or specialist. They can make a referral for you. Remember, you must get approval from your primary care provider before you see another doctor.

You can find a list of specialists in the MHS Health Network in the Find a Provider directory

Healthy Check-up (Well Check)

  • Doctors need to see children birth to age 21 for regular checkups, not just when they are sick. Your child may look and feel well yet may have a health problem.
  • Things that happen at a healthy check-up appointment
    • Age-appropriate immunizations (shots)
    • Blood and urine lab tests
    • Dental screening and a referral to a dentist beginning at 12 months
    • Health and developmental history
    • Hearing screening
    • Physical examination
    • Vision screening
  • Click this link to learn more about healthy check-ups for your child. (American Academy of Pediatrics)


Sick Appointment (non-urgent care)

  • Your child’s doctor is the best person to take care of them when they’re sick.
  • You can schedule an appointment with your child’s doctor if they are sick but it’s not an emergency. 
  • Many/most clinics have same-day or next-day open “sick appointment” time slots in their schedules.
  • Call your child’s doctor before you go to urgent care or the emergency room.
  • If you think your child’s illness is an emergency, call 9-1-1.
  • Where to take your child for urgent or emergency care (will link to specific section)


Telehealth

  • MHS Health allows certain covered services to be provided through telehealth. Telehealth is sometimes called “telemedicine.”
  • Telehealth lets your provider care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone. 

You should be able to get an appointment with your doctor when you need it. The following table shows the standard appointment wait times based on service.

Primary Care
Type of CareAppointment Timeframe
EmergencyImmediately upon request of an appointment
Urgent CareWithin 24 hours of request of an appointment
Non-urgent, Symptom CareWithin 7 calendar days of request of an appointment

Routine

Within 30 calendar days of request of appointment


Specialty Care
Type of CareAppointment Timeframe

Routine

Within 60 calendar days of request


Maternity Care
Type of CareAppointment Timeframe

First trimester

Within 30 days of request

Second trimester

Within 30 days of request

Third trimester

Within 30 days of request

High risk pregnancies

Within 2 weeks of request for an appointment, or within three weeks if the request is for a specific HMO provider, who is accepting new patients.


Dental Care
Type of CareAppointment Timeframe

Emergency

Within 24 hours of request

Urgent Care

Within 24 hours of request

Routine

Within 90 days from request


Behavioral Health Care
Type of CareAppointment Timeframe

Initial Routine Care

Within 10 days

Urgent

Within 24 hours for non-emergent urgent services

Emergent/Non-life threatening

Within 6 hours of a request on a 24-hour basis, seven days a week

Follow up routine care

Within 10 business days

Follow up after an inpatient mental health stay

Follow-up post discharge appointments are to be within seven days or no longer than 30 days for an appointment with a Mental Health Provider for follow-up after an inpatient mental health stay

Non-Psychiatric (non-prescriber)

Within 30 days

Psychiatric (prescriber)

Within 90 days

Medication assisted treatment (MAT)

No more than 72 hours including weekend and holidays

Note: Some providers, like specialists, may take a little longer for an appointment.

Call us at 1-888-713-6180 if you can’t get an appointment in a timely manner. If you need help scheduling an appointment call us at 1-844-908-0681.

BEFORE the appointment

  • Find out their policy for canceling or rescheduling an appointment.
  • Ask for an interpreter to be present at your appointment if you need one.
    • MHS Health offers interpreters at no cost to you. Call us if you need help finding an interpreter. 1-888-713-6180.
    • You should not use children, friends, and family as interpreters.
  • Coordinate how you will get to and from your appointment.
  • Prepare questions that you want to ask your doctor. Write down any questions you have before you go and bring them to the appointment.
  • Make plans to arrive early. Getting to the clinic about 15 minutes before the appointment will give you time to fill out paperwork and just relax.
  • Ask a friend or family member to go with you. Feeling nervous is normal. Bringing a friend can help you relax. They can also help you remember questions to ask and instructions you may receive.
  • Know your health history. Your doctor may ask you questions about your health and the health of your family. Asking these questions helps your doctor learn more about you.
  • Things to bring to your appointment
    • Your ForwardHealth member ID card
    • List of medications you are taking. You can also put all your medications in a bag and bring them with you.
    • Include all prescriptions, vitamins, supplements, and any medications you can buy without a prescription (over-the-counter)
      • Examples include acetaminophen, ibuprofen, antacids, allergy medicines,
  • Your prepared questions. 


DURING the appointment

  • Make sure the clinic office has your correct contact information (phone, address, email)
  • Ask your questions. Make sure your doctor knows that you have some questions to ask.
  • Take notes. Write down the answers to your questions. You can ask for paper and a pen.
  • Make sure you understand any directions given to you before you leave. Repeat them back to ensure you heard them correctly.
  • Be honest. Your doctor can help you with your health and any support you may need.
  • Ask questions. Questions or concerns about a medication or a test or procedure are easier asked in person. If you forget, call your doctor’s office right away to get the answer you need.
    • Ask for language assistance if you need it. MHS Health offers interpreters at no cost to you.
    • You should not use children, friends, and family as interpreters.
  • Understand why your doctor and staff are typing on the computer.
    • Your provider keeps your medical information in an electronic medical record (EMR).
    • About the EMR
      • Your EMR includes appointment notes, tests and results, your medication list, and more.
      • The EMR also is helpful for you, too.
        • Review test results
        • Ask questions of your doctor
        • Request prescription refills
        • Look up upcoming appointments
      • If you are not signed up to access your EMR, ask your provider or the clinic staff to help get you set up.


AFTER the appointment

  • Before you leave the exam room, ask to review the After-Visit Summary
    • As part of the Affordable Care Act, the Centers for Medicaid Services (CMS) recommend physicians provide patients with an After-Visit Summary (AVS) following a clinic visit. It may also be called a Summary of Care.
    • An AVS is a paper or electronic document given to patients at the end of a medical appointment.
    • An AVS includes
      • An overview of what was talked about and done during the appointment
      • Care plan goals and instructions
      • List of chronic conditions
      • List of current medications and refills
      • Vital signs
      • Lab tests and results
      • Future appointments and tests
      • Referrals to other providers
  • If you have questions after you leave the appointment, call your doctor.

There are several care options depending on your symptoms. Most minor illnesses do not need emergency care. They can be treated by your own provider or an urgent care clinic.

Your child's doctor

  • You can schedule an appointment with your child’s doctor if they are sick but it’s not an emergency. Many/most clinics have same-day or next-day open “sick appointment” time slots in their schedules.
  • For most health problems, you should call your doctor. Your doctor knows about your child’s health and can give you the best care for ongoing problems, such as asthma, diabetes, or sickle cell anemia.
  • If your child’s problem is not serious, you may wait a long time in urgent care or the emergency room.


Urgent care

  • If your child can’t wait to see their doctor but it’s not an emergency, you can visit a walk-in clinic or urgent care center.
  • MHS Health has more than 70 walk-in/urgent care clinics in our network.
    • Call the MHS Health 24-hour nurse advice line at 1-800-280-2348.
    • Call the MHS Health Customer Service line at 1-888-713-6180.

For a complete listing of urgent care and walk-in clinics in our network, visit our Find a Provider online directory.


Emergency room

  • Emergency rooms (ERs) are open 24 hours a day. You should call 911 or go to the nearest emergency room if you think your child’s life is in danger or they could be permanently hurt or disabled without care. The ER can provide help quickly to prevent permanent injury or death.
  • Still don’t know if you should go to the emergency room? Call your doctor or our 24-hour nurse advice line at 1-800-280-2348 before you go to the emergency room.
  • Call your doctor to let them know you are in the emergency room whenever it is safe for you to do so.
  • Call MHS Health at 1-888-713-6180 as soon as you can to tell us what happened.


Guide for choosing between urgent care and emergency care 

EMERGENCY

NON-EMERGENCY

Call 911 or go to the nearest emergency room for the following illnesses or injuries. These are problems that generally do not need emergency help.

Bleeding that won’t stop

Diarrhea

A broken bone

Throwing up

Chest pain or other severe pain

A cut or scrape

A bad burn

An earache

Poisoning

A sore throat

Seizures

A cough or cold

Shock (sweaty, thirsty, pale skin)

Diaper rash

Fainting/unconsciousness

Sexually transmitted disease (STD)

You are in labor

You need refills of medicines

Gun or knife wounds

Mild headache

Drug overdose

Lice, scabies, or ringworm

Suddenly not able to move or speak

 

If you still don’t know where to go for care:

  • In someone's life is in danger, call 911 or go to the nearest emergency room.
  • Call your child’s doctor. They should have a 24-hour emergency answering service.
  • Call the MHS Health 24-hour nurse advice line at 1-800-280-2348.


Suicide and Crisis Help

  • Call 911 or go to the nearest emergency room if you think your or someone’s life may be in danger.
  • The Suicide and Crisis Lifeline provides 24/7, free and confidential support for people in distress, prevention, and crisis resources

Just call 9-8-8.


MHS Health 24-hour Nurse Advice Line

  • Our nurse advice line provides free 24-hour medical advice, 7 days a week. Call 1-800-280-2348.
  • The nurse advice line has registered nurses ready to talk with you when you can’t reach your doctor.
  • Our nurses speak English and Spanish. They can answer your questions and help you.
    • For example, if your child has a fever, cough, or cold symptoms, you can call the nurse advice line for help deciding what you can do to help them.


MHS Health Appointment Unit

  • MHS Health can help you make or change an appointment with a provider. We can even help you find transportation to and from your appointment. Call 1-844-908-0681, Monday – Friday, 8 a.m. – 6 p.m., CST.

Regular doctor appointments 

Regular child check-ups are important. These doctor visits should occur on a set schedule based on age.

  • Teens may not need checkups as often as young kids do, but they should see their primary doctor at least once a year. Regular visits will help them stay up to date on vaccines.
    • It’s very important that your teen child who has diabetes or asthma keep seeing their primary doctor.

Need to find a doctor for your child?

Need to make or change an appointment? 

  • MHS Health can help. Call 1-844-908-0681, Monday – Friday, 8 a.m. – 6 p.m., CST.

Need help with getting to and from your appointment?

  • MHS Health can help. Call us at 1-888-713-6180.

Immunizations

  • Vaccines can protect your child from certain diseases. Vaccines are safe and effective. There is no cost for these vaccines.
  • Most vaccines are given to babies so they are protected early in life.
  • Some vaccines and booster vaccines are given when children are pre-teens and teenagers.
    • Human Papillomavirus (HPV) vaccination is recommended at ages 11–12 years. HPV vaccines can be given starting at age 9 years. All preteens need HPV vaccination, so they are protected from HPV infections that can cause cancer later in life. (CDC)
  • It is important to follow the recommended schedule for your child to get their vaccine shots.
  • Your child primary doctor will let you know what vaccines your child needs and when.
  • Click here to learn more about the recommended immunization schedule


Yearly Flu Vaccine

  • The flu virus changes every year. So, getting a yearly shot helps protect yourself and those around you. Plus, it’s available at no cost to you or your child.
  • The yearly flu shot is a good idea for just about everyone. But these people are at an even higher risk of health problems from the flu:
    • Being pregnant can put you at higher risk for getting the flu and put your unborn baby at risk, too. But getting a flu shot can help protect you and your baby.
    • Young children have a higher risk of health problems from the flu. Newborns are also at a high risk but can’t get the flu shot until they are 6 months old.
  • Learn more about the flu and where to get a flu vaccine.


COVID-19 Vaccine

  • COVID-19 vaccines protect people from getting seriously sick, being hospitalized, and dying. You should stay up to date with the recommended vaccinations and boosters. 
  • Talk with your child’s doctor about the COVID-19 vaccine and booster.
    • Children over the 6 months old are eligible for COVID-19 vaccinations.
  • Learn more about COVID and the vaccine and booster guidelines by visiting the following websites.

You play an important role in keeping your child safe. We have put together a list of resources to help you with some of the most dangerous situations that can occur with babies and toddlers. 

Safety for Your Child: Birth to 6 Months (American Academy of Pediatrics)

Information on Safety in the Home & Community for Parents with Infants & Toddlers (Ages 0-3) in English and Spanish (CDC)

What Does a Safe Environment Look Like? in English and Spanish (NIH)

Safe Infant Sleep Basics (NIH)

Myths and Facts about SIDS and Safe Infant Sleep (NIH)

Safe Infant Sleep and Breast feeding (Videos/Handout) (NIH)

Having a healthy pregnancy can lead to a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy.

This care can begin even before pregnancy with a pre-pregnancy care visit to your provider. Pre-Pregnancy and prenatal care can help prevent complications and inform parents about important steps they can take to protect their infant and ensure a healthy pregnancy. (NIH)
 

Start Smart for Your Baby® 

Start Smart for Your Baby (Start Smart) is our special program for women who are pregnant and postpartum. We want to help you take care of yourself and your child throughout your pregnancy. Our Start Smart staff can answer questions and give you support if you are having a problem. This program focuses on your health during your pregnancy and your baby’s first year. We can even arrange for a home visit, if needed. Start Smart for Your Baby® offers many benefits at no cost to you.

Visit the Start Smart for Your Baby page for more information.


My Health Pays Rewards

You can even earn My Health Pays rewards for healthy behaviors during and after pregnancy!

MHS Health Wisconsin resources

Member Handbook: Covered services, benefits, and wellness programs

Member Portal: Create and log in to your secure member account

Benefits Summary: Benefits available to you

Find a Provider: A directory of providers and facilities

Pregnancy Resources: Helpful information about pregnancy and birth

Start Smart for Your Baby: MHS Health Wisconsin pregnancy program

My Health Pays: Member rewards program

Health & Wellness: Health information on a variety of topics, online books, and more

Community Resources: Search community resources in your area

Diversity Resources: Helpful information about interpreter services

MHS Health Wisconsin Nurse Advice Line (24/7): Call 1-800-280-2348, 7 days a week, 24 hours a day

MHS Health Wisconsin Appointment Unit: Call 1-844-908-0681, Monday – Friday, 8 a.m. – 6 p.m.

MHS Health Wisconsin Member Services: Call 1-888-713-6180, Monday – Friday, 8 a.m. – 5 p.m.

 

Community and government resources 

ForwardHealth Portal

Access.WI.gov

Wisconsin Department of Health Services

Non-emergency Medical Transportation or call 1-866-907-1493 (TTY 711).

Medicaid.gov

Suicide and Crisis Lifeline or call 9-8-8

Krames Online Health library

Krames Online Education and Resources

HealthyChildren.org (American Academy of Pediatrics)

Centers for Disease Control and Prevention (CDC)

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) (Medicaid.gov)

Immunizations Checklists