Skip to Content

Wisconsin Health Insurance

Your Primary Care Practitioner

Primary Care Practitioner

When enrolling in your health plan, you may be required to select a Primary Care Practitioner (PCP). Because each family member has individual medical needs, you may choose a different PCP for each member of your family.

Choosing a PCP is an important decision for you and your family members. Your PCP is the first physician you access when needing medical care. The only exception to this would be in the event of an emergency or urgent care situation. Your PCP, with your help, manages your health care and makes decisions such as referring you to specialists when necessary.

A primary care practitioner should be a physician who practices a general scope of medicine. A physician who specializes in one area of medicine would not be able to treat all of your health care needs. The following physician practices can be selected as primary care practitioners.

  • Family Practice - treat medical conditions for people of all ages with an emphasis on family health problems.
  • General Practice - treat people of all ages.
  • Pediatrics - treat children and adolescents and generally manage their health.
  • Internal Medicine - treat diseases and disorders of the body of adult men and women.
  • Obstetrics/Gynecology - management of care during pregnancy, childbirth, and disorders unique to women.

The Provider Directory can help you choose a PCP. It lists all plan providers by city. PCPs are highlighted throughout the directory. Our Customer Care Center can assist you regarding the status and professional qualifications of a particular provider. You may also search for a plan provider.

Changing Your Primary Care Practitioner

Certain life events, such as moving, may create the need for you to change your PCP choice. If you would like to change your PCP, you may do so in one of the following ways:

  • If you are changing to another provider within the same clinic, you may simply ask the clinic staff for a new provider by calling or when scheduling your next appointment.
  • If you are changing clinics, you can change your PCP by calling our Customer Care Center. Members of the State of Wisconsin or Wisconsin Public Employer plan can request a PCP change by phone, but must also complete an application from the payroll office. The effective date of the change will be the date of the call, the date the application is received in our office, or a future date as you request.
  • Or you may complete an enrollment application indicating your new provider or clinic and mail it to Dean Health Plan. The application may be obtained from your employer or our office and must be received by us before your first appointment with the new PCP.
  • You can also change your PCP using DeanConnect, your complete member portal.

When a PCP change is made, you will receive a new ID card. It is important to carefully review the information on the ID card.

Provider Recredentialing

Because quality health care for our members is important to us, we take great care to ensure that members have quality health care providers from which to choose. This is done through our provider credentialing and recredentialing process. Before a provider is approved to participate in our network, we will verify their education, work experience, malpractice insurance, licensing information and board certification, if applicable. We also ensure that they have hospital privileges at a plan hospital which would allow them to treat our members.

Once providers have joined our network, we will recredential them at a minimum of every three years to ensure that they have maintained the proper credentials to practice. We will also re-verify the same information from the initial credentialing process. In addition, during a plan provider's recredentialing we will review any member concerns we received regarding that provider. The process may seem complex but we believe it is necessary to maintain the highest quality providers in our network.

Advance Directives

An advance directive tells, in writing, your choices about the treatments you want or do not want. You can decide ahead of time how health care decisions will be made for you if you become incapacitated. An advance directive expresses your personal wishes and is based upon your beliefs and values. When you make an advance directive, you will consider issues such as living as long as possible, dying, being kept alive on machines, being independent, and other issues relating to your overall quality of life.

After you finalize your advance directive, give a copy to your healthcare agent, your primary care practitioner and any loved ones who should be aware of your wishes.

If you would like information concerning an advance directive, please contact your Primary Care Practitioner. You may also contact our Customer Care Center for a packet of information which includes advance directive forms.

We're Here to Help

Contact Dean Health Plan

If you have any questions please contact our Customer Care Center by email, or at (800) 279-1301.