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Health Plan for Community Living Inc. |
| Wisconsin Partnership Program |
1. Contact Information:
Health Plan for Community Living
1414 MacArthur Road
Madison, WI 53714
Office Hours: 8:30 a.m. to 4:30 p.m.
Phone Number: 1(608)242-8335
TTY/TTD: 1(608)242-8583
Toll Free Number: 1(888)459-5255
Call 1(608)550-5444 for our On-Call Nurse at night, on a holiday or on the weekend.
2. What is the Community Living Alliance Wisconsin Partnership Program?
The Wisconsin Partnership Program (WPP) is a comprehensive health and long term support program of the Community Living Alliance (CLA). Our services span from community based to acute care. These services promote the independence of our members allowing them the choice of living in their own homes.
3. Wisconsin Partnership Program Mission Statement
Partnership enters into a shared responsibility with its members, who are encouraged and expected to take an active role in joint decision making regarding the services they receive. Partnership will ensure that members receive high quality health care and other supports necessary to be valued citizens in the community.
4. Who is eligible to become a Partnership Member?
Eligibility is determined by the following criteria. Applicants must:
- Be between the ages of 18 and 64.
- Be a resident of Dane County.
- Be eligible for Medicaid.
- Have a significant physical disability.
5. How does the Program serve a Member?
The member is at the center of the team. The others on the team are a Service Coordinator, Registered Nurse (RN) and a Nurse Practitioner (NP). A service plan is developed by the member and others on the team to meet the specific health and community based needs of the individual. As a member, your benefits are accessed through the team.
6. Service Area:
Dane County, Wisconsin
7. Benefits:
| Applicable conditions and limitations: |
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| Premiums: |
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| Cost Sharing (e.g. co-payments, co-insurance, and deductibles): |
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| Any conditions associated with receipt of or use of benefits: |
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8. Provider Directory & Pharmacy List:
The Wisconsin Partnership Program at Community Living Alliance has an adequate provider network including over 64 pharmacies. This exceeds CMS requirements for pharmacy access in Dane County. For a list of our providers and pharmacies, please click here:
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Provider Directory |
9. Current Formulary (01/01/2008):
Click below for the current formulary: |
Formulary |
Click below for the Medical Assistance-covered additional medications:
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WPP Additional Meds List |
Click below for the Medical Assistance-covered over-the-counter medications:
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WPP OTC Meds List |
10. Out Of Network Coverage:
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Evidence Of Coverage |
11. Grievance Procedures:
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Evidence Of Coverage |
12. Exceptions Procedures:
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Evidence Of Coverage |
13. Coverage Determinations:
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Evidence Of Coverage |
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Prior Authorization Instructions |
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Prior Authorization Form |
14. Appeal Procedures:
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Evidence Of Coverage |
15. Quality Assurance Policies and Procedures:
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Evidence Of Coverage |
16. NOTICE:
CMS requires all Medicare Part D Plans to inform members of the possibility that the contract between CMS and the Plan may be terminated and that the service area may be reduced. To find out what effect these actions may have on members, please click here:
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Evidence Of Coverage |
17. Enrollment Instructions and Form:
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Enrollment Form |
18. Privacy Notice:
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Privacy Notice |
19. Advance Directives:
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Information and forms are available here:
DHFS Advance Directive Forms Or by sending a stamped, self-addressed business sized envelope to: Living Will / Power of Attorney Division of Public Health PO Box 2659 Madison, WI 53701-2659 The Wisconsin Department of Health and Family Services designed these forms so that you can complete them with or without the assistance of an attorney, depending upon your particular circumstances or concerns. |
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