Getting Care
The Care You Need, When You Need It
When you’re sick or hurt, your recovery depends on getting the right kind of care. And that varies with your situation. After all, the ER is no place for earaches. And that annoying rash? You might be able to get the help you need — without even leaving home. Watch the video and review the chart below so you have the information you need to make the right call.
| Virtual visit | Telehealth | Primary care | Urgent care | Emergency care | |
|---|---|---|---|---|---|
| Description | An on-demand appointment with a health care provider via your smartphone, tablet, or computer | A scheduled appointment with your usual provider during clinic hours, via video chat or phone call | Regular, non-emergency care. Face-to-face appointment with your provider in their clinic or office | In-person, walk-in care at designated locations, usually with extended hours | In-person care 24/7 when help is needed right away to prevent an adverse health outcome |
| Hours | 24/7 | Normal clinic hours | Normal clinic hours | Extended hours | 24/7 |
| Cost | $ | $$ | $$ | $$$ | $$$$ |
| When to use | For urgent, non-emergency symptoms, like: • Cough • Headache • Nausea • Rashes • Sore throat • Sprains | For service outside of the clinic, including: • Routine visits • Surgery follow-ups • Mental health services • Screenings | For in-clinic services, for instance: • Routine checkups • Annual physicals • Preventive screenings • Vaccinations • Non-urgent injuries and illnesses | For health issues or injuries that need prompt attention, but are not serious enough for emergency care, such as: • Sprains and strains • Ear pain or infection • Rashes and insect bites • Sore or strep throat | For serious and/or life-threatening situations, for example: • Chest pain or heart attack • Shortness of breath • Major illness • Traumatic injury |
| How to access | Set up an account ahead of time so you’re prepared if you are sick or injured. Learn more on our Digital Tools page. | Call your provider’s office to schedule a telehealth visit (if available) and get connection instruction | Call your primary care provider or clinic to schedule ahead of time | Call your primary care provider or clinic first, day or night. They will advise you if you should go to urgent care | Call 911 or go to the nearest hospital emergency department for immediate help |
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Virtual First
At Quartz, we care about bringing you access to health care when and where you need it. We also want to help you save on health care costs. This is why we’re especially pleased to bring select members “Virtual First.”
Virtual First puts you first, providing convenient access to primary care, urgent care, and behavioral health providers for $0 cost-share* when you utilize telehealth or virtual visits.
- Visit with a primary care, urgent care, or behavioral health provider through the use of a telephone, smartphone, tablet, or computer.
- Enjoy the peace of mind knowing you’ll get the care to help you live your healthiest – when and where you need it – without traveling to your provider.
Learn more about telehealth and virtual visits.
*$0 cost-share applies only to telehealth or virtual visits for primary care, urgent care, and behavioral health. View your Summary of Benefits and Coverage to see when cost-sharing for other telehealth or virtual visits may apply. Virtual First is not available on all plans.
Hearing Aid Coverage
Hearing aid coverage is outlined in your Summary of Benefits and Coverage (SBC) or Certificate of Coverage document; you may also call customer service for hearing aid coverage information.
Covered Hearing Aids
For plans that cover hearing aids, Quartz covers the standard level of hearing aid technology as defined by each of the following approved manufactures listed below. Costs of treatment related to hearing aids such as earmolds and fittings are only covered when the hearing aid model is covered.
Please note: this coverage does not apply to members with State and Local Government (ETF), Quartz Medicare Advantage, and BadgerCare Plus plans.
Hearing Aid Models Covered as of January 1, 2022:
| Hearing Aid Manufacturer | Hearing Aid Style | Standard Technology Level |
|---|---|---|
| Phonak | BTE, RIC, ITE, ITC, and CROS | 30 and 50 |
| Widex | BTE, RIC, ITE, ITC, and CROS | 110 and 220 |
| GN ReSound | BTE, RIC, ITE, ITC, and CROS | 5 |
| Signia | BTE, RIC, ITE, ITC, and CROS | 3 |
| Unitron | BTE, RIC, ITE, ITC, and CROS | 500 and 600 |
| Oticon | BTE, RIC, ITE, ITC, and CROS (Adult) | 3 |
| Oticon | BTE, RIC, ITE, ITC, and CROS-Play (Pediatric) | 2 |
| Starkey | BTE, RIC, ITE, ITC, and CROS | 1000 and 1200 |
Approved hearing aids are limited to the following styles:
- BTE (behind the ear)
- V5257
- V5261
- RIC (receiver in the ear)
- V5257
- V5261
- ITE (in the ear)
- V5256
- V5260
- ITC (in the canal)
- V5255
- V5259
- CROS
- Monaural (1CROS device)
- V5171-HA, CROS, monaural, ITE
- V5172-HA, CROS, monaural, ITC
- V5181-HA, CROS, monaural, BTE
- Binaural (1 CROS device + 1 Hearing Aid)
- V5211-HA, CROS, binaural ITE/ITE
- V5212-HA, CROS, binaural, ITE/ITC
- V5213-HA, CROS, binaural, ITE/BTE
- V5214-HA, CROS, binaural ITC/ITC
- V5215-HA, CROS, binaural ITC/BTE
- V5221-HA, CROS, binaural BTE/BTE
*The approved hearing aid list will be reviewed at least annually.