Thank you for choosing Quartz! We want to make it as easy as possible for you to use your health plan. To help you, we've created this member kit to walk you through important details.
Quartz MyChart gives you access to your health insurance and UW Health medical information through one secure portal.
The member section of our website provides videos, interactive tools, and other resources to help you better understand the ins and outs of your health plan.
Curious about our latest news and programs? Want to discover new recipes or health tips? A complete Quartz experience awaits when you join our social community.
Quartz wants you to receive the care you need when you need it. You may need different types of care depending on your situation. This video will help you decide what type of provider is right for your situation. Below is a summary of how to access care depending on your needs –
Type of Care
What To Do
Contact your Primary Care Provider's (PCP) clinic
|Specialty Care||Contact your PCP clinic, they will tell you how to get appropriate care|
|After-Hours Care||Contact your PCP clinic, they will tell you how to get appropriate care|
|Urgent Care||Go to a participating Urgent Care Center if your injury is not life-threatening but you need prompt attention|
|Emergency Care||Go to the nearest hospital or call 911|
|Care Away from Home||Contact your PCP clinic, or if it's an emergency, go directly to the nearest hospital|
|Behavioral Health Care||You can call a provider directly to schedule an outpatient appointment. If you need assistance finding a provider or have questions about behavioral health services, including alcohol and drug treatment services, please call Behavioral Health Care Management at (608) 640-4450 or toll-free at (800) 683-2300.|
If you are looking for a Primary Care Provider at a UW Health Clinic and need help selecting one, visit the UW Health Welcome Center, an individualized service available to help new members select primary care physicians, and transition their care to UW Health. Otherwise, use Find a Doctor to browse providers in your network.
Select any of the options below to learn more about the different features of your health plan.
Out-of-network care typically isn't covered unless it is provided in the case of an emergency. If you utilize services out-of-network other than for emergency care, you may have financial liability for those claims and may be balance billed.
Some services and supplies covered by your insurance plan may require prior authorization or be reviewed for medical necessity. This means that you, your doctor or nurse must fill out a Prior Authorization Request Form before you can have the treatment to determine if it will be covered. Learn more about Prior Authorization.
Do you have more than one health insurance plan? If so, those plans need to work together to make sure you’re getting the most out of your coverage. One plan becomes your primary plan. It pays your claims first. Then the second plan pays toward the remaining cost. That process is called coordination of benefits.
At times, you may receive services from a health care provider that is not in your plan's network. In that case, you must send claims to Quartz to assure payment. To do this –
You can remove someone from your plan at any time during the year but you are required to request the dependent be removed from your plan the date you wish the change to take effect or prior to the date you wish the change to take effect.
During the annual Open Enrollment period, you may choose to add or remove someone from your plan. You can also choose a new plan.
Outside of Open Enrollment, you may add someone to your policy only if you have certain life events that qualify you for a special enrollment period. See if you qualify.
If you purchased your health plan through the Marketplace, you will need to contact the Marketplace at (800) 318-2596 or TTY: (855) 889-4325 or log into your account at HealthCare.gov (WI and IL residents) and (855) 366-7873 or visit MNsure.org (MN residents.).
During Open Enrollment, you may choose a new plan. You can also add or remove someone from your plan. At any other time, you may choose a new plan only if you have certain life events that qualify you for a special enrollment period. See if you qualify.
When is the next Open Enrollment period? Open Enrollment runs from November 1 through December 15 of each year. Sign up to be notified when Open Enrollment begins.
|You Want To||Where to Find Information|
|Check the Formulary Status or Restriction Status of a Drug||Visit the Prescription Drug Formulary|
|Find a Pharmacy||Visit Find a Pharmacy|
|Appeal a Prior Authorization Denial||Call Customer Service at (800) 362-3310|
|Speak to a Clinical Pharmacist about why a Prior Authorization Request was denied||Call Quartz Pharmacy Program at (888) 450-4884|
|Find Criteria for Coverage of a Medication||Call Quartz at (800) 362-3310 or view the Medication Prior Authorization information to learn more about the process and timeline|
|Get Early Refills, Vacation Supplies, Emergency Supplies, Supplies for a New Member, or Reimbursement of Medications Purchased Out-of-Pocket||Visit Understanding Your Pharmacy Benefits|
Momentum Insurance Plans, Inc. administers on their website or by calling toll-free (855) 729-6569 or locally (608) 729-6569.
We offer a wide range of programs and resources to help you manage your health.
Health Management and Prevention programs – Our Health Management and Prevention programs provide rewards, reminders, health news, online information, support and classes
Health Management Resources – Screenings, guidance and even healthy recipes to help you improve your health and wellness
Health Assessment Tools – Screening tools that can help you decide when to seek care
Wellness and Prevention – The best way to stay healthy is to prevent or find illness early - get some health guidance and even healthy recipes to help improve your health and fitness.
Health Topics – Browse health information, find decision tools for medical issues, or check your symptoms
Introducing Quartz Well*, a new, personalized digital wellness program that is simple, flexible and rewarding. It is designed to reward you for taking care of yourself — whatever your fitness level, wherever you are at.
Members age 18 and older can earn $100 for single plans and $100 each for the member and spouse (or domestic partner) on family plans.
Points can be redeemed and used for purchases on Amazon.com
Login to Quartz MyChart and sign on to Quartz Well to get started earning points!
- Due on the 1st of every month
- Payable to Quartz Health Benefit Plans Insurance Corporation (IL & WI) Quartz Health Plan MN Corporation (MN)
Illinois & Wisconsin
Quartz Health Benefits Plan Corporation
PO Box 78730
Milwaukee, WI 53278-0730
Quartz Health Plan MN Corporation
PO Box 78368
Milwaukee, WI 53278-8368
- It’s important to pay your full premium each month. Failure to do so may result in your account entering your allowable grace period and possible termination.
Your account will show a credit balance if you have overpaid your premium. This credit will be applied to future months’ coverage unless you request a refund. To request a refund contact Customer Service at (800) 362-3310.
Claims may be denied retro-actively if your policy is canceled/or terminated due to non-payment.
A grace period is the allowable time after your invoice is due to make your monthly premium payment. Depending on if you’re receiving advanced premium tax credits (APTC) or not will determine your allowable grace period.
|RECIEVING APTC||GRACE PERIOD|
|Yes||90 Days from Due Date|
|No||31 Days from Due Date|
During the 90-day (or 3 month) grace period your coverage remains active. However, how claims are treated is different depending on what stage of the grace period you are in.
- Month 1-All medical and pharmacy claims will pay as usual
- Months 2 & 3- pharmacy services will be denied at point of sale. While medical claims will be pended and not paid to the provider.
If at any point during your 90-day grace you satisfy the balance owed in full, medical claims will be release and paid and any pharmacy services can be submitted for reimbursement.
If you fail to make full payment due within the 90-day grace period, your coverage will be retro-terminated to the end of the first month of the 90-day grace period. Claims that were submitted during only the first month will be paid and claims received for service dates in months 2 and 3 will be denied and become your financial responsibility. You will also be financially responsible to pay Quartz the premium due for the first month of your grace period.
During the 31-Day grace your coverage remains active. If you fail to make payment in full by the end of your grace period, your coverage will be retro-terminated. All claims after this date will be denied and will become your financial responsibility.
Get secure and convenient access to member forms and resources through MyChart.
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You can also contact Quartz Customer Service at (800) 362-3310.
Printed materials you can request include –