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 out 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 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, of it 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 and need help selecting one, visit SwedishAmerican HealthConnect, an individualized service available to help new members select primary care physicians and transition their care to SwedishAmerican, a partner of UW Health. Call (779) 696-7081 or email: firstname.lastname@example.org. 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 at least 14 days before 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.
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 Pharmacy Program at (888) 450-4884 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|
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!
Claims may be denied retroactively if your policy is canceled for non-payment. You will be responsible for paying all claims incurred after the termination date of your policy. In order to avoid your claims being retroactively denied for payment, make sure to pay your premium on time each month.
We offer a variety of ways to pay your premium invoice.
A grace period is the amount of time you have to pay your Premium Invoice. The duration is dependent on whether you get subsidies or not.
Get secure and convenient access to member forms and resources through MyChart.
Not a MyChart member yet? Sign up now!
You can also contact Quartz Customer Service at (800) 362-3310.
Printed materials you can request include –