Group Health Cooperative

GHCSW is awful. Some doctors do care but others don’t really care about fixing the issue, only medicating it. I was having severe issues with my back and lower body. Dr. Hanna with UW health diagnosed me with Syringomeylia. He did not explain much and directed me to come back for a second MRI in 6 months, leaving me and my family confused.
Finally went to a second specialist. Who wanted to order an MRI to see if I had a tethered spinal cord because Syringomeylia can develop from a tethered cord.
According to GHC, I did not meet the «criteria» for a Tethered Spinal Cord. Therefore, I was rejected. Sent on my way… In pain. Finally I switched insurance plans. Went to an insurance out in Milwaukee because I needed a specialist, in neurology. They completed the MRI. AND GUESS WHAT GHC!!! I have a a Tethered Spinal Cord. Sorry I didn’t meet your criteria, GHC. It should be noted, not all patients experience the same symptoms! So, I will finally receive the surgery I need. Thanks to Dr. Heffez at the Milwaukee Neurological Institute.

Just, y’know, keeping everyone abreast of GHC still being godawful. I feel bad dissing them so much because I don’t want it to reflect on the providers, who honestly have been pretty stellar in general. But now pretty much ANYTHING you could want from them that’s in a specialty is booked 4 months out. Every time I try to schedule it’s worse. I know they’re having some financial issues as an insurer, but cutting services to patients really doesn’t help? I was in the midst of medication changes with a provider I love when open enrollment time came around last year, so I’m still here, but everything I’ve written about them in the past still stands and then some. Once you can see their staff they’re great, if you haven’t dropped dead while waiting to do so. And yet premiums keep going up. Whatever I’m paying them for, it sure isn’t an adequate number of care providers.

«The doctors huddle up and call a flea flicker
The reason that I say that
’Cause they flick you off like fleas
They be laughin’ at ya while you’re crawlin’ on your knees»
– Flavor Flav (Public Enemy) — 911 Is A Joke
I have been a member of GHC-​SCW for several years. I can wax on (and on) because in that time I have had a potpourri of non-​life threatening medical issues. There have been many specialists involved treating those conditions.
Overall, GHC’s patient care is excellent. Members of the doctor’s team (the doctor, Assistant Doctors, RNs) have all been friendly and helpful. I’ve only encountered rudeness with their Urgent Care (I was sick as a dog a few years ago and wanted an antibiotic and was dressed down a bit).
They are affiliated with both Meriter and UW-​Health, so you can get the best of both worlds. TIP: In my experience though, UW-​Health is far more efficient w/​ER Care.
I am not a huge fan of their triage policy for hospital care. Basically, before you go to the hospital you are required to contact them and have a nurse contact you to get permission to go the ER. Usually it has taken me at least 45 minutes to get a call back. When an ER visit is requested, it’s usually due to extreme fear or being in a lot of pain, so that hour or so to get a return call can seem like an eternity. However, you can just go to the ER — if they do not give you permission beforehand, you better meet their subjective standards of what qualifies as a valid ER visit. Clearly, it’s a money-​saving move, so patients go to Urgent Care Vs. ER Care when possible and not milk the HMO for ER duckets.
Even with those issues, GHC is nearly a 5 * HMO.
My primary care team has never dragged their legs on referrals. In my controversial opinion, primary care physicians (or physicians assistants) are glorified RNs and medical specialty matchmakers. I have had doctors in the past that either tried to do everything his/​herself or need to be begged for a referral — that limbo period is very frightening and dangerous. I have never experienced it here. Although not everything came back as positive based on my suspicions, they are exceptionally patient with me and have worked with me until I found the root of the problem or satisfied with their efforts.
They have many facilities internally. You have pretty much every known specialty of standard, complimentary and alternative medicine under the sun (although there is an additional cost for alt-​care). If they do not have it, they will immediately refer you to somewhere that does. Their Urgent Care is very good about seeing you that day.
Billing and so forth has been huge stressors I’ve had with prior HMO’s. I’ve never had charges that I needed to dispute for my family and me for the entire time. Prior to GHC, I had to beg for specialty care and even needed to appeal surgical charges. The
If you appreciate high quality & wide-​reaching medical care with very minor headaches (compared to most other HMOs), GHC is for you.

Group Health Cooperative has been great in general. Keep in mind that I’ve been lucky during my time with them and have had few medical needs, other than preventative care.
I really like my doctor, she seems competent and doesn’t rush. I love the Wellness reimbursement, which means I get half price massages every month at their clinic. You can also get acupuncture, reiki, etc. They also reimburse you for part of the cost of a farm share, which is awesome. I also like that they are non-​profit.
My primary complaint has been more with their dental coverage. They cover cleanings and all of that, but not more extensive work like crowns. Also, one reason prescription costs are so low is that they don’t offer as many choices as some other insurers.