With Centivo you have access to local doctors and hospitals, virtual care options, emergency coverage anywhere and much more. See below for helpful tips and FAQs.
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Search for doctors, see plan details, download your ID card and more, all in the palm of your hand.
• Search for doctors and facilities in your plan’s network
• Choose or change your primary care doctor (if applicable)
• Download a digital ID card
• See your coverage and costs
• Access pharmacy benefits
• View referrals (if applicable)
• See claims and spending
• Contact Centivo Member Care
Resources for current members.
Search for a doctor or provider from the Home page of the Centivo app or my.centivo.com, or by clicking Find Care. Search by provider type, location and other factors.
Remember, if you go out of network your care may not be covered, or it might cost more.
If you can’t find what you’re looking for, contact Centivo Member Care by calling the number on your Centivo ID card or sending a message through the app.
For plans using a Cigna network: The app will take you to myCigna.com. The first time you visit myCigna.com, you’ll need to create an account using your Centivo member ID located on your Centivo ID card (this ensures the information you see is specific for your plan)
For plans using the HPS Network: The HPS Network covers Eastern Wisconsin but if you live in or travel to an area where HPS providers aren’t available you have access to additional providers outside of the HPS service area.
If you are already an established patient with a primary care doctor who shows in the directory as “not accepting new patients” please contact Centivo Member Care. They will be able to help you assign this doctor as your primary care doctor.
Your Centivo ID card has the logo for your provider network on the front of the card. Your plan may use:
Find behavioral and mental health providers using Find Care or the Health Hub in the Centivo app or my.centivo.com. You can choose an in-person or virtual provider.
If you can’t find what you’re looking for, contact Centivo Member Care by calling the number on your Centivo ID card or sending a message through the app.
Most plans using the Centivo Network require you to activate, which means choosing a primary care doctor to lead your care. This keeps your costs lower and can keep you healthier, too.
To activate, follow the prompts in the Centivo app or my.centivo.com. You can choose an local primary care doctor in your plan’s network or a virtual primary care doctor, like Centivo Care.
If you don’t activate you may be assigned to a doctor, your care might not be covered, or you might pay more for your care. See your plan documents for details, or contact Centivo Member Care if you have questions.
How to activate:
If you have trouble activating, want to activate with a doctor who is showing as “not accepting new patients” or have any other questions, please contact Centivo Member Care by calling the number on your Centivo ID card or sending a message through the app.
If your Centivo ID card says “referrals required” you need to get a referral to see a specialist. Go to your designated primary care doctor for your referral.
Specialist visits that do NOT require a referral are:
Go to your designated primary care doctor and they will submit a referral to an in-network specialist for you. Referrals are automatically approved once they are submitted by your doctor.
Go to the nearest emergency room. Emergency care is covered at the in-network rate no matter where you are. You never need a referral for emergency care.
Urgent care is a good option for after-hours care, when you’re traveling, or when your regular provider isn’t available.
Depending on the network your plan uses, dependents living out of state may have other options for care.
The Centivo Network:
Cigna, HPS, PHCS and other networks:
Most plans include the convenience of virtual providers for primary care, urgent care, behavioral and mental health, physical and speech therapy and some other services.
To find virtual providers,
Centivo Care is a virtual primary care practice offered with many plans. If your plan includes Centivo Care, you’ll find it in the Find Care section of the Centivo app or my.centivo.com.
Centivo Care offers:
To get started, choose Centivo Care when you activate, or go to centivocare.com for more info.
Go to Centivo Care to get started. You’ll need to download the Centivo Care app to get started, which is different from the Centivo app.
Costs vary by plan. To see what your costs are:
If you have questions about the cost of a visit or service, contact Centivo Member Care by calling the number on the back of your ID card or sending a message through the Centivo app or my.centivo.com.
To see your claims or explanation of benefits statements (EOBs):
HPS Network: Explanation of Benefits statements for plans using the HPS Network aren’t available in the Centivo app or at my.centivo.com. Please contact HPS/Paymedix at 888-477-7968 or create a Paymedix account.
To see how much you or your family have spent on qualified medical expenses:
With plans that use HPS, you don’t pay providers when you get care. Instead, HPS/PayMedix will pay your providers and send you a PayMedix SuperEOB statement.
How it works:
Please note, SuperEOB statements will not show in the Centivo app. To access a digital copy, register for an HPS Member Portal account at my.paymedix.com/login.
Plans using HPS include bundled pricing for some surgeries and procedures, which means lower costs for you. If your procedure is eligible for bundling, you’ll get one bill with everything on it, including the surgery center, anesthesiologist and other services related to your procedure. Bundled savings are available for procedures such as:
To get these savings, you must contact the provider partner before you start your care to see if it qualifies. Log into the Centivo app or my.centivo.com, then go to the Health Hub for additional information.
You can download a digital copy of your ID card in the Centivo app or my.centivo.com. To request a new physical ID card, send a message to Centivo Member Care using the Centivo app, or contact your employer.
Members can contact Centivo Member Care by:
Help is available in Spanish and 150+ other languages.
Providers can contact Centivo by calling the number on the back of a member’s ID card. Providers can use Availity to verify eligibility, check claims and access Centivo’s referral portal through a single sign-on. Go to availity.com and select Centivo.
You can download the following forms here, or from the Coverage section of the Centivo app or my.centivo.com. Contact Centivo Member Care if you need a form you don’t see here.
Once you create your account, you’ll see the same information whether you log into the app on your phone or my.centivo.com on a laptop or other device.
However, if you are a patient of Centivo Care virtual primary care practice, you’ll need to download the Centivo Care app to visit with your doctor.
As our network continues to grow, this isn’t uncommon.
If you’re starting a new Centivo plan and are pregnant (will be in your second or third trimester once the plan year begins) or actively being treated for a medical condition by a provider who isn’t in the Centivo Network, you may be eligible to continue care with your current provider at the in-network rate until your current treatment is completed. However, you must submit your request and determination must be made prior to receiving additional care. For more information or to submit this request, contact Centivo Member Care by calling the number on the back of your ID card.
Your pharmacy coverage is managed by a separate company, known as a Pharmacy Benefit Manager or PBM. Find your pharmacy details:
Common terms used in health insurance:
Premium: The amount you pay each month for your coverage, typically taken out of each paycheck. Premiums do not count toward your out-of-pocket maximum. Contact your employer with questions about your premium.
Deductible: The amount you pay out-of-pocket before your health plan starts covering costs. Plans with no deductible start to pay for your care right away.
Copay: A fixed dollar amount you pay for a healthcare service or visit.
Coinsurance: The percentage of the cost you’ll pay for your care after you meet your deductible. In most cases, you either pay a copay or coinsurance, but not both.
Out-of-pocket maximum: The most you’ll pay for any covered healthcare and pharmacy expenses during the plan year. Premiums do not count toward your out-of-pocket maximum.
Referral: A formal recommendation from your primary care doctor to see another provider, like a specialist, for further evaluation or treatment.
Order: Instruction for a procedure, diagnostic service, lab test or other planned service.
Pre-certification: Approval from Centivo, your health plan administrator, for a specific service such as a surgery.
Contact Centivo Member Care by calling the number on your Centivo ID card or by sending a message through the app. Help is available in Spanish and 150+ other languages.
Providers and employers, use "Login" at top of screen.
Features and benefits described on this website may or may not be included in the plan(s) offered by your employer. If you’re already a Centivo member, log in to the Centivo app, my.centivo.com, or contact Centivo Member Care for additional details. Not a member yet? Ask your employer about your plan options.