2022 DeanCare Gold Shared Value (Cost)


DeanCare Gold Shared Value (Cost) H5264-005 is a 2022 Medicare Advantage Plan or Part-C by Dean Health Plan, Inc available to residents in Wisconsin. This plan does not provide additional prescription drug (Part-D) coverage. The DeanCare Gold Shared Value (Cost) has a monthly premium of $99.00 and has an in-network maximum out-of-pocket limit of $- (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $- out-of-pocket. This can be a extremely nice safety net.

DeanCare Gold Shared Value (Cost) is a Cost * plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

Dean Health Plan, Inc works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for DeanCare Gold Shared Value (Cost) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Dean Health Plan, Inc and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Dean Health Plan, Inc except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.




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2022 Dean Health Plan, Inc Medicare Advantage Plan Costs

Name:
DeanCare Gold Shared Value (Cost)
Plan ID:
H5264-005
Provider:Dean Health Plan, Inc
Year:2022
Type: Cost *
Monthly Premium C+D: $99.00
Part C Premium:
MOOP: $-
Similar Plan: H5264-002
New Plan: 2023 H5264-002




2021 DeanCare Gold Shared Value (Cost) Summary of Benefits

*This will be updated with 2022 data when available.



Additional Benefits


Yes



Comprehensive Dental


Diagnostic services Not covered
Endodontics Not covered
Extractions Not covered
Non-routine services Not covered
Periodontics Not covered
Prosthodontics, other oral/maxillofacial surgery, other services Not covered
Restorative services Not covered



Deductible


$0



Diagnostic Tests and Procedures


Diagnostic radiology services (e.g., MRI) $0 copay
Diagnostic tests and procedures $0 copay
Lab services $0 copay
Outpatient x-rays $0 copay



Doctor Visits


Primary $10 copay per visit
Specialist $10 copay per visit



Emergency care/Urgent Care


Emergency $50 copay per visit (always covered)
Urgent care $10 copay per visit (always covered)



Foot Care (podiatry services)


Foot exams and treatment $10 copay
Routine foot care Not covered



Ground Ambulance


$0 copay



Hearing


Fitting/evaluation $0 copay
Hearing aids $0 copay
Hearing exam $0 copay



Inpatient Hospital Coverage


$200 per stay



Medical Equipment/Supplies


Diabetes supplies $0 copay
Durable medical equipment (e.g., wheelchairs, oxygen) $0 copay
Prosthetics (e.g., braces, artificial limbs) $0 copay



Medicare Part B Drugs


Chemotherapy $0 copay
Other Part B drugs $0 copay



Mental Health Services


Inpatient hospital - psychiatric $200 per stay
Outpatient group therapy visit $0 copay
Outpatient group therapy visit with a psychiatrist $0 copay
Outpatient individual therapy visit $0 copay
Outpatient individual therapy visit with a psychiatrist $0 copay



MOOP


Not Applicable



Option


No



Optional supplemental benefits


No



Outpatient Hospital Coverage


$0 copay



Preventive Care


$0 copay



Preventive Dental


Cleaning $0 copay
Dental x-ray(s) $0 copay
Fluoride treatment Not covered
Oral exam $0 copay



Rehabilitation Services


Occupational therapy visit $0 copay
Physical therapy and speech and language therapy visit $0 copay



Skilled Nursing Facility


$0 copay



Transportation


Not covered



Vision


Contact lenses Not covered
Eyeglass frames Not covered
Eyeglass lenses Not covered
Eyeglasses (frames and lenses) $0 copay
Other Not covered
Routine eye exam $0 copay
Upgrades Not covered



Wellness Programs (e.g. fitness nursing hotline)


Covered





Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST




Coverage Area for DeanCare Gold Shared Value (Cost)

(Click county to compare all available Advantage plans)



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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

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