DeanCare Gold Shared Value (Cost) By Dean Health Plan, Inc.
DeanCare Gold Shared Value (Cost) is a 2014 Medicare Advantage ("Part C" or "MA Plan") plan by Dean Health Plan, Inc.. This plan from Dean Health Plan, Inc. works with Medicare to give you 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 Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Dean Health Plan, Inc. and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
2014 Medicare Advantage Plan Details
| Plan Name: | DeanCare Gold Shared Value (Cost) |
|---|---|
| Plan ID: | H5264-005 |
| Provider: | Dean Health Plan, Inc. |
| Plan Year: | 2014 |
| Plan Type: | Cost * |
| Monthly Premium C+D: | $68.00 |
| MOOP: |
Coverage Area for DeanCare Gold Shared Value (Cost)
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The DeanCare Gold Shared Value (Cost) H5264-005 is available to residents in Wisconsin, and has a in-network Maximum Out-of-Pocket limit of MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in DeanCare Gold Shared Value (Cost) plan you will stop paying co-pays for the rest of the year once you pay out of pocket This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.
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.
Ratings for DeanCare Gold Shared Value (Cost) H5264
| 2014 Overall Rating | ||
|---|---|---|
| Part C Summary Rating | ||
| Total Experience Rating | ||
| Complaints, Improvements | ||
| Total Customer Service Rating | ||
| Total Preventative Rating | ||
| Chronic And Long Term Care |
Member Experience Rating for DeanCare Gold Shared Value (Cost)
| Total Experience Rating | ||
|---|---|---|
| Getting Needed Care | ||
| Timely Care and Appointments | ||
| Customer Service | ||
| Health Care Quality | ||
| Rating of Health Plan | ||
| Care Coordination |
Member Complaints, Problems Getting Service and Improvements in Health Plans
| Total Rating | ||
|---|---|---|
| Members Leaving the Plan | ||
| Complaints about Health Plan | ||
| Access to Service | ||
| Performance Problems | ||
| Health Plan Quality Improvement |
Customer Service Rating for DeanCare Gold Shared Value (Cost)
| Total Customer Service Rating | ||
|---|---|---|
| Timely Decisions About Appeals | ||
| Reviewing Appeals Decisions | ||
| Call Center |
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating | ||
|---|---|---|
| Breast Cancer Screening | ||
| Colorectal Cancel Screening | ||
| Cardiovascular Screening | ||
| Diabetes Care | ||
| Glaucoma Testing | ||
| Annual Flu Vaccine | ||
| Improving Physical | ||
| Improving Mental Health | ||
| Monitoring Physical Activity | ||
| Adult BMI Assessment |
Ratings For Managing Chronic And Long Term Care
| Total Rating | ||
|---|---|---|
| Medication Review | ||
| Functional Status Assessment | ||
| Pain Screening | ||
| Osteoporosis Management | ||
| Diabetes Care - Eye Exam | ||
| Diabetes Care - Kidney Disease | ||
| Diabetes Care - Blood Sugar | ||
| Diabetes Care - Cholesterol | ||
| Controlling Blood Pressure | ||
| Rheumatoid Arthritis | ||
| Improving Bladder Control | ||
| Reducing Risk of Falling | ||
| Plan - Cause Readmissions |
Source: CMS.
Plans as of September 3, 2013.
Star Rating as of September 27, 2013.
For More Information on Ratings Please See the CMS Tech Notes Here.
Plans are subject to change as contracts are finalized.
Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.
