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.
Ready to Enroll?
Click Here |
Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST
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
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
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
Hearing
| Fitting/evaluation |
$0 copay |
| Hearing aids |
$0 copay |
| Hearing exam |
$0 copay |
Inpatient Hospital Coverage
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
Option
Optional supplemental benefits
Outpatient Hospital Coverage
Preventive Care
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
Transportation
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)
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)
Go to top
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.
