DeanCare Gold Enhanced (Cost)

H5264 - 002 - 0
0 out of 5 stars (0 / 5)

DeanCare Gold Enhanced (Cost) is a Medicare Advantage (Part C) Plan by Dean Health Plan, Inc..

This page features plan details for 2024 DeanCare Gold Enhanced (Cost) H5264 – 002 – 0 available in South Central Wisconsin.

IMPORTANT: This page has been updated with plan and premium data for 2024.

Locations

DeanCare Gold Enhanced (Cost) is offered in the following locations.

Plan Overview

DeanCare Gold Enhanced (Cost) offers the following coverage and cost-sharing.

Insurer:Dean Health Plan, Inc.
Health Plan Deductible:$0.00
MOOP:Not Applicable
Drugs Covered:No

Ready to sign up for DeanCare Gold Enhanced (Cost) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Premium Breakdown

DeanCare Gold Enhanced (Cost) has a monthly premium of $172.00. This amount includes your Part C premium but does not include your Part B premium.
Part B Part C Part B Give Back Total
$174.70 $172.00 $0.00 $346.70
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

DeanCare Gold Enhanced (Cost) also provides the following benefits.

Health plan deductible

$0

Other health plan deductibles?

In-network Yes

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

Not Applicable

Optional supplemental benefits

No

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-network No

Outpatient hospital coverage

$0 copay (Authorization is not required.) (Referral is not required.)

Doctor visits

Primary$0 copay (Not applicable.) (Not applicable.)
Specialist$0 copay (Authorization is not required.) (Referral is not required.)

Preventive care

$0 copay (Authorization is not required.) (Referral is not required.)

Emergency care/Urgent care

Emergency$0 copay (Not applicable.) (Not applicable.)
Urgent care$0 copay (Not applicable.) (Not applicable.)

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures$0 copay (Authorization is not required.) (Referral is not required.)
Lab services$0 copay (Authorization is not required.) (Referral is not required.)
Diagnostic radiology services (e.g., MRI)$0 copay (Authorization is not required.) (Referral is not required.)
Outpatient x-rays$0 copay (Authorization is not required.) (Referral is not required.)

Hearing

Hearing exam$0 copay (Authorization is not required.) (Referral is not required.)
Fitting/evaluation$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Hearing aids$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Preventive dental

Oral exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Cleaning$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Fluoride treatment$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Comprehensive dental

Non-routine services50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Diagnostic services0-50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Restorative services50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Endodontics50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Periodontics50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Extractions50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Prosthodontics, other oral/maxillofacial surgery, other services50% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Vision

Routine eye exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
OtherNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Contact lensesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglass framesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Eyeglass lensesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
UpgradesNot covered (Not applicable.) (Not applicable.)

Rehabilitation services

Occupational therapy visit$0 copay (Authorization is not required.) (Referral is not required.)
Physical therapy and speech and language therapy visit$0 copay (Authorization is not required.) (Referral is not required.)

Ground ambulance

$0 copay (Not applicable.) (Not applicable.)

Transportation

Not covered (Not applicable.) (Not applicable.)

Foot care (podiatry services)

Foot exams and treatment$0 copay (Authorization is not required.) (Referral is not required.)
Routine foot careNot covered (Not applicable.) (Not applicable.)

Medical equipment/supplies

Durable medical equipment (e.g., wheelchairs, oxygen)$0 copay (Authorization is not required.) (Not applicable.)
Prosthetics (e.g., braces, artificial limbs)$0 copay (Authorization is not required.) (Not applicable.)
Diabetes supplies$0 copay (Authorization is not required.) (Not applicable.)

Wellness programs (e.g., fitness, nursing hotline)

Covered (Authorization is not required.) (Referral is not required.)

Medicare Part B drugs

Chemotherapy$0 copay (Not applicable.) (Not applicable.)
Other Part B drugs$0 copay (Not applicable.) (Not applicable.)
Part B Insulin drugs$0 copay (Not applicable.) (Not applicable.)

Inpatient hospital coverage

$0 copay (Authorization is not required.) (Referral is not required.)

Mental health services

Inpatient hospital – psychiatric$0 copay (Authorization is not required.) (Referral is not required.)
Outpatient group therapy visit with a psychiatrist$0 copay (Authorization is not required.) (Referral is not required.)
Outpatient individual therapy visit with a psychiatrist$0 copay (Authorization is not required.) (Referral is not required.)
Outpatient group therapy visit$0 copay (Authorization is not required.) (Referral is not required.)
Outpatient individual therapy visit$0 copay (Authorization is not required.) (Referral is not required.)

Skilled Nursing Facility

$0 copay (Authorization is not required.) (Referral is not required.)

Ready to sign up for DeanCare Gold Enhanced (Cost) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

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