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DeanCare Gold Enhanced (Cost)
H5264 - 002 - 0
(5 / 5)
DeanCare Gold Enhanced (Cost) is a Medicare Advantage (Part C) Plan by Dean Health Plan Inc..
This page features plan details for 2023 DeanCare Gold Enhanced (Cost) H5264 – 002 – 0 available in South Central Wisconsin.
IMPORTANT: This page has been updated with plan and premium data for 2023.
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: | |
| Drugs Covered: | No |
Ready to sign up for DeanCare Gold Enhanced (Cost) ?
Get help from a licensed Medicare agent.
Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.
Premium Breakdown
DeanCare Gold Enhanced (Cost) has a monthly premium of $157.00. This amount includes your Part C premium but does not include your Part B premium.| Part B | Part C | Part B Give Back | Total |
|---|---|---|---|
| $164.90 | $157.00 | $0.00 | $321.90 |
- 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.
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
| In-Network: No |
Dental (comprehensive)
| Diagnostic services: | 0-50% coinsurance (limits may apply) (authorization not required) (referral not required) |
| Endodontics: | 50% coinsurance (limits may apply) (authorization not required) (referral not required) |
| Extractions: | 50% coinsurance (limits may apply) (authorization not required) (referral not required) |
| Non-routine services: | 50% coinsurance (limits may apply) (authorization not required) (referral not required) |
| Periodontics: | 50% coinsurance (limits may apply) (authorization not required) (referral not required) |
| Prosthodontics, other oral/maxillofacial surgery, other services: | 50% coinsurance (limits may apply) (authorization not required) (referral not required) |
| Restorative services: | 50% coinsurance (limits may apply) (authorization not required) (referral not required) |
Dental (preventive)
| Cleaning: | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Dental x-ray(s): | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Fluoride treatment: | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Oral exam: | $0 copay (limits may apply) (authorization not required) (referral not required) |
Diagnostic procedures/lab services/imaging
| Diagnostic radiology services (e.g., MRI): | $0 copay (authorization not required) (referral not required) |
| Diagnostic tests and procedures: | $0 copay (authorization not required) (referral not required) |
| Lab services: | $0 copay (authorization not required) (referral not required) |
| Outpatient x-rays: | $0 copay (authorization not required) (referral not required) |
Doctor visits
| Primary: | $0 copay |
| Specialist: | $0 copay (authorization not required) (referral not required) |
Emergency care/Urgent care
| Emergency: | $0 copay |
| Urgent care: | $0 copay |
Foot care (podiatry services)
| Foot exams and treatment: | $0 copay (authorization not required) (referral not required) |
| Routine foot care: | Not covered |
Ground ambulance
| $0 copay |
Health plan deductible
| $0.00 |
Health plan deductibles (other)
| In-Network: Yes |
Hearing
| Fitting/evaluation: | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Hearing aids: | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Hearing exam: | $0 copay (authorization not required) (referral not required) |
Hospital coverage (inpatient)
| $0 copay (authorization not required) (referral not required) |
Hospital coverage (outpatient)
| $0 copay (authorization not required) (referral not required) |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
| Not Applicable |
Medical equipment/supplies
| Diabetes supplies: | $0 copay (authorization not required) |
| Durable medical equipment (e.g., wheelchairs, oxygen): | $0 copay (authorization not required) |
| Prosthetics (e.g., braces, artificial limbs): | $0 copay (authorization not required) |
Mental health services
| Inpatient hospital – psychiatric: | $0 copay (authorization not required) (referral not required) |
| Outpatient group therapy visit: | $0 copay (authorization not required) (referral not required) |
| Outpatient group therapy visit with a psychiatrist: | $0 copay (authorization not required) (referral not required) |
| Outpatient individual therapy visit: | $0 copay (authorization not required) (referral not required) |
| Outpatient individual therapy visit with a psychiatrist: | $0 copay (authorization not required) (referral not required) |
Optional supplemental benefits
| No |
Preventive care
| $0 copay (authorization not required) (referral not required) |
Rehabilitation services
| Occupational therapy visit: | $0 copay (authorization not required) (referral not required) |
| Physical therapy and speech and language therapy visit: | $0 copay (authorization not required) (referral not required) |
Skilled Nursing Facility
| $0 copay (authorization not required) (referral not required) |
Transportation
| Not covered |
Vision
| Contact lenses: | Not covered (no limits) |
| Eyeglass frames: | Not covered (no limits) |
| Eyeglass lenses: | Not covered (no limits) |
| Eyeglasses (frames and lenses): | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Other: | Not covered (no limits) |
| Routine eye exam: | $0 copay (limits may apply) (authorization not required) (referral not required) |
| Upgrades: | Not covered |
Wellness programs (e.g., fitness, nursing hotline)
| Covered (authorization not required) (referral not required) |
Ready to sign up for DeanCare Gold Enhanced (Cost) ?
Get help from a licensed Medicare agent.
Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.