2021 State of Wisconsin - Group Health Insurance Program - Dean Health Plan

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2021 State of Wisconsin - Group Health Insurance Program - Dean Health Plan
2021   State of Wisconsin
       Group Health Insurance Program

   Rated 4.5
   out of 5!
2021 State of Wisconsin - Group Health Insurance Program - Dean Health Plan
Have questions?
                      We are here to Help
                              Call
                              Call our Customer Care Center for questions about your benefits a
                                                                                                nd more.
                              800-279-1301 (TTY: 711)
                              Monday – Thursday: 7:30 am – 5 pm
                              Friday: 8 am to 4:30 pm

                              Click
                              Visit deancare.com/contact-us and click the Dean Health Plan button

                              Come In*
                              Our Insurance Desk is open Monday through Friday, 8 am to 4:30 pm. Come in to our
                              Health Plan Office or one of the following SSM Health Dean Medical Group locations:

                                     • Health Plan Business Office: 1277 Deming Way, Madison

                                     • East: 1821 S. Stoughton Road, Madison

                                     • West: 752 N. High Point Road, Madison

                                     • Fish Hatchery Clinic:1313 Fish Hatchery Road, Madison

                                     • Janesville East:3200 E. Racine Street, Janesville

                                     *During the current public health crisis, these are offered by phone or video.
INSURANCE PROGRAM

                              Why Choose Dean					4
 STATE OF WISCONSIN
  2021 GROUP HEALTH

                              Convenient Tools and Resources			    6
                              New Member Checklist				7
                              The Dean Provider Network				        8
                              Understanding Your Benefits			       9
                                 Claims and Payment
                                 Explanation of Benefits
                              Health Insurance Kit 101				         10
                              Where to Go for Care				             11
                                 Urgent and Emergency Care
                                 Authorizations
                              Member Rights and Responsibilities		 13
       2                      Plan Details						14
                              Privacy and Confidentiality				14
2021 State of Wisconsin - Group Health Insurance Program - Dean Health Plan
Serving You
for More than 30 Years
Dean Health Plan is proud to serve the State of Wisconsin Group Health Insurance Program! Over three
decades ago, we responded to the needs of the state by creating managed care plans and effectively
managing the cost and quality of that care. Choose benefits that go above and beyond like free virtual
visits on most plans, urgent care visits that cost no more than your primary care physician, free digital
wellness programs and more:

                                  Access to Providers
                                  Dean Health Plan has been providing award-winning health care
                                  coverage since 1983. Our network is staffed with health care
                                  professionals who are dedicated to helping you and your loved ones
                                  remain as healthy as possible, even when you’re on the road.

                                  24-Hour Nurse Advice Line
                                  Answers to your health-related questions are available 24/7/365.
                                  If you’re not sure where to go for care or you have a health concern,
                                  experienced registered nurses at Dean On Call are here to help.
                                  Call 800-57-NURSE (800-576-8773).*

                                  *D
                                    ue to licensing regulations, 24-Hour Nurse Advice Line’s triage services are only
                                   available to Wisconsin residents. For any life-threatening emergencies, always dial 911.
Accredited by National Committee for Quality Assurance
                           Accreditation is by the National Committee for Quality Assurance (NCQA).
                           NCQA is an independent, not-for-profit organization that evaluates nearly
                           1,500 health plans nationwide based on more than 50 standards of care and
                           service to determine health plan accreditation. Learn more at ncqa.org.
                           Dean’s HMO Plans are rated 4.5 out of 5. NCQA’s Private Health Insurance
                           Plan ratings for 2019—2020 help consumers easily compare health plans
                           based on quality of care and service.
                           Dean Health Plan’s rating of 4.5 is in the top 17% of Commercial plans in
                           Wisconsin and the top 8% in the nation.

                           Care Management
                           While you should always start with your primary care provider for non-
                           emergency care, sometimes you might need additional help navigating
                           through the health care system. That’s where the Dean Health Plan Care
                           Management team comes in. If you’re diagnosed with a chronic health
                           condition have a complex health care or behavioral health need, we can help
                           guide you to the most appropriate method of care and ensure your needs are
                           met and your questions and concerns are addressed. Learn more about
                           Care Management at deancare.com/caremanagement.

                           Virtual Visit
                           Care is just a click a way. Virtual Visit brings you free care from the comfort
                           of home. Now you can reach trusted SSM Health providers with convenient
                           online access for common medical conditions like: cold/flu, sinus infections,
                           bladder infections and more. Learn more at deancare.com/virtualvisit.
INSURANCE PROGRAM

 STATE OF WISCONSIN
  2021 GROUP HEALTH

                      deancare.com/wi-employees
                                    or etf.wi.gov
       4
Convenient
Tools and Resources
Get the information you need, when you need it. Find it within member tools that easily connect you
to health information, benefit details and much more.

        ❯❯   Activate these accounts today! deancare.com/newmember

          Member Portal

                   Your online                                           Your online
                  member portal                                         health record

           View your insurance plan details                   Send and receive secure messages
                                                              with your primary care provider
           Request member ID cards
           or download a digital copy                         Schedule appointments

           Change your primary care clinic                    Get lab results

           Review past claim details and more                 Request prescription refills and more

                                                              View and pay your medical bill

              Visit deancare.com/login                           Visit deancare.com/mychart
         and use your member number from                           to activate your account.
        your ID card to activate your account.

                                                                                                           ?
                       Online Answers
                                                                                                      DEANCARE.COM/
                                                                                                       800-279-1302 OR
                                                                                                        WI-EMPLOYEES

                       Visit deancare.com/wi-employees for links to
                       important member documents with details of your
                       benefits and coverage. There you’ll also find a link for
                       our online directory so you can search for a provider,
                       clinic or pharmacy near you.

                                                                                                            5
New Member
                      Checklist
                      Begin your experience with Dean Health Plan by taking a few simple steps. Complete this checklist to
                      unlock resources and take important actions so you can get the most out of being a member.
                      This checklist is helpful even if you are continuing your coverage with Dean Health Plan.

                      Activate Your Accounts                                Choose a Primary Care Provider
                      Get access anytime to your personal health            Choose a primary care provider (PCP) who is
                      information with your MyChart account. Have           right for you. Go online or call our Customer Care
                      your health insurance and member information          Center at 800-279-1301. Fostering an open and
                      available at your fingertips with your Member         honest relationship with a primary care provider
                      Portal account. See page 6 to learn more.             whom you can trust is an important part of
                                                                            Dean’s integrated care model.
                      Review Your Health Care Benefits
                      Together, the “It’s Your Choice” materials from       Transfer Your Medical Records
                      the Wisconsin Department of Employee Trust            Once you’ve chosen a primary care provider and
                      Funds (ETF) and the “Summary of Benefits              made an initial appointment, have your medical
                      and Coverage” documents from Dean Health              records sent over from your previous clinic.
                      Plan specifically outline the benefits, services,     Simply fill out an “Authorization to Release
                      exclusions and limitations under your policy.         Protected Health Information” form, available at
                      The same Guide is issued for each of the many         deancare.com/members under Member Forms,
                      State of Wisconsin Group Health Insurance             and give it to your previous provider. He or she will
                      Program plans, but the Summary reflects               transfer the records to your new Dean provider.
                      Dean Health Plan’s specific benefits, so be sure
                      to read both. Visit deancare.com/wi-employees         Let Us Know if You Have Health Concerns
                      to access them online. Please also see etf.wi.gov     If you have a chronic health condition or have a
                      for more information.                                 complex health care need, we encourage you to
                                                                            take advantage of our Care Management services.
                                                                            Visit deancare.com or call the Customer Care
                                                                            Center at 800-279-1301 for more information.
INSURANCE PROGRAM

 STATE OF WISCONSIN
  2021 GROUP HEALTH

                                                                 Visit our State of Wisconsin Group
                                                                 Health Insurance Program website to
                                                                 access your policy’s specific benefits
                                                                 and coverage details:

                             deancare.com/wi-employees
       6
The Dean
Provider Network
As a Dean Health Plan member, you have access to       o search the directory, select Online under
                                                     •T
more than 2,000 in-network providers throughout       Provider Directory.
our 20-county service area. Visit our State of
                                                     •T
                                                       o download an electronic copy of the directory,
Wisconsin Group Health Insurance Program
                                                      select Printable under Provider Directory.
website at deancare.com/wi-employees for the
online provider directory to easily find excellent   •Y
                                                       ou may also call our Customer Care Center
doctors available in our network. Please see the      at 800-279-1301 to request a copy to be mailed
back inside cover of this book for a detailed         to you.
service area map.

Providers in the Network                             SSM Health Dean Medical Group
Madison and Beyond                                   Where Quality Soars

SSM Health Dean Medical Group is a major             We continue to lead the pack in a variety of key
provider of health care to Madison and its           measures linked to prevention and management of
surrounding communities. Our reach goes beyond       chronic conditions, as compiled by the Wisconsin
the capital city with more than two dozen clinic     Collaborative for Healthcare Quality in 2019. Go to
locations, all owned by SSM Health.                  wchq.org to see how we compare.

To complement our clinics, more than 2,000           Hospitals You Can Trust
other doctors across southern Wisconsin have         SSM Health St. Mary’s Hospital – Madison, SSM Health
joined the Dean Health Plan network. In addition     St. Mary’s Hospital – Janesville and SSM Health
to unsurpassed access, patients enjoy consistent,    St. Clare Hospital – Baraboo offer high-quality care
high-quality care that’s been recognized in a        and an exceptional patient experience. SSM Health
variety of independent measures. Our health plan,    St. Mary’s Hospital – Madison was named one of
clinics and hospitals have a long tradition          America’s Best Hospitals™ for 2019. St. Mary’s Hospital
of collaborating to provide you with the care        is one of just seven Wisconsin hospitals to receive
you need, where and when you need it. We             this honor. It was also named one of the nation’s
work together – for you.                             100 Top Hospitals by IBM Watson Health™.
                                                     SSM Health St. Mary’s Hospital – Janesville was
                                                     named one of America’s Best Hospitals for both
                                                     Obstetrics and Emergency Care by Women’s Choice
                                                                                                                    ?
                                                                                                               DEANCARE.COM/

                                                     Award. And SSM Health St. Clare Hospital – Baraboo
                                                                                                                800-279-1302 OR
                                                                                                                 WI-EMPLOYEES

                                                     was a recipient of the 2019 Healthgrades Outstanding
                                                     Patient Experience Award which is given to the
                                                     top 15% of hospitals nationwide.

                                                                                                                     7
Understanding
                      Your Benefits
                      The State of Wisconsin Group Health Insurance Program is a network-based plan. That means your
                      primary care provider from our Dean Health Plan network oversees all aspects of your health care needs
                      and emphasizes preventive care to keep you as healthy as possible. Please refer to the State of Wisconsin
                      Group Health Insurance Program’s “It’s Your Choice” materials and your “Summary of Benefits and
                      Coverage” from Dean for details.

                                                             deancare.com/wi-employees or etf.wi.gov
                                                             Your place to go for policy information, including:
                                                             • Provider listings
                                                             • Plan information and details
                                                             •D
                                                               ean Health Plan Communication – copies of letters and other
                                                              correspondence sent to members

                      Claims and Payment                                           If you have another insurance company that is
                                                                                   the primary payer, you will need to send the
                      Filing Claims                                                Explanation of Benefits (described below) to
                      Time is valuable to all of us; that’s why Dean               Dean Health Plan or to your health care provider.
                      Health Plan minimizes the amount of paperwork
                      required for our members. In most cases, claims              Explanation of Benefits (EOB)
                      are submitted directly to Dean Health Plan by                The EOB contains important information
                      providers or clinic staff. On occasion, if you’re            including the total amount charged, the amount
                      traveling out of the area or have a college-age              paid by Dean Health Plan, and the amount that is
                      dependent, for example, it may be necessary for              your (the member’s) responsibility. You may access
                      you to submit a claim for reimbursement. When                all of your EOBs online at any time through your
                      submitting the claim, please be sure to follow these         Member Portal account. Go to deancare.com/
                      guidelines:                                                  wi-employees and click Account Login at the top
                                                                                   right corner of the page. Remember, an EOB is not
                        1. S
                            end an itemized bill from the provider of
                                                                                   a bill.
                           services. If services were received outside of
                           the United States, you will need to submit the
                                                                                   Common Insurance Terms
                           original bill along with an itemized bill that has
                           been translated into English and indicate the           Do you know the ABCs of health insurance? It’s
                           appropriate currency exchange rate at the               OK—the language of health insurance can be
                                                                                   hard to understand at times. Yet every day, it’s
INSURANCE PROGRAM

                           time the services were received.
 STATE OF WISCONSIN
  2021 GROUP HEALTH

                                                                                   becoming more and more important for health
                        2. Send the bill within 60 days of receiving the          care consumers to have a basic knowledge of the
                            services to:                                           industry’s terminology.
                            Dean Health Plan
                            Attn: Claims Department                                We’ve spelled out these terms in plain English so
                            P.O. Box 56099                                         you can make smart decisions that will benefit
                            Madison, WI 53705                                      you and your family. Go to deancare.com/
                                                                                   insuranceterms to see a full list of terms explained.

       8
Getting the
Right Care
Your primary care provider is here to help you with basic medical needs. Plus, you have options for specialty
and other types of care. Knowing your care options in advance is not only good for your health—it’s also
better for your budget. Learn more at deancare.com/rightcare.

             Virtual Visit                                               • Acid reflux                        • Ringworm (tinea)
                                                                         • Allergies & hay fever              • Swimmer’s ear
             Get care for certain common conditions from the                                                     (otitis externa)
                                                                         • Bladder infections
             comfort of home via smart phone or computer at                                                   • Tick bite
             deancare.com/virtualvisit. Receive a diagnosis, a           • Cold/flu, sinus infections
                                                                         • Diaper rash                        • Tobacco cessation
             treatment plan and a prescription.
                                                                         • Lice                               • Vaginal yeast infection
                                                                         • Motion sickness                    • Whooping cough
                                                                                                                 (pertussis)
                   The lowest-cost option.                               • Pink eye
                                                                                                              • And more

             Primary Care                                                Annual Preventive Office             Managing
                                                                         Visits and checkups                  chronic conditions
             Need care? Call your primary care clinic for an
             appointment. Same-day appointments are usually
             available. Your primary care provider may offer             Flu and other recommended
                                                                                                              Migraines
                                                                         immunizations
             some appointments via telemedicine. Common
             reasons to visit include:                                   Less severe issues like
                                                                         earaches, cold or flu
                         The lower-cost option.                          symptoms and sore throat

             Urgent Care                                                        Out-of-Area Care: Both urgent and emergency care are
                                                                                covered by Dean Health Plan if you or your covered family
             If a same-day appointment is not available to
             treat your illness or injury at your primary care                  member are traveling and unable to return to the service area
             clinic, you may be directed to Urgent Care.                        for immediate treatment. In addition, qualified dependent
                                                                   children residing outside of the Dean Health Plan service area are covered
                               Possible higher-cost option.        for all health care services included in your plan’s covered benefits.*

             Emergency Care                                              Heart attack symptoms             Head injury or
             For a life-threatening illness or injury, go to the         (chest pain, shortness            sudden confusion
                                                                         of breath, nausea/vomiting)
             nearest emergency room or call 911. Tell your
             primary care provider that you went to the ER.
             You may need follow-up services. Common                     Stroke symptoms
                                                                         (slurred speech, sudden           Severe abdominal pain
             reasons to visit include:
                                                                         weakness and vision loss,
                                                                         and dizziness)
                                      The high-cost option.

                                                                                                                                               ?
  What is a Virtual Visit versus a Telehealth Visit? A virtual visit is an instant visit and is not scheduled
                                                                                                                                          DEANCARE.COM/
                                                                                                                                           800-279-1302 OR

  in advance. A virtual visit is a free care option with Dean Health Plan. Members complete a series of
                                                                                                                                            WI-EMPLOYEES

  online questions and a provider will follow up via phone or video chat, depending on your specific
  needs. A full list of conditions treated via virtual visit can be found at deancare.com/virtualvisit.

  For a telehealth visit, members schedule an appointment in advance with a provider. Members meet
  with their provider via video chat, or in some circumstances, on the phone. These visits are billed to
  insurance and members pay their normal visit copay.

                                                                                                                                                9
Care Decision Assistance
                      We can help if you have questions related to using health care services. Call our Customer Care Center
                      at 800-279-1301 (TTY: 711) and our representative will connect you to our Medical Affairs Department
                      if he or she is unable to address your questions. The Customer Care Center is open Monday – Thursday,
                      7:30 am to 5 pm, and Friday, 8 am to 4:30 pm. If you have an urgent need outside those hours, leave a
                      message with the Customer Care Center and your call will be returned within one business day. We can
                      assist members who do not speak English.

                      Behind the Scenes at Dean
                      Ways we’re helping you get the right care

                      Prior Authorization
                      As you navigate your health care, it’s important to note that there are certain medical services or
                      provider visits that will require prior authorization by Dean Health Plan. These authorizations are
                      required so our Medical Affairs team can make sure you are getting the appropriate care. A good
                      rule to remember is that any time you seek services with an out-of-network provider, you will need
                      to obtain a prior authorization.

                      Utilization Management
                      When you need to discuss issues or have questions related to the requirement of an authorization
                      for a particular service, Dean Health Plan is here to help. Contact the Customer Care Center at
                      800-279-1301 (TTY: 711), and you will be connected to the Utilization Management department.
                      This department ensures you receive the appropriate and necessary care for your condition.

                      Utilization Management staff members are available Monday through Friday, 8 am to 4:30 pm. If you
                      have an urgent need outside of those hours, please leave a message with the Customer Care Center
                      and your call will be returned within one business day.

                      New Medical Technology
                      Every year Dean Health Plan evaluates new medical technology and reviews existing technology
                      to determine if any changes or updates are needed to guidelines outlining appropriate use. During
                      this process, we review requests for ongoing care or treatment recommendations for all utilization
                      management decisions, including medical, behavioral health care, pharmaceuticals and medical devices.
                      Dean Health Plan follows the review process set by the National Commission for Quality Assurance
                      (NCQA). Based upon the results of the technology assessment, we will draft or revise medical policies
                      if necessary.
INSURANCE PROGRAM

                      For help to translate or understand this information, please
 STATE OF WISCONSIN
  2021 GROUP HEALTH

                      call 800-279-1301 (TTY: 711).

      10
How insurance works:
Health insurance 101.
We provide you with tools to learn where your health care dollars go, and we try to make it as easy
as possible to understand your financial responsibilities.*
Your policy may use a system of cost sharing that can include a copay, coinsurance, deductible or any combination of the three.

                                                         DEDUCTIBLE
                                                     1   Each time you receive medical services, you’ll pay the bill towards these
                                                         services up to a certain amount. This amount is your deductible, which is
                                                         what you must pay for covered health care services each year before we
                                                         begin to pay.

                                                         COINSURANCE†
                                                     2   Once you’ve paid the deductible amount, your insurance will then start
                                                         splitting the cost of additional medical services with you. This is known as
                     2                                   coinsurance, where you only pay a percentage or part of the total cost of
                                                         services and we’ll pay the rest.

                     1                                   Deductible and Coinsurance Limit – There’s a dollar limit to the
                                                         amount you’ll pay towards your deductible and coinsurance.

                                                         COPAYS
                                                     3   A copay is a fixed dollar amount, which you pay at the time you receive
                                                         medical services (for things like an office visit) and prescriptions. All your
* Not all of the cost-sharing terms listed              copays add up toward your Maximum Out-of-Pocket total.
 here apply to all members. Refer to your
 Member Policy document to understand                    Maximum Out-of-Pocket – There’s a dollar limit to all your cost
 which apply to you.                                    sharing. You reach this amount by means of your deductible, plus
† Coinsurance is your share of the costs of a           your coinsurance, plus your copays. Once this limit is reached, you’ll
 covered health care service. It’s calculated as a       pay nothing on subsequent covered medical charges for the remainder
 percent of the allowed amount for the service.          of your policy year.

                                                                                                                                               ?
                                                                                                                                          DEANCARE.COM/
                                                                                                                                           800-279-1302 OR
                                                                                                                                            WI-EMPLOYEES

                                                                                                                                                11
Member
                      Rights & Responsibilities
                      You deserve the best service and health care possible. Rights and responsibilities help foster cooperation
                      among members, practitioners and Dean Health Plan.

                      Members have the right to:                              Members have the responsibility to:
                      •B
                        e treated with respect and recognition of their      • Read
                                                                                    and understand the materials provided by
                       dignity and right to privacy.                            Dean Health Plan concerning their health care
                      •R
                        eceive a listing of Dean Health Plan participating     benefits. Dean Health Plan encourages members
                       practitioners in order to choose a Primary Care          to contact Dean Health Plan if they have any
                       Physician.                                               questions.

                      •P
                        resent a question or complaint or grievance to       • Present
                                                                                      their ID card in order to identify
                       Dean Health Plan, about the organization or the          themselves as Dean Health Plan members before
                       care it provides, without fear of discrimination or      receiving health care services.
                       repercussion.                                          • Notify Dean Health Plan of any enrollment status
                      •R
                        eceive information on procedures and policies          changes such as family size or address You must
                       regarding their health care benefits.                    also communicate enrollment status changes to
                                                                                your employer so that your system of record can
                      •T
                        imely responses to requests regarding their            be updated.
                       health care plan.
                                                                              • Supply
                                                                                      information (to the extent possible)
                      •R
                        equest information regarding Advance                   that the organization and its practitioners and
                       Directives.                                              providers need in order to provide care.
                      •P
                        articipate with practitioners in making decisions    •F
                                                                                ollow plans and instructions for care that they
                       about their health care.                                have agreed on with their practitioners.
                      •A
                        candid discussion of appropriate or medically       • Understand
                                                                                           their health problems and
                       necessary treatment options for their conditions,        participate in developing mutually agreed upon
                       regardless of cost or benefit coverage.                  treatment goals to the degree possible.
                      • Receive
                               information about the organization, its      • Fulfill
                                                                                      financial obligations as they relate to any
                        services, its practitioners and providers, and          copays, deductibles and/or premiums as outlined
                        members’ rights and responsibilities.                   in your policy.
                      •M
                        ake recommendations regarding the                    • Provide
                                                                                      information about any other health
                       organization’s members’ rights and
INSURANCE PROGRAM

                                                                                insurance coverage you have so that Dean
 STATE OF WISCONSIN

                       responsibilities policies.
  2021 GROUP HEALTH

                                                                                Health Plan can coordinate benefits with the
                      • Receive
                              a copy of the Dean Health Plan Notice of        other insurance plan(s).
                        Privacy Practices, which describes how medical
                        information about you may be used or disclosed
                        and how you can get access to this information.
                        The notice is available at deancare.com/privacy.

       12
Plan
Details
Limitations & Exclusions                              If after contacting us, you continue to feel a
                                                      decision has adversely affected your coverage,
For a list of services, treatments, equipment or
                                                      benefits or relationship with Dean Health Plan,
supplies that are excluded (meaning no benefits
                                                      you may file a grievance (sometimes called an
are payable under the Plan Benefits); or have some
                                                      appeal). For details on how to file or for more
limitations on the benefit provide, please refer to
                                                      information about these procedures, please visit
the State of Wisconsin Group Health Insurance
                                                      Grievances & Appeals under Helpful Links at
Program’s “Its Your Choice” materials, under
                                                      the bottom of deancare.com/wi-employee. Or
Uniform Benefits Exclusions and Limitations.
                                                      feel free to contact the Customer Care Center
                                                      at 800-279-1301 with any questions about
Complaints, Grievances
                                                      the process.
and Appeals Process
We know that at times you may have questions          As a member of the State of Wisconsin Group
and concerns about benefits, claims or services       Health Insurance Program, you also have the
you have received from Dean Health Plan. Sharing      right to request an administrative review through
your concerns will help us to identify areas of       ETF if an independent review organization has
improvement or clarification needed in our            not rendered a decision on your grievance that is
processes or documents as well as help clear up       final and binding. Refer to your “It’s Your Choice”
areas of confusion with your benefits or coverage.    materials for details on this process.
When a question or concern arises, we encourage
you to reach out to our Customer Care Center          Privacy & Confidentiality Statement
at 800-279-1301. Our Customer Care Specialists
                                                      Dean Health Plan is required by law to maintain
will make every effort to resolve your concern
                                                      the privacy of your personal health and financial
promptly and completely. Your input matters, and
                                                      information (collectively referred to as “nonpublic
we encourage you to call with any concerns you
                                                      personal information”) and provide you with
may have regarding your health care.
                                                      written notification of our legal duties and privacy
                                                      practices concerning that information.

                                                      Please visit our website at deancare.com/privacy
                                                      or give us a call at 800-279-1301 to request a copy.
Dean Health Plan Network
             Looking for a provider?

                                                                                                                                                                                                                Hospitals
                                                                                                                                     LEGEND                                                                     Beaver Dam
                                                                                                              Hospital and Primary Care Provider location                                                       Community Hospital
                                                                                                              Primary Care Provider location only                                                               Beloit Memorial Hospital
                                                                                                              Hospital only
                                                                                                                                                                                                                Crossing Rivers Health,
                                                                                 Adams                        Primary Care/Urgernt Care Provider location
                                                                                                                                                                                                                Prairie du Chien
                                                                                                              Hospital, Urgent Care and Primary Care Provider location
                                                              Necedah                                                                                                                                           Divine Savior Healthcare,
                                                                                     Friendship
                                                                                                         Marquette                                                                                              Portage
                                                         Juneau                                                 Westfield              Green                                         Mt. Calvary
                                                                                                                                                                                                                Edgerton Hospital &
                                                                  New Lisbon                                                           Lake              Ripon                Fond du Lac                       Health Services

                                                          Elroy
                                                                           Mauston                                                                                Fond du Lac                                   Finley Hospital, Dubuque, IA
                                                                                                            Oxford                                                Brandon
                                                                                                                                                                                                                Fort Healthcare, Inc.,
                                                                                                                                         Markesan
                                                                                                                                                              Waupun                                            Fort Atkinson
                 Vernon                  Hillsboro              Wonewoc
                                                                        Wisconsin Dells                                                                                                                         Grant Regional Health Center,
                                                                                                                                                        Fox Lake         Brownsville Campbellsport
                                                                                                                                                                                                                Lancaster
                                                                  Reedsburg
                                                                                                              Portage    Pardeeville        Randolph          Dodge                                             Gundersen Boscobel Area
                                                                                           Baraboo
                                                                                                                Columbia                              Beaver Dam            Mayville                            Hospital & Clinic
                                                                             Sauk                                               Rio                                                                             Gunderson Moundview
                                         Richland Center
        Crawford                                                   Plain       Prairie du Sac          Lodi                        Columbus                     Juneau                                          Memorial Hospital, Friendship
                                      Richland                                                                                                                                                                  Memorial Hospital of
                                                                               Sauk City                                                                      Watertown                                         Lafayette County, Darlington
                                                                 Spring Green                                 Dane                                                                                              Mile Bluff Medical Center,
                       Boscobel     Muscoda                                                                                   Sun Prairie          Waterloo                   Oconomowoc
                                                                                                              Waunakee
                                                                                                                              Marshall                                                       Sussex             Mauston
                                                                                                                                                  Lake Mills                             Pewaukee
    Prairie du Chien                                                                       Black Earth                         Deerfield                                                                        Monroe Clinic Hospital
                                                                                                                                                                                Hartland Brookfield Wauwatosa
                                                              Iowa                                   Madison                                            Johnson Creek

                       Fennimore
                                                  Highland                                                           Cottage Grove                  Jefferson                      Delafield
                                                                                                                                                                                        Waukesha New Berlin
                                                                                                                                                                                                                Oconomowoc
                                                                                                       Verona                                                                                                   Memorial Hospital
                                    Montfort
                                                                Dodgeville
                                                                                                                               Cambridge              Jefferson
                                                                                                                                                                              Waukesha
                                                                                                                                                                                    Muskego                     Prairie Ridge Health
                                                                                                                   Oregon Stoughton
                       Grant                                   Mineral Point
                                                                                                      Belleville                                    Fort Atkinson               Eagle   Mukwonago
                                                                                                                                                                                                                Reedsburg Area
                                                                                                New Glarus                             Edgerton                    Whitewater                                   Medical Center
                             Lancaster                              Blanchardville                                                                   Milton
                                                                                                                                                                                                                Richland Hospital,
                                   Platteville
                                                                               Argyle            Green
                                                                                                                         Evansville
                                                                                                                                                                   Walworth                                     Richland Center
                                                          Darlington
                                                                                                               Albany          Rock                                                                             Ripon Medical Center
                                   Cuba City           Lafayette                                   Monroe               Brodhead
                                                                                                                                                Janesville      Darien
                                                                                                                                                                         Delavan
                                                                                                                                                                                                                Sauk Prairie Healthcare
                                                         Shullsburg                                                                    Beloit       Clinton                                                     Southwest Health Center,
                 Dubuque, IA                                                                                                                                                                                    Platteville
                                                                                        Lena, IL                        Durand, IL
                                                 Galena, IL
                                                                                                      Freeport, IL                                 Roscoe, IL                                                   St. Agnes Hospital,
Peosta, IA
                                                                                                                                                                                                                Fond du Lac
                                  IOWA                              Elizabeth, IL
                                                                                                                                                                                         ILLINOIS               St. Joseph’s Health Services –
                                                                                                                                                                                                                Gundersen Lutheran, Hillsboro
                                                                                                                                                                                                                SSM Health St. Clare Hospital,
                                                                                                                                                                                                                - Baraboo
                                                                                                                                                                                                                SSM Health St. Mary’s Hospital,
                                                                                                                                                                                                                - Janesville
             Dean Health Plan offers a current and comprehensive listing of physicians,                                                                                                                         SSM Health St. Mary’s Hospital,
                                                                                                                                                                                                                - Madison
             specialists, pharmacies and more at deancare.com/doctors. Important                                                                                                                                Stoughton Hospital
                                                                                                                                                                                                                Upland Hills Health, Dodgeville
             contact information such as phone numbers and locations are listed on
                                                                                                                                                                                                                Watertown Regional
                                                                                                                                                                                                                Medical Center
             our website. Find a listing of our plan hospitals at right and our primary                                                                                                                         Waupun Memorial Hospital

             care locations on the reverse side of this sheet.                                                                                                                                                  Waukesha Memorial Hospital
                                                                                                                                                                                                                Willow Creek Behavioral
                                                                                                                                                                                                                Health, Green Bay

             Dean Health Plan is a Qualified Health Plan issuer in the Health Insurance Marketplace.

                Visit deancare.com/doctors
                  To find a provider today.
LEGEND        Urgent Care Location

                                                 ADAMS                             BROWNSVILLE                     MUSCODA                          DARLINGTON                          HARTLAND
                                                 FRIENDSHIP                        Fond du Lac Regional Clinic     Muscoda Health Center            Primary Care Clinic - Darlington    ProHealth Care
                                                 Gundersen Moundview Clinic         – Brownsville                  Gundersen Boscobel Area          SHULLSBURG                           Medical Associates
                                                                                   FOX LAKE                         Hospital & Clinic               Primary Care Clinic - Shullsburg    MUKWONAGO
                                                 COLUMBIA                          Fond du Lac Regional Clinic     PLATTEVILLE                                                          ProHealth Care
                                                 COLUMBUS                           – Fox Lake                                                      MARQUETTE                             Medical Associates
                                                                                                                   Southwest Health
                                                 SSM Health Dean                                                    – Platteville Clinic            OXFORD                              Timothy G McAvoy MD
                                                                                   HORICON
                                                  Medical Group                                                                                     Divine Savior Healthcare
                                                                                   Beaver Dam Community Hospital                                                                        MUSKEGO
                                                 Elizabeth Larson, MD                                            GREEN                               Crossroads Clinic
                                                                                    Horicon Clinic                                                                                      ProHealth Care
                                                 Poser Clinic                                                      ALBANY
                                                                                   JUNEAU                                                           RICHLAND                              Medical Associates
                                                 Prairie Ridge Health Clinic                                       Monroe Clinic – Albany
                                                                                   Beaver Dam Community Hospital                                    RICHLAND CENTER                     Timothy G McAvoy MD
                                                   - Columbus                       Juneau Clinic                BRODHEAD
                                                                                                                                                    Richland Hospital Clinic            NEW BERLIN
                                                 LODI                                                            Monroe Clinic – Brodhead
                                                                                   WRMC Juneau Clinic                                                                                   Nezih Z Hasanoglu DO
                                                 Lodi Medical Clinic                                               MONROE                           ROCK
                                                                                   MAYVILLE                                                                                             ProHealth Care
                                                                                                                   Monroe Clinic                    BELOIT
                                                 PARDEEVILLE                       Fond du Lac Regional Clinic                                                                           Medical Associates
                                                                                                                                                    Beloit Health System –
                                                 Divine Savior Clinic               – Mayville                     NEW GLARUS
                                                                                                                                                     Beloit Clinic                      OCONOMOWOC
                                                 PORTAGE                           RANDOLPH                        Monroe Clinic – New Glarus
                                                                                                                                                    Beloit Area Community               Lake Country Pediatrics
                                                 SSM Health Dean Medical Group     Randolph Community Clinic       GREEN LAKE                        Health Center                      Philip M Marden MD
                                                 Divine Savior Healthcare          WATERTOWN                       MARKESAN                         Convenient Care                     ProHealth Care
                                                 UW Health Portage                 Meade Medical Clinic            Fond du Lac Regional Clinic      West Side Medical Center             Medical Associates (2)
                                                                                   ProHealth Care Medical           – Markesan                                                          PEWAUKEE
                                                 CRAWFORD                                                                                           CLINTON
                                                                                    Associates                                                                                          Trinity Integrative
                                                 PRAIRIE DU CHIEN                                                  IOWA                             Beloit Health System –
                                                 Crossing Rivers Health Clinic     Watertown Family Practice                                         Clinton Clinic                       Family Medicine
                                                                                                                   DODGEVILLE
                                                  Prairie du Chien                 Watertown Medical Clinic        SSM Health Dean Medical Group    EDGERTON                            SUSSEX
                                                                                   Wisconsin Physicin Services     Dodgeville Medical Center        SSM Health Dean Medical Group       ProHealth Care
                                                 DANE                                                                                                                                    Medical Associates
                                                                                   WRMC Doctors Court Clinic       Upland Hills Health Center       EVANSVILLE
                                                 BELLEVILLE
                                                                                   WRMC Center for                                                  SSM Health Dean Medical Group       WAUKESHA
                                                 UW Health Belleville                                              HIGHLAND
                                                                                    Women’s Health                                                                                      Doenier Family Medicine
                                                 CAMBRIDGE                                                         Upland Hills Health Clinic       JANESVILLE
                                                                                   WAUPUN                           – Highland                      SSM Health Dean Medical Group       Pediatric Healthcare
                                                 Fort HealthCare
                                                                                   Community Pediatrics                                                                                 Practice Management Group
                                                  – Cambridge Clinic                                               MINERAL POINT                    MILTON
                                                                                   Fond du Lac Regional            SSM Health Dean Medical Group                                        ProHealth Care
                                                 COTTAGE GROVE                                                                                      Edgerton Hospital – Milton Clinic
                                                                                    Clinic – Waupun                                                                                       Medical Associates (4)
                                                 Wildwood Family Clinic                                            Mineral Point Medical Center
                                                                                   Mariano Rosales, MD                                              SAUK                                ProHealth Care
                                                 DEERFIELD                                                         JEFFERSON                        BARABOO                               Medical Associates
                                                 SSM Health Dean Medical Group     FOND DU LAC                                                                                            Moreland Family Medicine
                                                                                                                   FORT ATKINSON                    SSM Health Dean Medical Group
                                                                                   BRANDON
                                                 MADISON                                                           SSM Health Dean Medical Group    PLAIN                               Timothy G McAvoy, MD
                                                                                   Fond du Lac Regional
                                                 SSM Health Dean Medical Group                                     Fort HealthCare Center           Plain Medical Clinic                Waukesha Pediatric Associates
                                                                                    Clinic - Brandon
                                                  - Fish Hatchery                                                   for Women’s Health
                                                                                   CAMPBELLSPORT                                                    PRAIRIE DU SAC                      STATE OF ILLINOIS
                                                 SSM Health Dean Medical Group                                     Fort HealthCare Internal
                                                                                   Fond du Lac Regional Clinic                                      Prairie Clinic OB/GYN               DURAND, IL
                                                  - East                                                            Medicine & Pediatrics
                                                                                    – Campbellsport                                                 REEDSBURG                           Monroe Clinic – Durand
                                                 SSM Health Dean Medical Group                                     UW Health Fort Atkinson
                                                  - West                           FOND DU LAC                                                      Reedsburg Area Medical Center       FREEPORT, IL
                                                                                                                   JEFFERSON
                                                 Access Community – Erdman         Fond du Lac Regional Clinic                                      SAUK CITY                           Monroe Clinic – Freeport
                                                                                                                   Fort HealthCare Jefferson
                                                 Access Community – Evjue Clinic   Fond du Lac Regional Clinic                                      Prairie Clinic                      Monroe Clinic – Highland
                                                                                    – North                        JOHNSON CREEK                                                         Women’s Care
                                                 Access Community                                                                                   SPRING GREEN
                                                                                   Fond du Lac Regional Clinic     Fort HealthCare Center for
                                                  – Wingra Clinic                                                                                   River Valley Medical Clinic         GALENA, IL
                                                                                    – West                          Women’s Health
                                                 UW Health Northeast                                                                                Spring Green Medical Center         Midwest Medical Center
                                                                                   MT. CALVARY
                                                                                                                   Fort HealthCare Johnson Creek
                                                 Wildwood Family Clinic                                                                             Upland Hills Health Clinic          LENA, IL
                                                                                   Fond du Lac Regional Clinic     WRMC Johnson Creek Clinic
                                                 MARSHALL                                                                                            – Spring Green                     Monroe Clinic – Lena
                                                                                    – Mount Calvary                LAKE MILLS
                                                 Prairie Ridge Health Clinic                                                                        WISCONSIN DELLS                     ROSCOE, IL
                                                                                   RIPON                           Fort HealthCare Lake Mills
                                                  - Marshall                                                                                        SSM Health Dean Medical Group       Beloit Health System –
                                                                                   Fond du Lac Regional Clinic     WRMC Lake Mills Clinic
                                                 OREGON                                                                                                                                  Northpointe Clinic
                                                                                    – Ripon                        WATERLOO                         VERNON
                                                 SSM Health Dean Medical Group                                                                      HILLSBORO                           ELIZABETH, IL
                                                                                   Ripon Medical Primary           SSM Health Dean Medical Group
                                                 STOUGHTON                          Care Services                                                   St. Joseph’s Health Services –      Midwest Medical Center
                                                                                                                   WRMC Waterloo Clinic
                                                 SSM Health Dean Medical Group                                                                       Gundersen Lutheran                 STATE OF IOWA
                                                                                   GRANT                           JUNEAU
                                                 SUN PRAIRIE                                                                                        WALWORTH                            DUBUQUE, IA
                                                                                   BOSCOBEL
                                                 SSM Health Dean Medical Group                                     ELROY                                                                Grand River Medical Group
                                                                                   Gundersen Boscobel                                               DARIEN
                                                 VERONA                                                            Elroy Family Medical Center
                                                                                    Hospital & Clinics                                              Beloit Health System –              Tri - State Family Practice
                                                 UW Health Verona                                                  St Joseph’s Health Services –     Darien Clinic
                                                                                   CUBA CITY                                                                                            UnityPoint Clinic Family Medicine
                                                                                                                     Gundersen Lutheran
                                                 WAUNAKEE                          Southwest Health                                                 DELAVAN                               – Pennsylvania
                                                 SSM Health Dean Medical Group                                     MAUSTON                                                              UnityPoint Clinic- East
                                                                                    Center Clinic                                                   SSM Health Dean Medical Group
                                                                                                                   Mile Bluff Clinic
                                                 WISCONSIN HEIGHTS                 FENNIMORE                                                        WHITEWATER                          UnityPoint Clinic- West
©2020 Dean Health Plan, Inc. • 516028_R03_2008

                                                 Wisconsin Heights Clinic                                          NECEDAH
                                                                                   Crossing Rivers Health Clinic                                    SSM Health Dean Medical Group       PEOSTA, IA
                                                                                    Fennimore                      Necedah Family Medical Center
                                                 DODGE                                                                                              Fort Healthcare Center for          UnityPoint Clinic Family Walk-in
                                                                                   High Point Family Medicine      NEW LISBON                        Women’s Health                      Care – Peosta
                                                 BEAVER DAM                                                        New Lisbon Family
                                                 SSM Health Dean Medical Group     LANCASTER                                                        Fort HealthCare Internal
                                                                                                                    Medical Center                   Medicine & Pediatrics
                                                  - Beaver Dam                     Family Medical Center
                                                                                                                   WONEWOC                                                              If you would like a printed copy
                                                 Beaver Dam                        Grant Regional                                                   WAUKESHA
                                                                                    Community Clinic               St Joseph’s Health Services –                                        of the provider directory, please
                                                  Community Hospital                                                                                BROOKFIELD
                                                                                                                    Gundersen Lutheran                                                  call our Customer Care Center at
                                                  Beaver Dam Clinic                High Point Family Medicine                                       ProHealth Care
                                                 Community Pediatrics                                              LAFAYETTE                                                            (800) 279-1301. Please keep in
                                                                                   MONTFORT                                                          Medical Associates
                                                                                                                                                                                        mind that the online directory
                                                 Prairie Ridge Health Clinic       Upland Hills Health             ARGYLE                           DELAFIELD                           has the most up-to-date listing
                                                  - Beaver Dam                      Clinic – Montfort              Primary Care Clinic - Argyle     Lake Country Pediatrics             of providers.
                                                 UW Health Beaver Dam                                              BLANCHARDVILLE                   ProHealth Care
                                                 UW Health Beaver Dam                                              Monroe Clinic – Blanchardville    Medical Associates
                                                  Internal Medicine
Dean Health Plan, Inc. | 1277 Deming Way | Madison, WI 53717
   800-279-1301 (TTY: 711) | deancare.com/wi-employees

         ©2020 Dean Health Plan, Inc. • 597601_R01_2008
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