YOUR PLAN RESOURCES What you need to know
Important member documents and helpful terms to know • Your Member Certificate (sometimes called a “Member Policy”) has information about your insurance benefits and coverage, and it lists general limitations and exclusions to your plan • Your Summary of Benefits and Coverage (SBC) is an easy-to-read grid that lists the details of plan coverage, along with a basic cost estimate of your financial responsibilities for common medical services** • Common health insurance terms are listed on page 8. Find member documents and more at Deancare.com/Login . † • The Pharmacy Drug Formulary is a list of prescription drugs that help you understand what is and isn’t covered by your insurance If you have other health care coverage • Your Dean Health Plan policy has a Coordination of Benefits (COB) provision – a fancy way of saying we’ll need to sort through situations where you’re covered by another health insurance company (such as through an employer or Medicare) • Please contact Member Services to inform us of any additional coverage. See page 3 for contact details • If you have any questions about Medicare enrollment or eligibility, or need to report that you have Medicare, please contact the Medicare Coordination of Benefits Specialist at 1 (608) 827-4189 . If you have a chronic condition or a health concern • We’re here to support you if you have a serious condition or have a complex health care need • Visit Deancare.com/CareManagement and click on “ Complex Case Management ” to learn how we can help, or contact Member Services ** Your financial responsibilities may come in the form of a copay, coinsurance, or deductible. The terms stated in these documents may change at your annual policy renewal, and we will send you an outline of any changes at that time. † These documents are also available by contacting Member Services to request copies be mailed to you. See page 3 for contact details.
Get started with your new health plan in two easy steps
Activate your accounts You'll find most of the information you need in your member, MyChart and Living Healthy accounts. Manage your health insurance information with your secure and convenient member account by visiting Deancare.com/Login . Your member account lets you: • Download your ID card to your mobile wallet • View your insurance plan details • Find an in-network doctor, hospital, or clinic close to you • Check the status of claims Your MyChart account lets you: • Schedule appointments, send secure messages to your provider and more through your MyChart account* Your Living Healthy account lets you: • Explore your wellness benefits* to achieve your goals for a healthy lifestyle and earn rewards along the way * See pages 6-7 for details Decide where to receive primary care Contact our Welcome Center at (608) 250-1134 ( TTY : 711) or visit Deancare.com/Locations to find a primary care clinic near you. Before your first visit, contact your previous clinic to complete an Authorization to Release Protected Health Information Form. The form allows your previous clinic to send your medical records to your new clinic so your medical team can best continue your care.
Visit DeanCare.com or call 1 (800) 279-1301 ( TTY :711) | 5
4 | 2024 Group Member Guide
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