Dean Focus Network Silver HSA-E 4500 Plan Details for 2021- HealthPocket

Dean Focus Network Silver HSA-E 4500

$272.21/mo

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Zip Code53215
Applicant5/9/1986 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameDean Focus Network Silver HSA-E 4500
Plan IDhhs-38345WI0230017
Plan Year2021
Insurance ProviderDean Health Plan
Metal LevelSilver
Plan TypeEPO
Deductible$4,550
Out-of-Pocket Maximum$6,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness20.00% Coinsurance after deductible
Specialist Visit20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services20.00% Coinsurance after deductible
X-rays and Diagnostic Imaging20.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans20.00% Coinsurance after deductible
Deductible - Family$9100 per group
Out-of-Pocket Maximum - Family$13800 per group

Prescription drug coverage

Generic Drugs20.00% Coinsurance after deductible
Preferred Brand Drugs20.00% Coinsurance after deductible
Non-Preferred Brand Drugs20.00% Coinsurance after deductible
Specialty Drugs20.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.deancare.com/find-a-doctor
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?Yes - Emergency Only
Does this plan cover services outside the country?Yes - Emergency Only

Hospital services

Emergency Room Services20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services20.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service20.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care20.00% Coinsurance after deductible
Delivery and all inpatient services for maternity care20.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services20.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services20.00% Coinsurance after deductible
Substance use disorder outpatient services20.00% Coinsurance after deductible
Substance use disorder inpatient services20.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Diabetes, Heart Disease, Pregnancy
Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsIncluded

Child Dental Coverage

Child Dental Coverage - Routine Dental CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Hospice Services
Chiropractic Care
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsSkilled Nursing Facility
Acupuncture
Hearing Aids
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsBariatric Surgery
Cosmetic Surgery
Infertility Treatment
Long Term Care
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children
Routine Foot Care
Dental Care - Adult
Abortion for Which Public Funding is Prohibited
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $291Dean Silver HSA-E 4500$4,550.00Select
from $334Beloit One Silver I301 Direct$4,400.00Select
from $345Quartz One Silver I301 Direct$4,400.00Select
from $348Beloit One Silver I301 Direct with Dental$4,400.00Select
from $354Prevea360 Silver HSA-E 4500$4,550.00Select
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  • Phone Number
    (414) 672-1353
  • Office Locations
    2906 S 20th St
    Milwaukee, WI 53215
2906 S 20th St Milwaukee WI, 53215
  • What Is the Silver Plan?

    ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.

  • How are Silver Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.

  • How much does a Silver Plan cost?

    The monthly premium for a Silver Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Silver Plan premiums in your area.

  • When Can I Enroll in a Silver Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.