It's Your Choice 2013 - Decision Guide (ET-2128d-13) - ETF
It's Your Choice 2013 - Decision Guide (ET-2128d-13) - ETF
It's Your Choice 2013 - Decision Guide (ET-2128d-13) - ETF
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Dean Health Plan Inc.<br />
(800) 279-<strong>13</strong>01<br />
deancare.com/wi-employees<br />
Overall Quality Rating<br />
See Report Card section<br />
What’s New for <strong>20<strong>13</strong></strong><br />
Dean Health Plan’s (DHP) approach<br />
to prevention and health promotion<br />
is integrated into our overall medical<br />
management program. In the fall of 2012,<br />
we will launch DHP’s Living Healthy Program,<br />
which provides a suite of wellness and<br />
disease management offerings. To help<br />
identify and address health risks, members<br />
may access an online Well Being Assessment<br />
portal. Members are encouraged to use<br />
these tools to identify personal areas of risk<br />
and take actions to address them. DHP also<br />
offers members the opportunity to obtain<br />
a cash incentive by completing the Well<br />
Being Assessment. For complete details, visit<br />
deancare.com/wi-employees.<br />
Provider Directory<br />
Go to deancare.com/wi-employees. For a<br />
searchable directory, select Online Provider<br />
Directory. For a PDF directory, select<br />
Printable Provider Directory. You may also<br />
call the Customer Care Center to request a<br />
copy.<br />
Care Outside Service<br />
Area<br />
When you receive<br />
emergency or urgent<br />
care outside the DHP<br />
network, call the<br />
number on your ID card<br />
by the next business day<br />
or as soon as possible.<br />
Non-emergeny/urgent<br />
care is not covered<br />
unless an approved<br />
prior authorization is<br />
obtained.<br />
Qualified Plan<br />
Non-Qualified Plan<br />
See Glossary for definitions<br />
Mental and Behavioral Health Services<br />
You can see any plan provider for mental<br />
and behavioral health services. Inpatient<br />
mental health must be prior authorized.<br />
Dental Benefits<br />
No routine dental coverage provided.<br />
Referrals and Prior Authorizations<br />
Referrals are not needed when receiving<br />
care from plan providers. Prior authorizations<br />
are required for certain services and care<br />
from all non-plan providers. If you are<br />
unsure if a service or procedure requires<br />
prior authorization, contact the Customer<br />
Care Center. You must tell your provider<br />
to contact DHP for an approved prior<br />
authorization before receiving care. DHP will<br />
notify you and your provider in writing of the<br />
decision.<br />
Health Risk Assessment Information for Enrolled Members at:<br />
deancare.com/deanconnect<br />
<strong>Decision</strong> <strong>Guide</strong> Page 35
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