Dean Health Plan Insurance Review & Complaints: Health Insurance (2024)

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Wisconsin-based Dean Health Plan is part of the more than one hundred-year-old Dean Health System. The health insurance plans provide coverage for individuals and families through their network of providers in the south-central part of the state.

What is Dean Health Plan?

What is Dean Health Plan?

Dean Health Insurance System has its roots in the founding of a medical facility in 1904 by Dr. Joseph Dean. This first clinic in Madison, Wisconsin led to the creation of the Dean Corporation with Joseph Dean’s brother – who was also a doctor – in 1929. The brothers opened their first family clinic under the name Dean Clinic, and also provided free clinic services through the Great Depression. Dean remained a family business through 1979 when the last doctor in the family retired.

In 1982, Dean Clinic merged with East Madison Clinic, creating a second branch of the now multi-specialty medical provider. The first HMO, DeanHealth, was launched a year later. The medical group expanded over the following decade, opening several more locations and adding new specialties. In 1995, Dean Health became Dean Health System as they made the change to a for-profit shareholder-based company.

Major Catholic health system SSM purchased Dean Health System in 2013. Today they serve about 400,000 members with their network of hospitals and clinics. Their plans are HMOs, with several levels of coverage, including two networks and an HSA option. Dean also writes Medicare coverage, which we evaluate in a separate review. This review will focus on individual access plans.

What Types of Insurance Products Are Offered?

Dean’s health care coverage options are all HMO, but some feature provider network services known as Focus. Health plans are offered at Bronze, Silver, and Gold levels as well as a Catastrophic plan. For this review, we have researched the plans offered in the same county as the company headquarters – plans may vary by county.

Bronze Plans

There are several medical care plans through the healthcare insurance provider available at the Bronze level, with both the HMO and Focus networks.

The Focus Network Bronze HSA plan has a $6,650 individual deductible and includes the use of an HSA to help pay out-of-pocket costs. All doctor and emergency visits are covered at 100% after the deductible is met.

The Focus Network Value Copay plan has a slightly higher deductible at $7,350 individual. There is a $25 copay for primary care visits after the deductible, while other services (with the exception of emergency visits) have no copay once the deductible is met.

The Bronze HSA-E has the same deductibles and coverage as the Value version, but it includes the broader Dean HMO network. As a result, it is a little more expensive.

Similarly, the Bronze Value Copay plan has the same deductible and the same copay as the Value version of the plan, but again, coverage is extended to the wider HMO network.

All of the Bronze plans cover generic prescription drugs in full after the deductible is met.

Silver Plans

Like the Bronze level plans, there are two Focus and two HMO network offerings at the Silver level. There are also a few other plans at this level.

The Focus Network Silver HSA has a $3,500 individual deductible; with a 20% coinsurance after the deductible is met for services including office visits and emergency care. This same coinsurance amount applies to generic drugs.

The Focus Network Silver Value Copay plan has a $5,000 deductible with copays and coinsurance amounts that vary. Office visits are covered at a 20% coinsurance after deductible and a $25 copay with a deductible. Generic drugs are covered with a $15 copay.

The Silver HSA and Silver Value Copay plans match the coverage and deductibles of the Focus plans but offer a wider HMO network.

The Silver Copay Plus plan has a $3,250 individual deductible. Office visits are covered with a $30 copay, while specialist visits have a $60 copay. Generic drugs are covered with a $15 copay.

The Silver Classic plan is a combination of the Value Copay and the HSA plans. Office visits and specialist visits are covered with a 20% coinsurance after the deductible, while emergency care features a $325 copay with the deductible and 20% coinsurance after deductible. Generic drugs have a $15 copay. The deductible for this plan is $4,750.

Gold Plans

The Dean Focus Network Value Copay plan has a $3,500 individual deductible and a $25 copay for office visits. Specialist visits are subject to the deductible and covered in full thereafter. Generic drugs have the same copay as all of the silver plans at $15.

The Gold Value Copay plan has the same coverage and deductible as the Focus plan but offers the wider HMO network.

The Gold Copay Plus plan has the lowest deductible of the Gold plans at $1,500 individual. Copays are $30 for office visits and $60 for specialist visits. Generic drugs again have a $15 copay.

Catastrophic

Dean’s also offers the Safety Net Catastrophic coverage plan. This plan has a $7,150 individual deductible and, as that is also the out-of-pocket limit, full coverage after the deductible is met. This plan does offer three covered office visits per year, with the deductible applied after three.

This plan is provided through the Dean HMO network.

Group Health Insurance Benefits

Dean’s offers a range of insurance options to employers for group insurance. Unlike the individual plans, these include PPO and POS options as well as the Focus and HMO networks.

Dean also offers the option for businesses to choose a self-funded insurance plan with an Administrative Services Only choice.

Read more: Dean Health Plan Medicare Insurance Review & Complaints: Health Insurance

Are the Health Plan Rates Affordable?

We ran a quick quote for a single 30-year-old living in the same zip code as the Dean headquarters. Our search returned all but the catastrophic plan of those listed above.

The most affordable health care plan is the Bronze Focus Network HSA at $268/month. Surprisingly, all of the Gold plans came in at lower monthly rates than any of the Silver plans, with the most expensive option being the Silver HSA at $439 a month. We would have expected the Gold Copay plus plan to be the most expensive in terms of premiums; it is unusual to see an HSA plan with such a high monthly cost.

Since these plans are only available in a specific part of Wisconsin, we are unable to compare the rates to other insurance companies. However, the rates are generally a little on the high side compared to what we have seen elsewhere considering the fact that these are HMO plans offering no coverage at all for out-of-network care.

Dean Health Plan Claims Process

Ease of Filing a Claim (Online, Over the Phone, Mobile Apps)

Dean Health Plan offers a convenient and efficient claims process for its policyholders. As an HMO, most claims are handled internally, which simplifies the process for members.

Since the plans do not offer out-of-network coverage, there is no need for members to deal with claims submitted by outside providers. This streamlines the process and ensures that claims are processed smoothly within the network.

Average Claim Processing Time

Dean Health Plan does not provide specific information on its website regarding the average claim processing time. However, being an HMO with internal claims handling, members can generally expect a quicker turnaround time compared to plans that involve out-of-network providers. The absence of out-of-network claims typically results in faster claim processing.

Customer Feedback on Claim Resolutions and Payouts

While Dean Health Plan does not prominently feature customer feedback on its website, it’s essential to consider the company’s reputation and reviews of its parent organization, Dean Health System. Dean Health System has received an A- rating from the Better Business Bureau (BBB) with only two complaints in the past three years, one of which remains unresolved.

Additionally, Dean Health System has received generally positive reviews from customers, with limited complaints. While this feedback may not directly pertain to claim resolutions and payouts, it suggests that the company maintains a good overall reputation.

Digital and Technological Features of Dean Health Plan

Mobile App Features and Functionality

Dean Health Plan offers a mobile app to enhance the digital experience for its members. The app provides features and functionality that enable policyholders to manage their health insurance conveniently.

While specific details about the app’s features are not provided in the reviewed content, mobile apps typically allow users to access their insurance information, view claims status, find in-network providers, and even file claims or contact customer support.

Online Account Management Capabilities

Dean Health Plan’s online account management capabilities empower policyholders to take control of their health insurance. While the article does not delve into the specifics, online account management typically includes features like accessing policy details, reviewing claims history, making premium payments, and updating personal information.

These tools enable members to have a seamless and user-friendly experience when managing their policies online.

Digital Tools and Resources

The article does not provide detailed information about specific digital tools and resources offered by Dean Health Plan. However, health insurance providers often offer various digital resources to support their members, such as educational materials, health and wellness tools, telehealth services, and online customer support options.

These digital tools aim to enhance the overall healthcare experience for policyholders by providing valuable information and convenient access to services.

Are Ratings and Consumer Reviews Positive?

Dean Health Plan has an A- rating with the Better Business Bureau (BBB), with only two complaints on file in the past three years. Dean has been docked on the letter grade due to one complaint that has not been resolved. There have not been any complaints closed in the past 12 months.

Being a regional company, Dean’s does not appear on any of the major national consumer complaint sites. This is not unusual, as we rarely see smaller local insurers on these sites.

Because Dean is an HMO, we took a look at the reviews for the actual health system to see what kind of services customers are receiving from the network of providers. Dean Health Systems also has an A- rating with the BBB, with a total of six complaints on file in the past three years.

We found a few reviews of Dean on Yelp, with a couple of negatives and one glowing positive review.

Overall, there are a limited number of complaints, which generally bodes well for a company.

What’s the Bottom Line?

Dean Health System is a good choice for those living in the service area, and okay with the limitations in the provider network of an HMO insurance plan. We found their rates a little on the high side, but there is a good range of options for plans that will fit most budgets. They appear to enjoy a good reputation and their local network appears to be comprehensive, so members shouldn’t have trouble getting the care they need.