Dean Health Plan
Prevea360 Bronze Share
Premium, age 40$549to $582 a month
Deductible$8,000$16,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$9,670CMS example
Dean Health Plan
Prevea360 Silver Standard
Monthly premium, age 40
From $855
Up to $906 by area · before subsidies
Prices by age
Find a doctor in this plan
Summary of Benefits (PDF)
Plan ID38345WI0240016
Plan year2027Sold on HealthCare.gov
Plan typeHMONo referral needed
Metal levelSilverNot HSA-eligible
Sold in5 countiesof 72 in Wisconsin
Deductible$6,400$12,800 family
Out-of-pocket max$10,300$20,600 family
Primary care visit$40in network
Generic drugs$20per prescription
4,567 Wisconsin doctors and facilities in this plan's network · Directory updated Oct 14, 2026 · Premiums are full prices before subsidies (premium tax credits). NPI Profile does not sell insurance; HealthCare.gov lists premiums and handles enrollment.
Find a doctor in this plan
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What kind of doctor in ?
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Listed in Dean Health Plan's provider directory. Directories can be out of date, so call the office to confirm they take this plan.
What you pay with this plan
In-network costs for one person, from the CMS plan files for 2027. "After deductible" means you pay the full cost until you reach the $6,400 deductible.
Doctor visits
- Primary care visit
- $40
- Specialist visit
- $80
- Nurse practitioner or PA visit
- $40
- Preventive care and vaccines
- Free
- Urgent care
- $60
Prescription drugs
- Generic drugs
- $20
- Preferred brand drugs
- $40
- Non-preferred brand drugs
- $80 after deductible
- Specialty drugs
- $350 after deductible
Tests and imaging
- Lab work
- 40% after deductible
- X-rays
- 40% after deductible
- MRI, CT and PET scans
- 40% after deductible
Emergencies and hospital
- Emergency room
- 40% after deductible
- Ambulance
- 40% after deductible
- Hospital stay
- 40% after deductible
- Outpatient surgery (facility)
- 40% after deductible
Mental health
- Therapy and counseling visits
- $40
- Inpatient mental health care
- 40% after deductible
Pregnancy
- Prenatal and postnatal care
- 40% after deductible
- Delivery and hospital stay
- 40% after deductible
Other care
- Physical and occupational therapyLimit: 20 visits a year
- $40
- Chiropractic care
- $40
- Eye exam for childrenLimit: 1 exam a year
- $40
- Glasses for childrenLimit: 1 item a year
- 40% after deductible
- Adult dental
- Not covered
$8,370Having a baby (CMS example)
$2,000Managing type 2 diabetes for a year
$2,800A simple fracture
Every service in the plan file (67)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | 40% after deductible | See policy or plan document for additional benefit exclusions. |
| Acupuncture | Not covered | |
| Allergy Testing | 40% after deductible | See policy or plan document for additional benefit exclusions. |
| Bariatric Surgery | Not covered | |
| Basic Dental Care - Adult | Not covered | |
| Basic Dental Care - Child | Not covered | |
| Chemotherapy | $80 | |
| Chiropractic Care | $40 | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | 40% after deductible | |
| Dental Check-Up for Children | Not covered | |
| Diabetes Education | Free | See policy or plan document for additional benefit exclusions. |
| Dialysis | 40% after deductible | |
| Durable Medical Equipment | 40% after deductible | |
| Emergency Room Services | 40% after deductible | |
| Emergency Transportation/Ambulance | 40% after deductible | |
| Eye Glasses for Children | 40% after deductible | 1 item a year See policy or plan document for additional benefit exclusions. |
| Generic Drugs | $20 | |
| Habilitation Services | $40 | 60 visits a year See policy or plan document for additional benefit exclusions. |
| Hearing Aids | 40% after deductible | 2 items every 3 years See policy or plan document for additional benefit exclusions. |
| Home Health Care Services | 40% after deductible | 60 visits a year |
| Hospice Services | 40% after deductible | |
| Imaging (CT/PET Scans, MRIs) | 40% after deductible | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | 40% after deductible | |
| Inpatient Hospital Services (e.g., Hospital Stay) | 40% after deductible | |
| Inpatient Physician and Surgical Services | 40% after deductible | |
| Laboratory Outpatient and Professional Services | 40% after deductible | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | Not covered | |
| Major Dental Care - Child | Not covered | |
| Mental/Behavioral Health Inpatient Services | 40% after deductible | |
| Mental/Behavioral Health Outpatient Services | $40 | |
| Non-Preferred Brand Drugs | $80 after deductible | |
| Nutritional Counseling | 40% after deductible | |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | Not covered | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $40 | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 40% after deductible | |
| Outpatient Rehabilitation Services | $40 | 60 visits a year See policy or plan document for additional benefit exclusions. |
| Outpatient Surgery Physician/Surgical Services | 40% after deductible | |
| Preferred Brand Drugs | $40 | |
| Prenatal and Postnatal Care | 40% after deductible | |
| Preventive Care/Screening/Immunization | Free | |
| Primary Care Visit to Treat an Injury or Illness | $40 | |
| Private-Duty Nursing | Not covered | |
| Prosthetic Devices | 40% after deductible | See policy or plan document for additional benefit exclusions. |
| Radiation | 40% after deductible | |
| Reconstructive Surgery | 40% after deductible | |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $40 | 20 visits a year See policy or plan document for additional benefit exclusions. |
| Rehabilitative Speech Therapy | $40 | 20 visits a year See policy or plan document for additional benefit exclusions. |
| Routine Dental Services (Adult) | Not covered | |
| Routine Eye Exam (Adult) | Not covered | |
| Routine Eye Exam for Children | $40 | 1 exam a year See policy or plan document for additional benefit exclusions. |
| Routine Foot Care | Not covered | |
| Skilled Nursing Facility | 40% after deductible | 30 days a stay |
| Specialist Visit | $80 | |
| Specialty Drugs | $350 after deductible | |
| Substance Abuse Disorder Inpatient Services | 40% after deductible | |
| Substance Abuse Disorder Outpatient Services | $40 | |
| Transplant | 40% after deductible | |
| Treatment for Temporomandibular Joint Disorders | 40% after deductible | |
| Urgent Care Centers or Facilities | $60 | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Free | |
| X-rays and Diagnostic Imaging | 40% after deductible |
How this plan works
HMO: You pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies.
- Referral for specialists
- Not required
- Coinsurance
- 40% after the deductible
- Works with an HSA
- No
- Network
- Prevea360 Health Plan (WIN003)
- Sold in
- 5 Wisconsin countiesBrown County, Door County, Kewaunee County, Oconto County, Sheboygan County
Summary of Benefits and Coverage (PDF) Plan brochure Covered drugs (formulary)
Other Dean Health Plan plans on the same network
The same doctors and hospitals, with different costs.
Dean Health Plan
Prevea360 Bronze Standard
Premium, age 40$618to $655 a month
Deductible$7,500$15,000 family
Out-of-pocket max$12,000$24,000 family
Having a baby$9,370CMS example
Dean Health Plan
Prevea360 Bronze HSA
Premium, age 40$670to $711 a month
Deductible$8,700$17,400 family
Out-of-pocket max$8,700$17,400 family
Having a baby$8,760CMS example
Dean Health Plan
Prevea360 Silver Share
Premium, age 40$861to $913 a month
Deductible$3,525$7,050 family
Out-of-pocket max$9,300$18,600 family
Having a baby$5,870CMS example
Dean Health Plan
Prevea360 Gold Share
Premium, age 40$872to $924 a month
Deductible$2,600$5,200 family
Out-of-pocket max$6,000$12,000 family
Having a baby$4,370CMS example
Dean Health Plan
Prevea360 Gold Standard
Premium, age 40$873to $926 a month
Deductible$2,500$5,000 family
Out-of-pocket max$8,600$17,200 family
Having a baby$4,770CMS example
Dean Health Plan
Prevea360 Silver HSA
Premium, age 40$903to $957 a month
Deductible$4,200$8,400 family
Out-of-pocket max$8,700$17,400 family
Having a baby$5,660CMS example
Dean Health Plan
Prevea360 Gold HSA
Premium, age 40$911to $966 a month
Deductible$3,500$7,000 family
Out-of-pocket max$4,700$9,400 family
Having a baby$4,760CMS example
Questions about Prevea360 Silver Standard
Does Prevea360 Silver Standard cover my doctor?
Use "Find a doctor in this plan" on this page: choose the city, then the kind of doctor. The list shows providers Dean Health Plan lists in this plan's network for 2027. Directories can be out of date, so call the office to confirm before your visit.
What kind of plan is Prevea360 Silver Standard?
It is an HMO plan: you pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies. It is a Silver plan.
How much is a doctor visit with Prevea360 Silver Standard?
A primary care visit costs $40. A specialist visit costs $80. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $6,400 deductible.
Where is Prevea360 Silver Standard sold?
It is sold to people who live in 5 Wisconsin counties, through HealthCare.gov. The counties: Brown County, Door County, Kewaunee County, Oconto County, Sheboygan County. Dean Health Plan's directory can also list providers outside these counties, such as pharmacies and specialists, but the plan itself is only for people who live in its area.
How much does Prevea360 Silver Standard cost a month?
Before subsidies (premium tax credits), Prevea360 Silver Standard costs $855 to $906 a month for a 40-year-old in 2027, depending on where in Wisconsin you live. A 21-year-old pays $669 to $709 and someone 64 or older $2,007 to $2,128. Tobacco users pay more. Most people who enroll through HealthCare.gov qualify for a subsidy (premium tax credit) that lowers the monthly price, and HealthCare.gov shows your price after any subsidy.
About this data
These pages combine public files from CMS and from insurers. NPI Profile does not contract with insurers and does not decide who is in network.
| Source | What it provides here | Source date |
|---|---|---|
| CMS Marketplace public use files (Plan Attributes, Benefits and Cost Sharing, Rate, Service Area) | This plan's premiums, costs, covered services, coverage examples and the counties where it is sold | Plan year 2027 |
| Dean Health Plan's provider directory | The doctors and facilities listed in this plan's network. Only providers with an address in Wisconsin are counted. | Updated October 14, 2026 |
| NPPES NPI registry | Provider names, practice addresses and primary specialties | Matched November 10, 2026 |
- Costs are for the standard version of the plan, for one person, in network. People who qualify for cost-sharing reductions pay less.
- Premiums are the full monthly price before subsidies (premium tax credits). They depend on age, tobacco use and where you live (the plan's rating area). HealthCare.gov shows your price after any subsidy.
- Confirm costs in the plan documents and with the insurer, and confirm with the doctor's office that they take this plan.
