Dean Health Plan

Prevea360 Silver HSA

Monthly premium, age 40 From $903 Up to $957 by area · before subsidies Prices by age
Find a doctor in this plan Summary of Benefits (PDF)
Plan ID38345WI0240023
Plan year2027Sold on HealthCare.gov
Plan typeHMONo referral needed
Metal levelSilverWorks with an HSA
Sold in5 countiesof 72 in Wisconsin
Deductible$4,200$8,400 family
Out-of-pocket max$8,700$17,400 family
Primary care visit20% after deductiblein network
Generic drugs20% after deductibleper 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

Where do you want to see a doctor?

Monthly premium by age, before subsidies

The full monthly price for 2027, before premium tax credits. The price depends on where you live: this plan has 2 price regions (rating areas) in Wisconsin, so each row shows the lowest and highest.

AgeMonthly premiumTobacco user
Child (0 to 14)$541 to $573Same
Age 21$707 to $749$820 to $869
Age 27$741 to $785$859 to $911
Age 30$802 to $850$930 to $986
Age 40$903 to $957$1,048 to $1,110
Age 50$1,262 to $1,338$1,464 to $1,552
Age 60$1,918 to $2,033$2,225 to $2,358
64 and older$2,120 to $2,247$2,459 to $2,607

Most people who enroll through HealthCare.gov qualify for a subsidy (premium tax credit) based on household income, which lowers the monthly price. HealthCare.gov shows your price after any subsidy. NPI Profile does not sell 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 $4,200 deductible.

Doctor visits

Primary care visit
20% after deductible
Specialist visit
20% after deductible
Nurse practitioner or PA visit
20% after deductible
Preventive care and vaccines
Free
Urgent care
20% after deductible

Prescription drugs

Generic drugs
20% after deductible
Preferred brand drugs
20% after deductible
Non-preferred brand drugs
20% after deductible
Specialty drugs
20% after deductible

Tests and imaging

Lab work
20% after deductible
X-rays
20% after deductible
MRI, CT and PET scans
20% after deductible

Emergencies and hospital

Emergency room
20% after deductible
Ambulance
20% after deductible
Hospital stay
20% after deductible
Outpatient surgery (facility)
20% after deductible

Mental health

Therapy and counseling visits
20% after deductible
Inpatient mental health care
20% after deductible

Pregnancy

Prenatal and postnatal care
20% after deductible
Delivery and hospital stay
20% after deductible

Other care

Physical and occupational therapyLimit: 20 visits a year
20% after deductible
Chiropractic care
20% after deductible
Eye exam for childrenLimit: 1 exam a year
20% after deductible
Glasses for childrenLimit: 1 item a year
20% after deductible
Adult dental
Not covered
$5,660Having a baby (CMS example)
$2,800Managing type 2 diabetes for a year
$2,800A simple fracture
Every service in the plan file (67)
ServiceYou payLimits and notes
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental20% after deductibleSee policy or plan document for additional benefit exclusions.
AcupunctureNot covered
Allergy Testing20% after deductibleSee policy or plan document for additional benefit exclusions.
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy20% after deductible
Chiropractic Care20% after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care20% after deductible
Dental Check-Up for ChildrenNot covered
Diabetes EducationFreeSee policy or plan document for additional benefit exclusions.
Dialysis20% after deductible
Durable Medical Equipment20% after deductible
Emergency Room Services20% after deductible
Emergency Transportation/Ambulance20% after deductible
Eye Glasses for Children20% after deductible1 item a year See policy or plan document for additional benefit exclusions.
Generic Drugs20% after deductible
Habilitation Services20% after deductible60 visits a year See policy or plan document for additional benefit exclusions.
Hearing Aids20% after deductible2 items every 3 years See policy or plan document for additional benefit exclusions.
Home Health Care Services20% after deductible60 visits a year
Hospice Services20% after deductible
Imaging (CT/PET Scans, MRIs)20% after deductible
Infertility TreatmentNot covered
Infusion Therapy20% after deductible
Inpatient Hospital Services (e.g., Hospital Stay)20% after deductible
Inpatient Physician and Surgical Services20% after deductible
Laboratory Outpatient and Professional Services20% after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Mental/Behavioral Health Inpatient Services20% after deductible
Mental/Behavioral Health Outpatient Services20% after deductible
Non-Preferred Brand Drugs20% after deductible
Nutritional Counseling20% after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)20% after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20% after deductible
Outpatient Rehabilitation Services20% after deductible60 visits a year See policy or plan document for additional benefit exclusions.
Outpatient Surgery Physician/Surgical Services20% after deductible
Preferred Brand Drugs20% after deductible
Prenatal and Postnatal Care20% after deductible
Preventive Care/Screening/ImmunizationFree
Primary Care Visit to Treat an Injury or Illness20% after deductible
Private-Duty NursingNot covered
Prosthetic Devices20% after deductibleSee policy or plan document for additional benefit exclusions.
Radiation20% after deductible
Reconstructive Surgery20% after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy20% after deductible20 visits a year See policy or plan document for additional benefit exclusions.
Rehabilitative Speech Therapy20% after deductible20 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 Children20% after deductible1 exam a year See policy or plan document for additional benefit exclusions.
Routine Foot CareNot covered
Skilled Nursing Facility20% after deductible30 days a stay
Specialist Visit20% after deductible
Specialty Drugs20% after deductible
Substance Abuse Disorder Inpatient Services20% after deductible
Substance Abuse Disorder Outpatient Services20% after deductible
Transplant20% after deductible
Treatment for Temporomandibular Joint Disorders20% after deductible
Urgent Care Centers or Facilities20% after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareFree
X-rays and Diagnostic Imaging20% 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
20% after the deductible
Works with an HSA
Yes
Network
Prevea360 Health Plan (WIN003)
Sold in
5 Wisconsin countiesBrown County, Door County, Kewaunee County, Oconto County, Sheboygan County

Other Dean Health Plan plans on the same network

The same doctors and hospitals, with different costs.

Dean Health Plan

Prevea360 Bronze Share

BronzeHMOHSA
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
Plan ID 38345WI0240022Sold in 5 Wisconsin counties50% coinsuranceNo referral neededDetails
Dean Health Plan

Prevea360 Bronze Standard

Expanded BronzeHMOHSA
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
Plan ID 38345WI0240017Sold in 5 Wisconsin counties50% coinsuranceNo referral neededDetails
Dean Health Plan

Prevea360 Bronze HSA

Expanded BronzeHMOHSA
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
Plan ID 38345WI0240009Sold in 5 Wisconsin countiesNo coinsuranceNo referral neededDetails
Dean Health Plan

Prevea360 Silver Standard

SilverHMO
Premium, age 40$855to $906 a month
Deductible$6,400$12,800 family
Out-of-pocket max$10,300$20,600 family
Having a baby$8,370CMS example
Plan ID 38345WI0240016Sold in 5 Wisconsin counties40% coinsuranceNo referral neededDetails
Dean Health Plan

Prevea360 Silver Share

SilverHMO
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
Plan ID 38345WI0240021Sold in 5 Wisconsin counties30% coinsuranceNo referral neededDetails

Questions about Prevea360 Silver HSA

Does Prevea360 Silver HSA 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 HSA?
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 and works with a health savings account (HSA).
How much is a doctor visit with Prevea360 Silver HSA?
A primary care visit costs 20% after deductible. A specialist visit costs 20% after deductible. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $4,200 deductible.
Where is Prevea360 Silver HSA 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 HSA cost a month?
Before subsidies (premium tax credits), Prevea360 Silver HSA costs $903 to $957 a month for a 40-year-old in 2027, depending on where in Wisconsin you live. A 21-year-old pays $707 to $749 and someone 64 or older $2,120 to $2,247. 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.

SourceWhat it provides hereSource 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 soldPlan year 2027
Dean Health Plan's provider directoryThe doctors and facilities listed in this plan's network. Only providers with an address in Wisconsin are counted.Updated October 14, 2026
NPPES NPI registryProvider names, practice addresses and primary specialtiesMatched 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.