Colleagues Who Live In Wisconsin
Dean Health Plan is the medical claims administrator for colleagues who reside in Wisconsin.
You have two Exclusive Provider Organization (EPO) medical options through HSHS:
- Basic Option
- High Option
- Waive Coverage
Coverage Options
When you enroll in medical (including prescription drug coverage), you can choose from these coverage levels:
- Colleague only
- Colleague + Spouse/LDA
- Colleague + Child(ren)
- Colleague + Spouse and Child(ren)
Network
Depending on the zip code of your primary home residence, your provider network is:
- HSHS/Prevea 360
- HSHS/Prevea 360/First Health
Prior Authorization
Out-of-network services will not be covered unless you first obtain a referral from your network provider and prior authorization from Dean Health Plan. Your network provider will need to submit a referral request to Dean Health Plan. If you have questions regarding the referral process, please contact Dean Health Plan at 1-888-895-1188.
Find a Provider
To locate network providers, follow these steps:
2. Determine your network service area. Your network is determined by your home ZIP code.
3. Based on your network service area, select Find a Prevea360 provider or First Health provider.
Excluded Providers
The HSHS medical plan will not pay benefits for services received from particular providers. HSHS is proud of our facilities and physicians, and we want to encourage colleagues to use HSHS facilities and physicians for their care. The utilization of our own providers invests in our people and our organization, helping to build a stronger system of care in the communities we serve. Click HERE to see the list of excluded providers and facilities.
Traveling Outside Network Service Area
A referral is not required for urgent care when you are traveling outside your network service area and emergency care. For care required to treat an urgent situation while you are traveling outside your network service area or an emergency medical condition, the HSHS medical plan provides the same benefit level regardless of the provider who provides your care.
Out-of-area Dependents
If you have a dependent that does not live in the Prevea360 service area, such as a child attending college, you can register your dependent with Dean Health Plan after you receive your Dean Health Plan ID card. Call Dean Health Plan to get started. Once your dependent is registered, the First Health network will apply for your dependent’s medical plan coverage.
Additional Resources