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DeanCare Gold Enhanced (Cost)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DeanCare Gold Enhanced (Cost). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DeanCare Gold Enhanced (Cost) in 2025, please refer to our full plan details page.
DeanCare Gold Enhanced (Cost) is a Cost plan offered by Medica Holding Company available for enrollment in 2025 to people living in South Central Wisconsin. This plan received an overall rating of 5 out of 5 stars in 2025.
It's important to know that DeanCare Gold Enhanced (Cost) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DeanCare Gold Enhanced (Cost).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For DeanCare Gold Enhanced (Cost), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for DeanCare Gold Enhanced (Cost)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by DeanCare Gold Enhanced (Cost).
Additional Benefits
The DeanCare Gold Enhanced (Cost) plan offers a range of benefits, including inpatient and outpatient services, with no copay for emergency services, and primary care. The plan also includes coverage for preventive services, hearing exams with hearing aid benefits, vision exams with eyewear coverage, and dental services up to $300 per year. This plan has several additional benefits, such as ambulance services, home health services, and medical equipment, all with no copay or coinsurance. However, it is important to note that some services, such as certain outpatient services, specific hearing aids, and advanced vision or dental procedures, may have limited coverage or may not be covered at all.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital-Acute, and Non-Medicare-covered Stay for Inpatient Hospital-Acute. The plan does not cover Upgrades for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric benefits cover Additional Days for Inpatient Hospital Psychiatric (175 days per benefit period), while Non-Medicare-covered Stay for Inpatient Hospital Psychiatric is not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient substance abuse services are partially covered, as individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the plan. There is no additional information available about the cost of this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the DeanCare Gold Enhanced (Cost) plan, with no copay or coinsurance for all ambulance services. However, ground and air ambulance services, as well as transportation services to any health-related location, are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by DeanCare Gold Enhanced (Cost). Emergency Services and Urgently Needed Services have no copay and no coinsurance, while Worldwide Emergency Coverage and Worldwide Urgent Coverage have a 20% coinsurance after a $250 deductible, and Worldwide Emergency Transportation is not covered.
Primary Care See details
The DeanCare Gold Enhanced (Cost) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, and opioid treatment program services. Individual and group sessions for mental health and psychiatric services, podiatry services, and additional telehealth benefits are not covered.
Preventive Services See details
The DeanCare Gold Enhanced (Cost) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, and additional preventive services. Additional services covered include Weight Management Programs, In-Home Support Services, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. However, Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing services under the DeanCare Gold Enhanced (Cost) plan cover routine hearing exams once per year and fitting/evaluation for hearing aids once every three years. Prescription hearing aids (all types) are covered with a maximum benefit of $500.00 every three years, but inner ear, outer ear, and over-the-ear prescription hearing aids, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services include routine eye exams, covered once per year, and eyewear, which includes eyeglasses (lenses and frames), covered once every two years with a combined maximum benefit of $250. Contact lenses, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The DeanCare Gold Enhanced (Cost) plan covers dental services with a maximum benefit of $300 per year, including oral exams with 2 visits per year, dental x-rays with 50% coinsurance, and other diagnostic dental services. Other services such as prosthodontics, fixed, and maxillofacial prosthetics are covered with 50% coinsurance, and implant services are covered with 50% coinsurance. However, the plan does not cover maxillofacial prosthetics or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are not covered by the DeanCare Gold Enhanced (Cost) plan.
Dialysis Services See details
Dialysis Services are covered by the DeanCare Gold Enhanced (Cost) plan. There is no specific cost information provided for this benefit.
Medical Equipment See details
Medical Equipment benefits are covered, with no copay and no coinsurance for Durable Medical Equipment and Prosthetics/Medical Supplies - Non-Medicare benefit. However, Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by DeanCare Gold Enhanced (Cost), but diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-Ray services are not covered. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered by DeanCare Gold Enhanced (Cost) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the sub-services are covered, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the DeanCare Gold Enhanced (Cost) plan, including 30 additional days beyond Medicare coverage. Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the DeanCare Gold Enhanced (Cost) plan, acupuncture and meal benefits for chronic illnesses are covered. Other services such as over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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