Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Dean Advantage Harmony (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Dean Advantage Harmony (HMO-POS) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Dean Advantage Harmony (HMO-POS) is a HMO-POS plan offered by Dean Health Plan, Inc. available for the 2026 plan year to people living in South Central Wisconsin. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Dean Advantage Harmony (HMO-POS) 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.
Below are a few key facts and commonly-asked questions about Dean Advantage Harmony (HMO-POS).
The cost of a Medicare Advantage Plan is made up of four main parts.
For Dean Advantage Harmony (HMO-POS), 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. Additionally, this plan comes with a Part B Premium reduction of $20.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
Health deductible: information not available.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5000.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $5000.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $5000.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $5000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Prescription drugs are not covered by Dean Advantage Harmony (HMO-POS).
The Dean Advantage Harmony (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive exams, and home health services. For inpatient hospital stays, members pay no coinsurance and a copay of $350 to $400 for the first six days, after which there is no copay. Outpatient hospital services feature copays ranging from no copay up to $425, while emergency room visits require a $130 copay that is waived upon admission. Supplemental benefits include routine vision and hearing exams with low copays, alongside annual allowances of $175 for eyewear and $750 for hearing aids. Dental care is covered up to a $1,500 annual maximum, featuring no copay for preventive services and a 50% coinsurance for comprehensive procedures. Additionally, the plan provides a $40 quarterly over-the-counter allowance and up to 24 free one-way transportation trips to approved health-related locations with no copay.
Dean Advantage Harmony (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $400 copay for days 1 through 6 for acute care and a $350 copay for days 1 through 6 for psychiatric care, with no copay for days 7 through 90. While unlimited additional acute care days are covered, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Dean Advantage Harmony (HMO-POS) covers outpatient services with no coinsurance, featuring a copay of $0 to $425 for outpatient hospital services and $400 per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require a $30 copay for individual sessions and a $20 copay for group sessions with no coinsurance.
Dean Advantage Harmony (HMO-POS) covers partial hospitalization services with a copayment of $105.00 and no coinsurance.
Dean Advantage Harmony (HMO-POS) covers ground ambulance services with a $300 copay and air ambulance services with a $475 copay, with no coinsurance required for either service. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved health-related locations via bus or subway with no copay or coinsurance, though transportation to any health-related location is not covered.
Dean Advantage Harmony (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a range of no copay to a $40 copay and no coinsurance. Worldwide emergency and urgent services are partially covered with a $110 copay and no coinsurance, though worldwide emergency transportation is not covered.
Dean Advantage Harmony (HMO-POS) covers primary care physician services with no copay and no coinsurance. Additional covered services, including specialist visits, physical therapy, chiropractic care, and mental health services, have copays ranging from $0 to $40 and no coinsurance.
Dean Advantage Harmony (HMO-POS) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered, offering fitness benefits and in-home support, while sub-services such as health education, weight management programs, and nutritional benefits are not covered.
Hearing services are covered by Dean Advantage Harmony (HMO-POS) with a $40 copay and no coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to a $750 annual limit, excluding inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids.
Dean Advantage Harmony (HMO-POS) covers annual routine eye exams and refractions with a copay ranging from $0 to $40 and no coinsurance. Eyewear is also covered with no copay, no coinsurance, and no deductible, up to a $175 annual maximum limit.
Dean Advantage Harmony (HMO-POS) provides partially covered dental services up to a $1,500 annual maximum, excluding other preventive dental services, maxillofacial prosthetics, and orthodontics. Medicare-covered dental has a $40 copay and no coinsurance, preventive services have no copay and no coinsurance, and covered comprehensive services require no copay and a 50% coinsurance.
Home infusion bundled services are covered by Dean Advantage Harmony (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $30 to $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a 0% to 20% coinsurance.
Dialysis services are covered under the Dean Advantage Harmony (HMO-POS) plan with no copay and a 20% coinsurance.
Dean Advantage Harmony (HMO-POS) covers medical equipment with no copays, though prior authorization and coinsurance may apply. Durable medical equipment and diabetic supplies range from no coinsurance to 20% coinsurance, while prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts require 20% coinsurance.
Dean Advantage Harmony (HMO-POS) partially covers diagnostic and radiological services with no coinsurance, though lab services are not covered. Diagnostic procedures, therapeutic radiology, and outpatient X-rays require a $40 copay, while diagnostic radiology has no copay and radiological services require prior authorization.
Home Health Services are covered under the Dean Advantage Harmony (HMO-POS) plan with no copay and no coinsurance.
Dean Advantage Harmony (HMO-POS) covers cardiac rehabilitation services with no coinsurance, though only some services are covered; standard cardiac rehabilitation ($35 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and SET for PAD services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) services are covered by Dean Advantage Harmony (HMO-POS) with no coinsurance, though prior authorization is required and additional days beyond the standard 100 days are not covered. There is no copay for days 1 to 20 and days 45 to 100, while days 21 to 44 require a $218 copay.
Dean Advantage Harmony (HMO-POS) covers other services including acupuncture for a $40 copay and no coinsurance up to 12 treatments annually, alongside a chronic illness meal benefit and home infusion services with no copay or coinsurance. An OTC benefit is covered with no copay or coinsurance up to a $40 quarterly reimbursement limit, while non-transport ambulance services are available for a $395 copay and no coinsurance.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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