Part D Pharmacy Benefits Dean Advantage, Medicare - Dean Health Plan

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Published on October 01, 2017

Dean Advantage Plans (Medicare Part D) Pharmacy Benefits

Medications can play a significant role in your health care. The following information will help guide your decisions about medications and answer questions about your Medicare pharmacy benefits.

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:

  • 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
  • The Social Security Office at 1-800-772-1213 between 7 am and 7 pm, Monday through Friday. TTY users should call 1-800-325-0778; or
  • Your State Medicaid Office.

Formulary (List of Covered Drugs)
View a listing of covered medications in our comprehensive formulary.

Utilization Management for Prescription Drugs
Some covered medications have additional requirements, such as a prior authorization requirement, or limits on coverage. You may access Dean Advantage prior authorization forms here.

Part D Coverage Determinations, Exceptions, Appeals and Grievances
Read more about Part D coverage determinations, exceptions, appeals and grievances.

Pharmacy Benefit Guideline FAQ
Read some common question and answers on Medicare pharmacy (Part D) topics.

Pharmacy Transition Process
Learn about our pharmacy transition process for prescription drug coverage when you are a new member to plan, a returning member, when you change locations of care, and other special circumstances.

Find a Pharmacy
Search for nationwide pharmacy providers available through Dean Advantage plans.

Vaccine Coverage
Read about how some vaccines are covered under the Part D benefit and when vaccines are covered under Medicare Part B.

Medication Therapy Management Program
Read about our Medication Therapy Management Program.

Drug Overutilization Review Program
Learn about how we meet the CMS requirement to prevent clinically inappropriate overuse of opioid medicines and acetaminophen.

You can contact Member Services if you need additional information, including:

  • How we control the use of services and costs
  • The number of appeals and grievances filed by our members
  • A summary description of how we pay our doctors
  • A description of our financial condition, including a summary of our most recent audit statement

Dean Advantage is an HMO/HMO-POS plan with a Medicare contract. Enrollment in Dean Advantage depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. You must continue to pay your Medicare Part B premium. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. We also list pharmacies that are in our network but are outside the Dean Advantage service area.

H9096_WEB18v1 Approved

Contact us

Talk to a Dean Medicare representative by calling
1-877-234-0126 (TTY: 711)
8 am to 8 pm, weekdays (year-round) and weekends (Oct. 1 – Feb. 14).

For information in alternate formats and languages, call the number above.

Mailing Address:
Dean Health Plan
PO Box 56099
Madison, WI 53705

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