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State of Wisconsin Member FAQs
Quick, easy answers to your most frequently asked questions right here at your fingertips. A friendly, knowledgeable customer service representative will be able to assist you with any additional questions you may have. Contact our customer service department Monday through Thursday from 7:30 a.m. to 5 p.m. and Friday from 8 a.m. to 4:30 p.m. at (608) 828-1301 or 1-800-279-1301.
Please note these FAQs are for our State of Wisconsin Employee members only.
- Primary Care Provider (PCP)
- How do I get a provider directory?
- Can I still see the doctor I am currently seeing?
- If my current doctor is not a Dean Health Plan doctor, can I get a referral so I can continue to see this doctor?
- Can family members have different PCP's?
- How can I change my Primary Care Provider (PCP)?
- Do I need a new ID card specifically noting that I have Ameritas Group Dental insurance?
- When do I need a referral and how do I get one?
- Can I change the member number on my ID card?
- In what way does Medicare Eligibility affect my DHP insurance coverage?
- I am a current Dean Health Plan member, what should I do to continue my coverage with Dean Health Plan?
Dental Coverage
Referrals
Miscellaneous
Q. How can I change my Primary Care Provider (PCP)?
A. Please call Customer Service at 800-279-1301 or 608-828-1301 to change your PCP. Please remember to file a Health Insurance
Information Change form (found at your payroll/personnel office) displaying the effective date of the change as indicated from
Dean Health Plan, and submit it to your payroll office.
Q. Do I need a separate ID card specifically noting that I have Ameritas Group Dental insurance?
A. Yes. There will be a separate ID card issued for your dental coverage.
Q. I am a current Dean Health Plan member, what should I do to continue my coverage with Dean Health Plan?
A. You do not have to do anything to continue your coverage with Dean Health Plan.
Q. How do I get a provider directory?
A.You may use our provider directory on this web site and search by name or location. You may also
call us at 800-279-1301 or 608-828-1301 and use our automated system to have a provider directory
sent to you. Please choose menu options 3, 1, 2, 4 on your telephone keypad and answer the
questions. A provider directory will be mailed to you immediately.
Q. Can I still see the doctor I am currently seeing?
A. If your doctor is a Dean Health Plan provider, you may continue to receive services from this doctor. If this is your
Primary Care Provider you can select this doctor as your PCP when you complete an enrollment application. Search
the provider directory.
Q. If my current physician is not part of the Dean Health Plan network; can I get a referral so I can continue to see this doctor?
A. If your doctor is not a Dean Health Plan doctor, you do need to choose a plan doctor. You may check the provider directory
on our website to locate a plan doctor.
Q. Can family members have different PCPs?
A. Yes, each family member may choose a different PCP.
Q. What is a referral and when do I need one?
A. A referral request is a form sent to Dean Health Plan by your PCP or specialty physician requesting permission for you to receive outpatient treatment by another provider outside of the Dean Health Plan network. Services by out-of-plan providers are approved if the requested service is not available in plan.
Your referring physician may request a referral for up to one year. However, your physician or Dean Health Plan may limit the number of visits, type of service, or length of time. An approved referral expires when one of these limits is reached. For example, you may receive a referral to see an out-of-network specialist for three visits over the next three months. If you used only two visits and three months have elapsed, the third visit is not authorized. Or, if you used three visits in two months’ time, the referral is not valid for the remaining month. Before receiving additional care, you must contact your referring physician for another referral request.
As a DHP member, it is your responsibility to obtain a valid referral request for out-of-network care. Please keep in mind—a referral request does not authorize payment of non-covered or exhausted benefits. Services are subject to all benefit maximums, policy limitations, and eligibility requirements. Please refer to the “It’s Your Choice” book for benefit limitations.
Q. Can I change the member number on my ID card?
A. You may call a DHP customer service representative to ask for a randomly assigned ID number.
Q. In what way does Medicare Eligibility affect my DHP insurance coverage?
A. You should contact your payroll office, if “active at work” or the ETF, if retired/on COBRA. You can
also contact the DHP Medicare COB Analyst through our Customer Service Department for eligibility questions.
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