HMO Member Handbook
Welcome to Dean Health Plan. This is your complete member guide that explains your coverage with Dean Health Plan. If you have additional questions, please visit our frequently asked questions page or call one of our friendly Customer Care Specialists at (800) 279-1301.
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Enrollment & Eligibility
In this section of the Member Handbook you will find information detailing
- Dependent Eligibility
- Special Enrollment Periods
- Your ID Card
- Canceling Your Coverage
- Address Changes
Review this Section
Your Primary Care Practitioner
In this section of the Member Handbook you will find information detailing
- Primary Care Practitioner
- Changing Your Primary Care Practitioner
- Provider Recredentialing
- Advance Directives
Review this Section
Prior Approval Process
In this section of the Member Handbook you will find information detailing
- Understanding the Referral Process
- Pre-certification and Prior Authorization
- Dean On Call
- Urgent or Emergency Follow-up Care
Review this Section
Understanding Your Benefits
• Your Member Benefits
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• Privacy and Confidentiality
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• Member Rights and Responsibilities
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• Quality Improvement Program
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• Co-payments, Deductibles and Co-Insurance |
• Subrogation |
| • How Claims are Processed |
• Case Management |
• Mental Health and Alcohol and Other Drug Abuse Services
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• Services Obtained Outside the System or Service Area
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• Prescription Drug Benefit
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• New Technology
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• Drug Formulary |
• Complaints, Appeals and Grievances |
• Insulin and Disposable Diabetic Supplies
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• Utilization Management
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• Obtaining Durable Medical Equipment and Supplies |
• How to Obtain Specialty Care |
• Coordination of Benefits
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• Hospital Services
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Review this Section
Privacy
In this section of the Member Handbook you will find information detailing
- Web Privacy Statement
- Patient Privacy Statement
- Notice of Privacy Practice
Review this Section
