Finally, summer is here! It may be time for vacations, swimming and other outdoor fun. But do you know the answers to these questions:

• What should I do if I have an urgent or emergency situation?
• What happens if I have an injury when I am outside the Dean Health Plan (DHP) service area?
• How do I get reimbursed for emergency care I received while out of the country?

Types of Care
Urgent care is care you need sooner than a routine doctor’s visit. Examples of urgent care include broken bones, sprains, minor cuts, minor burns, drug reactions and nonsevere bleeding. Urgent care is not emergency care.

Emergency care is needed as a result of the sudden or unexpected onset of conditions that could result in serious jeopardy to your health. Such emergencies include heart attack, stroke, severe shortness of breath and significant blood loss.

Your Coverage
DHP will cover urgent and emergency services while you are out of the DHP service area (including out of the country), subject to any policy copayments, coinsurance, deductibles and maximum allowable fees. If you require urgent or emergency care outside the DHP service area and are unable to get to a plan provider, go to the nearest urgent care or emergency center for treatment. Notify our Customer Service Department at 800-279-1301 by the next business day after your visit or admission.

Some additional features of your coverage include:

• Private Healthcare Systems (PHCS) provides service if you are traveling outside Wisconsin and need urgent or emergency services. You will not be charged a maximum allowable fee difference between what a nonplan provider charges and what DHP allows for payment. You will still be required to pay any applicable copayments, coinsurance or deductible amounts. For information on available PHCS providers, call DHP Customer Service. Verification that the provider participates in the PHCS is required.
• Dean On Call Nurse Line, 800-57-NURSE (800-576-8773), can help you decide if you need urgent or emergency care services.

All follow-up care should be done by a DHP plan provider. If you are out of the area and not able to see a plan provider, call your doctor for a referral to an out-of-area provider; services require approval by DHP.

Traveling Overseas?
Are you planning a trip overseas soon? Emergencies can happen when you least expect it. Make sure you know how to get reimbursed for medical care that you pay for out-of-pocket.

Dean Health Plan (DHP) does cover urgent and emergency care for members who are out of the area or overseas, subject to any policy deductible, coinsurance, copayments or maximum allowable fee. To reimburse you for services, DHP needs an itemized billing, in English, with the current U.S. exchange rate along with DHP’s foreign claim form. Please complete the form to help us process your claim more efficiently. You can obtain a foreign claim form by either going to www.deancare.com or calling our Customer Service Department at 608-828-1301 or 800-279-1301.

If you have questions about your benefits or available providers, go to www.deancare.com. If you have questions regarding urgent, emergency or follow-up care, please call our Customer Service Department at 608-828-1301 or 800-279-1301.

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