Dean Advantage Harmony (HMO-POS) 2025 Plan Details for Fond du Lac County, Wisconsin Residents
Dean Advantage Harmony (HMO-POS) 2025 Plan Details for Fond du Lac County, Wisconsin Residents
Choosing the right Medicare Advantage plan in Fond du Lac County is crucial for your healthcare needs in 2025. With Dean Advantage Harmony (HMO-POS) as one of the options, you can compare it side-by-side with other available plans to find the best fit for you. Whether you prefer enrolling online or seeking advice from a licensed agent, we’ve made the process simple and straightforward.
According to CMS enrollment data (May, 2025), there are approximately 594 members enrolled in this plan, 0 in Fond du Lac County.
Dean Advantage Harmony Overview
| Plan ID H9096-010-0 Overview | |
|---|---|
| Health Plan ID: | H9096-010-0 |
| Medicare Advantage Plan Type: | HMO-POS |
| Plan Year: | 2025 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $4,900.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Fond du Lac County, WI |
| Insured By: | Dean Advantage |
Explore the Benefits of Dean Advantage Harmony
Looking for a plan with structure and flexibility? Dean Advantage Harmony is a Medicare Advantage HMO-POS option that includes all the standard benefits of Medicare Part A and Part B — with the added perk of limited out-of-network access. With a monthly premium of $0.00, you can choose from providers inside or outside the network, though in-network care will usually cost less.
Primary care visits have a not covered, specialist visits come with a $40 copay, urgent care services carry a $40 copay, and ambulance transportation is $300 copay. These costs count toward the plan’s annual maximum out-of-pocket (MOOP) limit of $4,900.00 . Once that’s reached, your in-network costs are fully covered — giving you the freedom to choose your care path without unexpected expenses.
You’ll find this plan listed by CMS as H9096-010-0. A summary of its cost sharing appears below. Still have questions? Check the FAQ section for more answers about this plan type.
| We're Here to Help You Enroll |
|---|
Out-of-Pocket Costs
Dean Advantage Harmony includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H9096-010-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | Not Covered |
| Specialist: | $40 Copay |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $110 Copay |
| Urgent care: | $40 Copay |
| Ground ambulance: | $300 Copay |
| Inpatient hospital care: | $350.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
| Skilled Nursing Facility: | $10.00 per day for days 1 through 20 $214.00 per day for days 21 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Foot Exams and Treatments (Medicare-covered): | $40 Copay |
| Routine Foot Care: | $40 Copay |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Medicare-covered chiropractic: | $20 Copay |
| Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | $40 Copay |
| Outpatient group therapy: | $30 Copay |
| Inpatient psychiatric hospital care: | $350.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | $40 Copay |
| Occupational therapy: | $40 Copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | Not Covered |
| Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
| Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | $200 Copay |
| Lab services: | $25 Copay |
| Outpatient x-rays: | $30 Copay |
| Diagnostic tests and procedures: | $40 Copay |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | 20% Coinsurance |
| Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Medicare Covered Preventive Dental | $40 Copay |
| Oral exam | $0 |
| Dental x-rays | $0 |
| Cleaning | $0 |
| Periodontics | Not Covered |
| Endodontics | Not Covered |
| Restorative Services | Not Covered |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Fitting/evaluation | Covered Limits may apply |
| Hearing aids | Covered Limits may apply |
| Hearing exam | Covered Limits may apply |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Medicare-covered eye exam (in-network) | $0 Copay |
| Routine eye exam (in-network) | Covered Limits may apply |
| Eyewear benefits | Eyeglasses: Yes Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $250.00 Every two years |
Certain preventive services are covered 100% by Dean Advantage Harmony as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
Understanding CMS Star Ratings
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
| CMS Measure | Star Rating |
|---|---|
| 2025 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Eligibility Requirements for Dean Advantage Harmony
To enroll in Dean Advantage Harmony , you must meet the following criteria:
- Be eligible for Medicare Part A and Part B.
- Reside in the plan’s service area.
If you meet these requirements, you are eligible to enroll in Dean Advantage Harmony and benefit from its comprehensive coverage options.
When Can I Enroll in Dean Advantage Harmony ?
To ensure you don’t miss your chance to enroll in Dean Advantage Harmony , be aware of these important enrollment periods:
- Initial Enrollment Period (IEP): Your IEP offers a seven-month window around your 65th birthday to sign up for Medicare.
- Annual Enrollment Period (AEP): The AEP, occurring from October 15 to December 7 each year, allows you to enroll in or make changes to your Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, the MA OEP provides an opportunity to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing insurance coverage, may qualify you for a SEP, giving you a chance to make adjustments outside the standard periods.
Need help figuring out the right time to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to get assistance from a licensed insurance agent.
Steps to Enroll in Dean Advantage Harmony
Joining Dean Advantage Harmony is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Dean Advantage Harmony .
- Direct Enrollment: You can also choose to enroll directly with Dean Advantage Harmony . The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H9096-010-0:
What’s the monthly premium for Dean Advantage Harmony (HMO-POS)?
For 2025, the monthly premium is $0.00, and you still pay your Part B premium to Medicare.
How high can my costs go in a worst-case year?
Your costs top out at $4,900.00 (for in-network services) in 2025; after that the plan pays 100% of covered services.
What’s the CMS star score for Dean Advantage Harmony ?
The latest CMS score is ★4.0 out of 5 stars; anything 4 or higher earns quality bonuses.
How many members does Dean Advantage Harmony have?
CMS reports 594 members in the latest file.
Contact Dean Advantage
| Website: | Dean Advantage Plan Page |
|---|---|
| Providers: | Dean Advantage Providers Page |
| New Member Health Plan Help: | (877)234-0126 |
| New Member Health Plan TTY: | 711 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- Dean Advantage, http://www.deancare.com/medicareadvantage, Last Accessed June 1, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 25 May, 2025
- Medicare.gov, "Joining a plan", Last Accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed 25 May, 2025
- CMS.gov, Landscape Source Files, Last Accessed October 15, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 15, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 15, 2024
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County, Last Accessed June 6, 2025
Medicare Advantage and Part D plans and benefits offered by: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.