Medical insurance and Virtual Care
The medical benefits portion of the medical plans are administered by Dean Health Plan Administrative Services (aka Dean Care/ASO) and the pharmacy benefits portion of the medical plan is administered by Smith RX.
Prevea’s medical plan provides for quality health care and 100% coverage for in-network preventive care. Premiums are based on the number of people you cover, and your employment status (full-time, part-time). All eligible employees have access to our HDHP High EPO plan, HDHP EPO plan, or the Traditional EPO Plan administered through Dean Health Plan Administrative Services. Those benefit eligible employees whom live outside of the Prevea360 provider network have access to enroll in our PPO high deductible health plan (PPO HDHP). The PPO HDHP medical plan uses the First Health Network.
After you have enrolled for medical plan coverage, watch your mail as you will receive an ID card. You will need to present this card to obtain medical and prescription drug services. Your ID card acts as both your medical and prescription ID Card.
For more information about Prevea 360's rules about transparency in coverage please visit their website.
Network information (HDHP High EPO plan, HDHP EPO plan, & Traditional EPO options)
PPO Medical Plan – Preferred Provider Network
For the Prevea PPO Medical Plan (the medical plan made available to employees who reside in Wisconsin, but outside the Prevea360 service area), the medical plan uses the First Health Network. For employees/families who reside outside of Wisconsin, the medical plan uses the First Health Network network of providers.
How to find an In-Network First Health Provider:
- Visit ASO Members - DHP (www.Deancare.com/Members/members-ASO/ASO-Member)
- Find and click on First Health in the middle-left side of the page under Find a Doctor
- Now you are on the First Health website provider finder page. Click Start Now
- Select the provider type (selecting all providers will yield more results)
- Choose one of two options:
- Zip code and adjust the distance from 5-100 miles
- Select a state: You can narrow down your search by county and/or city
- Select Search Now for immediate results (show more options) to narrow your search by the following:
- Physician or facility name: text field allows you to type in the name of the doctor (last name) or hospital (first name)
- Specialty: type of select up to five specialties to include
- If you need more detail on specialties, choose the “specialty Definitions” link at the bottom of the web page
- Condition: type or select a condition
- Focus: type or select up to five focus codes to include
- Select Search Now
- A user guide can be found on the bottom of the First Health website which contains additional instructions for refining your search results
It is important to note that providers are regularly added and removed from the network. Before you schedule an appointment, please verify that the provider you chose is listed as a participating provider. Prior to your appointment, you should also double-check that you’re seeing a participating provider. These steps will help you avoid additional charges.
Click here to verify PPO eligibility per the ZIP code listing.
If you have any questions or need assistance, please call the Dean Care Customer Service Center at (877) 234-4516.
How to find an In-Network Prevea360 Provider:
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- Visit ASO Members - DHP (www.Deancare.com/Members/members-ASO/ASO-Member)
- Under “Find a Doctor or location,” click on the link for Prevea360 ASO Network
- Top Right under “My Location” enter a city, state or zip code
- Enter Search Criteria
Prevea Health medical plans available to employees
Below is a brief outline of the medical plan designs offered to eligible employees. Please refer to the summary plan descriptions on myADP for complete plan details.
Prescription drug coverage through Smith Rx
For the medical plans offered by Prevea Health, pharmacy benefits are administered through SmithRx. To obtain reimbursement under the plan for pharmacy related expenses it is important to ensure your using an in-network pharmacy.
- Visit https://www.smithrx.com/members to get started
- Register and create an account (our member ID as found on your ID card)
- After registering, click “Find My Meds” in the upper right-hand corner of your dashboard
- Enter your zip code or city/state to find an in-network pharmacy near you
If you have any specific questions regarding participating pharmacies or other questions related to covered medications, call SmithRx Member Support Team at (844) 454-5201.
SmithRx partners with over 65,000 retail pharmacies across the nation including the major national chains, regional chains, grocers and independent pharmacies. In addition, we have three preferred mail order pharmacies and two specialty pharmacies. You can always find the pharmacy with the best price by using the Find My Meds search tool in the Member Portal at mysmithrx.com:
- Visit https://www.smithrx.com/members to get started
- Register and create an account (our member ID as found on your ID card)
- After registering, click “Find My Meds” in the upper right-hand corner of your dashboard
- Enter your zip code or city/state to find an in-network pharmacy near you
If you have any specific questions regarding participating pharmacies or other questions related to covered medications, call SmithRx Member Support Team at (844) 454-5201.
- Search for a drug
- Confirm coverage
- Understand cost
- Explore lower-cost options
Member Portal at mysmithrx.com:
- Visit https://www.smithrx.com/members to get started
- Register and create an account (our member ID as found on your ID card)
- After registering, click “Find My Meds” in the upper right-hand corner of your dashboard
- Enter your zip code or city/state to find an in-network pharmacy near you
If you have any specific questions regarding participating pharmacies or other questions related to covered medications, call SmithRx Member Support Team at 844-454-5201.
Amazon Pharmacy | Register at www.amazon.com/smithrx.
Doctors can send prescriptions via electronic prescribing, fax or phone:
Name/E-scribe: Amazon Pharmacy Home Delivery
Amazon Pharmacy Fax: 512-884-5981
Amazon Prescriber and Pharmacy Line; 855-206-3605
Walmart Pharmacy | Register at www.walmart.com/cp/1042239
Doctors can send prescriptions via electronic prescribing, fax or phone:
Walmart Pharmacy Fax: 800-406-8976
Walmart Prescriber and Pharmacy Line: 800-273-3455
Walmart Prescriber Email: wmsrx@wal-mart.com
Members can create an account on the Costco Pharmacy Member Portal (www.smithrx.com/specialty) to manage prescriptions, request refills, and track orders. You can also contact the Costco Pharmacy Member Customer Service Team at (855) 213-0070.
SmithRx can help lower drug costs with their Connect 360 Programs
SmithRxʼs Connect 360 programs help you access cost-saving options, often reducing medication costs to little or no cost at all. Continuously evolving, Connect 360 ensures members get the best prices on their medications.
| Connect Access (CA-T & CA-S) | Capture manufacturer coupon savings on traditional and specialty medications. Members have a low or $0 copay on prescriptions while also helping employers save on pharmacy benefit costs. |
| Cost Plus Drugs | Cost Plus Drugs is building an innovative pharmacy model that delivers medications at cost, plus a straightforward 15% markup, along with a $5 dispensing fee and shipping. Cost Plus Drugs carries over 1,000 medications and is continuing to expand their drug list weekly. |
| Autoimmune | Through this program, SmithRx members can now access low cost, FDA-approved biosimilars such as Yusimry, a biosimilar for Humira, and Otulfi, a biosimilar for Stelara, through Cost Plus Drugs and Costco Specialty Pharmacy. FDA-approved biosimilars have no clinically meaningful differences in terms of safety and effectiveness from their brand-name counterparts, while offering a more affordable option for members with autoimmune conditions. |
| Multiple Sclerosis (MS) | Through the MS Program, members will transition to the lowest- cost Multiple Sclerosis treatment options on the market through Cost Plus Drugs. |
| Low-Cost Insulin (LCI) | This program helps reduce insulin costs at the pharmacy by transitioning to generic and biosimilar insulin products. |
| Referral Partner Program (340B) | Provides members with lower net costs for eligible program medications. By providing access to discounted medications, the 340B program helps eligible healthcare organizations stretch their resources further, enhance patient care, and improve health outcomes. |
Enrollment Process
If eligible for a Connect 360 program, you will be assigned a dedicated agent to assist you throughout the entire enrollment process.
- The Connect 360 team will reach out via phone call, SMS text and/or a notification in the SmithRx Member portal to notify you if any of your medications are eligible cost savings.
- The Connect 360 Team will help you complete enrollment over the phone or online.
- The Connect 360 Team will inform you once the program enrollment was successful.
If you have any questions or need assistance, the SmithRx Connect 360 Team is here to help! You can reach out to us at 844-385-7612 or connect@smithrx.com.
Virtual Care
- $15* per visit will apply for Prevea Health employees, their spouses and dependents covered under the Prevea—sponsored medical plan
- Board-certified doctors are available by web
- Treat flu allergies, sinus infection, rash, sore throat and more
*The $15 fee does not apply towards your medical deductible and max out-of-pocket amounts.
- Visit www.prevea.com/virtualcare to complete an online health interview
- A provider reviews the interview usually within one hour and creates a treatment plan
- You are notified when the results are available
- Accessible 24/7
- If you cannot be treated online, you will not be responsible for the $15 fee
- If a prescription is part of your treatment plan, you’ll be able to send your prescription to the pharmacy of your choice
Treatment for minor conditions is available with no appointments necessary. Virtual Care is a convenient and affordable option for a variety of medical services. Access quality health care online from the comfort of home, during your lunch break or while traveling.
Questions or need help making changes?
Contact Shari Baer at Shari.Baer1@prevea.com or Marcy Clark at Marcy.Clark@prevea.com