QHP Index

Dean Focus Gold Standard

Gold · EPO · Dean Health Plan · Wisconsin

At age 40 it costs between $585.87 and $592.99 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.

What CMS publishes about it

Plan ID38345WI0080068
InsurerDean Health Plan
Metal levelGold
Plan typeEPO
Standardised designDesign 1 — a plan CMS defined the benefits of, so it can be compared like for like
Deductible (individual)$2,000
Deductible (family)$4,000
Drug deductibleIncluded in the medical deductible
Most you could pay in a year$8,200
Family maximum$16,400
Primary care visit$30
Specialist visit$60
Emergency room25% Coinsurance after deductible
Inpatient stay25% Coinsurance after deductible
Generic drugs$15
Preferred brand drugs$30
Specialty drugs$250
Adult dental includedNo
Child dental includedNo
Share of premium buying essential health benefits100.00%
Network directoryWho is in network
Summary of benefitsSummary of benefits and coverage
Drug listFormulary
Customer service1-877-394-9080 · TTY 1-877-394-9080

Where it is sold, and what it costs there

4 counties. The premium is the price before any tax credit; what you pay depends on your income.

CountyAt 21At 30At 40At 50At 60
Dane County $458.43$520.32 $585.87$818.75 $1,244.17
Sauk County $458.43$520.32 $585.87$818.75 $1,244.17
Green County $464$526.64 $592.99$828.70 $1,259.30
Rock County $464$526.64 $592.99$828.70 $1,259.30

Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.

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When this plan’s price or benefits change.

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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.