Aetna Silver OAEPO 2500 100% - 70767MD0160006 Health Insurance Plan

Aetna Life Insurance Company health insurance plan with the Plan ID 70767MD0160006. The plan is called Aetna Silver OAEPO 2500 100%.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 71.90% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 28.10% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 70767MD0160006
Health Insurance Plan Year 2023
State Maryland
Health Insurance Issuer Aetna Life Insurance Company
Health Insurance Plan Variant 70767MD0160006-01
Provider Network(s) ['MDN002']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT).

Providers Maryland All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard On Exchange Plan - 70767MD0160006-01

Last Plan Update Date Mon, 23 Jan 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

Aetna Silver OAEPO 2500 100% Health Insurance Plan Variant 70767MD0160006-01 Attributes

Plan Attribute Value
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Silver On Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Heart Disease, Diabetes, Pregnancy, Weight Loss Programs
First Tier Utilization 100%
Formulary ID MDF006
HIOS Product ID 70767MD016
HSA/HRA Employer Contribution No
Import Date 1/23/2023
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 71.90%
Issuer ID 70767
Market Coverage SHOP (Small Group)
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID MDN002
Out of Country Coverage No
Out of Service Area Coverage No
Plan Effective Date 1/1/2023
Plan ID (Standard Component ID with Variant) 70767MD0160006-01
Plan Marketing Name Aetna Silver OAEPO 2500 100%
Plan Type EPO
Plan Variant Marketing Name Aetna Silver OAEPO 2500 100%
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $1,000
SBC Scenario, Having a Baby, Deductible $2,500
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $1,300
SBC Scenario, Having Diabetes, Deductible $2,500
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $200
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,300
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MDS002
Source Name SERFF
Plan ID 70767MD0160006
State Code MD
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $2500 per person | $5000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $2,500
TEHBDedOutofNetFamily per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $9000 per person | $18000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,000
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of Aetna Silver OAEPO 2500 100% Health Insurance Plan, 70767MD0160006

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Aetna Silver OAEPO 2500 100%, 70767MD0160006 Health Insurance Plan, 70767MD0160006

  • Does Aetna Silver OAEPO 2500 100% Health Insurance Plan, 70767MD0160006 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (70767MD0160006) Health Insurance Plan, Variant (70767MD0160006-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Heart Disease, Diabetes, Pregnancy, Weight Loss Programs

    Does (70767MD0160006) Health Insurance Plan, Variant (70767MD0160006-01) have Out Of Country Coverage?

    No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan).

    Does (70767MD0160006) Health Insurance Plan, Variant (70767MD0160006-01) have Out of Service Area Coverage?

    No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan).

    Does (70767MD0160006) Health Insurance Plan, Variant (70767MD0160006-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Heart Disease, Diabetes, Pregnancy, Weight Loss Programs

    Does Aetna Silver OAEPO 2500 100% Health Insurance Plan, Variant (70767MD0160006-01) offer Disease Management Programs for Heart disease?

    Yes, the Aetna Silver OAEPO 2500 100% Health Insurance Plan Variant 70767MD0160006-01 offers Disease Management Program for Heart disease.

    Does Aetna Silver OAEPO 2500 100% Health Insurance Plan, Variant (70767MD0160006-01) offer Disease Management Programs for Diabetes?

    Yes, the Aetna Silver OAEPO 2500 100% Health Insurance Plan Variant 70767MD0160006-01 offers Disease Management Program for Diabetes.

    Does Aetna Silver OAEPO 2500 100% Health Insurance Plan, Variant (70767MD0160006-01) offer Disease Management Programs for Pregnancy?

    Yes, the Aetna Silver OAEPO 2500 100% Health Insurance Plan Variant 70767MD0160006-01 offers Disease Management Program for Pregnancy.

    Does Aetna Silver OAEPO 2500 100% Health Insurance Plan, Variant (70767MD0160006-01) offer Disease Management Programs for Weight loss programs?

    Yes, the Aetna Silver OAEPO 2500 100% Health Insurance Plan Variant 70767MD0160006-01 offers Disease Management Program for Weight loss programs.

 

Disclaimer: This is based on the import(Date: Tue, 07 May 2024 06:08 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API