BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 - 23435AZ0040016 Health Insurance Plan

Banner Health and Aetna Health Plan Inc. health insurance plan with the Plan ID 23435AZ0040016. The plan is called BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 64.99% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 35.01% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 23435AZ0040016
Health Insurance Plan Year 2025
State Arizona
Health Insurance Issuer Banner Health and Aetna Health Plan Inc.
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 23435AZ0040016-01
Provider Network(s) PREFERRED NON-PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 13 May 2025 06:05 GMT).

Providers Arizona All US States
All 22732 30417
PCP 2628 2850
Allergy 7 9
OB/GYN 134 153
Dentists 2318 2581
Available Variants of the Health Plan

Standard Off Exchange Plan - 23435AZ0040016-00

Standard On Exchange Plan - 23435AZ0040016-01

Open to Indians below 300% FPL - 23435AZ0040016-02

Open to Indians above 300% FPL - 23435AZ0040016-03

Last Plan Update Date Fri, 15 Nov 2024 00:00 GMT
Last Import Date Tue, 13 May 2025 06:05 GMT

BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2025
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze On Exchange Plan
Drug EHB Deductible, Combined In/Out of Network, Family Per Group $9990 per group
Drug EHB Deductible, Combined In/Out of Network, Family Per Person $4995 per person
Drug EHB Deductible, Combined In/Out of Network, Individual $4,995
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Drug EHB Deductible, In Network (Tier 1), Family Per Group $9990 per group
Drug EHB Deductible, In Network (Tier 1), Family Per Person $4995 per person
Drug EHB Deductible, In Network (Tier 1), Individual $4,995
Drug EHB Deductible, Out of Network, Family Per Group per group not applicable
Drug EHB Deductible, Out of Network, Family Per Person per person not applicable
Drug EHB Deductible, Out of Network, Individual Not Applicable
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
EHB Percent of Total Premium 1.0
First Tier Utilization 100%
Formulary ID AZF002
Formulary URL URL
HIOS Product ID 23435AZ004
Import Date 2024-11-15 00:01:36
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
Inpatient Copayment Maximum Days 0
HSA Eligible No
New/Existing Plan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 64.99%
Issuer ID 23435
Issuer Marketplace Marketing Name BannerAetna
Market Coverage Individual
Medical Drug Deductibles Integrated No
Medical Drug Maximum Out of Pocket Integrated Yes
Medical EHB Deductible, Combined In/Out of Network, Family Per Group $0 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $0 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $0
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance 50.00%
Medical EHB Deductible, In Network (Tier 1), Family Per Group $0 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person $0 per person
Medical EHB Deductible, In Network (Tier 1), Individual $0
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Metal Level Expanded Bronze
Multiple In Network Tiers No
National Network No
Network ID AZN003
Out of Country Coverage No
Out of Service Area Coverage No
Out of Service Area Coverage Description Except for Emergencies
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan ID (Standard Component ID with Variant) 23435AZ0040016-01
Plan Marketing Name BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7
Plan Type HMO
Plan Variant Marketing Name BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $5,400
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $2,900
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $2,000
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID AZS003
Source Name HIOS
Plan ID 23435AZ0040016
State Code AZ
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $18390 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $9195 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $9,195
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $18390 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $9195 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,195
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered Yes

Copay & Coinsurance of BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, 23435AZ0040016

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

Frequently Asked Questions(FAQ) about BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7, 23435AZ0040016 Health Insurance Plan, 23435AZ0040016

  • Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, 23435AZ0040016 support Mail Ordering?

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

  • Does (23435AZ0040016) Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy

    Does (23435AZ0040016) Health Insurance Plan, Variant (23435AZ0040016-01) have Out Of Country Coverage?

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

    Does (23435AZ0040016) Health Insurance Plan, Variant (23435AZ0040016-01) have Out of Service Area Coverage?

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

    Does (23435AZ0040016) Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for Asthma?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for Asthma.

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for Heart disease?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for Heart disease.

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for Depression?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for Depression.

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for Diabetes?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for Diabetes.

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for Low back pain?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for Low back pain.

    Does BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan, Variant (23435AZ0040016-01) offer Disease Management Programs for Pregnancy?

    Yes, the BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 Health Insurance Plan Variant 23435AZ0040016-01 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 13 May 2025 06:05 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