BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision - 23435AZ0040024 Health Insurance Plan
Banner Health and Aetna Health Plan Inc. health insurance plan with the Plan ID 23435AZ0040024. The plan is called BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 78.10% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 21.90% of the costs of all covered benefits (according to the Issuer).
| Health Insurance Plan ID | 23435AZ0040024 | ||||||||||||||||||
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| 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 | 23435AZ0040024-03 | ||||||||||||||||||
| 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). |
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| Available Variants of the Health Plan | Standard Off Exchange Plan - 23435AZ0040024-00 Standard On Exchange Plan - 23435AZ0040024-01 |
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| Last Plan Update Date | Fri, 15 Nov 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 13 May 2025 06:05 GMT |
BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant 23435AZ0040024-03 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 | Limited Cost Sharing Plan Variation |
| 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 | 0.9478 |
| First Tier Utilization | 100% |
| Formulary ID | AZF009 |
| 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 | New |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer Actuarial Value | 78.10% |
| Issuer ID | 23435 |
| Issuer Marketplace Marketing Name | BannerAetna |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Gold |
| 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) | 23435AZ0040024-03 |
| Plan Marketing Name | BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision |
| Plan Type | HMO |
| Plan Variant Marketing Name | BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $4,100 |
| SBC Scenario, Having a Baby, Copayment | $200 |
| SBC Scenario, Having a Baby, Deductible | $895 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $900 |
| SBC Scenario, Having Diabetes, Deductible | $0 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $500 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $200 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $895 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | AZS003 |
| Source Name | HIOS |
| Plan ID | 23435AZ0040024 |
| 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 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $1790 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $895 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $895 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 40.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group | $1790 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $895 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $895 |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group | per group not applicable |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | per person 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 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 Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, 23435AZ0040024
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision, 23435AZ0040024 Health Insurance Plan, 23435AZ0040024
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Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, 23435AZ0040024 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (23435AZ0040024) Health Insurance Plan, Variant (23435AZ0040024-03) 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 (23435AZ0040024) Health Insurance Plan, Variant (23435AZ0040024-03) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (23435AZ0040024) Health Insurance Plan, Variant (23435AZ0040024-03) 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 (23435AZ0040024) Health Insurance Plan, Variant (23435AZ0040024-03) 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 Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for Asthma?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 offers Disease
Management Program for Asthma.
Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for Heart disease?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 offers Disease
Management Program for Heart disease.
Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for Depression?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 offers Disease
Management Program for Depression.
Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for Diabetes?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 offers Disease
Management Program for Diabetes.
Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 offers Disease
Management Program for High blood pressure & high cholesterol.
Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for Low back pain?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 offers Disease
Management Program for Low back pain.
Does BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan, Variant (23435AZ0040024-03) offer Disease Management Programs for Pregnancy?
Yes, the BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision Health Insurance Plan Variant
23435AZ0040024-03 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