BlueEssential Catastrophic 100 $9200 Deductible - 37160ND2410021 Health Insurance Plan
Blue Cross Blue Shield of North Dakota health insurance plan with the Plan ID 37160ND2410021. The plan is called BlueEssential Catastrophic 100 $9200 Deductible.
| Health Insurance Plan ID | 37160ND2410021 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2025 | ||||||||||||||||||
| State | North Dakota | ||||||||||||||||||
| Health Insurance Issuer | Blue Cross Blue Shield of North Dakota | ||||||||||||||||||
| Plan Formulary Description URL | Formulary URL | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 37160ND2410021-00 | ||||||||||||||||||
| Provider Network(s) | PREFERRED IN-NETWORK | ||||||||||||||||||
| 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 | |||||||||||||||||||
| Last Plan Update Date | Fri, 15 Nov 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 13 May 2025 06:05 GMT |
BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant 37160ND2410021-00 Attributes
| Plan Attribute | Value |
|---|---|
| Begin Primary Care Cost-Sharing After Number Of Visits | 0 |
| Begin Primary Care Deductible Coinsurance After Number Of Copays | 3 |
| Business Year | 2025 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Catastrophic Off Exchange Plan |
| 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, Weight Loss Programs |
| EHB Percent of Total Premium | 1.0 |
| First Tier Utilization | 100% |
| Formulary ID | NDF001 |
| Formulary URL | URL |
| HIOS Product ID | 37160ND241 |
| 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 ID | 37160 |
| Issuer Marketplace Marketing Name | Blue Cross Blue Shield of North Dakota |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Catastrophic |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | NDN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Medical assistance for Emergency Services (including locating a doctor or hospital) outside the BlueCard service area, the Member should call the BlueCard Worldwide Service Center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, seven days a week. An assistance coordinator, working with a medical professional, can arrange a physician appointment or hospitalization, if necessary. |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Whenever a member obtains healthcare services outside of the service area, claims will be processed at the in-network level if visiting providers participating with the BlueCard PPO Network. |
| Plan Brochure | URL |
| Plan Effective Date | 2025-01-01 |
| Plan ID (Standard Component ID with Variant) | 37160ND2410021-00 |
| Plan Marketing Name | BlueEssential Catastrophic 100 $9200 Deductible |
| Plan Type | PPO |
| Plan Variant Marketing Name | BlueEssential Catastrophic 100 $9200 Deductible |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $9,200 |
| SBC Scenario, Having a Baby, Limit | $20 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $200 |
| SBC Scenario, Having Diabetes, Deductible | $1,800 |
| SBC Scenario, Having Diabetes, Limit | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $100 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,500 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | NDS001 |
| Source Name | HIOS |
| Plan ID | 37160ND2410021 |
| State Code | ND |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $73600 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $36800 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $36,800 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $55200 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $27600 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $27,600 |
| 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 Per Group | $18400 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $9200 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $9,200 |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group | $36800 per group |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | $18400 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $18,400 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group | $18400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $9200 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $9,200 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group | $55200 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | $27600 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $27,600 |
| Unique Plan Design | No |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | Yes |
Copay & Coinsurance of BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, 37160ND2410021
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about BlueEssential Catastrophic 100 $9200 Deductible, 37160ND2410021 Health Insurance Plan, 37160ND2410021
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Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, 37160ND2410021 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (37160ND2410021) Health Insurance Plan, Variant (37160ND2410021-00) 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, Weight Loss Programs
Does (37160ND2410021) Health Insurance Plan, Variant (37160ND2410021-00) have Out Of Country Coverage?
Yes. Details: Medical assistance for Emergency Services (including locating a doctor or hospital) outside the BlueCard service area, the Member should call the BlueCard Worldwide Service Center at 1-800-810-BLUE (2583) or call collect at 1-804-673-1177, 24 hours a day, seven days a week. An assistance coordinator, working with a medical professional, can arrange a physician appointment or hospitalization, if necessary.
Does (37160ND2410021) Health Insurance Plan, Variant (37160ND2410021-00) have Out of Service Area Coverage?
Yes. Details: Whenever a member obtains healthcare services outside of the service area, claims will be processed at the in-network level if visiting providers participating with the BlueCard PPO Network.
Does (37160ND2410021) Health Insurance Plan, Variant (37160ND2410021-00) 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, Weight Loss Programs
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Asthma?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Asthma.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Heart disease?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Heart disease.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Depression?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Depression.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Diabetes?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Diabetes.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for High blood pressure & high cholesterol.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Low back pain?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Low back pain.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Pregnancy?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Pregnancy.
Does BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan, Variant (37160ND2410021-00) offer Disease Management Programs for Weight loss programs?
Yes, the BlueEssential Catastrophic 100 $9200 Deductible Health Insurance Plan Variant
37160ND2410021-00 offers Disease
Management Program for Weight loss programs.
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