Bronze 60 EPO - 10544CA0350011 Health Insurance Plan
Oscar Health Plan of California health insurance plan with the Plan ID 10544CA0350011. The plan is called Bronze 60 EPO.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 100.00% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 0.00% of the costs of all covered benefits (according to the Issuer).
| Health Insurance Plan ID | 10544CA0350011 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | California | ||||||||||||||||||
| Health Insurance Issuer | Oscar Health Plan of California | ||||||||||||||||||
| Health Insurance Plan Variant | 10544CA0350011-02 | ||||||||||||||||||
| Provider Network(s) | ['CAN003'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 14 May 2024 06:16 GMT). |
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| Available Variants of the Health Plan | Standard On Exchange Plan - 10544CA0350011-01 |
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| Last Plan Update Date | Mon, 17 Apr 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 14 May 2024 06:16 GMT |
$0 Cost Share EPO AI-AN Health Insurance Plan Variant 10544CA0350011-02 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Zero Cost Sharing Plan Variation |
| Drug EHB Deductible, Combined In/Out of Network, Family | per person not applicable | per group not applicable |
| Drug EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 0.00% |
| Drug EHB Deductible, In Network (Tier 1), Family | $0 per person | $0 per group |
| Drug EHB Deductible, In Network (Tier 1), Individual | $0 |
| Drug EHB Deductible, Out of Network, Family | per person not applicable | per group not applicable |
| Drug EHB Deductible, Out of Network, Individual | Not Applicable |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Weight Loss Programs, Low Back Pain, High Blood Pressure & High Cholesterol |
| EHB Percent of Total Premium | 100% |
| First Tier Utilization | 100% |
| Formulary ID | CAF001 |
| HIOS Product ID | 10544CA035 |
| Import Date | 4/17/2023 |
| HSA Eligible | No |
| IsItANewPlan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer Actuarial Value | 100.00% |
| Issuer ID | 10544 |
| 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 person not applicable | per group not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Medical EHB Deductible, In Network (Tier 1), Default Coinsurance | 0.00% |
| Medical EHB Deductible, In Network (Tier 1), Family | $0 per person | $0 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $0 |
| Medical EHB Deductible, Out of Network, Family | per person not applicable | per group 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 | CAN003 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | No |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 10544CA0350011-02 |
| Plan Marketing Name | Bronze 60 EPO |
| Plan Type | EPO |
| Plan Variant Marketing Name | $0 Cost Share EPO AI-AN |
| QHP/Non QHP | On the Exchange |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $0 |
| SBC Scenario, Having a Baby, Limit | $0 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $0 |
| SBC Scenario, Having Diabetes, Deductible | $0 |
| SBC Scenario, Having Diabetes, Limit | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | CAS003 |
| Source Name | SERFF |
| Plan ID | 10544CA0350011 |
| State Code | CA |
| 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 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family | $0 per person | $0 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $0 |
| 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 | No |
Copay & Coinsurance of Bronze 60 EPO Health Insurance Plan, 10544CA0350011
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Bronze 60 EPO, 10544CA0350011 Health Insurance Plan, 10544CA0350011
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Does Bronze 60 EPO Health Insurance Plan, 10544CA0350011 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (10544CA0350011) Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Weight Loss Programs, Low Back Pain, High Blood Pressure & High Cholesterol
Does (10544CA0350011) Health Insurance Plan, Variant (10544CA0350011-02) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (10544CA0350011) Health Insurance Plan, Variant (10544CA0350011-02) 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 (10544CA0350011) Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Weight Loss Programs, Low Back Pain, High Blood Pressure & High Cholesterol
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Asthma?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Asthma.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Heart disease?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Heart disease.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Depression?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Depression.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Diabetes?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Diabetes.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for High blood pressure & high cholesterol.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Low back pain?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Low back pain.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Pregnancy?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Pregnancy.
Does $0 Cost Share EPO AI-AN Health Insurance Plan, Variant (10544CA0350011-02) offer Disease Management Programs for Weight loss programs?
Yes, the $0 Cost Share EPO AI-AN Health Insurance Plan Variant
10544CA0350011-02 offers Disease
Management Program for Weight loss programs.
Disclaimer: This is based on the import(Date: Tue, 14 May 2024 06:16 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