Dominion National offers this marketplace health insurance plan (Plan ID 66759NC0010001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in North Carolina). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Low Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
All providers in North CarolinaN/A
PCPs in North CarolinaN/A
Telehealth supportData pending
Nationwide providersN/A
N/A doctors statewideN/A PCPsN/A OB/GYN
Provider network(s)
['NCN001']
Providers
North Carolina
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
Drug coverage overview
0 drugs tracked
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Prior authorization
Drugs
Required
0
Not Required
0
Step therapy
Drugs
Required
0
Not Required
0
Quantity limits
Drugs
Has Limit
0
No Limit
0
Customer highlights
What stands out for members
Issuer: Dominion National · Plan ID 66759NC0010001 · 2025 filing.
Tier 1 in-network85.00% Coinsurance after deductible
Out-of-network90.00% Coinsurance after deductible
nan
Exclusions: nan
Basic Dental Care - Adult
50.00% Coinsurance after deductible
Tier 1 in-network50.00% Coinsurance after deductible
Out-of-network70.00% Coinsurance after deductible
Subject to deductible of $50/individual and $150/three or more adults. Annual maximum of $1,000 (Choice PPO Basic) and $1,500 (Choice PPO Premium). Benefit limitations may apply to individual services. Waiting Periods Apply to Basic Services of 6 months and Major services of 12 months (Choice PPO Premium)
Exclusions: nan
Dental Check-Up for Children
0.00%
Tier 1 in-network0.00%
Out-of-network20.00%
Limit: 2.0 Visit(s) per Benefit Period
nan
Exclusions: nan
Major Dental Care - Adult
85.00% Coinsurance after deductible
Tier 1 in-network85.00% Coinsurance after deductible
Out-of-network90.00% Coinsurance after deductible
Subject to deductible of $50/individual and $150/three or more adults. Annual maximum of $1,000 (Choice PPO Basic) and $1,500 (Choice PPO Premium). Benefit limitations may apply to individual services. Waiting Periods Apply to Basic Services of 6 months and Major services of 12 months (Choice PPO Premium)
Exclusions: nan
Orthodontia - Adult
Coverage details pending
nan
Exclusions: nan
Orthodontia - Child
50.00%
Tier 1 in-network50.00%
Out-of-network70.00%
nan
Exclusions: nan
Routine Dental Services (Adult)
0.00% Coinsurance after deductible
Tier 1 in-network0.00% Coinsurance after deductible
Out-of-network10.00% Coinsurance after deductible
Subject to deductible of $50/individual and $150/three or more adults. Annual maximum of $1,000 (Choice PPO Basic) and $1,500 (Choice PPO Premium). Benefit limitations may apply to individual services. Waiting Periods Apply to Basic Services of 6 months and Major services of 12 months (Choice PPO Premium)
Exclusions: nan
Variant attributes
Choice PPO Basic · Variant 66759NC0010001-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard Low Off Exchange Plan
HIOS Product ID
66759NC001
Metal Level
Low
Plan ID (Standard Component ID with Variant)
66759NC0010001-00
Plan Marketing Name
Choice PPO Basic
Plan Variant Marketing Name
Choice PPO Basic
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
66759
Issuer Marketplace Marketing Name
Dominion National
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
Yes
Network ID
NCN001
Out of Country Coverage
Yes
Out of Country Coverage Description
Standard Out of Network PPO Benefits
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
Standard Out of Network PPO Benefits
Service Area ID
NCS001
State Code
NC
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$850 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$425 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$425
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual
Begin Primary Care Cost-Sharing After Number Of Visits
0
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
Yes
EHB Apportionment for Pediatric Dental
1.0
First Tier Utilization
100%
Import Date
2025-01-15 00:01:52
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
Existing
Medical EHB Deductible, Combined In/Out of Network, Family Per Group
$200 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person
$100 per person
Medical EHB Deductible, Combined In/Out of Network, Individual
$100
Medical EHB Deductible, In Network (Tier 1), Family Per Group
per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person
per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual
Not Applicable
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
Plan Effective Date
2025-01-01
Plan Expiration Date
2025-12-31
Plan Level Exclusions
Out of Pocket Maximum applies to children only. Adults have separate deductible and plan payment maximum, refer to plan document for details.
Plan Type
PPO
QHP/Non QHP
Both
Source Name
HIOS
Plan ID
66759NC0010001
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in North Carolina?
Choice PPO Basic (66759NC0010001) is a Low PPO from Dominion National in North Carolina for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Choice PPO Basic support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Choice PPO Basic HSA-eligible and does it include dental or vision coverage?
HSA eligibility is not published; check the Summary of Benefits or ask the issuer.
Dental add-ons: Adult, Child.
Vision coverage is not listed for this plan.
Does Choice PPO Basic support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Is there out-of-country coverage for Choice PPO Basic?
Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Standard Out of Network PPO Benefits
Does Choice PPO Basic cover care outside the service area?
Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Standard Out of Network PPO Benefits
How do I enroll in or manage payments for Choice PPO Basic?
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
