CHRISTUS Silver - 98780LA0010003 Health Insurance Plan

CHRISTUS Health Plan Louisiana health insurance plan with the Plan ID 98780LA0010003. The plan is called CHRISTUS Silver.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 87.52% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 12.48% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Health Insurance Plan ID 98780LA0010003
Health Insurance Plan Year 2025
State Louisiana
Health Insurance Issuer CHRISTUS Health Plan Louisiana
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 98780LA0010003-05
Provider Network(s) PREFERRED NONPREFERRED
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 Louisiana All US States
All 3897 67730
PCP 766 3356
Allergy 1 6
OB/GYN 19 118
Dentists 1 12
Available Variants of the Health Plan

Standard Off Exchange Plan - 98780LA0010003-00

Standard On Exchange Plan - 98780LA0010003-01

Open to Indians below 300% FPL - 98780LA0010003-02

Open to Indians above 300% FPL - 98780LA0010003-03

73% AV Silver Plan - 98780LA0010003-04

87% AV Silver Plan - 98780LA0010003-05

94% AV Silver Plan - 98780LA0010003-06

Last Plan Update Date Tue, 24 Sep 2024 00:00 GMT
Last Import Date Tue, 13 May 2025 06:05 GMT

CHRISTUS Silver 87 ($0 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) Health Insurance Plan Variant 98780LA0010003-05 Attributes

Plan Attribute Value
AV Calculator Output Number 0.8751829108404631
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 87% AV Level Silver Plan
Drug EHB Deductible, Combined In/Out of Network, Family Per Group $500 per group
Drug EHB Deductible, Combined In/Out of Network, Family Per Person $250 per person
Drug EHB Deductible, Combined In/Out of Network, Individual $250
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Drug EHB Deductible, In Network (Tier 1), Family Per Group $500 per group
Drug EHB Deductible, In Network (Tier 1), Family Per Person $250 per person
Drug EHB Deductible, In Network (Tier 1), Individual $250
Drug EHB Deductible, Out of Network, Family Per Group $500 per group
Drug EHB Deductible, Out of Network, Family Per Person $250 per person
Drug EHB Deductible, Out of Network, Individual $250
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Diabetes
EHB Percent of Total Premium 1.0
First Tier Utilization 100%
Formulary ID LAF005
Formulary URL URL
HIOS Product ID 98780LA001
Import Date 2024-09-24 01:01:39
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 98780
Issuer Marketplace Marketing Name CHRISTUS Health Plan
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 $4200 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $2100 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $2,100
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance 40.00%
Medical EHB Deductible, In Network (Tier 1), Family Per Group $4200 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person $2100 per person
Medical EHB Deductible, In Network (Tier 1), Individual $2,100
Medical EHB Deductible, Out of Network, Family Per Group $4200 per group
Medical EHB Deductible, Out of Network, Family Per Person $2100 per person
Medical EHB Deductible, Out of Network, Individual $2,100
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID LAN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services Only
Out of Service Area Coverage No
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 98780LA0010003-05
Plan Marketing Name CHRISTUS Silver
Plan Type HMO
Plan Variant Marketing Name CHRISTUS Silver 87 ($0 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care)
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $200
SBC Scenario, Having a Baby, Copayment $300
SBC Scenario, Having a Baby, Deductible $2,100
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $500
SBC Scenario, Having Diabetes, Deductible $1,000
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $80
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,000
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID LAS001
Source Name HIOS
Plan ID 98780LA0010003
State Code LA
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $5300 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $2650 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $2,650
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $5300 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $2650 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $2,650
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group $5300 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person $2650 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $2,650
Unique Plan Design No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of CHRISTUS Silver Health Insurance Plan, 98780LA0010003

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

Frequently Asked Questions(FAQ) about CHRISTUS Silver, 98780LA0010003 Health Insurance Plan, 98780LA0010003

  • Does CHRISTUS Silver Health Insurance Plan, 98780LA0010003 support Mail Ordering?

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

  • Does (98780LA0010003) Health Insurance Plan, Variant (98780LA0010003-05) offer Disease Management Programs?

    Yes, and here is the list of available programs: Diabetes

    Does (98780LA0010003) Health Insurance Plan, Variant (98780LA0010003-05) have Out Of Country Coverage?

    Yes. Details: Emergency Services Only

    Does (98780LA0010003) Health Insurance Plan, Variant (98780LA0010003-05) 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 (98780LA0010003) Health Insurance Plan, Variant (98780LA0010003-05) offer Disease Management Programs?

    Yes, and here is the list of available programs: Diabetes

    Does CHRISTUS Silver 87 ($0 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) Health Insurance Plan, Variant (98780LA0010003-05) offer Disease Management Programs for Diabetes?

    Yes, the CHRISTUS Silver 87 ($0 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) Health Insurance Plan Variant 98780LA0010003-05 offers Disease Management Program for Diabetes.

 

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