Cigna Dental Pediatric - 52129IL0030001 Health Insurance Plan
Cigna Health and Life Insurance Company health insurance plan with the Plan ID 52129IL0030001. The plan is called Cigna Dental Pediatric.
| Health Insurance Plan ID | 52129IL0030001 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Illinois | ||||||||||||||||||
| Health Insurance Issuer | Cigna Health and Life Insurance Company | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 52129IL0030001-00 | ||||||||||||||||||
| Provider Network(s) | ['ILN001'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Mon, 18 Jul 2022 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
Benefits of Cigna Dental Pediatric Health Insurance Plan, 52129IL0030001-00
| Benefit | Covered | In Network | Out Of Network |
|---|---|---|---|
| Accidental Dental
Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 0.00% |
0.00% |
| Basic Dental Care - Adult
|
NO | ||
| Basic Dental Care - Child
Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Dental Check-Up for Children
Limit: 1.0 Visit(s) per 6 Months Dental Check-up is limited to 1 per 6 consecutive month period and one every 12 months in a school setting. Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 0.00% |
0.00% |
| Major Dental Care - Adult
|
NO | ||
| Major Dental Care - Child
Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Orthodontia - Adult
|
NO | ||
| Orthodontia - Child
Medically necessary only. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Routine Dental Services (Adult)
|
NO |
Cigna Dental Pediatric Health Insurance Plan Variant 52129IL0030001-00 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 | 2023 |
| Child-Only Offering | Allows Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Low Off Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 1 |
| First Tier Utilization | 100% |
| HIOS Product ID | 52129IL003 |
| Import Date | 7/18/2022 20:00 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Estimated Rate |
| New/Existing Plan | Existing |
| Issuer ID | 52129 |
| Issuer Marketplace Marketing Name | Cigna Healthcare |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group | $750 per group |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person | $375 per person |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | $375 |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Group | $300 per group |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Person | $150 per person |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $150 |
| 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 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | per person not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | Not Applicable |
| 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 | Not Applicable |
| Metal Level | Low |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | ILN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergency Only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | All Services |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 52129IL0030001-00 |
| Plan Marketing Name | Cigna Dental Pediatric |
| Plan Type | PPO |
| Plan Variant Marketing Name | Cigna Dental Pediatric |
| QHP/Non QHP | Off the Exchange |
| Service Area ID | ILS001 |
| Source Name | SERFF |
| Plan ID | 52129IL0030001 |
| State Code | IL |
| URL for Enrollment Payment | URL |
Copay & Coinsurance of Cigna Dental Pediatric Health Insurance Plan, 52129IL0030001
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Cigna Dental Pediatric, 52129IL0030001 Health Insurance Plan, 52129IL0030001
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Does Cigna Dental Pediatric Health Insurance Plan, 52129IL0030001 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (52129IL0030001) Health Insurance Plan, Variant (52129IL0030001-00) have Out Of Country Coverage?
Does (52129IL0030001) Health Insurance Plan, Variant (52129IL0030001-00) have Out of Service Area Coverage?
Disclaimer: This is based on the import(Date: Tue, 07 May 2024 06:08 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