Connect Catastrophic - 32225MT0090006 Health Insurance Plan
Montana Health Cooperative health insurance plan with the Plan ID 32225MT0090006. The plan is called Connect Catastrophic.
| Health Insurance Plan ID | 32225MT0090006 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2025 | ||||||||||||||||||
| State | Montana | ||||||||||||||||||
| Health Insurance Issuer | Montana Health Cooperative | ||||||||||||||||||
| Plan Formulary Description URL | Formulary URL | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 32225MT0090006-00 | ||||||||||||||||||
| Provider Network(s) | PREFERRED | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Jun 2025 12:51 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Wed, 30 Oct 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 17 Jun 2025 12:51 GMT |
Connect Catastrophic Health Insurance Plan Variant 32225MT0090006-00 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, Diabetes |
| EHB Percent of Total Premium | 1.0 |
| First Tier Utilization | 100% |
| Formulary ID | MTF005 |
| Formulary URL | URL |
| HIOS Product ID | 32225MT009 |
| Import Date | 2024-10-30 20:01:46 |
| 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 | 32225 |
| Issuer Marketplace Marketing Name | Mountain Health CO-OP |
| 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 | No |
| Network ID | MTN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergent Only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Emergent Only |
| Plan Brochure | URL |
| Plan Effective Date | 2025-01-01 |
| Plan Expiration Date | 2025-12-31 |
| Plan ID (Standard Component ID with Variant) | 32225MT0090006-00 |
| Plan Level Exclusions | See Policy |
| Plan Marketing Name | Connect Catastrophic |
| Plan Type | PPO |
| Plan Variant Marketing Name | Connect Catastrophic |
| 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 | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $20 |
| SBC Scenario, Having Diabetes, Copayment | $0 |
| SBC Scenario, Having Diabetes, Deductible | $5,200 |
| SBC Scenario, Having Diabetes, Limit | $2,800 |
| 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 | MTS001 |
| Source Name | SERFF |
| Plan ID | 32225MT0090006 |
| State Code | MT |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $73000 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $36500 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $36,500 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $73000 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $36500 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $36,500 |
| 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 | $54600 per group |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | $27300 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $27,300 |
| 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 | $54600 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | $27300 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $27,300 |
| Unique Plan Design | No |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | Yes |
Copay & Coinsurance of Connect Catastrophic Health Insurance Plan, 32225MT0090006
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Connect Catastrophic, 32225MT0090006 Health Insurance Plan, 32225MT0090006
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Does Connect Catastrophic Health Insurance Plan, 32225MT0090006 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (32225MT0090006) Health Insurance Plan, Variant (32225MT0090006-00) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Diabetes
Does (32225MT0090006) Health Insurance Plan, Variant (32225MT0090006-00) have Out Of Country Coverage?
Yes. Details: Emergent Only
Does (32225MT0090006) Health Insurance Plan, Variant (32225MT0090006-00) have Out of Service Area Coverage?
Yes. Details: Emergent Only
Does (32225MT0090006) Health Insurance Plan, Variant (32225MT0090006-00) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Diabetes
Does Connect Catastrophic Health Insurance Plan, Variant (32225MT0090006-00) offer Disease Management Programs for Asthma?
Yes, the Connect Catastrophic Health Insurance Plan Variant
32225MT0090006-00 offers Disease
Management Program for Asthma.
Does Connect Catastrophic Health Insurance Plan, Variant (32225MT0090006-00) offer Disease Management Programs for Diabetes?
Yes, the Connect Catastrophic Health Insurance Plan Variant
32225MT0090006-00 offers Disease
Management Program for Diabetes.
Disclaimer: This is based on the import(Date: Tue, 17 Jun 2025 12:51 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