Constant Care Silver 1 - 91278ID0010002 Health Insurance Plan
Molina Healthcare of Idaho, Inc. health insurance plan with the Plan ID 91278ID0010002. The plan is called Constant Care Silver 1.
Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 73.97% (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 26.03% 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 | 91278ID0010002 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Idaho | ||||||||||||||||||
| Health Insurance Issuer | Molina Healthcare of Idaho, Inc. | ||||||||||||||||||
| Health Insurance Plan Variant | 91278ID0010002-04 | ||||||||||||||||||
| Provider Network(s) | ['IDN001'] | ||||||||||||||||||
| 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 - 91278ID0010002-01 Open to Indians below 300% FPL - 91278ID0010002-02 Open to Indians above 300% FPL - 91278ID0010002-03 73% AV Silver Plan - 91278ID0010002-04 |
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| Last Plan Update Date | Mon, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 14 May 2024 06:16 GMT |
Constant Care Silver 1 200 Health Insurance Plan Variant 91278ID0010002-04 Attributes
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.739720947 |
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | 73% AV Level Silver Plan |
| 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 | 50.00% |
| Drug EHB Deductible, In Network (Tier 1), Family | $1750 per person | $3500 per group |
| Drug EHB Deductible, In Network (Tier 1), Individual | $1,750 |
| Drug EHB Deductible, Out of Network, Family | $14500 per person | $29000 per group |
| Drug EHB Deductible, Out of Network, Individual | $14,500 |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol |
| EHB Percent of Total Premium | 100% |
| First Tier Utilization | 100% |
| Formulary ID | IDF002 |
| HIOS Product ID | 91278ID001 |
| Import Date | 1/23/2023 |
| Inpatient Copayment Maximum Days | 2 |
| HSA Eligible | No |
| IsItANewPlan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer ID | 91278 |
| 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 | 50.00% |
| Medical EHB Deductible, In Network (Tier 1), Family | $1750 per person | $3500 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $1,750 |
| Medical EHB Deductible, Out of Network, Family | $14500 per person | $29000 per group |
| Medical EHB Deductible, Out of Network, Individual | $14,500 |
| Metal Level | Silver |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | IDN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Out-of-Network providers |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 91278ID0010002-04 |
| Plan Marketing Name | Constant Care Silver 1 |
| Plan Type | HMO |
| Plan Variant Marketing Name | Constant Care Silver 1 200 |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $2,100 |
| 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 | $1,400 |
| SBC Scenario, Having Diabetes, Deductible | $800 |
| SBC Scenario, Having Diabetes, Limit | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $900 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $1,200 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | IDS001 |
| Source Name | SERFF |
| Plan ID | 91278ID0010002 |
| State Code | ID |
| 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 | $7250 per person | $14500 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $7,250 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family | $72500 per person | $145000 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $72,500 |
| Unique Plan Design | No |
| Version Number | 1 |
| Wellness Program Offered | Yes |
Copay & Coinsurance of Constant Care Silver 1 Health Insurance Plan, 91278ID0010002
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Constant Care Silver 1, 91278ID0010002 Health Insurance Plan, 91278ID0010002
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Does Constant Care Silver 1 Health Insurance Plan, 91278ID0010002 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (91278ID0010002) Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol
Does (91278ID0010002) Health Insurance Plan, Variant (91278ID0010002-04) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (91278ID0010002) Health Insurance Plan, Variant (91278ID0010002-04) have Out of Service Area Coverage?
Yes. Details: Out-of-Network providers
Does (91278ID0010002) Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol
Does Constant Care Silver 1 200 Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs for Asthma?
Yes, the Constant Care Silver 1 200 Health Insurance Plan Variant
91278ID0010002-04 offers Disease
Management Program for Asthma.
Does Constant Care Silver 1 200 Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs for Heart disease?
Yes, the Constant Care Silver 1 200 Health Insurance Plan Variant
91278ID0010002-04 offers Disease
Management Program for Heart disease.
Does Constant Care Silver 1 200 Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs for Depression?
Yes, the Constant Care Silver 1 200 Health Insurance Plan Variant
91278ID0010002-04 offers Disease
Management Program for Depression.
Does Constant Care Silver 1 200 Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs for Diabetes?
Yes, the Constant Care Silver 1 200 Health Insurance Plan Variant
91278ID0010002-04 offers Disease
Management Program for Diabetes.
Does Constant Care Silver 1 200 Health Insurance Plan, Variant (91278ID0010002-04) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the Constant Care Silver 1 200 Health Insurance Plan Variant
91278ID0010002-04 offers Disease
Management Program for High blood pressure & high cholesterol.
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