Constant Care Silver 4 - 79975MS0010004 Health Insurance Plan

Molina Healthcare of Mississippi, Inc health insurance plan with the Plan ID 79975MS0010004. The plan is called Constant Care Silver 4.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 69.38% (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 30.62% 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 79975MS0010004
Health Insurance Plan Year 2022
State Mississippi
Health Insurance Issuer Molina Healthcare of Mississippi, Inc
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 79975MS0010004-00
Provider Network(s) ['MSN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 02 Jul 2024 06:38 GMT).

Providers Mississippi 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
Available Variants of the Health Plan

Standard Off Exchange Plan - 79975MS0010004-00

Standard On Exchange Plan - 79975MS0010004-01

Open to Indians below 300% FPL - 79975MS0010004-02

Open to Indians above 300% FPL - 79975MS0010004-03

73% AV Silver Plan - 79975MS0010004-04

87% AV Silver Plan - 79975MS0010004-05

94% AV Silver Plan - 79975MS0010004-06

Last Plan Update Date Fri, 03 Dec 2021 00:00 GMT
Last Import Date Tue, 02 Jul 2024 06:38 GMT

Constant Care Silver 4 Health Insurance Plan Variant 79975MS0010004-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.693768111
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Silver Off Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol
EHB Percent of Total Premium 1
First Tier Utilization 100%
Formulary ID MSF004
Formulary URL URL
HIOS Product ID 79975MS001
Import Date 12/3/2021 1:01
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
Inpatient Copayment Maximum Days 2
HSA Eligible No
New/Existing Plan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer ID 79975
Issuer Marketplace Marketing Name Molina Healthcare
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID MSN001
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 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 79975MS0010004-00
Plan Marketing Name Constant Care Silver 4
Plan Type HMO
Plan Variant Marketing Name Constant Care Silver 4
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $1,700
SBC Scenario, Having a Baby, Deductible $1,500
SBC Scenario, Having a Baby, Limit $0
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $700
SBC Scenario, Having Diabetes, Deductible $900
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $200
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,100
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MSS001
Source Name HIOS
Plan ID 79975MS0010004
State Code MS
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $14900 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $7450 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $7,450
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group $14900 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person $7450 per person
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $7,450
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 $14900 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $7450 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $7,450
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person per person not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $14900 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $7450 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $7,450
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered Yes

Copay & Coinsurance of Constant Care Silver 4 Health Insurance Plan, 79975MS0010004

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

Frequently Asked Questions(FAQ) about Constant Care Silver 4, 79975MS0010004 Health Insurance Plan, 79975MS0010004

  • Does Constant Care Silver 4 Health Insurance Plan, 79975MS0010004 support Mail Ordering?

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

  • Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol

    Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-00) have Out Of Country Coverage?

    Yes. Details: Emergent Only

    Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-00) have Out of Service Area Coverage?

    Yes. Details: Emergent Only

    Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-00) 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 4 Health Insurance Plan, Variant (79975MS0010004-00) offer Disease Management Programs for Asthma?

    Yes, the Constant Care Silver 4 Health Insurance Plan Variant 79975MS0010004-00 offers Disease Management Program for Asthma.

    Does Constant Care Silver 4 Health Insurance Plan, Variant (79975MS0010004-00) offer Disease Management Programs for Heart disease?

    Yes, the Constant Care Silver 4 Health Insurance Plan Variant 79975MS0010004-00 offers Disease Management Program for Heart disease.

    Does Constant Care Silver 4 Health Insurance Plan, Variant (79975MS0010004-00) offer Disease Management Programs for Depression?

    Yes, the Constant Care Silver 4 Health Insurance Plan Variant 79975MS0010004-00 offers Disease Management Program for Depression.

    Does Constant Care Silver 4 Health Insurance Plan, Variant (79975MS0010004-00) offer Disease Management Programs for Diabetes?

    Yes, the Constant Care Silver 4 Health Insurance Plan Variant 79975MS0010004-00 offers Disease Management Program for Diabetes.

    Does Constant Care Silver 4 Health Insurance Plan, Variant (79975MS0010004-00) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Constant Care Silver 4 Health Insurance Plan Variant 79975MS0010004-00 offers Disease Management Program for High blood pressure & high cholesterol.

 

Disclaimer: This is based on the import(Date: Tue, 02 Jul 2024 06:38 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