Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19 - 10345NY0010001 Health Insurance Plan
10345 health insurance plan with the Plan ID 10345NY0010001. The plan is called Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19.
| Health Insurance Plan ID | 10345NY0010001 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | New York | ||||||||||||||||||
| Health Insurance Issuer | 10345 | ||||||||||||||||||
| Health Insurance Plan Variant | 10345NY0010001-01 | ||||||||||||||||||
| Provider Network(s) | ['NYN001'] | ||||||||||||||||||
| 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, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19 Health Insurance Plan Variant 10345NY0010001-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2023 |
| Child-Only Offering | Allows Child-Only |
| Composite Rating Offered | No |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 100% |
| First Tier Utilization | 100% |
| HIOS Product ID | 10345NY001 |
| Import Date | 1/23/2023 |
| Guaranteed Rate | Guaranteed Rate |
| IsItANewPlan | Existing |
| Issuer ID | 10345 |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | Not Applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family | $65 per person | $195 per group |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $65 |
| Medical EHB Deductible, In Network (Tier 1), Family | $65 per person | $195 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $65 |
| Medical EHB Deductible, Out of Network, Family | $65 per person | $195 per group |
| Medical EHB Deductible, Out of Network, Individual | $65 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family | $375 per person | $750 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $375 |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family | per person not applicable | per group 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 | NYN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Nationwide Network |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 10345NY0010001-01 |
| Plan Marketing Name | Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19 |
| Plan Type | PPO |
| Plan Variant Marketing Name | Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19 |
| QHP/Non QHP | Both |
| Service Area ID | NYS001 |
| Source Name | SERFF |
| Plan ID | 10345NY0010001 |
| State Code | NY |
| Version Number | 1 |
| Wellness Program Offered | No |
Copay & Coinsurance of Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19 Health Insurance Plan, 10345NY0010001
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19, 10345NY0010001 Health Insurance Plan, 10345NY0010001
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Does Delta Dental PPO Pediatric Basic Plan ST OON Pediatric Dental Dep 19 Health Insurance Plan, 10345NY0010001 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (10345NY0010001) Health Insurance Plan, Variant (10345NY0010001-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (10345NY0010001) Health Insurance Plan, Variant (10345NY0010001-01) have Out of Service Area Coverage?
Yes. Details: Nationwide Network
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