Delta Dental Premier Plan - 21989AK0030001 Health Insurance Plan

Oregon Dental Service health insurance plan with the Plan ID 21989AK0030001. The plan is called Delta Dental Premier Plan.

Health Insurance Plan ID 21989AK0030001
Health Insurance Plan Year 2022
State Alaska
Health Insurance Issuer Oregon Dental Service
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 21989AK0030001-01
Provider Network(s) ['AKN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 22 Oct 2024 06:47 GMT).

Providers Alaska 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 - 21989AK0030001-00

Standard On Exchange Plan - 21989AK0030001-01

Last Plan Update Date Thu, 19 Aug 2021 00:00 GMT
Last Import Date Tue, 22 Oct 2024 06:47 GMT

Delta Dental Premier Plan Health Insurance Plan Variant 21989AK0030001-01 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 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low On Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1
First Tier Utilization 100%
HIOS Product ID 21989AK003
Import Date 8/19/2021 15:35
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 21989
Issuer Marketplace Marketing Name Delta Dental of Alaska
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 $0 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $0 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $0
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 AKN001
Out of Country Coverage Yes
Out of Country Coverage Description providers treated as out of network
Out of Service Area Coverage Yes
Out of Service Area Coverage Description national network
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 21989AK0030001-01
Plan Marketing Name Delta Dental Premier Plan
Plan Type Indemnity
Plan Variant Marketing Name Delta Dental Premier Plan
QHP/Non QHP Both
Service Area ID AKS001
Source Name HIOS
Plan ID 21989AK0030001
State Code AK

Copay & Coinsurance of Delta Dental Premier Plan Health Insurance Plan, 21989AK0030001

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

Frequently Asked Questions(FAQ) about Delta Dental Premier Plan, 21989AK0030001 Health Insurance Plan, 21989AK0030001

  • Does Delta Dental Premier Plan Health Insurance Plan, 21989AK0030001 support Mail Ordering?

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

  • Does (21989AK0030001) Health Insurance Plan, Variant (21989AK0030001-01) have Out Of Country Coverage?

    Yes. Details: providers treated as out of network

    Does (21989AK0030001) Health Insurance Plan, Variant (21989AK0030001-01) have Out of Service Area Coverage?

    Yes. Details: national network

 

Disclaimer: This is based on the import(Date: Tue, 22 Oct 2024 06:47 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