DeltaCare USA Basic Plan for Families · 14948UT0040003
DeltaCare USA offers this marketplace health insurance plan (Plan ID 14948UT0040003) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Metal level: LowPlan type: HMOCSR: Standard Low On Exchange PlanIssuer: DeltaCare USA
Telehealth
Data pending
HSA eligible
Check with issuer
Dental
Adult/Child
Vision
Not listed
Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Utah). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Low On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
Issuer did not share extra notes for this benefit beyond the summary above.
Basic Dental Care - Adult
$45.00
Tier 1 in-network$45.00
Out-of-network100.00%
Refer to plan summary for specific copay/cost-share information.
Dental Check-Up for Children
$10.00
Tier 1 in-network$10.00
Out-of-network100.00%
Limit: 2.0 Procedure(s) per Benefit Period
Routine cleaning, exams, x-rays, palliative, and fluoride. Sealants once every five years.\nRefer to plan summary for specific copay/cost-share information.
Major Dental Care - Adult
$400.00
Tier 1 in-network$400.00
Out-of-network100.00%
Refer to plan summary for specific copay/cost-share information.
Orthodontia - Adult
$3,250.00
Tier 1 in-network$3,250.00
Out-of-network100.00%
Refer to plan summary for specific copay/cost-share information.
Orthodontia - Child
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Routine Dental Services (Adult)
$10.00
Tier 1 in-network$10.00
Out-of-network100.00%
Refer to plan summary for specific copay/cost-share information.
Additional benefits
Other plan-specific services and limitations.
Palliative - Child
$30.00
Tier 1 in-network$30.00
Out-of-network100.00%
Variant attributes
DeltaCare USA Basic Plan for Families · Variant 14948UT0040003-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2026
CSR Variation Type
Standard Low On Exchange Plan
HIOS Product ID
14948UT004
Metal Level
Low
Plan ID (Standard Component ID with Variant)
14948UT0040003-01
Plan Marketing Name
DeltaCare USA Basic Plan for Families
Plan Variant Marketing Name
DeltaCare USA Basic Plan for Families
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
14948
Issuer Marketplace Marketing Name
DeltaCare USA
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
No
Network ID
UTN001
Out of Country Coverage
No
Out of Service Area Coverage
No
Service Area ID
UTS001
State Code
UT
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$900 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$450 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$450
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
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
