DeltaCare USA Pediatric Basic Plan - 97725FL0030001 Health Insurance Plan

Delta Dental Insurance Company health insurance plan with the Plan ID 97725FL0030001. The plan is called DeltaCare USA Pediatric Basic Plan.

Health Insurance Plan ID 97725FL0030001
Health Insurance Plan Year 2025
State Florida
Health Insurance Issuer Delta Dental Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 97725FL0030001-00
Provider Network(s) ['FLN003']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 10 Dec 2024 06:32 GMT).

Providers Florida 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 - 97725FL0030001-00

Last Plan Update Date Thu, 15 Aug 2024 00:00 GMT
Last Import Date Tue, 10 Dec 2024 06:32 GMT

Benefits of DeltaCare USA Pediatric Basic Plan Health Insurance Plan, 97725FL0030001-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult
NO
Basic Dental Care - Child
YES

$50.00

100.00%
Dental Check-Up for Children
YES

$0.00

100.00%
Major Dental Care - Adult
NO
Major Dental Care - Child
YES

$390.00

100.00%
Orthodontia - Adult
NO
Orthodontia - Child
YES

$350.00

100.00%
Routine Dental Services (Adult)
NO

DeltaCare USA Pediatric Basic Plan Health Insurance Plan Variant 97725FL0030001-00 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 2025
Child-Only Offering Allows Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1.0
First Tier Utilization 100%
HIOS Product ID 97725FL003
Import Date 2024-08-15 01:01:23
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 97725
Issuer Marketplace Marketing Name Delta Dental
Market Coverage Individual
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
Medical EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
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 $850 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $425 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $425
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 No
Network ID FLN003
Out of Country Coverage No
Out of Service Area Coverage No
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 97725FL0030001-00
Plan Marketing Name DeltaCare USA Pediatric Basic Plan
Plan Type HMO
Plan Variant Marketing Name DeltaCare USA Pediatric Basic Plan
QHP/Non QHP Off the Exchange
Service Area ID FLS003
Source Name HIOS
Plan ID 97725FL0030001
State Code FL
URL for Enrollment Payment URL

Copay & Coinsurance of DeltaCare USA Pediatric Basic Plan Health Insurance Plan, 97725FL0030001

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

Frequently Asked Questions(FAQ) about DeltaCare USA Pediatric Basic Plan, 97725FL0030001 Health Insurance Plan, 97725FL0030001

  • Does DeltaCare USA Pediatric Basic Plan Health Insurance Plan, 97725FL0030001 support Mail Ordering?

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

  • Does (97725FL0030001) Health Insurance Plan, Variant (97725FL0030001-00) have Out Of Country Coverage?

    No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan).

    Does (97725FL0030001) Health Insurance Plan, Variant (97725FL0030001-00) have Out of Service Area Coverage?

    No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan).

 

Disclaimer: This is based on the import(Date: Tue, 10 Dec 2024 06:32 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