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 | ||||||||||||||||||
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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). |
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Available Variants of the Health Plan | |||||||||||||||||||
Last Plan Update Date | Thu, 15 Aug 2024 00:00 GMT | ||||||||||||||||||
Last Import Date | Tue, 10 Dec 2024 06:32 GMT |
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 |
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 |
Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
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