Dental Plan 5 (Voluntary) - Alliance - 80627OH0150050 Health Insurance Plan
Medical Mutual of Ohio health insurance plan with the Plan ID 80627OH0150050. The plan is called Dental Plan 5 (Voluntary) - Alliance.
| Health Insurance Plan ID | 80627OH0150050 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2022 | ||||||||||||||||||
| State | Ohio | ||||||||||||||||||
| Health Insurance Issuer | Medical Mutual of Ohio | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 80627OH0150050-00 | ||||||||||||||||||
| Provider Network(s) | ['OHN001'] | ||||||||||||||||||
| 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, 16 Aug 2021 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
Dental Plan 5 (Voluntary) - Alliance Health Insurance Plan Variant 80627OH0150050-00 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 | 2022 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard High Off Exchange Plan |
| Dental Only Plan | Yes |
| First Tier Utilization | 100% |
| HIOS Product ID | 80627OH015 |
| Import Date | 8/16/2021 20:01 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Estimated Rate |
| New/Existing Plan | Existing |
| Issuer ID | 80627 |
| Issuer Marketplace Marketing Name | MedMutual |
| Market Coverage | SHOP (Small Group) |
| 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 | $0 per person |
| Medical EHB Deductible, In Network (Tier 1), Individual | $0 |
| Medical EHB Deductible, Out of Network, Family Per Group | per group not applicable |
| Medical EHB Deductible, Out of Network, Family Per Person | $100 per person |
| Medical EHB Deductible, Out of Network, Individual | $100 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | $0 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $0 per person |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $0 |
| 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 | High |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | OHN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergency Only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Covered as Non-Network |
| Plan Effective Date | 1/1/2022 |
| Plan ID (Standard Component ID with Variant) | 80627OH0150050-00 |
| Plan Marketing Name | Dental Plan 5 (Voluntary) - Alliance |
| Plan Type | Indemnity |
| Plan Variant Marketing Name | Dental Plan 5 (Voluntary) - Alliance |
| QHP/Non QHP | Off the Exchange |
| Service Area ID | OHS001 |
| Source Name | SERFF |
| Plan ID | 80627OH0150050 |
| State Code | OH |
Copay & Coinsurance of Dental Plan 5 (Voluntary) - Alliance Health Insurance Plan, 80627OH0150050
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Dental Plan 5 (Voluntary) - Alliance, 80627OH0150050 Health Insurance Plan, 80627OH0150050
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Does Dental Plan 5 (Voluntary) - Alliance Health Insurance Plan, 80627OH0150050 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (80627OH0150050) Health Insurance Plan, Variant (80627OH0150050-00) have Out Of Country Coverage?
Yes. Details: Emergency Only
Does (80627OH0150050) Health Insurance Plan, Variant (80627OH0150050-00) have Out of Service Area Coverage?
Yes. Details: Covered as Non-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