DentaQuest EPO Family Basic - 68711PA0030010 Health Insurance Plan
68711 health insurance plan with the Plan ID 68711PA0030010. The plan is called DentaQuest EPO Family Basic.
| Health Insurance Plan ID | 68711PA0030010 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Pennsylvania | ||||||||||||||||||
| Health Insurance Issuer | 68711 | ||||||||||||||||||
| Health Insurance Plan Variant | 68711PA0030010-01 | ||||||||||||||||||
| Provider Network(s) | ['PAN002'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT). |
|
||||||||||||||||||
| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Mon, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
DentaQuest EPO Family Basic Health Insurance Plan Variant 68711PA0030010-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2023 |
| 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 | 100% |
| First Tier Utilization | 100% |
| HIOS Product ID | 68711PA003 |
| Import Date | 1/23/2023 |
| Guaranteed Rate | Guaranteed Rate |
| IsItANewPlan | New |
| Issuer ID | 68711 |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family | per person not applicable | per group 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 person not applicable | per group not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Medical EHB Deductible, In Network (Tier 1), Family | $50 per person | $150 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $50 |
| Medical EHB Deductible, Out of Network, Family | per person not applicable | per group not applicable |
| Medical EHB Deductible, Out of Network, Individual | Not Applicable |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family | $350 per person | $700 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $350 |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family | per person not applicable | per group 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 | PAN002 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Emergency Only. In excess of 50 miles from nearest provider. |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 68711PA0030010-01 |
| Plan Marketing Name | DentaQuest EPO Family Basic |
| Plan Type | EPO |
| Plan Variant Marketing Name | DentaQuest EPO Family Basic |
| QHP/Non QHP | Both |
| Service Area ID | PAS001 |
| Source Name | SERFF |
| Plan ID | 68711PA0030010 |
| State Code | PA |
| Version Number | 1 |
| Wellness Program Offered | No |
Copay & Coinsurance of DentaQuest EPO Family Basic Health Insurance Plan, 68711PA0030010
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about DentaQuest EPO Family Basic, 68711PA0030010 Health Insurance Plan, 68711PA0030010
-
Does DentaQuest EPO Family Basic Health Insurance Plan, 68711PA0030010 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (68711PA0030010) Health Insurance Plan, Variant (68711PA0030010-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (68711PA0030010) Health Insurance Plan, Variant (68711PA0030010-01) have Out of Service Area Coverage?
Yes. Details: Emergency Only. In excess of 50 miles from nearest provider.
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