EssentialSmile Tennessee - Total Care - 69443TN0190001 Health Insurance Plan

UnitedHealthcare Insurance Company health insurance plan with the Plan ID 69443TN0190001. The plan is called EssentialSmile Tennessee - Total Care.

Health Insurance Plan ID 69443TN0190001
Health Insurance Plan Year 2025
State Tennessee
Health Insurance Issuer UnitedHealthcare Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 69443TN0190001-01
Provider Network(s) ['TNN016']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 10 Jun 2025 06:07 GMT).

Providers Tennessee 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 On Exchange Plan - 69443TN0190001-01

Last Plan Update Date Sat, 17 Aug 2024 00:00 GMT
Last Import Date Tue, 10 Jun 2025 06:07 GMT

EssentialSmile Tennessee - Total Care Health Insurance Plan Variant 69443TN0190001-01 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 Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard High On Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1.0
First Tier Utilization 100%
HIOS Product ID 69443TN019
Import Date 2024-08-17 01:01:43
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan New
Issuer ID 69443
Issuer Marketplace Marketing Name UnitedHealthcare
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 $800 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $400 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $400
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 No
Network ID TNN016
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Only for palliative care where a network provider is not available.
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 69443TN0190001-01
Plan Marketing Name EssentialSmile Tennessee - Total Care
Plan Type EPO
Plan Variant Marketing Name EssentialSmile Tennessee - Total Care
QHP/Non QHP On the Exchange
Service Area ID TNS016
Source Name HIOS
Plan ID 69443TN0190001
State Code TN
URL for Enrollment Payment URL

Copay & Coinsurance of EssentialSmile Tennessee - Total Care Health Insurance Plan, 69443TN0190001

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

Frequently Asked Questions(FAQ) about EssentialSmile Tennessee - Total Care, 69443TN0190001 Health Insurance Plan, 69443TN0190001

  • Does EssentialSmile Tennessee - Total Care Health Insurance Plan, 69443TN0190001 support Mail Ordering?

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

  • Does (69443TN0190001) Health Insurance Plan, Variant (69443TN0190001-01) have Out Of Country Coverage?

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

    Does (69443TN0190001) Health Insurance Plan, Variant (69443TN0190001-01) have Out of Service Area Coverage?

    Yes. Details: Only for palliative care where a network provider is not available.

 

Disclaimer: This is based on the import(Date: Tue, 10 Jun 2025 06:07 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