Friday Gold Copay + Vision Exam - 82461NV0010009 Health Insurance Plan
Friday Health Plans of Nevada, Inc. health insurance plan with the Plan ID 82461NV0010009. The plan is called Friday Gold Copay + Vision Exam.
Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 78.35% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 21.65% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.
| Health Insurance Plan ID | 82461NV0010009 | ||||||||||||||||||
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| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Nevada | ||||||||||||||||||
| Health Insurance Issuer | Friday Health Plans of Nevada, Inc. | ||||||||||||||||||
| Health Insurance Plan Variant | 82461NV0010009-01 | ||||||||||||||||||
| Provider Network(s) | ['NVN001'] | ||||||||||||||||||
| 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 | Standard On Exchange Plan - 82461NV0010009-01 |
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| Last Plan Update Date | Mon, 17 Apr 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
FRIDAY Gold Copay + Vision Exam: Unlimited $0 Primary Care Visits, Up to $10 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam Health Insurance Plan Variant 82461NV0010009-01 Attributes
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.783544305 |
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Gold On Exchange Plan |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Diabetes |
| EHB Percent of Total Premium | 99.91% |
| First Tier Utilization | 100% |
| Formulary ID | NVF010 |
| HIOS Product ID | 82461NV001 |
| Import Date | 4/17/2023 |
| HSA Eligible | No |
| IsItANewPlan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer ID | 82461 |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Gold |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | NVN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Urgent and Emergent only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Urgent and Emergent only |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 82461NV0010009-01 |
| Plan Marketing Name | Friday Gold Copay + Vision Exam |
| Plan Type | EPO |
| Plan Variant Marketing Name | FRIDAY Gold Copay + Vision Exam: Unlimited $0 Primary Care Visits, Up to $10 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $2,000 |
| SBC Scenario, Having a Baby, Copayment | $200 |
| SBC Scenario, Having a Baby, Deductible | $2,300 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $1,200 |
| SBC Scenario, Having Diabetes, Deductible | $1,600 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $500 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,000 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | NVS001 |
| Source Name | SERFF |
| Plan ID | 82461NV0010009 |
| State Code | NV |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family | $8250 per person | $16500 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $8,250 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family | $2300 per person | $4600 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $2,300 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 20.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family | $2300 per person | $4600 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $2,300 |
| TEHBDedOutofNetFamily | per person not applicable | per group not applicable |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | Not Applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family | $8250 per person | $16500 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $8,250 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | Not Applicable |
| Unique Plan Design | No |
| Version Number | 1 |
| Wellness Program Offered | Yes |
Copay & Coinsurance of Friday Gold Copay + Vision Exam Health Insurance Plan, 82461NV0010009
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Friday Gold Copay + Vision Exam, 82461NV0010009 Health Insurance Plan, 82461NV0010009
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Does Friday Gold Copay + Vision Exam Health Insurance Plan, 82461NV0010009 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (82461NV0010009) Health Insurance Plan, Variant (82461NV0010009-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Diabetes
Does (82461NV0010009) Health Insurance Plan, Variant (82461NV0010009-01) have Out Of Country Coverage?
Yes. Details: Urgent and Emergent only
Does (82461NV0010009) Health Insurance Plan, Variant (82461NV0010009-01) have Out of Service Area Coverage?
Yes. Details: Urgent and Emergent only
Does (82461NV0010009) Health Insurance Plan, Variant (82461NV0010009-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Diabetes
Does FRIDAY Gold Copay + Vision Exam: Unlimited $0 Primary Care Visits, Up to $10 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam Health Insurance Plan, Variant (82461NV0010009-01) offer Disease Management Programs for Diabetes?
Yes, the FRIDAY Gold Copay + Vision Exam: Unlimited $0 Primary Care Visits, Up to $10 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam Health Insurance Plan Variant
82461NV0010009-01 offers Disease
Management Program for Diabetes.
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