Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) - 89217NJ0130003 Health Insurance Plan
Aetna Life Insurance Company health insurance plan with the Plan ID 89217NJ0130003. The plan is called Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care).
Based on the data of Health Plan Issuer, this plan has an actuarial value of 80.51% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 19.49% of the costs of all covered benefits (according to the Issuer).
| Health Insurance Plan ID | 89217NJ0130003 | ||||||||||||||||||
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| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | New Jersey | ||||||||||||||||||
| Health Insurance Issuer | Aetna Life Insurance Company | ||||||||||||||||||
| Health Insurance Plan Variant | 89217NJ0130003-01 | ||||||||||||||||||
| Provider Network(s) | ['NJN001'] | ||||||||||||||||||
| 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 - 89217NJ0130003-01 |
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| Last Plan Update Date | Mon, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant 89217NJ0130003-01 Attributes
| Plan Attribute | Value |
|---|---|
| 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 | Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Low Back Pain, High Blood Pressure & High Cholesterol |
| EHB Percent of Total Premium | 100% |
| First Tier Utilization | 100% |
| Formulary ID | NJF003 |
| HIOS Product ID | 89217NJ013 |
| Import Date | 1/23/2023 |
| HSA Eligible | No |
| IsItANewPlan | New |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer Actuarial Value | 80.51% |
| Issuer ID | 89217 |
| 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 | NJN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | For emergencies and in-network. Aetna Whole Health providers in all 21 NJ counties. |
| Plan Effective Date | 1/1/2023 |
| Plan ID (Standard Component ID with Variant) | 89217NJ0130003-01 |
| Plan Marketing Name | Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) |
| Plan Type | EPO |
| Plan Variant Marketing Name | Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $1,700 |
| SBC Scenario, Having a Baby, Copayment | $200 |
| SBC Scenario, Having a Baby, Deductible | $1,500 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $1,000 |
| SBC Scenario, Having Diabetes, Deductible | $1,500 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $200 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $100 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $1,500 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | NJS001 |
| Source Name | SERFF |
| Plan ID | 89217NJ0130003 |
| State Code | NJ |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | Not Applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family | per person not applicable | per group not applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| 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 | $1500 per person | $3000 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $1,500 |
| 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 | $7000 per person | $14000 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $7,000 |
| 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 | Yes |
| Version Number | 1 |
| Wellness Program Offered | Yes |
Copay & Coinsurance of Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, 89217NJ0130003
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care), 89217NJ0130003 Health Insurance Plan, 89217NJ0130003
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Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, 89217NJ0130003 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (89217NJ0130003) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Low Back Pain, High Blood Pressure & High Cholesterol
Does (89217NJ0130003) Health Insurance Plan, Variant (89217NJ0130003-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (89217NJ0130003) Health Insurance Plan, Variant (89217NJ0130003-01) have Out of Service Area Coverage?
Yes. Details: For emergencies and in-network. Aetna Whole Health providers in all 21 NJ counties.
Does (89217NJ0130003) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Low Back Pain, High Blood Pressure & High Cholesterol
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for Asthma?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for Asthma.
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for Heart disease?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for Heart disease.
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for Depression?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for Depression.
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for Diabetes?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for Diabetes.
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for High blood pressure & high cholesterol.
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for Low back pain?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for Low back pain.
Does Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan, Variant (89217NJ0130003-01) offer Disease Management Programs for Pregnancy?
Yes, the Gold: Aetna Whole Health network ($0 MinuteClinic + $0 CVS Health Virtual Care) Health Insurance Plan Variant
89217NJ0130003-01 offers Disease
Management Program for Pregnancy.
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