Guardian Preventive Plus for Families and Individuals - 10204ID0100001 Health Insurance Plan

10204 health insurance plan with the Plan ID 10204ID0100001. The plan is called Guardian Preventive Plus for Families and Individuals.

Health Insurance Plan ID 10204ID0100001
Health Insurance Plan Year 2023
State Idaho
Health Insurance Issuer 10204
Health Insurance Plan Variant 10204ID0100001-01
Provider Network(s) ['IDN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT).

Providers Idaho 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 - 10204ID0100001-01

Last Plan Update Date Mon, 23 Jan 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

Guardian Preventive Plus for Families and Individuals Health Insurance Plan Variant 10204ID0100001-01 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 10204ID010
Import Date 1/23/2023
Guaranteed Rate Guaranteed Rate
IsItANewPlan New
Issuer ID 10204
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 | per group not applicable
Medical EHB Deductible, In Network (Tier 1), Individual $50
Medical EHB Deductible, Out of Network, Family $75 per person | per group not applicable
Medical EHB Deductible, Out of Network, Individual $75
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family $375 per person | $750 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $375
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 Yes
Network ID IDN001
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Coverage is provided outside of the Service Area.
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 10204ID0100001-01
Plan Marketing Name Guardian Preventive Plus for Families and Individuals
Plan Type PPO
Plan Variant Marketing Name Guardian Preventive Plus for Families and Individuals
QHP/Non QHP Both
Service Area ID IDS001
Source Name SERFF
Plan ID 10204ID0100001
State Code ID
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of Guardian Preventive Plus for Families and Individuals Health Insurance Plan, 10204ID0100001

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

Frequently Asked Questions(FAQ) about Guardian Preventive Plus for Families and Individuals, 10204ID0100001 Health Insurance Plan, 10204ID0100001

  • Does Guardian Preventive Plus for Families and Individuals Health Insurance Plan, 10204ID0100001 support Mail Ordering?

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

  • Does (10204ID0100001) Health Insurance Plan, Variant (10204ID0100001-01) have Out Of Country Coverage?

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

    Does (10204ID0100001) Health Insurance Plan, Variant (10204ID0100001-01) have Out of Service Area Coverage?

    Yes. Details: Coverage is provided outside of the Service Area.

 

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