HMSA Catastrophic Plan - 18350HI0880003 Health Insurance Plan
Hawaii Medical Service Association health insurance plan with the Plan ID 18350HI0880003. The plan is called HMSA Catastrophic Plan.
| Health Insurance Plan ID | 18350HI0880003 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2022 | ||||||||||||||||||
| State | Hawaii | ||||||||||||||||||
| Health Insurance Issuer | Hawaii Medical Service Association | ||||||||||||||||||
| Plan Formulary Description URL | Formulary URL | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 18350HI0880003-00 | ||||||||||||||||||
| Provider Network(s) | ['HIN001'] | ||||||||||||||||||
| 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 | |||||||||||||||||||
| Last Plan Update Date | Tue, 07 Dec 2021 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
HMSA Catastrophic Plan Health Insurance Plan Variant 18350HI0880003-00 Attributes
| Plan Attribute | Value |
|---|---|
| Begin Primary Care Cost-Sharing After Number Of Visits | 0 |
| Begin Primary Care Deductible Coinsurance After Number Of Copays | 3 |
| Business Year | 2022 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Catastrophic Off Exchange Plan |
| Dental Only Plan | No |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy |
| EHB Percent of Total Premium | 0.9789 |
| First Tier Utilization | 100% |
| Formulary ID | HIF001 |
| Formulary URL | URL |
| HIOS Product ID | 18350HI088 |
| Import Date | 12/7/2021 20:01 |
| Limited Cost Sharing Plan Variation - Estimated Advanced Payment | $0.00 |
| Inpatient Copayment Maximum Days | 0 |
| HSA Eligible | No |
| New/Existing Plan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer ID | 18350 |
| Issuer Marketplace Marketing Name | HMSA |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Catastrophic |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | HIN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Covered |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Covered |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2022 |
| Plan ID (Standard Component ID with Variant) | 18350HI0880003-00 |
| Plan Marketing Name | HMSA Catastrophic Plan |
| Plan Type | PPO |
| Plan Variant Marketing Name | HMSA Catastrophic Plan |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $8,700 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $400 |
| SBC Scenario, Having Diabetes, Deductible | $4,400 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $100 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,500 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | HIS001 |
| Source Name | SERFF |
| Plan ID | 18350HI0880003 |
| State Code | HI |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $17400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $8700 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $8,700 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $17400 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $8700 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $8,700 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group | $17400 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $8700 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $8,700 |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group | $17400 per group |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | $8700 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $8,700 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group | $17400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $8700 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $8,700 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group | $17400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | $8700 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $8,700 |
| Unique Plan Design | Yes |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | Yes |
Copay & Coinsurance of HMSA Catastrophic Plan Health Insurance Plan, 18350HI0880003
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about HMSA Catastrophic Plan, 18350HI0880003 Health Insurance Plan, 18350HI0880003
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Does HMSA Catastrophic Plan Health Insurance Plan, 18350HI0880003 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (18350HI0880003) Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy
Does (18350HI0880003) Health Insurance Plan, Variant (18350HI0880003-00) have Out Of Country Coverage?
Yes. Details: Covered
Does (18350HI0880003) Health Insurance Plan, Variant (18350HI0880003-00) have Out of Service Area Coverage?
Yes. Details: Covered
Does (18350HI0880003) Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy
Does HMSA Catastrophic Plan Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs for Asthma?
Yes, the HMSA Catastrophic Plan Health Insurance Plan Variant
18350HI0880003-00 offers Disease
Management Program for Asthma.
Does HMSA Catastrophic Plan Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs for Heart disease?
Yes, the HMSA Catastrophic Plan Health Insurance Plan Variant
18350HI0880003-00 offers Disease
Management Program for Heart disease.
Does HMSA Catastrophic Plan Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs for Depression?
Yes, the HMSA Catastrophic Plan Health Insurance Plan Variant
18350HI0880003-00 offers Disease
Management Program for Depression.
Does HMSA Catastrophic Plan Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs for Diabetes?
Yes, the HMSA Catastrophic Plan Health Insurance Plan Variant
18350HI0880003-00 offers Disease
Management Program for Diabetes.
Does HMSA Catastrophic Plan Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the HMSA Catastrophic Plan Health Insurance Plan Variant
18350HI0880003-00 offers Disease
Management Program for High blood pressure & high cholesterol.
Does HMSA Catastrophic Plan Health Insurance Plan, Variant (18350HI0880003-00) offer Disease Management Programs for Pregnancy?
Yes, the HMSA Catastrophic Plan Health Insurance Plan Variant
18350HI0880003-00 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