Health Resources, Inc. health insurance plan with the Plan ID 33086IN0060003. The plan is called HRI Total Care Plan.
Health Insurance Plan ID | 33086IN0060003 | ||||||||||||||||||
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Health Insurance Plan Year | 2025 | ||||||||||||||||||
State | Indiana | ||||||||||||||||||
Health Insurance Issuer | Health Resources, Inc. | ||||||||||||||||||
Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
Health Insurance Plan Variant | 33086IN0060003-01 | ||||||||||||||||||
Provider Network(s) | PARTICIPATING | ||||||||||||||||||
In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 03 Dec 2024 06:24 GMT). |
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Available Variants of the Health Plan | |||||||||||||||||||
Last Plan Update Date | Thu, 19 Sep 2024 00:00 GMT | ||||||||||||||||||
Last Import Date | Tue, 03 Dec 2024 06:24 GMT |
Benefit | Covered | In Network | Out Of Network |
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Accidental Dental
|
NO | ||
Basic Dental Care - Adult
Filings are limited to replacement once every 2 years. Waiting periods may apply. See detailed information in your benefits summary. |
YES | 30.00% Coinsurance after deductible |
100.00% |
Basic Dental Care - Child
|
YES | 50.00% Coinsurance after deductible |
100.00% |
Dental Check-Up for Children
Limit: 2.0 Exam(s) per Year Limit of 2 cleanings and 2 exams per calendar year. |
YES | No Charge |
100.00% |
Major Dental Care - Adult
Crowns are limited to replacement every 5 years. Waiting periods may apply. See detailed information in your benefits summary. |
YES | 50.00% Coinsurance after deductible |
100.00% |
Major Dental Care - Child
Crowns are limited to replacement every 5 years. |
YES | 50.00% Coinsurance after deductible |
100.00% |
Orthodontia - Adult
|
NO | ||
Orthodontia - Child
Limited to Medically Necessary Orthodontia. See detailed information in your benefits summary. |
YES | 50.00% |
100.00% |
Routine Dental Services (Adult)
Limit: 2.0 Exam(s) per Year Limit of 2 cleanings and 2 exams per calendar year. |
YES | No Charge |
100.00% |
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 Low On Exchange Plan |
Dental Only Plan | Yes |
EHB Apportionment for Pediatric Dental | 1.0 |
First Tier Utilization | 100% |
HIOS Product ID | 33086IN006 |
Import Date | 2024-09-19 01:01:32 |
Inpatient Copayment Maximum Days | 0 |
Guaranteed Rate | Guaranteed Rate |
New/Existing Plan | Existing |
Issuer ID | 33086 |
Issuer Marketplace Marketing Name | Paramount Dental |
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 | $25 |
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 | $850 per group |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $425 per person |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $425 |
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 | Low |
Multiple In Network Tiers | No |
National Network | Yes |
Network ID | INN001 |
Out of Country Coverage | No |
Out of Service Area Coverage | Yes |
Out of Service Area Coverage Description | Coverage allowed using any of our in-network dentists nationwide. |
Plan Brochure | URL |
Plan Effective Date | 2025-01-01 |
Plan Expiration Date | 2025-12-31 |
Plan ID (Standard Component ID with Variant) | 33086IN0060003-01 |
Plan Marketing Name | HRI Total Care Plan |
Plan Type | HMO |
Plan Variant Marketing Name | HRI Total Care Plan |
QHP/Non QHP | On the Exchange |
Service Area ID | INS001 |
Source Name | HIOS |
Plan ID | 33086IN0060003 |
State Code | IN |
URL for Enrollment Payment | URL |
URL for Summary of Benefits & Coverage | URL |
Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Disclaimer: This is based on the import(Date: Tue, 03 Dec 2024 06:24 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