Humana Dental Smart Choice - Low - 82120TN0630004 Health Insurance Plan
Humana Insurance Company health insurance plan with the Plan ID 82120TN0630004. The plan is called Humana Dental Smart Choice - Low.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 71.19% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 28.81% of the costs of all covered benefits (according to the Issuer).
| Health Insurance Plan ID | 82120TN0630004 | ||||||||||||||||||
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| Health Insurance Plan Year | 2022 | ||||||||||||||||||
| State | Tennessee | ||||||||||||||||||
| Health Insurance Issuer | Humana Insurance Company | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 82120TN0630004-01 | ||||||||||||||||||
| Provider Network(s) | ['TNN001'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 23 Apr 2024 07:07 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Wed, 02 Jun 2021 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 23 Apr 2024 07:07 GMT |
Humana Dental Smart Choice - Low Health Insurance Plan Variant 82120TN0630004-01 Attributes
| 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 | 2022 |
| 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 | 0.99092323 |
| First Tier Utilization | 100% |
| HIOS Product ID | 82120TN063 |
| Import Date | 6/2/2021 1:00 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Guaranteed Rate |
| New/Existing Plan | Existing |
| Issuer Actuarial Value | 71.19% |
| Issuer ID | 82120 |
| Issuer Marketplace Marketing Name | Humana |
| 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 | $25 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | $750 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $375 per person |
| 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 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 | TNN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Out of Country Coverage is covered for any expense incurred for services received outside of the United States as required by law for emergency care services. |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Any covered expense incurred for services received from an out of network provider will be covered at a lower coinsurance, based on the maximum allowable fee and providers can balance bill which will result in higher out of pocket costs, except for covered expense incurred for services received outside of the service area as required by law for emergency care services. |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2022 |
| Plan ID (Standard Component ID with Variant) | 82120TN0630004-01 |
| Plan Marketing Name | Humana Dental Smart Choice - Low |
| Plan Type | PPO |
| Plan Variant Marketing Name | Humana Dental Smart Choice - Low |
| QHP/Non QHP | On the Exchange |
| Service Area ID | TNS001 |
| Source Name | HIOS |
| Plan ID | 82120TN0630004 |
| State Code | TN |
| URL for Enrollment Payment | URL |
Copay & Coinsurance of Humana Dental Smart Choice - Low Health Insurance Plan, 82120TN0630004
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Humana Dental Smart Choice - Low, 82120TN0630004 Health Insurance Plan, 82120TN0630004
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Does Humana Dental Smart Choice - Low Health Insurance Plan, 82120TN0630004 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (82120TN0630004) Health Insurance Plan, Variant (82120TN0630004-01) have Out Of Country Coverage?
Yes. Details: Out of Country Coverage is covered for any expense incurred for services received outside of the United States as required by law for emergency care services.
Does (82120TN0630004) Health Insurance Plan, Variant (82120TN0630004-01) have Out of Service Area Coverage?
Yes. Details: Any covered expense incurred for services received from an out of network provider will be covered at a lower coinsurance, based on the maximum allowable fee and providers can balance bill which will result in higher out of pocket costs, except for covered expense incurred for services received outside of the service area as required by law for emergency care services.
Disclaimer: This is based on the import(Date: Tue, 23 Apr 2024 07:07 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