IHC Local Value Simple Saver - 91762NJ0070014 Health Insurance Plan
AmeriHealth Insurance Company of New Jersey health insurance plan with the Plan ID 91762NJ0070014. The plan is called IHC Local Value Simple Saver.
| Health Insurance Plan ID | 91762NJ0070014 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | New Jersey | ||||||||||||||||||
| Health Insurance Issuer | AmeriHealth Insurance Company of New Jersey | ||||||||||||||||||
| Health Insurance Plan Variant | 91762NJ0070014-01 | ||||||||||||||||||
| Provider Network(s) | ['NJN002'] | ||||||||||||||||||
| 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 | Mon, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
IHC Local Value Simple Saver Health Insurance Plan Variant 91762NJ0070014-01 Attributes
| Plan Attribute | Value |
|---|---|
| Begin Primary Care Deductible Coinsurance After Number Of Copays | 3 |
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Catastrophic On Exchange Plan |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Diabetes, Pregnancy, Weight Loss Programs, High Blood Pressure & High Cholesterol |
| EHB Percent of Total Premium | 99.89% |
| First Tier Utilization | 100% |
| Formulary ID | NJF020 |
| HIOS Product ID | 91762NJ007 |
| Import Date | 1/23/2023 |
| HSA Eligible | No |
| IsItANewPlan | Existing |
| Notice Required for Pregnancy | Yes |
| Is a Referral Required for Specialist? | No |
| Issuer ID | 91762 |
| 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 | No |
| Network ID | NJN002 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Services are available in Hunterdon County. Emergency Care is covered outside of the service area. |
| Plan Effective Date | 1/1/2023 |
| Plan ID (Standard Component ID with Variant) | 91762NJ0070014-01 |
| Plan Marketing Name | IHC Local Value Simple Saver |
| Plan Type | EPO |
| Plan Variant Marketing Name | IHC Local Value Simple Saver |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $8,150 |
| SBC Scenario, Having a Baby, Limit | $10 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $90 |
| SBC Scenario, Having Diabetes, Deductible | $6,700 |
| SBC Scenario, Having Diabetes, Limit | $60 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $1,900 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | NJS002 |
| Source Name | SERFF |
| Plan ID | 91762NJ0070014 |
| 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 | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family | $9100 per person | $18200 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $9,100 |
| 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 | $9100 per person | $18200 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $9,100 |
| 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 IHC Local Value Simple Saver Health Insurance Plan, 91762NJ0070014
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about IHC Local Value Simple Saver, 91762NJ0070014 Health Insurance Plan, 91762NJ0070014
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Does IHC Local Value Simple Saver Health Insurance Plan, 91762NJ0070014 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (91762NJ0070014) Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy, Weight Loss Programs, High Blood Pressure & High Cholesterol
Does (91762NJ0070014) Health Insurance Plan, Variant (91762NJ0070014-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (91762NJ0070014) Health Insurance Plan, Variant (91762NJ0070014-01) have Out of Service Area Coverage?
Yes. Details: Services are available in Hunterdon County.
Emergency Care is covered outside of the service area.
Does (91762NJ0070014) Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy, Weight Loss Programs, High Blood Pressure & High Cholesterol
Does IHC Local Value Simple Saver Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs for Asthma?
Yes, the IHC Local Value Simple Saver Health Insurance Plan Variant
91762NJ0070014-01 offers Disease
Management Program for Asthma.
Does IHC Local Value Simple Saver Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs for Heart disease?
Yes, the IHC Local Value Simple Saver Health Insurance Plan Variant
91762NJ0070014-01 offers Disease
Management Program for Heart disease.
Does IHC Local Value Simple Saver Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs for Diabetes?
Yes, the IHC Local Value Simple Saver Health Insurance Plan Variant
91762NJ0070014-01 offers Disease
Management Program for Diabetes.
Does IHC Local Value Simple Saver Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the IHC Local Value Simple Saver Health Insurance Plan Variant
91762NJ0070014-01 offers Disease
Management Program for High blood pressure & high cholesterol.
Does IHC Local Value Simple Saver Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs for Pregnancy?
Yes, the IHC Local Value Simple Saver Health Insurance Plan Variant
91762NJ0070014-01 offers Disease
Management Program for Pregnancy.
Does IHC Local Value Simple Saver Health Insurance Plan, Variant (91762NJ0070014-01) offer Disease Management Programs for Weight loss programs?
Yes, the IHC Local Value Simple Saver Health Insurance Plan Variant
91762NJ0070014-01 offers Disease
Management Program for Weight loss programs.
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