Managed Care for Families and Individuals · 87304IL0060009
First Commonwealth Insurance Company offers this marketplace health insurance plan (Plan ID 87304IL0060009) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Illinois). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
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Special Enrollment Periods
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Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Low Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
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Premium snapshot
Plan identifiers & filings
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
All providers in IllinoisN/A
PCPs in IllinoisN/A
Telehealth supportData pending
Nationwide providersN/A
N/A doctors statewideN/A PCPsN/A OB/GYN
Provider network(s)
['ILN002']
Providers
Illinois
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
Drug coverage overview
0 drugs tracked
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Prior authorization
Drugs
Required
0
Not Required
0
Step therapy
Drugs
Required
0
Not Required
0
Quantity limits
Drugs
Has Limit
0
No Limit
0
Customer highlights
What stands out for members
Issuer: First Commonwealth Insurance Company · Plan ID 87304IL0060009 · 2025 filing.
Variant 87304IL0060009-00 (Standard Off Exchange Plan) currently displayed.
Use the cards on this page to explore network stats, drug coverage, and cost-sharing details.
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Benefits
Covered services & limitations
Pregnancy & family
Maternity, newborn, pediatric dental and vision extras.
Basic Dental Care - Child
$28.00
Tier 1 in-network$28.00
Out-of-network100.00%
Patient charge listed is a sample copayment of basic service D2140 (Amalgam - one surface, primary or permanent). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure but member responsibility for Pediatric Essential Benefits will not exceed the Maximum Out Of Pocket of $425 per child. Plan documents are the final arbiter of coverage.
Exclusions: nan
Major Dental Care - Child
$326.00
Tier 1 in-network$326.00
Out-of-network100.00%
Limitations vary based on procedures. Patient charge listed is a sample copayment of major service D2510 (Inlay - metallic - one surface). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure but member responsibility for Pediatric Essential Benefits will not exceed the Maximum Out Of Pocket of $425 per child. Plan documents are the final arbiter of coverage.
Patient charge listed is a sample copayment of basic service D2140 (Amalgam - one surface, primary or permanent). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure. Plan documents are the final arbiter of coverage.
Exclusions: nan
Dental Check-Up for Children
$0.00
Tier 1 in-network$0.00
Out-of-network100.00%
Patient charge listed is a sample copayment of preventive service D0120 (Periodic oral evaluation - established patient). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure but member responsibility for Pediatric Essential Benefits will not exceed the Maximum Out Of Pocket of $425 per child. Plan documents are the final arbiter of coverage.
Exclusions: nan
Major Dental Care - Adult
$326.00
Tier 1 in-network$326.00
Out-of-network100.00%
Patient charge listed is a sample copayment of major service D2510 (Inlay - metallic - one surface). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure. Plan documents are the final arbiter of coverage.
Exclusions: nan
Orthodontia - Adult
$2,800.00
Tier 1 in-network$2,800.00
Out-of-network100.00%
Patient charge listed is a sample copayment of orthodontic service D8090 (Comprehensive orthodontic treatment of the adult dentition). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure. Plan documents are the final arbiter of coverage.
Exclusions: nan
Orthodontia - Child
$425.00
Tier 1 in-network$425.00
Out-of-network100.00%
Limitations vary based on procedures. Patient charge listed is a sample copayment of orthodontic service for D8080 (Comprehensive orthodontic treatment of the adolescent dentition) and is for when orthodontic treatment is deemed medically necessary as defined by your states Pediatric Essential Benefits benchmark definition. The Pediatric Essential Benefits orthodontic coverage does not include cosmetic treatment. Plan documents are the final arbiter of coverage.
Exclusions: nan
Routine Dental Services (Adult)
$0.00
Tier 1 in-network$0.00
Out-of-network100.00%
Patient charge listed is a sample copayment of preventive service D0120 (Periodic oral evaluation - established patient). A complete list of copayments can be obtained from the plans benefit copayment schedule. Actual patient charges will vary based on the procedure. Plan documents are the final arbiter of coverage.
Exclusions: nan
Variant attributes
Managed Care for Families and Individuals · Variant 87304IL0060009-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard Low Off Exchange Plan
HIOS Product ID
87304IL006
Metal Level
Low
Plan ID (Standard Component ID with Variant)
87304IL0060009-00
Plan Marketing Name
Managed Care for Families and Individuals
Plan Variant Marketing Name
Managed Care for Families and Individuals
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
87304
Issuer Marketplace Marketing Name
First Commonwealth Insurance Company
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
No
Network ID
ILN002
Out of Country Coverage
No
Out of Service Area Coverage
No
Service Area ID
ILS001
State Code
IL
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
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
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
Begin Primary Care Cost-Sharing After Number Of Visits
0
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
Yes
EHB Apportionment for Pediatric Dental
1.0
First Tier Utilization
100%
Import Date
2024-10-18 20:01:44
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
New
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
Not Applicable
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
Plan Effective Date
2025-01-01
Plan Expiration Date
2025-12-31
Plan Type
HMO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
87304IL0060009
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Illinois?
Managed Care for Families and Individuals (87304IL0060009) is a Low HMO from First Commonwealth Insurance Company in Illinois for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Managed Care for Families and Individuals support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Managed Care for Families and Individuals HSA-eligible and does it include dental or vision coverage?
HSA eligibility is not published; check the Summary of Benefits or ask the issuer.
Dental add-ons: Adult, Child.
Vision coverage is not listed for this plan.
Does Managed Care for Families and Individuals support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Is there out-of-country coverage for Managed Care for Families and Individuals?
No, out-of-country services are not covered for this plan.
Does Managed Care for Families and Individuals cover care outside the service area?
No, the issuer indicates out-of-service-area care is not covered except for emergencies.
How do I enroll in or manage payments for Managed Care for Families and Individuals?
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
