Moda Pioneer Alaska Standard Bronze - 73836AK0960001 Health Insurance Plan

Moda Health Plan, Inc. health insurance plan with the Plan ID 73836AK0960001. The plan is called Moda Pioneer Alaska Standard Bronze.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 63.81% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 36.19% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Health Insurance Plan ID 73836AK0960001
Health Insurance Plan Year 2025
State Alaska
Health Insurance Issuer Moda Health Plan, Inc.
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 73836AK0960001-01
Provider Network(s) PREFERRED NON-PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 13 May 2025 06:05 GMT).

Providers Alaska All US States
All 3839 69779
PCP 560 1255
Allergy 6 7
OB/GYN 16 67
Dentists 168 223
Available Variants of the Health Plan

Standard Off Exchange Plan - 73836AK0960001-00

Standard On Exchange Plan - 73836AK0960001-01

Open to Indians below 300% FPL - 73836AK0960001-02

Open to Indians above 300% FPL - 73836AK0960001-03

Last Plan Update Date Sat, 11 Jan 2025 00:00 GMT
Last Import Date Tue, 13 May 2025 06:05 GMT

Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.638091065338329
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 Bronze On Exchange Plan
Dental Only Plan No
Design Type Design 1
Disease Management Programs Offered Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
EHB Percent of Total Premium 0.99
First Tier Utilization 100%
Formulary ID AKF015
Formulary URL URL
HIOS Product ID 73836AK096
Import Date 2025-01-11 00:01:52
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 73836
Issuer Marketplace Marketing Name Moda Health Plan, Inc.
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Expanded Bronze
Multiple In Network Tiers No
National Network No
Network ID AKN002
Out of Country Coverage Yes
Out of Country Coverage Description Emergency care only
Out of Service Area Coverage Yes
Out of Service Area Coverage Description For emergency care during travel and for out-of-area dependents
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 73836AK0960001-01
Plan Marketing Name Moda Pioneer Alaska Standard Bronze
Plan Type PPO
Plan Variant Marketing Name Moda Pioneer Alaska Standard Bronze
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,700
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $7,500
SBC Scenario, Having a Baby, Limit $50
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $500
SBC Scenario, Having Diabetes, Deductible $4,500
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $300
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,300
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID AKS002
Source Name HIOS
Plan ID 73836AK0960001
State Code AK
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person per person 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 Group per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person per person 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 50.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $15000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $7500 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $7,500
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group $45000 per group
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person $22500 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $22,500
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $18400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $9200 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,200
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group $56400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person $28200 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $28,200
Unique Plan Design No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of Moda Pioneer Alaska Standard Bronze Health Insurance Plan, 73836AK0960001

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Moda Pioneer Alaska Standard Bronze, 73836AK0960001 Health Insurance Plan, 73836AK0960001

  • Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, 73836AK0960001 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (73836AK0960001) Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy

    Does (73836AK0960001) Health Insurance Plan, Variant (73836AK0960001-01) have Out Of Country Coverage?

    Yes. Details: Emergency care only

    Does (73836AK0960001) Health Insurance Plan, Variant (73836AK0960001-01) have Out of Service Area Coverage?

    Yes. Details: For emergency care during travel and for out-of-area dependents

    Does (73836AK0960001) Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for Asthma?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for Asthma.

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for Heart disease?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for Heart disease.

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for Depression?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for Depression.

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for Diabetes?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for Diabetes.

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for Low back pain?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for Low back pain.

    Does Moda Pioneer Alaska Standard Bronze Health Insurance Plan, Variant (73836AK0960001-01) offer Disease Management Programs for Pregnancy?

    Yes, the Moda Pioneer Alaska Standard Bronze Health Insurance Plan Variant 73836AK0960001-01 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 13 May 2025 06:05 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