MyHPN Silver 12 - 95865NV0030093 Health Insurance Plan
Health Plan of Nevada, Inc. health insurance plan with the Plan ID 95865NV0030093. The plan is called MyHPN Silver 12.
Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 70.37% (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 29.63% 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 | 95865NV0030093 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Nevada | ||||||||||||||||||
| Health Insurance Issuer | Health Plan of Nevada, Inc. | ||||||||||||||||||
| Health Insurance Plan Variant | 95865NV0030093-01 | ||||||||||||||||||
| Provider Network(s) | ['NVN001'] | ||||||||||||||||||
| 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 | Standard On Exchange Plan - 95865NV0030093-01 Open to Indians below 300% FPL - 95865NV0030093-02 Open to Indians above 300% FPL - 95865NV0030093-03 73% AV Silver Plan - 95865NV0030093-04 |
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| Last Plan Update Date | Mon, 17 Apr 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
MyHPN Silver 12 Health Insurance Plan Variant 95865NV0030093-01 Attributes
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.703653899 |
| Business Year | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Silver On Exchange Plan |
| Drug EHB Deductible, Combined In/Out of Network, Family | $1500 per person | $3000 per group |
| Drug EHB Deductible, Combined In/Out of Network, Individual | $1,500 |
| Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 40.00% |
| Drug EHB Deductible, In Network (Tier 1), Family | $1500 per person | $3000 per group |
| Drug EHB Deductible, In Network (Tier 1), Individual | $1,500 |
| Drug EHB Deductible, Out of Network, Family | per person not applicable | per group not applicable |
| Drug EHB Deductible, Out of Network, Individual | Not Applicable |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Weight Loss Programs, High Blood Pressure & High Cholesterol |
| EHB Percent of Total Premium | 100% |
| First Tier Utilization | 100% |
| Formulary ID | NVF005 |
| HIOS Product ID | 95865NV003 |
| Import Date | 4/17/2023 |
| HSA Eligible | No |
| IsItANewPlan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | Yes |
| Issuer ID | 95865 |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | No |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Medical EHB Deductible, Combined In/Out of Network, Family | $7000 per person | $14000 per group |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $7,000 |
| Medical EHB Deductible, In Network (Tier 1), Default Coinsurance | 40.00% |
| Medical EHB Deductible, In Network (Tier 1), Family | $7000 per person | $14000 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $7,000 |
| Medical EHB Deductible, Out of Network, Family | per person not applicable | per group not applicable |
| Medical EHB Deductible, Out of Network, Individual | Not Applicable |
| Metal Level | Silver |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | NVN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Urgent and Emergent |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 95865NV0030093-01 |
| Plan Marketing Name | MyHPN Silver 12 |
| Plan Type | HMO |
| Plan Variant Marketing Name | MyHPN Silver 12 |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $1,300 |
| SBC Scenario, Having a Baby, Copayment | $400 |
| SBC Scenario, Having a Baby, Deductible | $7,000 |
| SBC Scenario, Having a Baby, Limit | $80 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $1,200 |
| SBC Scenario, Having Diabetes, Deductible | $0 |
| SBC Scenario, Having Diabetes, Limit | $40 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $700 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $1,300 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | NVS001 |
| Source Name | SERFF |
| Specialist Requiring a Referral | All |
| Plan ID | 95865NV0030093 |
| State Code | NV |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family | $8700 per person | $17400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $8,700 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family | $8700 per person | $17400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $8,700 |
| 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 | No |
| Version Number | 1 |
| Wellness Program Offered | Yes |
Copay & Coinsurance of MyHPN Silver 12 Health Insurance Plan, 95865NV0030093
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about MyHPN Silver 12, 95865NV0030093 Health Insurance Plan, 95865NV0030093
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Does MyHPN Silver 12 Health Insurance Plan, 95865NV0030093 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (95865NV0030093) Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Weight Loss Programs, High Blood Pressure & High Cholesterol
Does (95865NV0030093) Health Insurance Plan, Variant (95865NV0030093-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (95865NV0030093) Health Insurance Plan, Variant (95865NV0030093-01) have Out of Service Area Coverage?
Yes. Details: Urgent and Emergent
Does (95865NV0030093) Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Pain Management, Pregnancy, Weight Loss Programs, High Blood Pressure & High Cholesterol
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for Asthma?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 offers Disease
Management Program for Asthma.
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for Heart disease?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 offers Disease
Management Program for Heart disease.
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for Depression?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 offers Disease
Management Program for Depression.
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for Diabetes?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 offers Disease
Management Program for Diabetes.
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 offers Disease
Management Program for High blood pressure & high cholesterol.
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for Pregnancy?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 offers Disease
Management Program for Pregnancy.
Does MyHPN Silver 12 Health Insurance Plan, Variant (95865NV0030093-01) offer Disease Management Programs for Weight loss programs?
Yes, the MyHPN Silver 12 Health Insurance Plan Variant
95865NV0030093-01 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