NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP - 92786NY0010005 Health Insurance Plan

92786 health insurance plan with the Plan ID 92786NY0010005. The plan is called NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP.

Health Insurance Plan ID 92786NY0010005
Health Insurance Plan Year 2023
State New York
Health Insurance Issuer 92786
Health Insurance Plan Variant 92786NY0010005-01
Provider Network(s) ['NYN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT).

Providers New York 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
Available Variants of the Health Plan

Standard On Exchange Plan - 92786NY0010005-01

Last Plan Update Date Mon, 23 Jan 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP Health Insurance Plan Variant 92786NY0010005-01 Attributes

Plan Attribute Value
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 100%
First Tier Utilization 100%
HIOS Product ID 92786NY001
Import Date 1/23/2023
Guaranteed Rate Guaranteed Rate
IsItANewPlan Existing
Issuer ID 92786
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family per person not applicable | per group 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 person not applicable | per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family per person not applicable | per group not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
Medical EHB Deductible, Out of Network, Family per person not applicable | per group not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family $350 per person | $700 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $350
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family per person not applicable | per group 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 No
Network ID NYN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 92786NY0010005-01
Plan Marketing Name NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP
Plan Type EPO
Plan Variant Marketing Name NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP
QHP/Non QHP Both
Service Area ID NYS001
Source Name SERFF
Plan ID 92786NY0010005
State Code NY
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP Health Insurance Plan, 92786NY0010005

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

Frequently Asked Questions(FAQ) about NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP, 92786NY0010005 Health Insurance Plan, 92786NY0010005

  • Does NS, INN, DP, Family Dental, DEP 29, Healthplex Network, WP Health Insurance Plan, 92786NY0010005 support Mail Ordering?

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

  • Does (92786NY0010005) Health Insurance Plan, Variant (92786NY0010005-01) have Out Of Country Coverage?

    No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan).

    Does (92786NY0010005) Health Insurance Plan, Variant (92786NY0010005-01) have Out of Service Area Coverage?

    No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan).

 

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