DentaQuest PPO Family Low - 68711PA0030013 Health Insurance Plan
68711 health insurance plan with the Plan ID 68711PA0030013. The plan is called DentaQuest PPO Family Low.
| Health Insurance Plan ID | 68711PA0030013 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | Pennsylvania | ||||||||||||||||||
| Health Insurance Issuer | 68711 | ||||||||||||||||||
| Health Insurance Plan Variant | 68711PA0030013-01 | ||||||||||||||||||
| Provider Network(s) | NULL | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Sep 2024 06:33 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Mon, 12 Feb 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 17 Sep 2024 06:33 GMT |
DentaQuest PPO Family Low Health Insurance Plan Variant 68711PA0030013-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2024 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Low On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 100.00% |
| First Tier Utilization | 100% |
| HIOS Product ID | 68711PA003 |
| Import Date | 2/12/2024 |
| Guaranteed Rate | Guaranteed Rate |
| IsItANewPlan | New |
| Issuer ID | 68711 |
| 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 | $50 per person | $150 per group |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $50 |
| 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 | $400 per person | $800 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $400 |
| 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 | PAN003 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Emergency Only. In excess of 50 miles from nearest provider. |
| Plan Effective Date | 1/1/2024 |
| Plan Expiration Date | 12/31/2024 |
| Plan ID (Standard Component ID with Variant) | 68711PA0030013-01 |
| Plan Marketing Name | DentaQuest PPO Family Low |
| Plan Type | PPO |
| Plan Variant Marketing Name | DentaQuest PPO Family Low |
| QHP/Non QHP | Both |
| Service Area ID | PAS001 |
| Source Name | SERFF |
| Plan ID | 68711PA0030013 |
| State Code | PA |
| Version Number | 1 |
| Wellness Program Offered | No |
Copay & Coinsurance of DentaQuest PPO Family Low Health Insurance Plan, 68711PA0030013
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about DentaQuest PPO Family Low, 68711PA0030013 Health Insurance Plan, 68711PA0030013
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Does DentaQuest PPO Family Low Health Insurance Plan, 68711PA0030013 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (68711PA0030013) Health Insurance Plan, Variant (68711PA0030013-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (68711PA0030013) Health Insurance Plan, Variant (68711PA0030013-01) have Out of Service Area Coverage?
Yes. Details: Emergency Only. In excess of 50 miles from nearest provider.
Disclaimer: This is based on the import(Date: Tue, 17 Sep 2024 06:33 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