Piedmont Gold 2100 - 37204VA0080001 Health Insurance Plan

Piedmont Community Healthcare HMO, Inc health insurance plan with the Plan ID 37204VA0080001. The plan is called Piedmont Gold 2100.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 100.00% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 0.00% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 37204VA0080001
Health Insurance Plan Year 2022
State Virginia
Health Insurance Issuer Piedmont Community Healthcare HMO, Inc
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 37204VA0080001-02
Provider Network(s) ['VAN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 23 Jul 2024 06:37 GMT).

Providers Virginia 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 Off Exchange Plan - 37204VA0080001-00

Standard On Exchange Plan - 37204VA0080001-01

Open to Indians below 300% FPL - 37204VA0080001-02

Open to Indians above 300% FPL - 37204VA0080001-03

Last Plan Update Date Mon, 16 Aug 2021 00:00 GMT
Last Import Date Tue, 23 Jul 2024 06:37 GMT

Piedmont Gold 2100 ZCS Health Insurance Plan Variant 37204VA0080001-02 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Zero Cost Sharing Plan Variation
Dental Only Plan No
Disease Management Programs Offered Heart Disease, Diabetes
EHB Percent of Total Premium 1
First Tier Utilization 100%
Formulary ID VAF001
Formulary URL URL
HIOS Product ID 37204VA008
Import Date 8/16/2021 20:01
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 Actuarial Value 100.00%
Issuer ID 37204
Issuer Marketplace Marketing Name Piedmont Community HealthCare HMO, Inc.
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers No
National Network No
Network ID VAN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 37204VA0080001-02
Plan Marketing Name Piedmont Gold 2100
Plan Type HMO
Plan Variant Marketing Name Piedmont Gold 2100 ZCS
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID VAS001
Source Name SERFF
Plan ID 37204VA0080001
State Code VA
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 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $0 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $0
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person per person not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $0 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of Piedmont Gold 2100 Health Insurance Plan, 37204VA0080001

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

Frequently Asked Questions(FAQ) about Piedmont Gold 2100, 37204VA0080001 Health Insurance Plan, 37204VA0080001

  • Does Piedmont Gold 2100 Health Insurance Plan, 37204VA0080001 support Mail Ordering?

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

  • Does (37204VA0080001) Health Insurance Plan, Variant (37204VA0080001-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Heart Disease, Diabetes

    Does (37204VA0080001) Health Insurance Plan, Variant (37204VA0080001-02) have Out Of Country Coverage?

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

    Does (37204VA0080001) Health Insurance Plan, Variant (37204VA0080001-02) have Out of Service Area Coverage?

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

    Does (37204VA0080001) Health Insurance Plan, Variant (37204VA0080001-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Heart Disease, Diabetes

    Does Piedmont Gold 2100 ZCS Health Insurance Plan, Variant (37204VA0080001-02) offer Disease Management Programs for Heart disease?

    Yes, the Piedmont Gold 2100 ZCS Health Insurance Plan Variant 37204VA0080001-02 offers Disease Management Program for Heart disease.

    Does Piedmont Gold 2100 ZCS Health Insurance Plan, Variant (37204VA0080001-02) offer Disease Management Programs for Diabetes?

    Yes, the Piedmont Gold 2100 ZCS Health Insurance Plan Variant 37204VA0080001-02 offers Disease Management Program for Diabetes.

 

Disclaimer: This is based on the import(Date: Tue, 23 Jul 2024 06:37 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