Secure - 45819IA0010011 Health Insurance Plan

Oscar Insurance Company health insurance plan with the Plan ID 45819IA0010011. The plan is called Secure.

Health Insurance Plan ID 45819IA0010011
Health Insurance Plan Year 2023
State Iowa
Health Insurance Issuer Oscar Insurance Company
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 45819IA0010011-00
Provider Network(s) ['IAN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 30 Apr 2024 06:06 GMT).

Providers Iowa 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 - 45819IA0010011-00

Standard On Exchange Plan - 45819IA0010011-01

Last Plan Update Date Tue, 28 Feb 2023 00:00 GMT
Last Import Date Tue, 30 Apr 2024 06:06 GMT

Benefits of Secure Health Insurance Plan, 45819IA0010011-00

Benefit Covered In Network Out Of Network
Abortion for Which Public Funding is Prohibited
NO
Accidental Dental
YES

$0.00 Copay after deductible

100.00%
Acupuncture
NO
Allergy Testing
YES

$0.00 Copay after deductible

100.00%
Bariatric Surgery

Surgery must be medically necessary. Not all procedures classified as weight reduction surgery are covered. Prior approval for weight reduction surgery is required.

YES

$0.00 Copay after deductible

100.00%
Basic Dental Care - Adult
NO
Basic Dental Care - Child
NO
Chemotherapy
YES

0.00% Coinsurance after deductible

100.00%
Chiropractic Care
YES

$0.00 Copay after deductible

100.00%
Cosmetic Surgery
NO
Delivery and All Inpatient Services for Maternity Care
YES

$0.00 Copay after deductible

100.00%
Dental Check-Up for Children
NO
Diabetes Education
YES

$0.00 Copay after deductible

100.00%
Dialysis
YES

0.00% Coinsurance after deductible

100.00%
Durable Medical Equipment
YES

0.00% Coinsurance after deductible

100.00%
Emergency Room Services
YES

$0.00 Copay after deductible

$0.00 Copay after deductible
Emergency Transportation/Ambulance
YES

$0.00 Copay after deductible

$0.00 Copay after deductible
Eye Glasses for Children

Limit: 1.0 Item(s) per Benefit Period

YES

$0.00 Copay after deductible

100.00%
Gender Affirming Care
YES

$0.00 Copay after deductible

100.00%
Generic Drugs
YES

$0.00 Copay after deductible

100.00%
Habilitation Services

Treatment for Autism with speech therapy, occupational therapy, or physical therapy is covered. Use of Applied Behavior Analysis for the treatment of Autism is covered.

YES

$0.00 Copay after deductible

100.00%
Hearing Aids
NO
Home Health Care Services
YES

$0.00 Copay after deductible

100.00%
Hospice Services

Care (generally in a home setting) for patients who are terminally ill and who have a life expectancy of six months or less. Hospice respite care has a quantity limit of 15 inpatient days and 15 outpatient days per lifetime. Hospice respite care must be used in increments of not more than five days at a time.

YES

0.00% Coinsurance after deductible

100.00%
Imaging (CT/PET Scans, MRIs)
YES

$0.00 Copay after deductible

100.00%
Infertility Treatment
YES

0.00% Coinsurance after deductible

100.00%
Infusion Therapy

Intravenous administration of nutrients, antibiotics, and other drugs and fluids when provided in the home (home infusion therapy).

YES

0.00% Coinsurance after deductible

100.00%
Inpatient Hospital Services (e.g., Hospital Stay)
YES

0.00% Coinsurance after deductible

100.00%
Inpatient Physician and Surgical Services
YES

$0.00 Copay after deductible

100.00%
Laboratory Outpatient and Professional Services
YES

$0.00 Copay after deductible

100.00%
Long-Term/Custodial Nursing Home Care
NO
Major Dental Care - Adult
NO
Major Dental Care - Child
NO
Mental/Behavioral Health Inpatient Services
YES

$0.00 Copay after deductible

100.00%
Mental/Behavioral Health Outpatient Services
YES

$0.00 Copay after deductible

100.00%
Non-Preferred Brand Drugs
YES

$0.00 Copay after deductible

100.00%
Nutritional Counseling
NO
Orthodontia - Adult
NO
Orthodontia - Child
NO
Other Practitioner Office Visit (Nurse, Physician Assistant)
YES

$0.00 Copay after deductible

100.00%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
YES

$0.00 Copay after deductible

100.00%
Outpatient Rehabilitation Services
YES

$0.00 Copay after deductible

100.00%
Outpatient Surgery Physician/Surgical Services
YES

$0.00 Copay after deductible

100.00%
Preferred Brand Drugs
YES

$0.00 Copay after deductible

100.00%
Prenatal and Postnatal Care
YES

0.00% Coinsurance after deductible

100.00%
Preventive Care/Screening/Immunization
YES

$0.00

100.00%
Primary Care Visit to Treat an Injury or Illness

First three (3) non-preventive visits are $0 and not subject to the deductible. Virtual urgent care visits with Oscar designated telemedicine providers are covered in full after the deductible has been met.

YES

$0.00 Copay after deductible

100.00%
Private-Duty Nursing

Plan refers to home skilled nursing as private duty nursing. Home skilled nursing is intended to provide a safe transition from other levels of care when medically necessary, to provide teaching to caregivers for ongoing care, or to provide short-term treatments that can be safely administered in the home setting.

YES

$0.00 Copay after deductible

100.00%
Prosthetic Devices
YES

0.00% Coinsurance after deductible

100.00%
Radiation
YES

0.00% Coinsurance after deductible

100.00%
Reconstructive Surgery
YES

$0.00 Copay after deductible

100.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy
YES

$0.00 Copay after deductible

100.00%
Rehabilitative Speech Therapy
YES

$0.00 Copay after deductible

100.00%
Routine Dental Services (Adult)
NO
Routine Eye Exam (Adult)
NO
Routine Eye Exam for Children

Limit: 1.0 Exam(s) per Benefit Period

YES

$0.00 Copay after deductible

100.00%
Routine Foot Care
NO
Skilled Nursing Facility
YES

0.00% Coinsurance after deductible

100.00%
Specialist Visit
YES

$0.00 Copay after deductible

100.00%
Specialty Drugs
YES

$0.00 Copay after deductible

100.00%
Substance Abuse Disorder Inpatient Services
YES

$0.00 Copay after deductible

100.00%
Substance Abuse Disorder Outpatient Services
YES

$0.00 Copay after deductible

100.00%
Transplant

Transplants are subject to Case Management.

YES

$0.00 Copay after deductible

100.00%
Treatment for Temporomandibular Joint Disorders
YES

0.00% Coinsurance after deductible

100.00%
Urgent Care Centers or Facilities
YES

$0.00 Copay after deductible

100.00%
Weight Loss Programs
NO
Well Baby Visits and Care

Covered for child through age 7.

YES

0.00% Coinsurance after deductible

100.00%
X-rays and Diagnostic Imaging
YES

$0.00 Copay after deductible

100.00%

Secure Health Insurance Plan Variant 45819IA0010011-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 3
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Catastrophic Off Exchange Plan
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
EHB Percent of Total Premium 1
First Tier Utilization 100%
Formulary ID IAF001
Formulary URL URL
HIOS Product ID 45819IA001
Import Date 2/28/2023 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 ID 45819
Issuer Marketplace Marketing Name Oscar Insurance Company
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Catastrophic
Multiple In Network Tiers No
National Network No
Network ID IAN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services only.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency and Urgent Services only.
Plan Brochure URL
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 45819IA0010011-00
Plan Marketing Name Secure
Plan Type EPO
Plan Variant Marketing Name Secure
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $9,100
SBC Scenario, Having a Baby, Limit $0
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $5,400
SBC Scenario, Having Diabetes, Limit $0
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 $2,800
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID IAS001
Source Name SERFF
Plan ID 45819IA0010011
State Code IA
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 $18200 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $9100 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $9,100
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 $18200 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $9100 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,100
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 No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered Yes

Copay & Coinsurance of Secure Health Insurance Plan, 45819IA0010011

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

Frequently Asked Questions(FAQ) about Secure, 45819IA0010011 Health Insurance Plan, 45819IA0010011

  • Does Secure Health Insurance Plan, 45819IA0010011 support Mail Ordering?

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

  • Does (45819IA0010011) Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs?

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

    Does (45819IA0010011) Health Insurance Plan, Variant (45819IA0010011-00) have Out Of Country Coverage?

    Yes. Details: Emergency Services only.

    Does (45819IA0010011) Health Insurance Plan, Variant (45819IA0010011-00) have Out of Service Area Coverage?

    Yes. Details: Emergency and Urgent Services only.

    Does (45819IA0010011) Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs?

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

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Asthma?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Asthma.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Heart disease?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Heart disease.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Depression?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Depression.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Diabetes?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Diabetes.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Low back pain?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Low back pain.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Pregnancy?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Pregnancy.

    Does Secure Health Insurance Plan, Variant (45819IA0010011-00) offer Disease Management Programs for Weight loss programs?

    Yes, the Secure Health Insurance Plan Variant 45819IA0010011-00 offers Disease Management Program for Weight loss programs.

 

Disclaimer: This is based on the import(Date: Tue, 30 Apr 2024 06:06 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