Secure - 91908OK0010011 Health Insurance Plan
Oscar Insurance Company health insurance plan with the Plan ID 91908OK0010011. The plan is called Secure.
| Health Insurance Plan ID | 91908OK0010011 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | Oklahoma | ||||||||||||||||||
| Health Insurance Issuer | Oscar Insurance Company | ||||||||||||||||||
| Plan Formulary Description URL | Formulary URL | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 91908OK0010011-01 | ||||||||||||||||||
| Provider Network(s) | ['OKN001'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 30 Apr 2024 06:06 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Fri, 24 Feb 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 30 Apr 2024 06:06 GMT |
Benefits of Secure Health Insurance Plan, 91908OK0010011-01
| Benefit | Covered | In Network | Out Of Network |
|---|---|---|---|
| Abortion for Which Public Funding is Prohibited
|
NO | ||
| Accidental Dental
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Acupuncture
|
NO | ||
| Allergy Testing
Issuer clarifies this is a covered benefit but stipulated under the Medical Policy and not written in the member materials. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Bariatric Surgery
|
NO | ||
| Basic Dental Care - Adult
|
NO | ||
| Basic Dental Care - Child
|
NO | ||
| Chemotherapy
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Chiropractic Care
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Cosmetic Surgery
|
NO | ||
| Delivery and All Inpatient Services for Maternity Care
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Dental Check-Up for Children
Limit: 2.0 Visit(s) per Year |
NO | ||
| Diabetes Education
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Dialysis
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Durable Medical Equipment
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| 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 Year |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Gender Affirming Care
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Generic Drugs
|
YES | $0.00 Copay after deductible |
100.00% |
| Habilitation Services
Limit: 25.0 Visit(s) per Benefit Period |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Hearing Aids
One hearing aid per ear every 48 months. |
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Home Health Care Services
Limit: 30.0 Visit(s) per Benefit Period |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Hospice Services
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs)
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Infertility Treatment
|
NO | ||
| Infusion Therapy
Limit: 25.0 Visit(s) per Benefit Period Covered under Outpatient Therapy Services. |
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay)
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Long-Term/Custodial Nursing Home Care
|
NO | ||
| Major Dental Care - Adult
|
NO | ||
| Major Dental Care - Child
|
NO | ||
| Mental/Behavioral Health Inpatient Services
Benefits for the treatment of Mental Illness include treatments for drug addiction, substance abuse and alcoholism. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services
Benefits for the treatment of Mental Illness include treatments for drug addiction, substance abuse and alcoholism. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Non-Preferred Brand Drugs
|
YES | $0.00 Copay after deductible |
100.00% |
| Nutritional Counseling
Diabetes self-management training and training related to medical nutrition therapy. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Orthodontia - Adult
|
NO | ||
| Orthodontia - Child
|
NO | ||
| Other Practitioner Office Visit (Nurse, Physician Assistant)
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services
Limit: 30.0 Days per Benefit Period |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Preferred Brand Drugs
|
YES | $0.00 Copay after deductible |
100.00% |
| Prenatal and Postnatal Care
|
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Preventive Care/Screening/Immunization
|
YES | $0.00 |
50.00% Coinsurance after deductible |
| 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 |
50.00% Coinsurance after deductible |
| Private-Duty Nursing
Limit: 85.0 Visit(s) per Benefit Period Pre-authorization required. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Prosthetic Devices
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Radiation
|
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Reconstructive Surgery
Breast reconstruction or implantation or removal of breast prostheses is a Covered Service only when performed solely and directly as a result of mastectomy which is Medically Necessary. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy
Limit: 25.0 Visit(s) per Benefit Period Maximum of 25 Outpatient visits for Physical Therapy, Occupational Therapy and Speech Therapy (combined). |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy
Limit: 25.0 Visit(s) per Benefit Period Maximum of 25 Outpatient visits for Physical Therapy, Occupational Therapy and Speech Therapy (combined). |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Routine Dental Services (Adult)
|
NO | ||
| Routine Eye Exam (Adult)
|
NO | ||
| Routine Eye Exam for Children
Limit: 1.0 Exam(s) per Year |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Routine Foot Care
|
NO | ||
| Skilled Nursing Facility
Limit: 30.0 Days per Benefit Period |
YES | 0.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Specialist Visit
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Specialty Drugs
|
YES | $0.00 Copay after deductible |
100.00% |
| Substance Abuse Disorder Inpatient Services
Benefits for the treatment of Mental Illness include treatments for drug addiction, substance abuse and alcoholism. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services
Benefits for the treatment of Mental Illness include treatments for drug addiction, substance abuse and alcoholism. |
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Transplant
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders
|
NO | ||
| Urgent Care Centers or Facilities
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
| Weight Loss Programs
|
NO | ||
| Well Baby Visits and Care
|
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| X-rays and Diagnostic Imaging
|
YES | $0.00 Copay after deductible |
50.00% Coinsurance after deductible |
Secure Health Insurance Plan Variant 91908OK0010011-01 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 On 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 | OKF001 |
| Formulary URL | URL |
| HIOS Product ID | 91908OK001 |
| Import Date | 2/24/2023 1:01 |
| 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 | 91908 |
| 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 | OKN001 |
| 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) | 91908OK0010011-01 |
| Plan Marketing Name | Secure |
| Plan Type | PPO |
| 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 | OKS001 |
| Source Name | HIOS |
| Plan ID | 91908OK0010011 |
| State Code | OK |
| 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 | $54600 per group |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | $27300 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $27,300 |
| 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 | No |
Copay & Coinsurance of Secure Health Insurance Plan, 91908OK0010011
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about Secure, 91908OK0010011 Health Insurance Plan, 91908OK0010011
-
Does Secure Health Insurance Plan, 91908OK0010011 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (91908OK0010011) Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs?
Does (91908OK0010011) Health Insurance Plan, Variant (91908OK0010011-01) have Out Of Country Coverage?
Does (91908OK0010011) Health Insurance Plan, Variant (91908OK0010011-01) have Out of Service Area Coverage?
Does (91908OK0010011) Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for Asthma?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for Heart disease?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for Depression?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for Diabetes?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for High blood pressure & high cholesterol?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for Low back pain?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs for Pregnancy?
Does Secure Health Insurance Plan, Variant (91908OK0010011-01) offer Disease Management Programs 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