Standard High Gold: UHC Choice Plus Gold 0-1 - 31779MA0010032 Health Insurance Plan

UnitedHealthcare Insurance Company health insurance plan with the Plan ID 31779MA0010032. The plan is called Standard High Gold: UHC Choice Plus Gold 0-1.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 81.90% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 18.10% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 31779MA0010032
Health Insurance Plan Year 2023
State Massachusetts
Health Insurance Issuer UnitedHealthcare Insurance Company
Health Insurance Plan Variant 31779MA0010032-01
Provider Network(s) ['MAN002']
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 Massachusetts 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 - 31779MA0010032-01

Last Plan Update Date Mon, 22 May 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan Variant 31779MA0010032-01 Attributes

Plan Attribute Value
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Gold On Exchange Plan
Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Drug EHB Deductible, In Network (Tier 1), Family $0 per person | $0 per group
Drug EHB Deductible, In Network (Tier 1), Individual $0
Drug EHB Deductible, Out of Network, Family $0 per person | $0 per group
Drug EHB Deductible, Out of Network, Individual $0
Dental Only Plan No
Disease Management Programs Offered Heart Disease, Diabetes, Pregnancy
First Tier Utilization 100%
Formulary ID MAF001
HIOS Product ID 31779MA001
HSA/HRA Employer Contribution No
Import Date 5/22/2023
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 81.90%
Issuer ID 31779
Market Coverage SHOP (Small Group)
Medical Drug Deductibles Integrated No
Medical Drug Maximum Out of Pocket Integrated Yes
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), Default Coinsurance 0.00%
Medical EHB Deductible, In Network (Tier 1), Family $0 per person | $0 per group
Medical EHB Deductible, In Network (Tier 1), Individual $0
Medical EHB Deductible, Out of Network, Family $3000 per person | $6000 per group
Medical EHB Deductible, Out of Network, Individual $3,000
Metal Level Gold
Multiple In Network Tiers No
National Network Yes
Network ID MAN002
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Covered as out of network benefits.
Plan Effective Date 1/1/2023
Plan ID (Standard Component ID with Variant) 31779MA0010032-01
Plan Marketing Name Standard High Gold: UHC Choice Plus Gold 0-1
Plan Type POS
Plan Variant Marketing Name Standard High Gold: UHC Choice Plus Gold 0-1
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $800
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 $1,600
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $700
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MAS002
Source Name SERFF
Plan ID 31779MA0010032
State Code MA
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $5000 per person | $10000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $5,000
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family $15000 per person | $30000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $15,000
Unique Plan Design Yes
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan, 31779MA0010032

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

Frequently Asked Questions(FAQ) about Standard High Gold: UHC Choice Plus Gold 0-1, 31779MA0010032 Health Insurance Plan, 31779MA0010032

  • Does Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan, 31779MA0010032 support Mail Ordering?

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

  • Does (31779MA0010032) Health Insurance Plan, Variant (31779MA0010032-01) offer Disease Management Programs?

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

    Does (31779MA0010032) Health Insurance Plan, Variant (31779MA0010032-01) have Out Of Country Coverage?

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

    Does (31779MA0010032) Health Insurance Plan, Variant (31779MA0010032-01) have Out of Service Area Coverage?

    Yes. Details: Covered as out of network benefits.

    Does (31779MA0010032) Health Insurance Plan, Variant (31779MA0010032-01) offer Disease Management Programs?

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

    Does Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan, Variant (31779MA0010032-01) offer Disease Management Programs for Heart disease?

    Yes, the Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan Variant 31779MA0010032-01 offers Disease Management Program for Heart disease.

    Does Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan, Variant (31779MA0010032-01) offer Disease Management Programs for Diabetes?

    Yes, the Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan Variant 31779MA0010032-01 offers Disease Management Program for Diabetes.

    Does Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan, Variant (31779MA0010032-01) offer Disease Management Programs for Pregnancy?

    Yes, the Standard High Gold: UHC Choice Plus Gold 0-1 Health Insurance Plan Variant 31779MA0010032-01 offers Disease Management Program for Pregnancy.

 

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