DentaTrust PPO Family Basic Option - 38886TN0070005 Health Insurance Plan

Dental Care Plus, Inc. health insurance plan with the Plan ID 38886TN0070005. The plan is called DentaTrust PPO Family Basic Option.

Health Insurance Plan ID 38886TN0070005
Health Insurance Plan Year 2022
State Tennessee
Health Insurance Issuer Dental Care Plus, Inc.
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 38886TN0070005-01
Provider Network(s) ['TNN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 16 Jul 2024 06:14 GMT).

Providers Tennessee 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 - 38886TN0070005-00

Standard On Exchange Plan - 38886TN0070005-01

Last Plan Update Date Tue, 18 May 2021 00:00 GMT
Last Import Date Tue, 16 Jul 2024 06:14 GMT

DentaTrust PPO Family Basic Option Health Insurance Plan Variant 38886TN0070005-01 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 Standard Low On Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1
First Tier Utilization 100%
HIOS Product ID 38886TN007
Import Date 5/18/2021 1:00
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 38886
Issuer Marketplace Marketing Name DentaTrust/DentaSpan
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Not Applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Group $150 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $50 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $50
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $700 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $350 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $350
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person per person 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 TNN001
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Out-of-Network coverage is available for covered services obtained from non-participating dentists. See the schedule of benefits for out-of-network coverage levels.
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 38886TN0070005-01
Plan Level Exclusions Please refer to the exclusions listed in the Plan Brochure for specific plan level exclusions
Plan Marketing Name DentaTrust PPO Family Basic Option
Plan Type PPO
Plan Variant Marketing Name DentaTrust PPO Family Basic Option
QHP/Non QHP Both
Service Area ID TNS001
Source Name HIOS
Plan ID 38886TN0070005
State Code TN
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL

Copay & Coinsurance of DentaTrust PPO Family Basic Option Health Insurance Plan, 38886TN0070005

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

Frequently Asked Questions(FAQ) about DentaTrust PPO Family Basic Option, 38886TN0070005 Health Insurance Plan, 38886TN0070005

  • Does DentaTrust PPO Family Basic Option Health Insurance Plan, 38886TN0070005 support Mail Ordering?

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

  • Does (38886TN0070005) Health Insurance Plan, Variant (38886TN0070005-01) have Out Of Country Coverage?

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

    Does (38886TN0070005) Health Insurance Plan, Variant (38886TN0070005-01) have Out of Service Area Coverage?

    Yes. Details: Out-of-Network coverage is available for covered services obtained from non-participating dentists. See the schedule of benefits for out-of-network coverage levels.

 

Disclaimer: This is based on the import(Date: Tue, 16 Jul 2024 06:14 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