UHC Core Essential Platinum 0-4 - 21066DC0040008 Health Insurance Plan

UnitedHealthcare of the Mid-Atlantic, Inc. health insurance plan with the Plan ID 21066DC0040008. The plan is called UHC Core Essential Platinum 0-4.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 91.30% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 8.70% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 21066DC0040008
Health Insurance Plan Year 2023
State District of Columbia
Health Insurance Issuer UnitedHealthcare of the Mid-Atlantic, Inc.
Health Insurance Plan Variant 21066DC0040008-01
Provider Network(s) ['DCN001']
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 District of Columbia 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 - 21066DC0040008-01

Last Plan Update Date Mon, 23 Jan 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

UHC Core Essential Platinum 0-4 Health Insurance Plan Variant 21066DC0040008-01 Attributes

Plan Attribute Value
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Platinum 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 per person not applicable | per group not applicable
Drug EHB Deductible, Out of Network, Individual Not Applicable
Dental Only Plan No
Disease Management Programs Offered Heart Disease, Diabetes, Pregnancy
First Tier Utilization 100%
Formulary ID DCF005
HIOS Product ID 21066DC004
HSA/HRA Employer Contribution No
Import Date 1/23/2023
Inpatient Copayment Maximum Days 5
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 91.30%
Issuer ID 21066
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 10.00%
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 per person not applicable | per group not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Metal Level Platinum
Multiple In Network Tiers No
National Network No
Network ID DCN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan Effective Date 1/1/2023
Plan ID (Standard Component ID with Variant) 21066DC0040008-01
Plan Marketing Name UHC Core Essential Platinum 0-4
Plan Type HMO
Plan Variant Marketing Name UHC Core Essential Platinum 0-4
QHP/Non QHP On the Exchange
SBC Scenario, Having a Baby, Coinsurance $100
SBC Scenario, Having a Baby, Copayment $700
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $10
SBC Scenario, Having Diabetes, Copayment $700
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 $600
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID DCS001
Source Name SERFF
Plan ID 21066DC0040008
State Code DC
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 $2000 per person | $4000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $2,000
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of UHC Core Essential Platinum 0-4 Health Insurance Plan, 21066DC0040008

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

Frequently Asked Questions(FAQ) about UHC Core Essential Platinum 0-4, 21066DC0040008 Health Insurance Plan, 21066DC0040008

  • Does UHC Core Essential Platinum 0-4 Health Insurance Plan, 21066DC0040008 support Mail Ordering?

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

  • Does (21066DC0040008) Health Insurance Plan, Variant (21066DC0040008-01) offer Disease Management Programs?

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

    Does (21066DC0040008) Health Insurance Plan, Variant (21066DC0040008-01) have Out Of Country Coverage?

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

    Does (21066DC0040008) Health Insurance Plan, Variant (21066DC0040008-01) 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 (21066DC0040008) Health Insurance Plan, Variant (21066DC0040008-01) offer Disease Management Programs?

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

    Does UHC Core Essential Platinum 0-4 Health Insurance Plan, Variant (21066DC0040008-01) offer Disease Management Programs for Heart disease?

    Yes, the UHC Core Essential Platinum 0-4 Health Insurance Plan Variant 21066DC0040008-01 offers Disease Management Program for Heart disease.

    Does UHC Core Essential Platinum 0-4 Health Insurance Plan, Variant (21066DC0040008-01) offer Disease Management Programs for Diabetes?

    Yes, the UHC Core Essential Platinum 0-4 Health Insurance Plan Variant 21066DC0040008-01 offers Disease Management Program for Diabetes.

    Does UHC Core Essential Platinum 0-4 Health Insurance Plan, Variant (21066DC0040008-01) offer Disease Management Programs for Pregnancy?

    Yes, the UHC Core Essential Platinum 0-4 Health Insurance Plan Variant 21066DC0040008-01 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