WellCare Secure Health Gold - 44007NC0120003 Health Insurance Plan

Celtic Insurance Company health insurance plan with the Plan ID 44007NC0120003. The plan is called WellCare Secure Health Gold.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 80.51% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 19.49% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 44007NC0120003
Health Insurance Plan Year 2025
State North Carolina
Health Insurance Issuer Celtic Insurance Company
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 44007NC0120003-00
Provider Network(s) PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Jun 2025 12:51 GMT).

Providers North Carolina All US States
All 28342 90556
PCP 5466 12721
Allergy 10 34
OB/GYN 219 496
Dentists 888 2600
Available Variants of the Health Plan

Standard Off Exchange Plan - 44007NC0120003-00

Standard On Exchange Plan - 44007NC0120003-01

Open to Indians below 300% FPL - 44007NC0120003-02

Open to Indians above 300% FPL - 44007NC0120003-03

Last Plan Update Date Wed, 14 Aug 2024 00:00 GMT
Last Import Date Tue, 17 Jun 2025 12:51 GMT

WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 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 2025
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Gold Off Exchange Plan
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Asthma, Diabetes, Heart Disease, Pregnancy
EHB Percent of Total Premium 1.0
First Tier Utilization 100%
Formulary ID NCF003
Formulary URL URL
HIOS Product ID 44007NC012
Import Date 2024-08-14 01:01:35
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 Yes
Is a Referral Required for Specialist? No
Issuer Actuarial Value 80.51%
Issuer ID 44007
Issuer Marketplace Marketing Name WellCare of North Carolina
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers No
National Network No
Network ID NCN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan ID (Standard Component ID with Variant) 44007NC0120003-00
Plan Marketing Name WellCare Secure Health Gold
Plan Type PPO
Plan Variant Marketing Name WellCare Secure Health Gold
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,400
SBC Scenario, Having a Baby, Copayment $300
SBC Scenario, Having a Baby, Deductible $1,850
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $800
SBC Scenario, Having Diabetes, Deductible $800
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $100
SBC Scenario, Treatment of a Simple Fracture, Copayment $100
SBC Scenario, Treatment of a Simple Fracture, Deductible $1,850
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID NCS001
Source Name HIOS
Plan ID 44007NC0120003
State Code NC
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $41400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $20700 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $20,700
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group $11100 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person $5550 per person
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $5,550
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 20.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $3700 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $1850 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $1,850
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group $7400 per group
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person $3700 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $3,700
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $13800 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $6900 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $6,900
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group $27600 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person $13800 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $13,800
Unique Plan Design Yes
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of WellCare Secure Health Gold Health Insurance Plan, 44007NC0120003

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

Frequently Asked Questions(FAQ) about WellCare Secure Health Gold, 44007NC0120003 Health Insurance Plan, 44007NC0120003

  • Does WellCare Secure Health Gold Health Insurance Plan, 44007NC0120003 support Mail Ordering?

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

  • Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs?

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

    Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) have Out Of Country Coverage?

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

    Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) 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 (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs?

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

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Asthma?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Asthma.

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Heart disease?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Heart disease.

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Diabetes?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Diabetes.

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Pregnancy?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 17 Jun 2025 12:51 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