WellFirst by Medica Catastrophic - 47840MO0010010 Health Insurance Plan
Medica Central Insurance Company health insurance plan with the Plan ID 47840MO0010010. The plan is called WellFirst by Medica Catastrophic.
| Health Insurance Plan ID | 47840MO0010010 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2025 | ||||||||||||||||||
| State | Missouri | ||||||||||||||||||
| Health Insurance Issuer | Medica Central Insurance Company | ||||||||||||||||||
| Plan Formulary Description URL | Formulary URL | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 47840MO0010010-01 | ||||||||||||||||||
| Provider Network(s) | ['MON001'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 13 May 2025 06:05 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Tue, 31 Dec 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 13 May 2025 06:05 GMT |
WellFirst by Medica Catastrophic Health Insurance Plan Variant 47840MO0010010-01 Attributes
| Plan Attribute | Value |
|---|---|
| Begin Primary Care Cost-Sharing After Number Of Visits | 0 |
| Begin Primary Care Deductible Coinsurance After Number Of Copays | 3 |
| Business Year | 2025 |
| 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, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy |
| EHB Percent of Total Premium | 1.0 |
| First Tier Utilization | 100% |
| Formulary ID | MOF009 |
| Formulary URL | URL |
| HIOS Product ID | 47840MO001 |
| Import Date | 2024-12-31 00:02:01 |
| 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 | 47840 |
| Issuer Marketplace Marketing Name | Medica |
| 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 | MON001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Emergency Services |
| Plan Brochure | URL |
| Plan Effective Date | 2025-01-01 |
| Plan Expiration Date | 2025-12-31 |
| Plan ID (Standard Component ID with Variant) | 47840MO0010010-01 |
| Plan Marketing Name | WellFirst by Medica Catastrophic |
| Plan Type | EPO |
| Plan Variant Marketing Name | WellFirst by Medica Catastrophic |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $9,200 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $90 |
| SBC Scenario, Having Diabetes, Deductible | $5,000 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $90 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,500 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | MOS001 |
| Source Name | HIOS |
| Plan ID | 47840MO0010010 |
| State Code | MO |
| 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 | $18400 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $9200 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $9,200 |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group | per group not applicable |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | per person not applicable |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | Not Applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group | $18400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $9200 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $9,200 |
| 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 WellFirst by Medica Catastrophic Health Insurance Plan, 47840MO0010010
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about WellFirst by Medica Catastrophic, 47840MO0010010 Health Insurance Plan, 47840MO0010010
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Does WellFirst by Medica Catastrophic Health Insurance Plan, 47840MO0010010 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (47840MO0010010) Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does (47840MO0010010) Health Insurance Plan, Variant (47840MO0010010-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (47840MO0010010) Health Insurance Plan, Variant (47840MO0010010-01) have Out of Service Area Coverage?
Yes. Details: Emergency Services
Does (47840MO0010010) Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for Asthma?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for Asthma.
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for Heart disease?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for Heart disease.
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for Depression?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for Depression.
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for Diabetes?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for Diabetes.
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for High blood pressure & high cholesterol.
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for Low back pain?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for Low back pain.
Does WellFirst by Medica Catastrophic Health Insurance Plan, Variant (47840MO0010010-01) offer Disease Management Programs for Pregnancy?
Yes, the WellFirst by Medica Catastrophic Health Insurance Plan Variant
47840MO0010010-01 offers Disease
Management Program for Pregnancy.
Disclaimer: This is based on the import(Date: Tue, 13 May 2025 06:05 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