Ambetter Secure Care 5 - 61836WA0050008 Health Insurance Plan

Coordinated Care Corporation health insurance plan with the Plan ID 61836WA0050008. The plan is called Ambetter Secure Care 5.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 80.92% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 19.08% of the costs of all covered benefits (according to the Issuer).

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 82.43% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 17.57% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Health Insurance Plan ID 61836WA0050008
Health Insurance Plan Year 2024
State Washington
Health Insurance Issuer Coordinated Care Corporation
Health Insurance Plan Variant 61836WA0050008-01
Provider Network(s) PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 03 Dec 2024 06:24 GMT).

Providers Washington All US States
All 80 90
PCP 26 27
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 - 61836WA0050008-01

Open to Indians below 300% FPL - 61836WA0050008-02

Open to Indians above 300% FPL - 61836WA0050008-03

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Tue, 03 Dec 2024 06:24 GMT

Ambetter Secure Care 5 Health Insurance Plan Variant 61836WA0050008-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.824255154
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Gold On Exchange Plan
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Pregnancy, Diabetes, Heart Disease, Asthma
EHB Percent of Total Premium 99%
First Tier Utilization 100%
Formulary ID WAF008
HIOS Product ID 61836WA005
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy Yes
Is a Referral Required for Specialist? No
Issuer Actuarial Value 80.92%
Issuer ID 61836
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 WAN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan Effective Date 1/1/2024
Plan ID (Standard Component ID with Variant) 61836WA0050008-01
Plan Marketing Name Ambetter Secure Care 5
Plan Type HMO
Plan Variant Marketing Name Ambetter Secure Care 5
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,500
SBC Scenario, Having a Baby, Copayment $300
SBC Scenario, Having a Baby, Deductible $1,450
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 $200
SBC Scenario, Treatment of a Simple Fracture, Copayment $100
SBC Scenario, Treatment of a Simple Fracture, Deductible $1,450
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID WAS001
Source Name SERFF
Plan ID 61836WA0050008
State Code WA
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
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group 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 20.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $1450 per person | $2900 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $1,450
TEHBDedOutofNetFamily per person not applicable | per group 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 $7500 per person | $15000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $7,500
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 Ambetter Secure Care 5 Health Insurance Plan, 61836WA0050008

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

Frequently Asked Questions(FAQ) about Ambetter Secure Care 5, 61836WA0050008 Health Insurance Plan, 61836WA0050008

  • Does Ambetter Secure Care 5 Health Insurance Plan, 61836WA0050008 support Mail Ordering?

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

  • Does (61836WA0050008) Health Insurance Plan, Variant (61836WA0050008-01) offer Disease Management Programs?

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

    Does (61836WA0050008) Health Insurance Plan, Variant (61836WA0050008-01) have Out Of Country Coverage?

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

    Does (61836WA0050008) Health Insurance Plan, Variant (61836WA0050008-01) 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 (61836WA0050008) Health Insurance Plan, Variant (61836WA0050008-01) offer Disease Management Programs?

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

    Does Ambetter Secure Care 5 Health Insurance Plan, Variant (61836WA0050008-01) offer Disease Management Programs for Asthma?

    Yes, the Ambetter Secure Care 5 Health Insurance Plan Variant 61836WA0050008-01 offers Disease Management Program for Asthma.

    Does Ambetter Secure Care 5 Health Insurance Plan, Variant (61836WA0050008-01) offer Disease Management Programs for Heart disease?

    Yes, the Ambetter Secure Care 5 Health Insurance Plan Variant 61836WA0050008-01 offers Disease Management Program for Heart disease.

    Does Ambetter Secure Care 5 Health Insurance Plan, Variant (61836WA0050008-01) offer Disease Management Programs for Diabetes?

    Yes, the Ambetter Secure Care 5 Health Insurance Plan Variant 61836WA0050008-01 offers Disease Management Program for Diabetes.

    Does Ambetter Secure Care 5 Health Insurance Plan, Variant (61836WA0050008-01) offer Disease Management Programs for Pregnancy?

    Yes, the Ambetter Secure Care 5 Health Insurance Plan Variant 61836WA0050008-01 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 03 Dec 2024 06:24 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