Anthem Dental Family Preventive - 32753MO0860006 Health Insurance Plan

Healthy Alliance Life Co(Anthem BCBS) health insurance plan with the Plan ID 32753MO0860006. The plan is called Anthem Dental Family Preventive.

Health Insurance Plan ID 32753MO0860006
Health Insurance Plan Year 2024
State Missouri
Health Insurance Issuer Healthy Alliance Life Co(Anthem BCBS)
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 32753MO0860006-00
Provider Network(s) PARTICIPATING
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 26 Nov 2024 06:27 GMT).

Providers Missouri All US States
All 2959 3298
PCP 739 821
Allergy 4 5
OB/GYN 27 31
Dentists N/A 12
Available Variants of the Health Plan

Standard Off Exchange Plan - 32753MO0860006-00

Standard On Exchange Plan - 32753MO0860006-01

Last Plan Update Date Wed, 03 Jul 2024 00:00 GMT
Last Import Date Tue, 26 Nov 2024 06:27 GMT

Benefits of Anthem Dental Family Preventive Health Insurance Plan, 32753MO0860006-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult
NO
Basic Dental Care - Child
YES

40.00% Coinsurance after deductible

40.00% Coinsurance after deductible
Dental Check-Up for Children

Limit: 2.0 Visit(s) per Year

YES

No Charge after deductible

No Charge after deductible
Major Dental Care - Adult
NO
Major Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child

Dentally necessary orthodontia only

YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Routine Dental Services (Adult)
YES

No Charge after deductible

30.00% Coinsurance after deductible

Anthem Dental Family Preventive Health Insurance Plan Variant 32753MO0860006-00 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 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1.0
First Tier Utilization 100%
HIOS Product ID 32753MO086
Import Date 2024-07-03 04:01:58
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 32753
Issuer Marketplace Marketing Name Anthem Blue Cross and Blue Shield
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 per group not applicable
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 $750 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $375
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 Yes
Network ID MON003
Out of Country Coverage Yes
Out of Country Coverage Description Out of Country covered services are reimbursed as out-of-network benefits.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description If a member does not use a network dentist, services will be reimbursed at the out-of-network level.
Plan Brochure URL
Plan Effective Date 2024-01-01
Plan Expiration Date 2024-12-31
Plan ID (Standard Component ID with Variant) 32753MO0860006-00
Plan Marketing Name Anthem Dental Family Preventive
Plan Type PPO
Plan Variant Marketing Name Anthem Dental Family Preventive
QHP/Non QHP Both
Service Area ID MOS009
Source Name HIOS
Plan ID 32753MO0860006
State Code MO
URL for Enrollment Payment URL

Copay & Coinsurance of Anthem Dental Family Preventive Health Insurance Plan, 32753MO0860006

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

Frequently Asked Questions(FAQ) about Anthem Dental Family Preventive, 32753MO0860006 Health Insurance Plan, 32753MO0860006

  • Does Anthem Dental Family Preventive Health Insurance Plan, 32753MO0860006 support Mail Ordering?

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

  • Does (32753MO0860006) Health Insurance Plan, Variant (32753MO0860006-00) have Out Of Country Coverage?

    Yes. Details: Out of Country covered services are reimbursed as out-of-network benefits.

    Does (32753MO0860006) Health Insurance Plan, Variant (32753MO0860006-00) have Out of Service Area Coverage?

    Yes. Details: If a member does not use a network dentist, services will be reimbursed at the out-of-network level.

 

Disclaimer: This is based on the import(Date: Tue, 26 Nov 2024 06:27 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