BEST Life and Health Insurance Company health insurance plan with the Plan ID 63790KS0020006. The plan is called BEST Life Essential Value Dental Plan.
Health Insurance Plan ID | 63790KS0020006 | ||||||||||||||||||
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Health Insurance Plan Year | 2025 | ||||||||||||||||||
State | Kansas | ||||||||||||||||||
Health Insurance Issuer | BEST Life and Health Insurance Company | ||||||||||||||||||
Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
Health Insurance Plan Variant | 63790KS0020006-01 | ||||||||||||||||||
Provider Network(s) | IN-NETWORK | ||||||||||||||||||
In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT). |
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Available Variants of the Health Plan | |||||||||||||||||||
Last Plan Update Date | Tue, 24 Sep 2024 00:00 GMT | ||||||||||||||||||
Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
Benefit | Covered | In Network | Out Of Network |
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Accidental Dental
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YES | ||
Basic Dental Care - Adult
|
YES | 50.00% Coinsurance after deductible |
70.00% Coinsurance after deductible |
Basic Dental Care - Child
|
YES | 40.00% Coinsurance after deductible |
70.00% Coinsurance after deductible |
Dental Check-Up for Children
|
YES | No Charge after deductible |
20.00% Coinsurance after deductible |
Major Dental Care - Adult
|
YES | 70.00% Coinsurance after deductible |
80.00% Coinsurance after deductible |
Major Dental Care - Child
|
YES | 50.00% Coinsurance after deductible |
70.00% Coinsurance after deductible |
Orthodontia - Adult
|
NO | ||
Orthodontia - Child
Orthodontic services require prior authorization and are only covered for eligible children with cases of severe orthodontic abnormality caused by genetic deformity (such as cleft lip or cleft palate) or traumatic facial injury resulting in serious health impairment to the beneficiary at the present time. |
YES | 50.00% |
70.00% |
Routine Dental Services (Adult)
|
YES | No Charge |
30.00% |
Plan Attribute | Value |
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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 Low On Exchange Plan |
Dental Only Plan | Yes |
EHB Apportionment for Pediatric Dental | 1.0 |
First Tier Utilization | 100% |
HIOS Product ID | 63790KS002 |
Import Date | 2024-09-24 20:01:47 |
Inpatient Copayment Maximum Days | 0 |
Guaranteed Rate | Guaranteed Rate |
New/Existing Plan | Existing |
Issuer ID | 63790 |
Issuer Marketplace Marketing Name | BEST Life |
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 | $75 per person |
Medical EHB Deductible, Combined In/Out of Network, Individual | $75 |
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 | $700 per group |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $350 per person |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $350 |
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group | $1400 per group |
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person | $700 per person |
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual | $700 |
Metal Level | Low |
Multiple In Network Tiers | No |
National Network | Yes |
Network ID | KSN001 |
Out of Country Coverage | No |
Out of Service Area Coverage | Yes |
Out of Service Area Coverage Description | Network or UCR |
Plan Brochure | URL |
Plan Effective Date | 2025-01-01 |
Plan Expiration Date | 2025-12-31 |
Plan ID (Standard Component ID with Variant) | 63790KS0020006-01 |
Plan Marketing Name | BEST Life Essential Value Dental Plan |
Plan Type | PPO |
Plan Variant Marketing Name | BEST Life Essential Value Dental Plan |
QHP/Non QHP | Both |
Service Area ID | KSS001 |
Source Name | SERFF |
Plan ID | 63790KS0020006 |
State Code | KS |
URL for Enrollment Payment | URL |
Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Disclaimer: This is based on the import(Date: Thu, 21 Nov 2024 00:44 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