Choice PPO Basic Pediatric - 35152NJ0010003 Health Insurance Plan
35152 health insurance plan with the Plan ID 35152NJ0010003. The plan is called Choice PPO Basic Pediatric.
| Health Insurance Plan ID | 35152NJ0010003 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | New Jersey | ||||||||||||||||||
| Health Insurance Issuer | 35152 | ||||||||||||||||||
| Health Insurance Plan Variant | 35152NJ0010003-01 | ||||||||||||||||||
| Provider Network(s) | CHOICE | ||||||||||||||||||
| 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 | Mon, 12 Feb 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
Choice PPO Basic Pediatric Health Insurance Plan Variant 35152NJ0010003-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2024 |
| Child-Only Offering | Allows Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Low On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 100.00% |
| First Tier Utilization | 100% |
| HIOS Product ID | 35152NJ001 |
| Import Date | 2/12/2024 |
| Guaranteed Rate | Guaranteed Rate |
| IsItANewPlan | Existing |
| Issuer ID | 35152 |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | Not Applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family | $100 per person | $200 per group |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $100 |
| Medical EHB Deductible, In Network (Tier 1), Family | $100 per person | $200 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $100 |
| Medical EHB Deductible, Out of Network, Family | $100 per person | $200 per group |
| Medical EHB Deductible, Out of Network, Individual | $100 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family | $400 per person | $800 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $400 |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family | per person not applicable | per group 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 | NJN002 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Standard Out of Network PPO Benefits |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Standard Out of Network PPO Benefits |
| Plan Effective Date | 1/1/2024 |
| Plan Expiration Date | 12/31/2024 |
| Plan ID (Standard Component ID with Variant) | 35152NJ0010003-01 |
| Plan Marketing Name | Choice PPO Basic Pediatric |
| Plan Type | PPO |
| Plan Variant Marketing Name | Choice PPO Basic Pediatric |
| QHP/Non QHP | Both |
| Service Area ID | NJS002 |
| Source Name | SERFF |
| Plan ID | 35152NJ0010003 |
| State Code | NJ |
| Version Number | 1 |
| Wellness Program Offered | No |
Copay & Coinsurance of Choice PPO Basic Pediatric Health Insurance Plan, 35152NJ0010003
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Choice PPO Basic Pediatric, 35152NJ0010003 Health Insurance Plan, 35152NJ0010003
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Does Choice PPO Basic Pediatric Health Insurance Plan, 35152NJ0010003 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (35152NJ0010003) Health Insurance Plan, Variant (35152NJ0010003-01) have Out Of Country Coverage?
Does (35152NJ0010003) Health Insurance Plan, Variant (35152NJ0010003-01) have Out of Service Area Coverage?
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