Cigna Dental Family + Pediatric - 86830AZ0050002 Health Insurance Plan
Cigna Health and Life Insurance Company health insurance plan with the Plan ID 86830AZ0050002. The plan is called Cigna Dental Family + Pediatric.
| Health Insurance Plan ID | 86830AZ0050002 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | Arizona | ||||||||||||||||||
| Health Insurance Issuer | Cigna Health and Life Insurance Company | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 86830AZ0050002-01 | ||||||||||||||||||
| Provider Network(s) | PREFERRED | ||||||||||||||||||
| 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 | Fri, 03 Nov 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
Benefits of Cigna Dental Family + Pediatric Health Insurance Plan, 86830AZ0050002-01
| Benefit | Covered | In Network | Out Of Network |
|---|---|---|---|
| Accidental Dental
Child Coverage Only. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 0.00% |
0.00% |
| Accidental Dental Adult
Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 20.00% Coinsurance after deductible |
20.00% Coinsurance after deductible |
| Basic Dental Care - Adult
Adult dental benefits are subject to $1000 per person per year maximum for all covered services. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 20.00% Coinsurance after deductible |
20.00% Coinsurance after deductible |
| Basic Dental Care - Child
Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Dental Check-Up for Children
Limit: 1.0 Visit(s) per 6 Months Dental Check-up is limited to 1 per 6 consecutive month period. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 0.00% |
0.00% |
| Major Dental Care - Adult
Adult dental benefits are subject to $1000 per person per year maximum for all covered services. Routine Dental Services is limited to 1 per 6 consecutive month period. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Major Dental Care - Child
Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Orthodontia - Adult
|
NO | ||
| Orthodontia - Child
Medically necessary only. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Routine Dental Services (Adult)
Limit: 1.0 Visit(s) per 6 Months Adult dental benefits are subject to $1000 per person per year maximum for all covered services. Routine Dental Services is limited to 1 per 6 consecutive month period. Please refer to the Plan Brochure for detailed services covered, not covered, and frequency limitations. |
YES | 0.00% |
0.00% |
Cigna Dental Family + Pediatric Health Insurance Plan Variant 86830AZ0050002-01 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 On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 1.0 |
| First Tier Utilization | 100% |
| HIOS Product ID | 86830AZ005 |
| Import Date | 2023-11-03 01:01:53 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Guaranteed Rate |
| New/Existing Plan | Existing |
| Issuer ID | 86830 |
| Issuer Marketplace Marketing Name | Cigna Healthcare |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group | $800 per group |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person | $400 per person |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | $400 |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Group | $300 per group |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Person | $150 per person |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $150 |
| 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 | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | per person not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | Not Applicable |
| 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 | AZN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergency Services |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | All Services |
| Plan Brochure | URL |
| Plan Effective Date | 2024-01-01 |
| Plan Expiration Date | 2024-12-31 |
| Plan ID (Standard Component ID with Variant) | 86830AZ0050002-01 |
| Plan Marketing Name | Cigna Dental Family + Pediatric |
| Plan Type | PPO |
| Plan Variant Marketing Name | Cigna Dental Family + Pediatric |
| QHP/Non QHP | On the Exchange |
| Service Area ID | AZS001 |
| Source Name | HIOS |
| Plan ID | 86830AZ0050002 |
| State Code | AZ |
| URL for Enrollment Payment | URL |
Copay & Coinsurance of Cigna Dental Family + Pediatric Health Insurance Plan, 86830AZ0050002
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Cigna Dental Family + Pediatric, 86830AZ0050002 Health Insurance Plan, 86830AZ0050002
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Does Cigna Dental Family + Pediatric Health Insurance Plan, 86830AZ0050002 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (86830AZ0050002) Health Insurance Plan, Variant (86830AZ0050002-01) have Out Of Country Coverage?
Does (86830AZ0050002) Health Insurance Plan, Variant (86830AZ0050002-01) 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