Clear Choice Maine's Choice Plus HMO Silver 3000 - 96667ME0310110 Health Insurance Plan

Harvard Pilgrim Healthcare, Inc. health insurance plan with the Plan ID 96667ME0310110. The plan is called Clear Choice Maine's Choice Plus HMO Silver 3000 .

Based on the data of Health Plan Issuer, this plan has an actuarial value of 100.00% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 0.00% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 96667ME0310110
Health Insurance Plan Year 2024
State Maine
Health Insurance Issuer Harvard Pilgrim Healthcare, Inc.
Health Insurance Plan Variant 96667ME0310110-02
Provider Network(s) ['MEN002']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT).

Providers Maine All US States
All N/A N/A
PCP N/A N/A
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 - 96667ME0310110-01

Open to Indians below 300% FPL - 96667ME0310110-02

Open to Indians above 300% FPL - 96667ME0310110-03

73% AV Silver Plan - 96667ME0310110-04

87% AV Silver Plan - 96667ME0310110-05

94% AV Silver Plan - 96667ME0310110-06

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Thu, 21 Nov 2024 00:44 GMT

Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 Attributes

Plan Attribute Value
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Zero Cost Sharing Plan Variation
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
EHB Percent of Total Premium 99%
First Tier Utilization 70%
Formulary ID MEF011
HIOS Product ID 96667ME031
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer Actuarial Value 100.00%
Issuer ID 96667
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers Yes
National Network No
Network ID MEN002
Out of Country Coverage No
Out of Service Area Coverage No
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 96667ME0310110-02
Plan Marketing Name Clear Choice Maine's Choice Plus HMO Silver 3000
Plan Type HMO
Plan Variant Marketing Name Maine's Choice Plus HMO CSR 100
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $0
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Second Tier Utilization 30%
Service Area ID MES002
Source Name SERFF
Specialist Requiring a Referral A Referral is Needed for all Specialist except for OB/GYN, Chiropractic Care, Routine Eye Exams, and Mental Health Providers.
Plan ID 96667ME0310110
State Code ME
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $0
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 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $0
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Default Coinsurance 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual $0
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 $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $0
Unique Plan Design Yes
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of Clear Choice Maine's Choice Plus HMO Silver 3000 Health Insurance Plan, 96667ME0310110

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

Frequently Asked Questions(FAQ) about Clear Choice Maine's Choice Plus HMO Silver 3000 , 96667ME0310110 Health Insurance Plan, 96667ME0310110

  • Does Clear Choice Maine's Choice Plus HMO Silver 3000 Health Insurance Plan, 96667ME0310110 support Mail Ordering?

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

  • Does (96667ME0310110) Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

    Does (96667ME0310110) Health Insurance Plan, Variant (96667ME0310110-02) have Out Of Country Coverage?

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

    Does (96667ME0310110) Health Insurance Plan, Variant (96667ME0310110-02) 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 (96667ME0310110) Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Asthma?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Asthma.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Heart disease?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Heart disease.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Depression?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Depression.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Diabetes?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Diabetes.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Low back pain?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Low back pain.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Pregnancy?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Pregnancy.

    Does Maine's Choice Plus HMO CSR 100 Health Insurance Plan, Variant (96667ME0310110-02) offer Disease Management Programs for Weight loss programs?

    Yes, the Maine's Choice Plus HMO CSR 100 Health Insurance Plan Variant 96667ME0310110-02 offers Disease Management Program for Weight loss programs.

 

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