Delta Dental of Illinois health insurance plan with the Plan ID 60600IL0010003. The plan is called Delta Dental Individual Preferred Plan.
Health Insurance Plan ID | 60600IL0010003 | ||||||||||||||||||
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Health Insurance Plan Year | 2024 | ||||||||||||||||||
State | Illinois | ||||||||||||||||||
Health Insurance Issuer | Delta Dental of Illinois | ||||||||||||||||||
Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
Health Insurance Plan Variant | 60600IL0010003-01 | ||||||||||||||||||
Provider Network(s) | DELTA-DENTAL-PPO | ||||||||||||||||||
In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 27 Aug 2024 05:58 GMT). |
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Available Variants of the Health Plan | |||||||||||||||||||
Last Plan Update Date | Tue, 15 Aug 2023 00:00 GMT | ||||||||||||||||||
Last Import Date | Tue, 27 Aug 2024 05:58 GMT |
Benefit | Covered | In Network | Out Of Network |
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Accidental Dental
|
NO | ||
Basic Dental Care - Adult
6 Month Waiting Period |
YES | 50.00% Coinsurance after deductible |
100.00% |
Basic Dental Care - Child
|
YES | 20.00% Coinsurance after deductible |
100.00% |
Dental Check-Up for Children
One every 6 months and one every 12 months in a school setting |
YES | 0.00% |
100.00% |
Major Dental Care - Adult
12 Month Waiting Period |
YES | 50.00% Coinsurance after deductible |
100.00% |
Major Dental Care - Child
|
YES | 50.00% Coinsurance after deductible |
100.00% |
Orthodontia - Adult
|
NO | ||
Orthodontia - Child
Medically Necessary Only |
YES | 50.00% |
100.00% |
Routine Dental Services (Adult)
Limit: 1.0 Visit(s) per 6 Months |
YES | 0.00% Coinsurance after deductible |
100.00% |
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 | 2024 |
Child-Only Offering | Allows Adult and Child-Only |
Composite Rating Offered | No |
CSR Variation Type | Standard High On Exchange Plan |
Dental Only Plan | Yes |
EHB Apportionment for Pediatric Dental | 1.0 |
First Tier Utilization | 100% |
HIOS Product ID | 60600IL001 |
Import Date | 2023-08-15 20:02:25 |
Inpatient Copayment Maximum Days | 0 |
Guaranteed Rate | Guaranteed Rate |
New/Existing Plan | Existing |
Issuer ID | 60600 |
Issuer Marketplace Marketing Name | Delta Dental of Illinois |
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 | per person not applicable |
Medical EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
Medical EHB Deductible, In Network (Tier 1), Family Per Group | per group not applicable |
Medical EHB Deductible, In Network (Tier 1), Family Per Person | $50 per person |
Medical EHB Deductible, In Network (Tier 1), Individual | $50 |
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 | 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 | High |
Multiple In Network Tiers | No |
National Network | Yes |
Network ID | ILN001 |
Out of Country Coverage | Yes |
Out of Country Coverage Description | Emergency Only |
Out of Service Area Coverage | Yes |
Out of Service Area Coverage Description | All Benefits; Must See Delta Dental PPO Provider |
Plan Brochure | URL |
Plan Effective Date | 2024-01-01 |
Plan Expiration Date | 2024-12-31 |
Plan ID (Standard Component ID with Variant) | 60600IL0010003-01 |
Plan Marketing Name | Delta Dental Individual Preferred Plan |
Plan Type | EPO |
Plan Variant Marketing Name | Delta Dental Individual Preferred Plan |
QHP/Non QHP | Both |
Service Area ID | ILS001 |
Source Name | SERFF |
Plan ID | 60600IL0010003 |
State Code | IL |
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: Tue, 27 Aug 2024 05:58 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