Delta Dental PPO Basic Plan for Families - 18802LA0010006 Health Insurance Plan

Delta Dental Insurance Company health insurance plan with the Plan ID 18802LA0010006. The plan is called Delta Dental PPO Basic Plan for Families.

Health Insurance Plan ID 18802LA0010006
Health Insurance Plan Year 2025
State Louisiana
Health Insurance Issuer Delta Dental Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 18802LA0010006-01
Provider Network(s) DELTA-DENTAL-PPO
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Dec 2024 06:12 GMT).

Providers Louisiana All US States
All 910 1018
PCP N/A 1
Allergy N/A N/A
OB/GYN N/A N/A
Dentists 602 680
Available Variants of the Health Plan

Standard On Exchange Plan - 18802LA0010006-01

Last Plan Update Date Wed, 07 Aug 2024 00:00 GMT
Last Import Date Tue, 17 Dec 2024 06:12 GMT

Benefits of Delta Dental PPO Basic Plan for Families Health Insurance Plan, 18802LA0010006-01

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Basic Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Dental Check-Up for Children
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Major Dental Care - Adult
NO
Major Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Routine Dental Services (Adult)
YES

0.00% Coinsurance after deductible

0.00% Coinsurance after deductible

Delta Dental PPO Basic Plan for Families Health Insurance Plan Variant 18802LA0010006-01 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 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 18802LA001
Import Date 2024-08-07 08:50:15
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 18802
Issuer Marketplace Marketing Name Delta Dental
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 $50 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $50
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 $50 per person
Medical EHB Deductible, Out of Network, Individual $50
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $850 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $425 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $425
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 LAN001
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Nationwide Network
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 18802LA0010006-01
Plan Marketing Name Delta Dental PPO Basic Plan for Families
Plan Type PPO
Plan Variant Marketing Name Delta Dental PPO Basic Plan for Families
QHP/Non QHP On the Exchange
Service Area ID LAS001
Source Name HIOS
Plan ID 18802LA0010006
State Code LA
URL for Enrollment Payment URL

Copay & Coinsurance of Delta Dental PPO Basic Plan for Families Health Insurance Plan, 18802LA0010006

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

Frequently Asked Questions(FAQ) about Delta Dental PPO Basic Plan for Families, 18802LA0010006 Health Insurance Plan, 18802LA0010006

  • Does Delta Dental PPO Basic Plan for Families Health Insurance Plan, 18802LA0010006 support Mail Ordering?

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

  • Does (18802LA0010006) Health Insurance Plan, Variant (18802LA0010006-01) have Out Of Country Coverage?

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

    Does (18802LA0010006) Health Insurance Plan, Variant (18802LA0010006-01) have Out of Service Area Coverage?

    Yes. Details: Nationwide Network

 

Disclaimer: This is based on the import(Date: Tue, 17 Dec 2024 06:12 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