DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental - 10345NY0030009 Health Insurance Plan

10345 health insurance plan with the Plan ID 10345NY0030009. The plan is called DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental.

Health Insurance Plan ID 10345NY0030009
Health Insurance Plan Year 2024
State New York
Health Insurance Issuer 10345
Health Insurance Plan Variant 10345NY0030009-01
Provider Network(s) ['NYN002']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 10 Dec 2024 06:32 GMT).

Providers New York 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 - 10345NY0030009-01

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Tue, 10 Dec 2024 06:32 GMT

DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental Health Insurance Plan Variant 10345NY0030009-01 Attributes

Plan Attribute Value
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 100.00%
First Tier Utilization 100%
HIOS Product ID 10345NY003
Import Date 2/12/2024
Guaranteed Rate Guaranteed Rate
IsItANewPlan Existing
Issuer ID 10345
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 per person not applicable | per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family per person not applicable | per group not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
Medical EHB Deductible, Out of Network, Family per person not applicable | per group not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
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 NYN002
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Nationwide Network
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 10345NY0030009-01
Plan Marketing Name DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental
Plan Type HMO
Plan Variant Marketing Name DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental
QHP/Non QHP On the Exchange
Service Area ID NYS002
Source Name SERFF
Plan ID 10345NY0030009
State Code NY
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental Health Insurance Plan, 10345NY0030009

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

Frequently Asked Questions(FAQ) about DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental, 10345NY0030009 Health Insurance Plan, 10345NY0030009

  • Does DeltaCare USA Basic Plan for Families NS INN Dep 25 Family Dental Health Insurance Plan, 10345NY0030009 support Mail Ordering?

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

  • Does (10345NY0030009) Health Insurance Plan, Variant (10345NY0030009-01) have Out Of Country Coverage?

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

    Does (10345NY0030009) Health Insurance Plan, Variant (10345NY0030009-01) have Out of Service Area Coverage?

    Yes. Details: Nationwide Network

 

Disclaimer: This is based on the import(Date: Tue, 10 Dec 2024 06:32 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