DentaQuest Family High - 40198VA0020012 Health Insurance Plan

40198 health insurance plan with the Plan ID 40198VA0020012. The plan is called DentaQuest Family High.

Health Insurance Plan ID 40198VA0020012
Health Insurance Plan Year 2024
State Virginia
Health Insurance Issuer 40198
Health Insurance Plan Variant 40198VA0020012-01
Provider Network(s) NULL
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 Virginia 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 - 40198VA0020012-01

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

DentaQuest Family High Health Insurance Plan Variant 40198VA0020012-01 Attributes

Plan Attribute Value
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 100.00%
First Tier Utilization 100%
HIOS Product ID 40198VA002
Import Date 2/12/2024
Guaranteed Rate Guaranteed Rate
IsItANewPlan New
Issuer ID 40198
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 $50 per person | $150 per group
Medical EHB Deductible, Combined In/Out of Network, Individual $50
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 High
Multiple In Network Tiers No
National Network No
Network ID VAN003
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency Only. In excess of 50 miles from nearest provider.
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 40198VA0020012-01
Plan Marketing Name DentaQuest Family High
Plan Type PPO
Plan Variant Marketing Name DentaQuest Family High
QHP/Non QHP Both
Service Area ID VAS002
Source Name SERFF
Plan ID 40198VA0020012
State Code VA
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of DentaQuest Family High Health Insurance Plan, 40198VA0020012

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

Frequently Asked Questions(FAQ) about DentaQuest Family High, 40198VA0020012 Health Insurance Plan, 40198VA0020012

  • Does DentaQuest Family High Health Insurance Plan, 40198VA0020012 support Mail Ordering?

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

  • Does (40198VA0020012) Health Insurance Plan, Variant (40198VA0020012-01) have Out Of Country Coverage?

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

    Does (40198VA0020012) Health Insurance Plan, Variant (40198VA0020012-01) have Out of Service Area Coverage?

    Yes. Details: Emergency Only. In excess of 50 miles from nearest provider.

 

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