Guardian Family Essentials, NS, OON DentalGuard Preferred Network, Dep25, Adult/Family Dental, WP - 42640NY0320001 Health Insurance Plan

42640 health insurance plan with the Plan ID 42640NY0320001. The plan is called Guardian Family Essentials, NS, OON DentalGuard Preferred Network, Dep25, Adult/Family Dental, WP.

Health Insurance Plan ID 42640NY0320001
Health Insurance Plan Year 2024
State New York
Health Insurance Issuer 42640
Health Insurance Plan Variant 42640NY0320001-01
Provider Network(s) ['NYN001']
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 - 42640NY0320001-01

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

Guardian Family Essentials, NS, INN, OON DentalGuard Preferred Network, Adult/Family Dental, Dep 25, Family Dental, WP Health Insurance Plan Variant 42640NY0320001-01 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 42640NY032
Import Date 2/12/2024
Guaranteed Rate Guaranteed Rate
IsItANewPlan Existing
Issuer ID 42640
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 $50 per person | $100 per group
Medical EHB Deductible, In Network (Tier 1), Individual $50
Medical EHB Deductible, Out of Network, Family $100 per person | $200 per group
Medical EHB Deductible, Out of Network, Individual $100
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 NYN001
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Coverage is provided outside of the Service Area.
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 42640NY0320001-01
Plan Marketing Name Guardian Family Essentials, NS, OON DentalGuard Preferred Network, Dep25, Adult/Family Dental, WP
Plan Type PPO
Plan Variant Marketing Name Guardian Family Essentials, NS, INN, OON DentalGuard Preferred Network, Adult/Family Dental, Dep 25, Family Dental, WP
QHP/Non QHP Both
Service Area ID NYS001
Source Name SERFF
Plan ID 42640NY0320001
State Code NY
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of Guardian Family Essentials, NS, OON DentalGuard Preferred Network, Dep25, Adult/Family Dental, WP Health Insurance Plan, 42640NY0320001

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

Frequently Asked Questions(FAQ) about Guardian Family Essentials, NS, OON DentalGuard Preferred Network, Dep25, Adult/Family Dental, WP, 42640NY0320001 Health Insurance Plan, 42640NY0320001

  • Does Guardian Family Essentials, NS, OON DentalGuard Preferred Network, Dep25, Adult/Family Dental, WP Health Insurance Plan, 42640NY0320001 support Mail Ordering?

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

  • Does (42640NY0320001) Health Insurance Plan, Variant (42640NY0320001-01) have Out Of Country Coverage?

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

    Does (42640NY0320001) Health Insurance Plan, Variant (42640NY0320001-01) have Out of Service Area Coverage?

    Yes. Details: Coverage is provided outside of the Service Area.

 

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