Guardian Pediatric Essentials - 62818MT0020005 Health Insurance Plan

Guardian Life Insurance Company of America health insurance plan with the Plan ID 62818MT0020005. The plan is called Guardian Pediatric Essentials.

Health Insurance Plan ID 62818MT0020005
Health Insurance Plan Year 2024
State Montana
Health Insurance Issuer Guardian Life Insurance Company of America
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 62818MT0020005-00
Provider Network(s) ['MTN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 24 Dec 2024 06:21 GMT).

Providers Montana 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 Off Exchange Plan - 62818MT0020005-00

Last Plan Update Date Tue, 15 Aug 2023 00:00 GMT
Last Import Date Tue, 24 Dec 2024 06:21 GMT

Benefits of Guardian Pediatric Essentials Health Insurance Plan, 62818MT0020005-00

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

50.00% Coinsurance after deductible

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

40.00%

40.00%
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

Orthodontia for children is only covered when medically necessary.

YES

50.00%

50.00%
Routine Dental Services (Adult)
NO

Guardian Pediatric Essentials Health Insurance Plan Variant 62818MT0020005-00 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 2024
Child-Only Offering Allows Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
First Tier Utilization 100%
HIOS Product ID 62818MT002
Import Date 2023-08-15 20:02:25
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan New
Issuer ID 62818
Issuer Marketplace Marketing Name Guardian
Market Coverage SHOP (Small Group)
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group $800 per group
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person $400 per person
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out $400
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 $150 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $150
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
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 per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual Not Applicable
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 MTN001
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 Brochure URL
Plan Effective Date 2024-01-01
Plan Expiration Date 2024-12-31
Plan ID (Standard Component ID with Variant) 62818MT0020005-00
Plan Marketing Name Guardian Pediatric Essentials
Plan Type Indemnity
Plan Variant Marketing Name Guardian Pediatric Essentials
QHP/Non QHP Off the Exchange
Service Area ID MTS001
Source Name SERFF
Plan ID 62818MT0020005
State Code MT
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL

Copay & Coinsurance of Guardian Pediatric Essentials Health Insurance Plan, 62818MT0020005

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

Frequently Asked Questions(FAQ) about Guardian Pediatric Essentials, 62818MT0020005 Health Insurance Plan, 62818MT0020005

  • Does Guardian Pediatric Essentials Health Insurance Plan, 62818MT0020005 support Mail Ordering?

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

  • Does (62818MT0020005) Health Insurance Plan, Variant (62818MT0020005-00) have Out Of Country Coverage?

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

    Does (62818MT0020005) Health Insurance Plan, Variant (62818MT0020005-00) 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, 24 Dec 2024 06:21 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