IAFN Gold 2500 POS - 44648ID1310011 Health Insurance Plan

Regence BlueShield of Idaho health insurance plan with the Plan ID 44648ID1310011. The plan is called IAFN Gold 2500 POS.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 78.07% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 21.93% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Health Insurance Plan ID 44648ID1310011
Health Insurance Plan Year 2024
State Idaho
Health Insurance Issuer Regence BlueShield of Idaho
Health Insurance Plan Variant 44648ID1310011-03
Provider Network(s) PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT).

Providers Idaho All US States
All 5548 6360
PCP 593 671
Allergy 2 2
OB/GYN 20 25
Dentists 409 496
Available Variants of the Health Plan

Standard On Exchange Plan - 44648ID1310011-01

Open to Indians below 300% FPL - 44648ID1310011-02

Open to Indians above 300% FPL - 44648ID1310011-03

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Thu, 21 Nov 2024 00:44 GMT

IAFN Gold 2500 POS Health Insurance Plan Variant 44648ID1310011-03 Attributes

Plan Attribute Value
AV Calculator Output Number 0.780690421
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Limited Cost Sharing Plan Variation
Dental Only Plan No
Design Type Not Applicable
EHB Percent of Total Premium 99%
First Tier Utilization 100%
Formulary ID IDF005
HIOS Product ID 44648ID131
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer ID 44648
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers No
National Network Yes
Network ID IDN001
Out of Country Coverage Yes
Out of Country Coverage Description Members traveling outside the United States receive coverage for the same benefits as inside the United States. Members who do not seek inpatient care at a BlueCross BlueShield Global Hospital may have to pay a provider upfront for care and submit an international claim form to be reimbursed.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Out of Area benefits are covered on Blue Card which provides access to the largest network of doctors in the United States
Plan Effective Date 1/1/2024
Plan ID (Standard Component ID with Variant) 44648ID1310011-03
Plan Marketing Name IAFN Gold 2500 POS
Plan Type POS
Plan Variant Marketing Name IAFN Gold 2500 POS
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,000
SBC Scenario, Having a Baby, Copayment $10
SBC Scenario, Having a Baby, Deductible $2,500
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $600
SBC Scenario, Having Diabetes, Copayment $300
SBC Scenario, Having Diabetes, Deductible $900
SBC Scenario, Having Diabetes, Limit $200
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $200
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,500
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID IDS001
Source Name SERFF
Specialist Requiring a Referral A provider focusing on a specific area of medicine or a group of patients to diagnose, manage, prevent, or treat certain types of symptoms and conditions.
Plan ID 44648ID1310011
State Code ID
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family $90950 per person | $181900 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $90,950
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family $18800 per person | $37600 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $18,800
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 10.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $2500 per person | $5000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $2,500
TEHBDedOutofNetFamily $16300 per person | $32600 per group
Combined Medical and Drug EHB Deductible, Out of Network, Individual $16,300
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $9450 per person | $18900 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,450
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family $81500 per person | $163000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $81,500
Unique Plan Design No
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of IAFN Gold 2500 POS Health Insurance Plan, 44648ID1310011

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

Frequently Asked Questions(FAQ) about IAFN Gold 2500 POS, 44648ID1310011 Health Insurance Plan, 44648ID1310011

  • Does IAFN Gold 2500 POS Health Insurance Plan, 44648ID1310011 support Mail Ordering?

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

  • Does (44648ID1310011) Health Insurance Plan, Variant (44648ID1310011-03) have Out Of Country Coverage?

    Yes. Details: Members traveling outside the United States receive coverage for the same benefits as inside the United States. Members who do not seek inpatient care at a BlueCross BlueShield Global Hospital may have to pay a provider upfront for care and submit an international claim form to be reimbursed.

    Does (44648ID1310011) Health Insurance Plan, Variant (44648ID1310011-03) have Out of Service Area Coverage?

    Yes. Details: Out of Area benefits are covered on Blue Card which provides access to the largest network of doctors in the United States

 

Disclaimer: This is based on the import(Date: Thu, 21 Nov 2024 00:44 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