IAFN Silver 5500 Separate RX Deductible POS - 44648ID1310008 Health Insurance Plan
Regence BlueShield of Idaho health insurance plan with the Plan ID 44648ID1310008. The plan is called IAFN Silver 5500 Separate RX Deductible POS.
Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 73.63% (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 26.37% 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 | 44648ID1310008 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | Idaho | ||||||||||||||||||
| Health Insurance Issuer | Regence BlueShield of Idaho | ||||||||||||||||||
| Health Insurance Plan Variant | 44648ID1310008-04 | ||||||||||||||||||
| 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). |
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| Available Variants of the Health Plan | Standard On Exchange Plan - 44648ID1310008-01 Open to Indians below 300% FPL - 44648ID1310008-02 Open to Indians above 300% FPL - 44648ID1310008-03 73% AV Silver Plan - 44648ID1310008-04 |
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| Last Plan Update Date | Mon, 12 Feb 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
IAFN Silver 5500 Separate RX Deductible POS Health Insurance Plan Variant 44648ID1310008-04 Attributes
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.736293183 |
| Business Year | 2024 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | 73% AV Level Silver Plan |
| Drug EHB Deductible, Combined In/Out of Network, Family | $4000 per person | $8000 per group |
| Drug EHB Deductible, Combined In/Out of Network, Individual | $4,000 |
| Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 20.00% |
| Drug EHB Deductible, In Network (Tier 1), Family | $2000 per person | $4000 per group |
| Drug EHB Deductible, In Network (Tier 1), Individual | $2,000 |
| Drug EHB Deductible, Out of Network, Family | $2000 per person | $4000 per group |
| Drug EHB Deductible, Out of Network, Individual | $2,000 |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| EHB Percent of Total Premium | 99% |
| First Tier Utilization | 100% |
| Formulary ID | IDF007 |
| 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? | No |
| Issuer ID | 44648 |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | No |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Medical EHB Deductible, Combined In/Out of Network, Family | $20300 per person | $40600 per group |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $20,300 |
| Medical EHB Deductible, In Network (Tier 1), Default Coinsurance | 20.00% |
| Medical EHB Deductible, In Network (Tier 1), Family | $4000 per person | $8000 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $4,000 |
| Medical EHB Deductible, Out of Network, Family | $16300 per person | $32600 per group |
| Medical EHB Deductible, Out of Network, Individual | $16,300 |
| Metal Level | Silver |
| 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) | 44648ID1310008-04 |
| Plan Marketing Name | IAFN Silver 5500 Separate RX Deductible POS |
| Plan Type | POS |
| Plan Variant Marketing Name | IAFN Silver 5500 Separate RX Deductible POS |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $1,743 |
| SBC Scenario, Having a Baby, Copayment | $11 |
| SBC Scenario, Having a Baby, Deductible | $3,500 |
| SBC Scenario, Having a Baby, Limit | $61 |
| SBC Scenario, Having Diabetes, Coinsurance | $937 |
| SBC Scenario, Having Diabetes, Copayment | $384 |
| SBC Scenario, Having Diabetes, Deductible | $877 |
| SBC Scenario, Having Diabetes, Limit | $178 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $257 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,454 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | IDS001 |
| Source Name | SERFF |
| Plan ID | 44648ID1310008 |
| State Code | ID |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family | $88750 per person | $177500 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $88,750 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family | $7250 per person | $14500 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $7,250 |
| 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 Silver 5500 Separate RX Deductible POS Health Insurance Plan, 44648ID1310008
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about IAFN Silver 5500 Separate RX Deductible POS, 44648ID1310008 Health Insurance Plan, 44648ID1310008
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Does IAFN Silver 5500 Separate RX Deductible POS Health Insurance Plan, 44648ID1310008 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (44648ID1310008) Health Insurance Plan, Variant (44648ID1310008-04) have Out Of Country Coverage?
Does (44648ID1310008) Health Insurance Plan, Variant (44648ID1310008-04) have Out of Service Area Coverage?
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