Innovation Health - Aetna Bronze S: HMO - 86443VA0080010 Health Insurance Plan

Innovation Health Plan, Inc. health insurance plan with the Plan ID 86443VA0080010. The plan is called Innovation Health - Aetna Bronze S: HMO.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 64.39% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 35.61% of the costs of all covered benefits (according to the Issuer).

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 64.39% (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 35.61% 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 86443VA0080010
Health Insurance Plan Year 2024
State Virginia
Health Insurance Issuer Innovation Health Plan, Inc.
Health Insurance Plan Variant 86443VA0080010-01
Provider Network(s) NON-PREFERRED 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 Virginia All US States
All 1626 2024
PCP 388 456
Allergy 2 3
OB/GYN 13 16
Dentists 3 3
Available Variants of the Health Plan

Standard On Exchange Plan - 86443VA0080010-01

Open to Indians below 300% FPL - 86443VA0080010-02

Open to Indians above 300% FPL - 86443VA0080010-03

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

Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.6439
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze On Exchange Plan
Dental Only Plan No
Design Type Design 1
Disease Management Programs Offered Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
EHB Percent of Total Premium 100%
First Tier Utilization 100%
Formulary ID VAF005
HIOS Product ID 86443VA008
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer Actuarial Value 64.39%
Issuer ID 86443
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Expanded Bronze
Multiple In Network Tiers No
National Network No
Network ID VAN001
Out of Country Coverage No
Out of Service Area Coverage No
Out of Service Area Coverage Description Except for Emergencies
Plan Effective Date 1/1/2024
Plan ID (Standard Component ID with Variant) 86443VA0080010-01
Plan Marketing Name Innovation Health - Aetna Bronze S: HMO
Plan Type HMO
Plan Variant Marketing Name Innovation Health - Aetna Bronze S: HMO
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,900
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $7,500
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $1,200
SBC Scenario, Having Diabetes, Deductible $3,200
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $400
SBC Scenario, Treatment of a Simple Fracture, Deductible $1,900
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID VAS001
Source Name SERFF
Specialist Requiring a Referral Referral required for all physicians EXCEPT OB/GYN, ER, Internal Medicine, Family Practice, General Medicine and Pediatrician.
Plan ID 86443VA0080010
State Code VA
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 50.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $7500 per person | $15000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $7,500
TEHBDedOutofNetFamily per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $9400 per person | $18800 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,400
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, 86443VA0080010

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

Frequently Asked Questions(FAQ) about Innovation Health - Aetna Bronze S: HMO, 86443VA0080010 Health Insurance Plan, 86443VA0080010

  • Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, 86443VA0080010 support Mail Ordering?

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

  • Does (86443VA0080010) Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

    Does (86443VA0080010) Health Insurance Plan, Variant (86443VA0080010-01) have Out Of Country Coverage?

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

    Does (86443VA0080010) Health Insurance Plan, Variant (86443VA0080010-01) have Out of Service Area Coverage?

    No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan). Details: Except for Emergencies

    Does (86443VA0080010) Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for Asthma?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for Asthma.

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for Heart disease?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for Heart disease.

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for Depression?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for Depression.

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for Diabetes?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for Diabetes.

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for Low back pain?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for Low back pain.

    Does Innovation Health - Aetna Bronze S: HMO Health Insurance Plan, Variant (86443VA0080010-01) offer Disease Management Programs for Pregnancy?

    Yes, the Innovation Health - Aetna Bronze S: HMO Health Insurance Plan Variant 86443VA0080010-01 offers Disease Management Program for Pregnancy.

 

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