MedMutual Dental 3 - 99969OH0150003 Health Insurance Plan
Medical Health Insuring Corp. of Ohio health insurance plan with the Plan ID 99969OH0150003. The plan is called MedMutual Dental 3.
| Health Insurance Plan ID | 99969OH0150003 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | Ohio | ||||||||||||||||||
| Health Insurance Issuer | Medical Health Insuring Corp. of Ohio | ||||||||||||||||||
| Health Insurance Plan Variant | 99969OH0150003-00 | ||||||||||||||||||
| Provider Network(s) | ['OHN003'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 03 Dec 2024 06:24 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Thu, 11 Jan 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 03 Dec 2024 06:24 GMT |
Benefits of MedMutual Dental 3 Health Insurance Plan, 99969OH0150003-00
| Benefit | Covered | In Network | Out Of Network |
|---|---|---|---|
| Accidental Dental
|
NO | ||
| Basic Dental Care - Adult
Fillings only. 6 month waiting period. |
YES | 20.00% Coinsurance after deductible |
60.00% Coinsurance after deductible |
| Basic Dental Care - Child
|
YES | No Charge |
60.00% Coinsurance after deductible |
| Dental Check-Up for Children
Limit: 1.0 Exam(s) per 6 Months |
YES | No Charge |
50.00% Coinsurance after deductible |
| Major Dental Care - Adult
|
NO | ||
| Major Dental Care - Child
|
YES | No Charge |
75.00% Coinsurance after deductible |
| Orthodontia - Adult
|
NO | ||
| Orthodontia - Child
Medically necessary only. |
YES | No Charge |
75.00% Coinsurance after deductible |
| Routine Dental Services (Adult)
Limit: 1.0 Exam(s) per 6 Months |
YES | No Charge |
50.00% Coinsurance after deductible |
MedMutual Dental 3 Health Insurance Plan Variant 99969OH0150003-00 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 Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard High Off Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 1.0 |
| First Tier Utilization | 100% |
| HIOS Product ID | 99969OH015 |
| Import Date | 2024-01-11 20:02:02 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Guaranteed Rate |
| New/Existing Plan | Existing |
| Issuer ID | 99969 |
| Issuer Marketplace Marketing Name | MedMutual |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person | per person 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 Group | per group not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Person | per person not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Medical EHB Deductible, In Network (Tier 1), Family Per Group | per group not applicable |
| Medical EHB Deductible, In Network (Tier 1), Family Per Person | $0 per person |
| Medical EHB Deductible, In Network (Tier 1), Individual | $0 |
| Medical EHB Deductible, Out of Network, Family Per Group | per group not applicable |
| Medical EHB Deductible, Out of Network, Family Per Person | $100 per person |
| Medical EHB Deductible, Out of Network, Individual | $100 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | $0 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $0 per person |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $0 |
| 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 | High |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | OHN003 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergency Only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Covered as Non-Network |
| Plan Effective Date | 2024-01-01 |
| Plan ID (Standard Component ID with Variant) | 99969OH0150003-00 |
| Plan Marketing Name | MedMutual Dental 3 |
| Plan Type | PPO |
| Plan Variant Marketing Name | MedMutual Dental 3 |
| QHP/Non QHP | Off the Exchange |
| Service Area ID | OHS003 |
| Source Name | SERFF |
| Plan ID | 99969OH0150003 |
| State Code | OH |
Copay & Coinsurance of MedMutual Dental 3 Health Insurance Plan, 99969OH0150003
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about MedMutual Dental 3, 99969OH0150003 Health Insurance Plan, 99969OH0150003
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Does MedMutual Dental 3 Health Insurance Plan, 99969OH0150003 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (99969OH0150003) Health Insurance Plan, Variant (99969OH0150003-00) have Out Of Country Coverage?
Does (99969OH0150003) Health Insurance Plan, Variant (99969OH0150003-00) have Out of Service Area Coverage?
Disclaimer: This is based on the import(Date: Tue, 03 Dec 2024 06:24 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