Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - 66516MD0080008 Health Insurance Plan

Aetna Health Inc. (a PA corp.) health insurance plan with the Plan ID 66516MD0080008. The plan is called Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 73.03% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 26.97% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 66516MD0080008
Health Insurance Plan Year 2024
State Maryland
Health Insurance Issuer Aetna Health Inc. (a PA corp.)
Health Insurance Plan Variant 66516MD0080008-04
Provider Network(s) NON-PREFERRED PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 26 Nov 2024 06:27 GMT).

Providers Maryland All US States
All 5845 6574
PCP 865 986
Allergy 4 5
OB/GYN 49 62
Dentists 8 9
Available Variants of the Health Plan

Standard On Exchange Plan - 66516MD0080008-01

Open to Indians below 300% FPL - 66516MD0080008-02

Open to Indians above 300% FPL - 66516MD0080008-03

73% AV Silver Plan - 66516MD0080008-04

87% AV Silver Plan - 66516MD0080008-05

94% AV Silver Plan - 66516MD0080008-06

Last Plan Update Date Fri, 31 May 2024 00:00 GMT
Last Import Date Tue, 26 Nov 2024 06:27 GMT

Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 Attributes

Plan Attribute Value
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type 73% AV Level Silver Plan
Dental Only Plan No
Design Type Not Applicable
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 99%
First Tier Utilization 100%
Formulary ID MDF007
HIOS Product ID 66516MD008
Import Date 5/31/2024
HSA Eligible No
IsItANewPlan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer Actuarial Value 73.03%
Issuer ID 66516
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID MDN001
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) 66516MD0080008-04
Plan Marketing Name Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7
Plan Type HMO
Plan Variant Marketing Name Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $900
SBC Scenario, Having a Baby, Copayment $100
SBC Scenario, Having a Baby, Deductible $6,300
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $1,300
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $20
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 $1,900
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MDS001
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 66516MD0080008
State Code MD
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 $6300 per person | $12600 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $6,300
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 $7325 per person | $14650 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $7,325
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 Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, 66516MD0080008

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

Frequently Asked Questions(FAQ) about Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7, 66516MD0080008 Health Insurance Plan, 66516MD0080008

  • Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, 66516MD0080008 support Mail Ordering?

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

  • Does (66516MD0080008) Health Insurance Plan, Variant (66516MD0080008-04) 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 (66516MD0080008) Health Insurance Plan, Variant (66516MD0080008-04) have Out Of Country Coverage?

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

    Does (66516MD0080008) Health Insurance Plan, Variant (66516MD0080008-04) 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 (66516MD0080008) Health Insurance Plan, Variant (66516MD0080008-04) 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 Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for Asthma?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for Asthma.

    Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for Heart disease?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for Heart disease.

    Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for Depression?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for Depression.

    Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for Diabetes?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for Diabetes.

    Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for Low back pain?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for Low back pain.

    Does Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan, Variant (66516MD0080008-04) offer Disease Management Programs for Pregnancy?

    Yes, the Silver 7: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 Health Insurance Plan Variant 66516MD0080008-04 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 26 Nov 2024 06:27 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