Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care - 66516MD0080011 Health Insurance Plan

Aetna Health Inc. (a PA corp.) health insurance plan with the Plan ID 66516MD0080011. The plan is called Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 71.49% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 28.51% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 66516MD0080011
Health Insurance Plan Year 2024
State Maryland
Health Insurance Issuer Aetna Health Inc. (a PA corp.)
Health Insurance Plan Variant 66516MD0080011-01
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 - 66516MD0080011-01

Open to Indians below 300% FPL - 66516MD0080011-02

Open to Indians above 300% FPL - 66516MD0080011-03

73% AV Silver Plan - 66516MD0080011-04

87% AV Silver Plan - 66516MD0080011-05

94% AV Silver Plan - 66516MD0080011-06

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

Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 Attributes

Plan Attribute Value
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Silver On Exchange Plan
Maximum Out of Pocket for Drug EHB Benefits, Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Drug EHB Benefits, Combined In/Out Network, Individual Not Applicable
Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Drug EHB Deductible, In Network (Tier 1), Family $750 per person | $1500 per group
Drug EHB Deductible, In Network (Tier 1), Individual $750
Drug EHB Deductible, Out of Network, Family per person not applicable | per group not applicable
Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Drug EHB Benefits, In Network (Tier 1), Individual $1,500
Maximum Out of Pocket for Drug EHB Benefits, In Network (Tier 2), Individual $1500 per person | $3000 per group
Maximum Out of Pocket for Drug EHB Benefits, Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Drug EHB Benefits, Out of Network, Individual Not Applicable
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 MDF019
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 71.49%
Issuer ID 66516
Market Coverage Individual
Medical Drug Deductibles Integrated No
Medical Drug Maximum Out of Pocket Integrated No
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family per person not applicable | per group 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 person not applicable | per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance 30.00%
Medical EHB Deductible, In Network (Tier 1), Family $4500 per person | $9000 per group
Medical EHB Deductible, In Network (Tier 1), Individual $4,500
Medical EHB Deductible, Out of Network, Family per person not applicable | per group not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family $7600 per person | $15200 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $7,600
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual Not Applicable
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) 66516MD0080011-01
Plan Marketing Name Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care
Plan Type HMO
Plan Variant Marketing Name Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $1,100
SBC Scenario, Having a Baby, Deductible $4,500
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $1,900
SBC Scenario, Having Diabetes, Deductible $800
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $600
SBC Scenario, Treatment of a Simple Fracture, Deductible $1,000
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 66516MD0080011
State Code MD
Unique Plan Design Yes
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, 66516MD0080011

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

Frequently Asked Questions(FAQ) about Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care, 66516MD0080011 Health Insurance Plan, 66516MD0080011

  • Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, 66516MD0080011 support Mail Ordering?

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

  • Does (66516MD0080011) Health Insurance Plan, Variant (66516MD0080011-01) 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 (66516MD0080011) Health Insurance Plan, Variant (66516MD0080011-01) have Out Of Country Coverage?

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

    Does (66516MD0080011) Health Insurance Plan, Variant (66516MD0080011-01) 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 (66516MD0080011) Health Insurance Plan, Variant (66516MD0080011-01) 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 Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for Asthma?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 offers Disease Management Program for Asthma.

    Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for Heart disease?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 offers Disease Management Program for Heart disease.

    Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for Depression?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 offers Disease Management Program for Depression.

    Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for Diabetes?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 offers Disease Management Program for Diabetes.

    Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for Low back pain?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 offers Disease Management Program for Low back pain.

    Does Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan, Variant (66516MD0080011-01) offer Disease Management Programs for Pregnancy?

    Yes, the Silver Value: Aetna Network + $0 MinuteClinic + $0 CVS Health Virtual Care Health Insurance Plan Variant 66516MD0080011-01 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