Smile Now Arizona - No Waiting Period PPO - 82011AZ0110001 Health Insurance Plan

UnitedHealthcare Insurance Company health insurance plan with the Plan ID 82011AZ0110001. The plan is called Smile Now Arizona - No Waiting Period PPO.

Health Insurance Plan ID 82011AZ0110001
Health Insurance Plan Year 2025
State Arizona
Health Insurance Issuer UnitedHealthcare Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 82011AZ0110001-00
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).

Providers Arizona All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard Off Exchange Plan - 82011AZ0110001-00

Standard On Exchange Plan - 82011AZ0110001-01

Last Plan Update Date Thu, 15 Aug 2024 00:00 GMT
Last Import Date Thu, 21 Nov 2024 00:44 GMT

Benefits of Smile Now Arizona - No Waiting Period PPO Health Insurance Plan, 82011AZ0110001-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult
YES

40.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Basic Dental Care - Child
YES

40.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Dental Check-Up for Children
YES

No Charge after deductible

50.00% Coinsurance after deductible
Major Dental Care - Adult
YES

75.00% Coinsurance after deductible

75.00% Coinsurance after deductible
Major Dental Care - Child
YES

75.00% Coinsurance after deductible

75.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child
YES

75.00% Coinsurance after deductible

75.00% Coinsurance after deductible
Routine Dental Services (Adult)
YES

No Charge after deductible

50.00% Coinsurance after deductible

Smile Now Arizona - No Waiting Period PPO Health Insurance Plan Variant 82011AZ0110001-00 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 2025
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 82011AZ011
Import Date 2024-08-15 01:01:23
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 82011
Issuer Marketplace Marketing Name UnitedHealthcare
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 $60 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $60
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person $60 per person
Medical EHB Deductible, In Network (Tier 1), Individual $60
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person $60 per person
Medical EHB Deductible, Out of Network, Individual $60
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $800 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $400 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $400
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 AZN012
Out of Country Coverage Yes
Out of Country Coverage Description Available only for emergency services to treat an Emergency Condition.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Only for palliative care where a network provider is not available.
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 82011AZ0110001-00
Plan Marketing Name Smile Now Arizona - No Waiting Period PPO
Plan Type PPO
Plan Variant Marketing Name Smile Now Arizona - No Waiting Period PPO
QHP/Non QHP On the Exchange
Service Area ID AZS012
Source Name HIOS
Plan ID 82011AZ0110001
State Code AZ
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL

Copay & Coinsurance of Smile Now Arizona - No Waiting Period PPO Health Insurance Plan, 82011AZ0110001

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

Frequently Asked Questions(FAQ) about Smile Now Arizona - No Waiting Period PPO, 82011AZ0110001 Health Insurance Plan, 82011AZ0110001

  • Does Smile Now Arizona - No Waiting Period PPO Health Insurance Plan, 82011AZ0110001 support Mail Ordering?

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

  • Does (82011AZ0110001) Health Insurance Plan, Variant (82011AZ0110001-00) have Out Of Country Coverage?

    Yes. Details: Available only for emergency services to treat an Emergency Condition.

    Does (82011AZ0110001) Health Insurance Plan, Variant (82011AZ0110001-00) have Out of Service Area Coverage?

    Yes. Details: Only for palliative care where a network provider is not available.

 

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