Standard High Gold: HNE Gold - 34484MA1880001 Health Insurance Plan

Health New England health insurance plan with the Plan ID 34484MA1880001. The plan is called Standard High Gold: HNE Gold.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 100.00% (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 0.00% 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 34484MA1880001
Health Insurance Plan Year 2024
State Massachusetts
Health Insurance Issuer Health New England
Health Insurance Plan Variant 34484MA1880001-02
Provider Network(s) ['MAN001']
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 Massachusetts 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 On Exchange Plan - 34484MA1880001-01

Open to Indians below 300% FPL - 34484MA1880001-02

Open to Indians above 300% FPL - 34484MA1880001-03

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

Standard High Gold: HNE Gold Health Insurance Plan Variant 34484MA1880001-02 Attributes

Plan Attribute Value
AV Calculator Output Number 1
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Zero Cost Sharing Plan Variation
Dental Only Plan No
Design Type Not Applicable
EHB Percent of Total Premium 99%
First Tier Utilization 100%
Formulary ID MAF002
HIOS Product ID 34484MA188
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer ID 34484
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers No
National Network No
Network ID MAN001
Out of Country Coverage Yes
Out of Country Coverage Description Urgent or Emergency
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Urgent or Emergency
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 34484MA1880001-02
Plan Marketing Name Standard High Gold: HNE Gold
Plan Type HMO
Plan Variant Marketing Name Standard High Gold: HNE Gold
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $0
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MAS001
Source Name SERFF
Plan ID 34484MA1880001
State Code MA
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $0
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $0
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $0
TEHBDedOutofNetFamily $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, Out of Network, Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $0
Unique Plan Design No
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of Standard High Gold: HNE Gold Health Insurance Plan, 34484MA1880001

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

Frequently Asked Questions(FAQ) about Standard High Gold: HNE Gold, 34484MA1880001 Health Insurance Plan, 34484MA1880001

  • Does Standard High Gold: HNE Gold Health Insurance Plan, 34484MA1880001 support Mail Ordering?

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

  • Does (34484MA1880001) Health Insurance Plan, Variant (34484MA1880001-02) have Out Of Country Coverage?

    Yes. Details: Urgent or Emergency

    Does (34484MA1880001) Health Insurance Plan, Variant (34484MA1880001-02) have Out of Service Area Coverage?

    Yes. Details: Urgent or Emergency

 

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