TRUASSURE INSURANCE COMPANY health insurance plan with the Plan ID 87417IN0020001. The plan is called TruAssure Preferred Adult or Child Dental Plan.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 84.70% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 15.30% of the costs of all covered benefits (according to the Issuer).
Health Insurance Plan ID | 87417IN0020001 | ||||||||||||||||||
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Health Insurance Plan Year | 2024 | ||||||||||||||||||
State | Indiana | ||||||||||||||||||
Health Insurance Issuer | TRUASSURE INSURANCE COMPANY | ||||||||||||||||||
Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
Health Insurance Plan Variant | 87417IN0020001-00 | ||||||||||||||||||
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). |
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Available Variants of the Health Plan | |||||||||||||||||||
Last Plan Update Date | Fri, 22 Dec 2023 00:00 GMT | ||||||||||||||||||
Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
Benefit | Covered | In Network | Out Of Network |
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Accidental Dental
Dental procedures are covered and paid via covered ADA procedure codes regardless of whether the dental treatment is needed due to an accident or otherwise. Refer to policy for complete benefit information. |
YES | 30.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
Basic Dental Care - Adult
|
YES | 30.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
Basic Dental Care - Child
|
YES | 30.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
Dental Check-Up for Children
Limit: 1.0 Visit(s) per 6 Months |
YES | 0.00% |
0.00% |
Major Dental Care - Adult
6 Month Waiting Period |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
Major Dental Care - Child
|
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
Orthodontia - Adult
|
NO | ||
Orthodontia - Child
Medically Necessary Only |
YES | 50.00% |
100.00% |
Routine Dental Services (Adult)
Limit: 1.0 Visit(s) per 6 Months |
YES | 0.00% |
0.00% |
Plan Attribute | Value |
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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 | 87417IN002 |
Import Date | 2023-12-22 01:01:34 |
Inpatient Copayment Maximum Days | 0 |
Guaranteed Rate | Guaranteed Rate |
New/Existing Plan | Existing |
Issuer Actuarial Value | 84.70% |
Issuer ID | 87417 |
Issuer Marketplace Marketing Name | TRUASSURE INSURANCE COMPANY |
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 | $30 per person |
Medical EHB Deductible, In Network (Tier 1), Individual | $30 |
Medical EHB Deductible, Out of Network, Family Per Group | per group not applicable |
Medical EHB Deductible, Out of Network, Family Per Person | $75 per person |
Medical EHB Deductible, Out of Network, Individual | $75 |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | $700 per group |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $350 per person |
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $350 |
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 | INN001 |
Out of Country Coverage | Yes |
Out of Country Coverage Description | Emergency Only |
Out of Service Area Coverage | Yes |
Out of Service Area Coverage Description | All Covered Benefits |
Plan Brochure | URL |
Plan Effective Date | 2024-01-01 |
Plan Expiration Date | 2024-12-31 |
Plan ID (Standard Component ID with Variant) | 87417IN0020001-00 |
Plan Marketing Name | TruAssure Preferred Adult or Child Dental Plan |
Plan Type | PPO |
Plan Variant Marketing Name | TruAssure Preferred Adult or Child Dental Plan |
QHP/Non QHP | Both |
Service Area ID | INS001 |
Source Name | HIOS |
Plan ID | 87417IN0020001 |
State Code | IN |
URL for Enrollment Payment | URL |
Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Unfortunately, this health insurance plan does not support mail ordering or the plan data in 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