UHC Navigate HSA Silver 2800 - 21066DC0050007 Health Insurance Plan
UnitedHealthcare of the Mid-Atlantic, Inc. health insurance plan with the Plan ID 21066DC0050007. The plan is called UHC Navigate HSA Silver 2800.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 71.90% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 28.10% of the costs of all covered benefits (according to the Issuer).
| Health Insurance Plan ID | 21066DC0050007 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | District of Columbia | ||||||||||||||||||
| Health Insurance Issuer | UnitedHealthcare of the Mid-Atlantic, Inc. | ||||||||||||||||||
| Health Insurance Plan Variant | 21066DC0050007-01 | ||||||||||||||||||
| Provider Network(s) | ['DCN002'] | ||||||||||||||||||
| 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 | Mon, 12 Feb 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
UHC Navigate HSA Silver 2800 Health Insurance Plan Variant 21066DC0050007-01 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 |
| Dental Only Plan | No |
| Disease Management Programs Offered | Pregnancy, Diabetes, Heart Disease |
| First Tier Utilization | 47% |
| Formulary ID | DCF009 |
| HIOS Product ID | 21066DC005 |
| HSA/HRA Employer Contribution | No |
| Import Date | 2/12/2024 |
| HSA Eligible | Yes |
| IsItANewPlan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | Yes |
| Issuer Actuarial Value | 71.90% |
| Issuer ID | 21066 |
| Market Coverage | SHOP (Small Group) |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Silver |
| Multiple In Network Tiers | Yes |
| National Network | No |
| Network ID | DCN002 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | No |
| Plan Effective Date | 1/1/2024 |
| Plan ID (Standard Component ID with Variant) | 21066DC0050007-01 |
| Plan Marketing Name | UHC Navigate HSA Silver 2800 |
| Plan Type | HMO |
| Plan Variant Marketing Name | UHC Navigate HSA Silver 2800 |
| QHP/Non QHP | On the Exchange |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $500 |
| SBC Scenario, Having a Baby, Deductible | $2,800 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $600 |
| SBC Scenario, Having Diabetes, Deductible | $2,800 |
| 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 | $2,800 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Second Tier Utilization | 53% |
| Service Area ID | DCS002 |
| Source Name | SERFF |
| Specialist Requiring a Referral | All, except OBGYN and as state mandated |
| Plan ID | 21066DC0050007 |
| State Code | DC |
| 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 | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family | $2800 per person | $5600 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $2,800 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Default Coinsurance | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family | $2800 per person | $5600 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual | $2,800 |
| 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 | $7400 per person | $14800 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $7,400 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family | $7400 per person | $14800 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual | $7,400 |
| 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 | No |
Copay & Coinsurance of UHC Navigate HSA Silver 2800 Health Insurance Plan, 21066DC0050007
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about UHC Navigate HSA Silver 2800, 21066DC0050007 Health Insurance Plan, 21066DC0050007
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Does UHC Navigate HSA Silver 2800 Health Insurance Plan, 21066DC0050007 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (21066DC0050007) Health Insurance Plan, Variant (21066DC0050007-01) offer Disease Management Programs?
Does (21066DC0050007) Health Insurance Plan, Variant (21066DC0050007-01) have Out Of Country Coverage?
Does (21066DC0050007) Health Insurance Plan, Variant (21066DC0050007-01) have Out of Service Area Coverage?
Does (21066DC0050007) Health Insurance Plan, Variant (21066DC0050007-01) offer Disease Management Programs?
Does UHC Navigate HSA Silver 2800 Health Insurance Plan, Variant (21066DC0050007-01) offer Disease Management Programs for Heart disease?
Does UHC Navigate HSA Silver 2800 Health Insurance Plan, Variant (21066DC0050007-01) offer Disease Management Programs for Diabetes?
Does UHC Navigate HSA Silver 2800 Health Insurance Plan, Variant (21066DC0050007-01) offer Disease Management Programs for Pregnancy?
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