UHC Silver Standard - 24251VA0060038 Health Insurance Plan

Optimum Choice, Inc health insurance plan with the Plan ID 24251VA0060038. The plan is called UHC Silver Standard.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 70.01% (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 29.99% 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 24251VA0060038
Health Insurance Plan Year 2024
State Virginia
Health Insurance Issuer Optimum Choice, Inc
Health Insurance Plan Variant 24251VA0060038-01
Provider Network(s) NON-PREFERRED NETWORK
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Dec 2024 06:12 GMT).

Providers Virginia All US States
All 20547 31495
PCP 2798 4235
Allergy 12 19
OB/GYN 100 189
Dentists 15 23
Available Variants of the Health Plan

Standard On Exchange Plan - 24251VA0060038-01

Open to Indians below 300% FPL - 24251VA0060038-02

Open to Indians above 300% FPL - 24251VA0060038-03

73% AV Silver Plan - 24251VA0060038-04

87% AV Silver Plan - 24251VA0060038-05

94% AV Silver Plan - 24251VA0060038-06

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Tue, 17 Dec 2024 06:12 GMT

UHC Silver Standard Health Insurance Plan Variant 24251VA0060038-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.700149497
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
Design Type Design 1
EHB Percent of Total Premium 100%
First Tier Utilization 100%
Formulary ID VAF008
HIOS Product ID 24251VA006
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer ID 24251
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID VAN001
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state
Plan Effective Date 1/1/2024
Plan ID (Standard Component ID with Variant) 24251VA0060038-01
Plan Level Exclusions 0
Plan Marketing Name UHC Silver Standard
Plan Type HMO
Plan Variant Marketing Name UHC Silver Standard
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $2,100
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $5,900
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $300
SBC Scenario, Having Diabetes, Deductible $4,000
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $300
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,200
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID VAS001
Source Name SERFF
Plan ID 24251VA0060038
State Code VA
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 40.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $5900 per person | $11800 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $5,900
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 $9100 per person | $18200 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,100
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 No
Version Number 1
Wellness Program Offered No

Copay & Coinsurance of UHC Silver Standard Health Insurance Plan, 24251VA0060038

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

Frequently Asked Questions(FAQ) about UHC Silver Standard, 24251VA0060038 Health Insurance Plan, 24251VA0060038

  • Does UHC Silver Standard Health Insurance Plan, 24251VA0060038 support Mail Ordering?

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

  • Does (24251VA0060038) Health Insurance Plan, Variant (24251VA0060038-01) have Out Of Country Coverage?

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

    Does (24251VA0060038) Health Insurance Plan, Variant (24251VA0060038-01) have Out of Service Area Coverage?

    Yes. Details: Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state

 

Disclaimer: This is based on the import(Date: Tue, 17 Dec 2024 06:12 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