Alabama Preferred Plan (Pediatric Only) - 28725AL0130002 Health Insurance Plan

Renaissance Life & Health Insurance Company of America health insurance plan with the Plan ID 28725AL0130002. The plan is called Alabama Preferred Plan (Pediatric Only).

Health Insurance Plan ID 28725AL0130002
Health Insurance Plan Year 2023
State Alabama
Health Insurance Issuer Renaissance Life & Health Insurance Company of America
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 28725AL0130002-01
Provider Network(s) ['ALN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Wed, 27 Mar 2024 12:10 GMT).

Providers Alabama 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 - 28725AL0130002-01

Last Plan Update Date Tue, 16 Aug 2022 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Benefits of Alabama Preferred Plan (Pediatric Only) Health Insurance Plan, 28725AL0130002-01

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

Exclusions: See Plan Brochure.

YES

40% Coinsurance after deductible

60.00% Coinsurance after deductible
Dental Check-Up for Children

Limit: 2.0 Visit(s) per Benefit Period

Exclusions: See Plan Brochure. X-Rays may be subject to deductible.

YES

0.00%

30.00%
Major Dental Care - Adult
NO
Major Dental Care - Child

Exclusions: See Plan Brochure.

YES

50.00% Coinsurance after deductible

70.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child

Exclusions: Limited to medically necessary. See Plan Brochure.

YES

50.00%

50.00%
Routine Dental Services (Adult)
NO

Alabama Preferred Plan (Pediatric Only) Health Insurance Plan Variant 28725AL0130002-01 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 2023
Child-Only Offering Allows Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low On Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1
First Tier Utilization 100%
HIOS Product ID 28725AL013
Import Date 8/16/2022 1:00
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 28725
Issuer Marketplace Marketing Name Renaissance Dental
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 $150 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $50 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $50
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $750 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $375
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 Low
Multiple In Network Tiers No
National Network Yes
Network ID ALN001
Out of Country Coverage Yes
Out of Country Coverage Description Benefits paid at the Out of Network Level
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Same Benefit Level
Plan Brochure URL
Plan Effective Date 1/1/2023
Plan ID (Standard Component ID with Variant) 28725AL0130002-01
Plan Marketing Name Alabama Preferred Plan (Pediatric Only)
Plan Type PPO
Plan Variant Marketing Name Alabama Preferred Plan (Pediatric Only)
QHP/Non QHP On the Exchange
Service Area ID ALS001
Source Name HIOS
Plan ID 28725AL0130002
State Code AL
URL for Enrollment Payment URL

Copay & Coinsurance of Alabama Preferred Plan (Pediatric Only) Health Insurance Plan, 28725AL0130002

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

Frequently Asked Questions(FAQ) about Alabama Preferred Plan (Pediatric Only), 28725AL0130002 Health Insurance Plan, 28725AL0130002

  • Does Alabama Preferred Plan (Pediatric Only) Health Insurance Plan, 28725AL0130002 support Mail Ordering?

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

  • Does (28725AL0130002) Health Insurance Plan, Variant (28725AL0130002-01) have Out Of Country Coverage?

    Yes. Details: Benefits paid at the Out of Network Level

    Does (28725AL0130002) Health Insurance Plan, Variant (28725AL0130002-01) have Out of Service Area Coverage?

    Yes. Details: Same Benefit Level

 

Disclaimer: This is based on the import(Date: Wed, 27 Mar 2024 12:10 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