BESTOne Plus Gold - 93895MT0020004 Health Insurance Plan

BEST Life and Health Insurance Company health insurance plan with the Plan ID 93895MT0020004. The plan is called BESTOne Plus Gold.

Health Insurance Plan ID 93895MT0020004
Health Insurance Plan Year 2023
State Montana
Health Insurance Issuer BEST Life and Health Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 93895MT0020004-00
Provider Network(s) ['MTN001']
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 Montana 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 Off Exchange Plan - 93895MT0020004-00

Standard On Exchange Plan - 93895MT0020004-01

Last Plan Update Date Fri, 09 Sep 2022 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Benefits of BESTOne Plus Gold Health Insurance Plan, 93895MT0020004-00

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

30.00% Coinsurance after deductible

30.00% Coinsurance after deductible
Basic Dental Care - Child
YES

30.00% Coinsurance after deductible

30.00% Coinsurance after deductible
Dental Check-Up for Children
YES

No Charge

No Charge
Major Dental Care - Adult
YES

60.00% Coinsurance after deductible

60.00% Coinsurance after deductible
Major Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child

Orthodontia for children is only covered when medically necessary.

YES

50.00%

50.00%
Routine Dental Services (Adult)
YES

No Charge

No Charge

BESTOne Plus Gold Health Insurance Plan Variant 93895MT0020004-00 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 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
First Tier Utilization 100%
HIOS Product ID 93895MT002
Import Date 9/9/2022 20:01
Inpatient Copayment Maximum Days 0
Guaranteed Rate Estimated Rate
New/Existing Plan Existing
Issuer ID 93895
Issuer Marketplace Marketing Name BEST Life
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group $700 per group
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person $350 per person
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out $350
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 $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 per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual Not Applicable
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 MTN001
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Network or Network
Plan Brochure URL
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 93895MT0020004-00
Plan Marketing Name BESTOne Plus Gold
Plan Type Indemnity
Plan Variant Marketing Name BESTOne Plus Gold
QHP/Non QHP Both
Service Area ID MTS001
Source Name SERFF
Plan ID 93895MT0020004
State Code MT
URL for Enrollment Payment URL

Copay & Coinsurance of BESTOne Plus Gold Health Insurance Plan, 93895MT0020004

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

Frequently Asked Questions(FAQ) about BESTOne Plus Gold, 93895MT0020004 Health Insurance Plan, 93895MT0020004

  • Does BESTOne Plus Gold Health Insurance Plan, 93895MT0020004 support Mail Ordering?

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

  • Does (93895MT0020004) Health Insurance Plan, Variant (93895MT0020004-00) have Out Of Country Coverage?

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

    Does (93895MT0020004) Health Insurance Plan, Variant (93895MT0020004-00) have Out of Service Area Coverage?

    Yes. Details: Network or Network

 

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