| Field | Data |
|---|---|
| Health Insurance Plan ID | 87416WI0040001 |
| Health Insurance Plan Year | 2022 |
| State | Wisconsin |
| Health Insurance Issuer | Common Ground Healthcare Cooperative |
| Plan Formulary Description URL | Formulary URL |
| Plan Marketing Materials URL | Marketing URL |
| Last Plan Update Date | Tue, 21 Sep 2021 00:00 GMT |
| Last Import Date | Fri, 31 Mar 2023 05:06 GMT |
| Available Variants of the Health Plan | |
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|---|---|---|---|---|---|
| Generic | 1 month in retail | $10.0 | Before deductible | 0% | No charge | YES |
| Generic | 3 month in mail | $20.0 | Before deductible | 0% | No charge | YES |
| Insulin discount | 1 month in retail | $15.0 | Before deductible | 0% | No charge | YES |
| Insulin discount | 3 month in mail | $30.0 | Before deductible | 0% | No charge | YES |
| Non preferred | 1 month in retail | $70.0 | Before deductible | 0% | No charge | YES |
| Non preferred | 3 month in mail | $140.0 | Before deductible | 0% | No charge | YES |
| Preferred | 1 month in retail | $35.0 | Before deductible | 0% | No charge | YES |
| Preferred | 3 month in mail | $70.0 | Before deductible | 0% | No charge | YES |
| Specialty | 1 month in retail | $0 | No charge | 20.0% | After deductible | YES |
Frequently Asked Questions(FAQ) about CGHC EPO Platinum $500 Deductible/20% , 87416WI0040001 Health Insurance Plan, 87416WI0040001
Does CGHC EPO Platinum $500 Deductible/20% Health Insurance Plan, 87416WI0040001 support Mail Ordering?
Yes, CGHC EPO Platinum $500 Deductible/20% Health Insurance
Plan, 87416WI0040001 supports mail ordering for the next drug tiers: Generic, Insulin discount, Non preferred, Preferred, Specialty
What are the Generic Medications coinsurance & copay options with CGHC EPO Platinum $500 Deductible/20% (87416WI0040001) Health Insurance Plan?
For generic drug tier copay (Before deductible) is $10.0 and coinsurance (No charge) is 0.0%, generic drug tier copay (Before deductible) is $20.0 and coinsurance (No charge) is 0.0%
Disclaimer: This is based on the import(Date: Fri, 31 Mar 2023 05:06 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