| Field | Data |
|---|---|
| Health Insurance Plan ID | 66252TX0160001 |
| Health Insurance Plan Year | 2023 |
| State | Texas |
| Health Insurance Issuer | CHRISTUS Health Plan |
| Plan Formulary Description URL | Formulary URL |
| Plan Marketing Materials URL | Marketing URL |
| Last Plan Update Date | Thu, 15 Sep 2022 00:00 GMT |
| Last Import Date | Sun, 28 May 2023 07:51 GMT |
| Health Insurance Plan Variant | 66252TX0160001-05 |
| Available Variants of the Health Plan | |
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.871483573 |
| Begin Primary Care Cost-Sharing After Number Of Visits | 2 |
| 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 | 87% AV Level Silver Plan |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Diabetes |
| EHB Percent of Total Premium | 1 |
| First Tier Utilization | 100% |
| Formulary ID | TXF007 |
| Formulary URL | URL |
| HIOS Product ID | 66252TX016 |
| Import Date | 2/24/2023 1:01 |
| Limited Cost Sharing Plan Variation - Estimated Advanced Payment | $0.00 |
| Inpatient Copayment Maximum Days | 0 |
| HSA Eligible | No |
| New/Existing Plan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer ID | 66252 |
| Issuer Marketplace Marketing Name | CHRISTUS Health Plan |
| 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 | TXN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergency Services |
| Out of Service Area Coverage | No |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 66252TX0160001-05 |
| Plan Marketing Name | CHRISTUS Silver - 2 free PCP visits, includes Virtual |
| Plan Type | HMO |
| Plan Variant Marketing Name | CHRISTUS Silver - 2 free PCP visits, includes Virtual |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $2,000 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $400 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $1,900 |
| SBC Scenario, Having Diabetes, Copayment | $0 |
| SBC Scenario, Having Diabetes, Deductible | $400 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $1,000 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $400 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | TXS001 |
| Source Name | HIOS |
| Plan ID | 66252TX0160001 |
| State Code | TX |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $4800 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $2400 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $2,400 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $800 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $400 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $400 |
| 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 Per Group | $800 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $400 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $400 |
| TEHBDedOutOfNetFamilyPerGroup | $800 per group |
| TEHBDedOutOfNetFamilyPerPerson | $400 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $400 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group | $4800 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $2400 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $2,400 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group | $4800 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | $2400 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $2,400 |
| Unique Plan Design | No |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | No |
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about CHRISTUS Silver - 2 free PCP visits, includes Virtual, 66252TX0160001 Health Insurance Plan, 66252TX0160001
Does CHRISTUS Silver - 2 free PCP visits, includes Virtual Health Insurance Plan, 66252TX0160001 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (66252TX0160001) Health Insurance Plan, Variant (66252TX0160001-05) offer Disease Management Programs?
Yes, and here is the list of available programs: Diabetes
Does (66252TX0160001) Health Insurance Plan, Variant (66252TX0160001-05) have Out Of Country Coverage?
Yes. Details: Emergency Services
Does (66252TX0160001) Health Insurance Plan, Variant (66252TX0160001-05) have Out of Service Area Coverage?
No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan).
Does (66252TX0160001) Health Insurance Plan, Variant (66252TX0160001-05) offer Disease Management Programs?
Yes, and here is the list of available programs: Diabetes
Does CHRISTUS Silver - 2 free PCP visits, includes Virtual Health Insurance Plan, Variant (66252TX0160001-05) offer Disease Management Programs for Diabetes?
Yes, the CHRISTUS Silver - 2 free PCP visits, includes Virtual Health Insurance Plan Variant 66252TX0160001-05 offers Disease Management Program for Diabetes.
Disclaimer: This is based on the import(Date: Sun, 28 May 2023 07:51 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