Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) - 97667AZ0110025 Health Insurance Plan

Cigna HealthCare of Arizona, Inc health insurance plan with the Plan ID 97667AZ0110025. The plan is called Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin).

Based on the data of Health Plan Issuer, this plan has an actuarial value of 64.90% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 35.10% of the costs of all covered benefits (according to the Issuer).

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 66.75% (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 33.25% 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 97667AZ0110025
Health Insurance Plan Year 2022
State Arizona
Health Insurance Issuer Cigna HealthCare of Arizona, Inc
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 97667AZ0110025-00
Provider Network(s) ['AZN001']
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 Arizona 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 - 97667AZ0110025-00

Standard On Exchange Plan - 97667AZ0110025-01

Open to Indians below 300% FPL - 97667AZ0110025-02

Open to Indians above 300% FPL - 97667AZ0110025-03

Last Plan Update Date Tue, 08 Mar 2022 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan Variant 97667AZ0110025-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.66751426
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze Off Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy
EHB Percent of Total Premium 1
First Tier Utilization 100%
Formulary ID AZF004
Formulary URL URL
HIOS Product ID 97667AZ011
Import Date 3/8/2022 1:01
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
Inpatient Copayment Maximum Days 0
HSA Eligible No
New/Existing Plan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 64.90%
Issuer ID 97667
Issuer Marketplace Marketing Name Cigna HealthCare of Arizona, Inc
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Expanded Bronze
Multiple In Network Tiers No
National Network No
Network ID AZN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Only
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency Only
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 97667AZ0110025-00
Plan Marketing Name Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin)
Plan Type HMO
Plan Variant Marketing Name Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin)
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,900
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $6,800
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $600
SBC Scenario, Having Diabetes, Deductible $900
SBC Scenario, Having Diabetes, Limit $20
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 $2,100
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID AZS001
Source Name HIOS
Plan ID 97667AZ0110025
State Code AZ
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person per person 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 Group per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person per person 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 Per Group $13600 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $6800 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $6,800
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person per person 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 Per Group $17400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $8700 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $8,700
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, 97667AZ0110025

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

Frequently Asked Questions(FAQ) about Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin), 97667AZ0110025 Health Insurance Plan, 97667AZ0110025

  • Does Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, 97667AZ0110025 support Mail Ordering?

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

  • Does (97667AZ0110025) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

    Does (97667AZ0110025) Health Insurance Plan, Variant (97667AZ0110025-00) have Out Of Country Coverage?

    Yes. Details: Emergency Only

    Does (97667AZ0110025) Health Insurance Plan, Variant (97667AZ0110025-00) have Out of Service Area Coverage?

    Yes. Details: Emergency Only

    Does (97667AZ0110025) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

    Does Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs for Asthma?

    Yes, the Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan Variant 97667AZ0110025-00 offers Disease Management Program for Asthma.

    Does Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs for Heart disease?

    Yes, the Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan Variant 97667AZ0110025-00 offers Disease Management Program for Heart disease.

    Does Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs for Diabetes?

    Yes, the Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan Variant 97667AZ0110025-00 offers Disease Management Program for Diabetes.

    Does Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan Variant 97667AZ0110025-00 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan, Variant (97667AZ0110025-00) offer Disease Management Programs for Pregnancy?

    Yes, the Cigna Connect 6800 Enhanced Diabetes Care ($0 Preferred Insulin) Health Insurance Plan Variant 97667AZ0110025-00 offers Disease Management Program for Pregnancy.

 

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