Cigna Dental Pediatric - 86830AZ0050001 Health Insurance Plan

Cigna Health and Life Insurance Company health insurance plan with the Plan ID 86830AZ0050001. The plan is called Cigna Dental Pediatric.

Health Insurance Plan ID 86830AZ0050001
Health Insurance Plan Year 2023
State Arizona
Health Insurance Issuer Cigna Health and Life Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 86830AZ0050001-00
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 - 86830AZ0050001-00

Standard On Exchange Plan - 86830AZ0050001-01

Last Plan Update Date Wed, 17 Aug 2022 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Benefits of Cigna Dental Pediatric Health Insurance Plan, 86830AZ0050001-00

Benefit Covered In Network Out Of Network
Accidental Dental

Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.

YES

0.00%

0.00%
Basic Dental Care - Adult
NO
Basic Dental Care - Child

Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.

YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Dental Check-Up for Children

Limit: 1.0 Visit(s) per 6 Months

Dental Check-up is limited to 1 per 6 consecutive month period. Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.

YES

0.00%

0.00%
Major Dental Care - Adult
NO
Major Dental Care - Child

Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.

YES

50.00% Coinsurance after deductible

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

Medically necessary only. Please refer to Plan Brochure for detailed services covered, not covered, and frequency limitations.

YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Routine Dental Services (Adult)
NO

Cigna Dental Pediatric Health Insurance Plan Variant 86830AZ0050001-00 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 Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1
First Tier Utilization 100%
HIOS Product ID 86830AZ005
Import Date 8/17/2022 1:01
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 86830
Issuer Marketplace Marketing Name Cigna Healthcare
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group $750 per group
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out $375
Medical EHB Deductible, Combined In/Out of Network, Family Per Group $300 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $150 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $150
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 Low
Multiple In Network Tiers No
National Network Yes
Network ID AZN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services
Out of Service Area Coverage Yes
Out of Service Area Coverage Description All Services
Plan Brochure URL
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 86830AZ0050001-00
Plan Marketing Name Cigna Dental Pediatric
Plan Type PPO
Plan Variant Marketing Name Cigna Dental Pediatric
QHP/Non QHP Both
Service Area ID AZS001
Source Name HIOS
Plan ID 86830AZ0050001
State Code AZ
URL for Enrollment Payment URL

Copay & Coinsurance of Cigna Dental Pediatric Health Insurance Plan, 86830AZ0050001

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

Frequently Asked Questions(FAQ) about Cigna Dental Pediatric, 86830AZ0050001 Health Insurance Plan, 86830AZ0050001

  • Does Cigna Dental Pediatric Health Insurance Plan, 86830AZ0050001 support Mail Ordering?

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

  • Does (86830AZ0050001) Health Insurance Plan, Variant (86830AZ0050001-00) have Out Of Country Coverage?

    Yes. Details: Emergency Services

    Does (86830AZ0050001) Health Insurance Plan, Variant (86830AZ0050001-00) have Out of Service Area Coverage?

    Yes. Details: All Services

 

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