| Field | Data |
|---|---|
| Health Insurance Plan ID | 79975MS0010004 |
| Health Insurance Plan Year | 2022 |
| State | Mississippi |
| Health Insurance Issuer | Molina Healthcare of Mississippi, Inc |
| Plan Formulary Description URL | Formulary URL |
| Plan Marketing Materials URL | Marketing URL |
| Last Plan Update Date | Fri, 03 Dec 2021 00:00 GMT |
| Last Import Date | Sun, 24 Sep 2023 09:34 GMT |
| Health Insurance Plan Variant | 79975MS0010004-04 |
| Available Variants of the Health Plan | |
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.738833289 |
| 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 | 73% AV Level Silver Plan |
| Dental Only Plan | No |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol |
| EHB Percent of Total Premium | 1 |
| First Tier Utilization | 100% |
| Formulary ID | MSF004 |
| Formulary URL | URL |
| HIOS Product ID | 79975MS001 |
| Import Date | 12/3/2021 1:01 |
| Limited Cost Sharing Plan Variation - Estimated Advanced Payment | $0.00 |
| Inpatient Copayment Maximum Days | 2 |
| HSA Eligible | No |
| New/Existing Plan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer ID | 79975 |
| Issuer Marketplace Marketing Name | Molina Healthcare |
| 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 | MSN001 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergent Only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Emergent Only |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2022 |
| Plan Expiration Date | 12/31/2022 |
| Plan ID (Standard Component ID with Variant) | 79975MS0010004-04 |
| Plan Marketing Name | Constant Care Silver 4 |
| Plan Type | HMO |
| Plan Variant Marketing Name | Constant Care Silver 4 200 |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $1,400 |
| SBC Scenario, Having a Baby, Deductible | $1,500 |
| SBC Scenario, Having a Baby, Limit | $0 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $600 |
| SBC Scenario, Having Diabetes, Deductible | $900 |
| SBC Scenario, Having Diabetes, Limit | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $200 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,100 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | MSS001 |
| Source Name | HIOS |
| Plan ID | 79975MS0010004 |
| State Code | MS |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $11950 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $5975 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $5,975 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $11950 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $5975 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $5,975 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group | $11950 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $5975 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $5,975 |
| TEHBDedOutOfNetFamilyPerGroup | per group not applicable |
| TEHBDedOutOfNetFamilyPerPerson | 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 | $11950 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $5975 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $5,975 |
| 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 | No |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | Yes |
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about Constant Care Silver 4, 79975MS0010004 Health Insurance Plan, 79975MS0010004
Does Constant Care Silver 4 Health Insurance Plan, 79975MS0010004 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol
Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-04) have Out Of Country Coverage?
Yes. Details: Emergent Only
Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-04) have Out of Service Area Coverage?
Yes. Details: Emergent Only
Does (79975MS0010004) Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol
Does Constant Care Silver 4 200 Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs for Asthma?
Yes, the Constant Care Silver 4 200 Health Insurance Plan Variant 79975MS0010004-04 offers Disease Management Program for Asthma.
Does Constant Care Silver 4 200 Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs for Heart disease?
Yes, the Constant Care Silver 4 200 Health Insurance Plan Variant 79975MS0010004-04 offers Disease Management Program for Heart disease.
Does Constant Care Silver 4 200 Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs for Depression?
Yes, the Constant Care Silver 4 200 Health Insurance Plan Variant 79975MS0010004-04 offers Disease Management Program for Depression.
Does Constant Care Silver 4 200 Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs for Diabetes?
Yes, the Constant Care Silver 4 200 Health Insurance Plan Variant 79975MS0010004-04 offers Disease Management Program for Diabetes.
Does Constant Care Silver 4 200 Health Insurance Plan, Variant (79975MS0010004-04) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the Constant Care Silver 4 200 Health Insurance Plan Variant 79975MS0010004-04 offers Disease Management Program for High blood pressure & high cholesterol.
Disclaimer: This is based on the import(Date: Sun, 24 Sep 2023 09:34 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