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Constant Care Silver 7 250

Field Data
Health Insurance Plan ID40047MI0010007
Health Insurance Plan Year2022
StateMichigan
Health Insurance IssuerMolina Healthcare of Michigan, Inc.
Plan Formulary Description URLFormulary URL
Plan Marketing Materials URLMarketing URL
Last Plan Update DateTue, 24 Aug 2021 00:00 GMT
Last Import DateFri, 31 Mar 2023 05:06 GMT
Health Insurance Plan Variant40047MI0010007-00
 
Available Variants of the Health Plan

40047MI0010007-00

40047MI0010007-01

40047MI0010007-02

40047MI0010007-03

40047MI0010007-04

40047MI0010007-05

40047MI0010007-06

Constant Care Silver 7 250 Health Insurance Plan Variant 40047MI0010007-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.660729205
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 Silver Off Exchange Plan
Drug EHB Deductible, Combined In/Out of Network, Family Per Group $2700 per group
Drug EHB Deductible, Combined In/Out of Network, Family Per Person $1350 per person
Drug EHB Deductible, Combined In/Out of Network, Individual $1,350
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 40.00%
Drug EHB Deductible, In Network (Tier 1), Family Per Group $2700 per group
Drug EHB Deductible, In Network (Tier 1), Family Per Person $1350 per person
Drug EHB Deductible, In Network (Tier 1), Individual $1,350
DEHBDedOutOfNetFamilyPerGroup per group not applicable
DEHBDedOutOfNetFamilyPerPerson per person not applicable
Drug EHB Deductible, Out of Network, Individual Not Applicable
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 MIF004
Formulary URLURL
HIOS Product ID 40047MI001
Import Date 8/17/2021 20:00
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
Inpatient Copayment Maximum Days 2
HSA Eligible No
New/Existing Plan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer ID 40047
Issuer Marketplace Marketing Name Molina Healthcare
Market Coverage Individual
Medical Drug Deductibles Integrated No
Medical Drug Maximum Out of Pocket Integrated Yes
Medical EHB Deductible, Combined In/Out of Network, Family Per Group $0 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $0 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $0
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Medical EHB Deductible, In Network (Tier 1), Family Per Group $0 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person $0 per person
Medical EHB Deductible, In Network (Tier 1), Individual $0
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
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID MIN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan BrochureURL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 40047MI0010007-00
Plan Marketing Name Constant Care Silver 7
Plan Type HMO
Plan Variant Marketing Name Constant Care Silver 7 250
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $1,600
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $0
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $1,600
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $1,500
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MIS001
Source Name SERFF
Plan ID 40047MI0010007
State Code MI
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $17100 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $8550 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $8,550
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $17100 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $8550 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $8,550
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 PaymentURL
URL for Summary of Benefits & CoverageURL
Wellness Program Offered No

Copay & Coinsurance of Constant Care Silver 7 250 Health Insurance Plan, 40047MI0010007

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order
Five preventive 1 month in retail $0 No charge 0% No charge YES
Five preventive 3 month in mail $0 No charge 0% No charge YES
Four specialty 1 month in retail $0 40.0% After deductible NO
One preferred generic 1 month in retail $0 0% YES
One preferred generic 3 month in mail $0 0% YES
Three non preferred brand and generic 1 month in retail $0 40.0% After deductible YES
Three non preferred brand and generic 3 month in mail $0 26.669999999999998% After deductible YES
Two preferred brand 1 month in retail $0 0% YES
Two preferred brand 3 month in mail $0 0% YES

Frequently Asked Questions(FAQ) about Constant Care Silver 7 250, 40047MI0010007 Health Insurance Plan, 40047MI0010007

Does Constant Care Silver 7 250 Health Insurance Plan, 40047MI0010007 support Mail Ordering?

Yes, Constant Care Silver 7 250 Health Insurance Plan, 40047MI0010007 supports mail ordering for the next drug tiers: Five preventive, One preferred generic, Three non preferred brand and generic, Two preferred brand

Does (40047MI0010007) Health Insurance Plan, Variant (40047MI0010007-00) offer Disease Management Programs?

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

Does (40047MI0010007) Health Insurance Plan, Variant (40047MI0010007-00) have Out Of Country Coverage?

No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan).

Does (40047MI0010007) Health Insurance Plan, Variant (40047MI0010007-00) 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 (40047MI0010007) Health Insurance Plan, Variant (40047MI0010007-00) 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 7 250 Health Insurance Plan, Variant (40047MI0010007-00) offer Disease Management Programs for Asthma?

Yes, the Constant Care Silver 7 250 Health Insurance Plan Variant 40047MI0010007-00 offers Disease Management Program for Asthma.

Does Constant Care Silver 7 250 Health Insurance Plan, Variant (40047MI0010007-00) offer Disease Management Programs for Heart disease?

Yes, the Constant Care Silver 7 250 Health Insurance Plan Variant 40047MI0010007-00 offers Disease Management Program for Heart disease.

Does Constant Care Silver 7 250 Health Insurance Plan, Variant (40047MI0010007-00) offer Disease Management Programs for Depression?

Yes, the Constant Care Silver 7 250 Health Insurance Plan Variant 40047MI0010007-00 offers Disease Management Program for Depression.

Does Constant Care Silver 7 250 Health Insurance Plan, Variant (40047MI0010007-00) offer Disease Management Programs for Diabetes?

Yes, the Constant Care Silver 7 250 Health Insurance Plan Variant 40047MI0010007-00 offers Disease Management Program for Diabetes.

Does Constant Care Silver 7 250 Health Insurance Plan, Variant (40047MI0010007-00) offer Disease Management Programs for High blood pressure & high cholesterol?

Yes, the Constant Care Silver 7 250 Health Insurance Plan Variant 40047MI0010007-00 offers Disease Management Program for High blood pressure & high cholesterol.

 

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