Friday Gold - 90617GA0010006 Health Insurance Plan

Friday Health Plans of Georgia Inc health insurance plan with the Plan ID 90617GA0010006. The plan is called Friday Gold.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 77.23% (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 22.77% 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 90617GA0010006
Health Insurance Plan Year 2022
State Georgia
Health Insurance Issuer Friday Health Plans of Georgia Inc
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 90617GA0010006-00
Provider Network(s) ['GAN001']
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 Georgia 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 - 90617GA0010006-00

Standard On Exchange Plan - 90617GA0010006-01

Open to Indians below 300% FPL - 90617GA0010006-02

Open to Indians above 300% FPL - 90617GA0010006-03

Last Plan Update Date Fri, 22 Oct 2021 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

FRIDAY Gold: Unlimited $0 Primary Care Visits, $0 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam, Off Exch. Health Insurance Plan Variant 90617GA0010006-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.772312093
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 Gold Off Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Diabetes, Weight Loss Programs
EHB Percent of Total Premium 0.998633298
First Tier Utilization 100%
Formulary ID GAF001
Formulary URL URL
HIOS Product ID 90617GA001
Import Date 10/22/2021 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 ID 90617
Issuer Marketplace Marketing Name Friday Health Plans
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers No
National Network No
Network ID GAN001
Out of Country Coverage No
Out of Country Coverage Description Urgent and Emergent Only
Out of Service Area Coverage No
Out of Service Area Coverage Description Urgent and Emergent Only
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 90617GA0010006-00
Plan Marketing Name Friday Gold
Plan Type HMO
Plan Variant Marketing Name FRIDAY Gold: Unlimited $0 Primary Care Visits, $0 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam, Off Exch.
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $2,100
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $2,300
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $400
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $2,300
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $100
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,300
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID GAS001
Source Name HIOS
Plan ID 90617GA0010006
State Code GA
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 20.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $4600 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $2300 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $2,300
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 $16500 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $8250 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $8,250
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

Copay & Coinsurance of Friday Gold Health Insurance Plan, 90617GA0010006

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

Frequently Asked Questions(FAQ) about Friday Gold, 90617GA0010006 Health Insurance Plan, 90617GA0010006

  • Does Friday Gold Health Insurance Plan, 90617GA0010006 support Mail Ordering?

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

  • Does (90617GA0010006) Health Insurance Plan, Variant (90617GA0010006-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Diabetes, Weight Loss Programs

    Does (90617GA0010006) Health Insurance Plan, Variant (90617GA0010006-00) have Out Of Country Coverage?

    No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan). Details: Urgent and Emergent Only

    Does (90617GA0010006) Health Insurance Plan, Variant (90617GA0010006-00) have Out of Service Area Coverage?

    No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan). Details: Urgent and Emergent Only

    Does (90617GA0010006) Health Insurance Plan, Variant (90617GA0010006-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Diabetes, Weight Loss Programs

    Does FRIDAY Gold: Unlimited $0 Primary Care Visits, $0 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam, Off Exch. Health Insurance Plan, Variant (90617GA0010006-00) offer Disease Management Programs for Diabetes?

    Yes, the FRIDAY Gold: Unlimited $0 Primary Care Visits, $0 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam, Off Exch. Health Insurance Plan Variant 90617GA0010006-00 offers Disease Management Program for Diabetes.

    Does FRIDAY Gold: Unlimited $0 Primary Care Visits, $0 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam, Off Exch. Health Insurance Plan, Variant (90617GA0010006-00) offer Disease Management Programs for Weight loss programs?

    Yes, the FRIDAY Gold: Unlimited $0 Primary Care Visits, $0 Preferred Generic Rx, $0 Mental Health Counseling, $0 Vision Exam, Off Exch. Health Insurance Plan Variant 90617GA0010006-00 offers Disease Management Program for Weight loss programs.

 

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