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Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers)

Field Data
Health Insurance Plan ID23552TN0020013
Health Insurance Plan Year2022
StateTennessee
Health Insurance IssuerOscar Insurance Company
Last Plan Update DateWed, 26 Oct 2022 00:00 GMT
Last Import DateFri, 24 Mar 2023 05:06 GMT
 
Available Variants of the Health Plan

23552TN0020013-00

23552TN0020013-01

23552TN0020013-02

23552TN0020013-03

Copay & Coinsurance of Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) Health Insurance Plan, 23552TN0020013

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order
Non preferred brand 1 month in retail $0 After deductible 30.000000000000004% After deductible YES
Non preferred brand 3 month in mail $0 After deductible 30.000000000000004% After deductible YES
Non preferred brand 3 month in retail $0 After deductible 30.000000000000004% After deductible YES
Non preferred generic 1 month in retail $15.0 Before deductible 0% Before deductible YES
Non preferred generic 3 month in mail $37.5 Before deductible 0% Before deductible YES
Non preferred generic 3 month in retail $45.0 Before deductible 0% Before deductible YES
Non preferred specialty drugs 1 month in retail $0 After deductible 30.000000000000004% After deductible NO
Preferred brand 1 month in retail $50.0 Before deductible 0% Before deductible YES
Preferred brand 3 month in mail $125.0 Before deductible 0% Before deductible YES
Preferred brand 3 month in retail $150.0 Before deductible 0% Before deductible YES
Preferred generic 1 month in retail $3.0 Before deductible 0% Before deductible YES
Preferred generic 3 month in mail $7.5 Before deductible 0% Before deductible YES
Preferred generic 3 month in retail $9.0 Before deductible 0% Before deductible YES
Specialty drugs 1 month in retail $0 After deductible 30.000000000000004% After deductible NO
Zero cost share preventive drugs 1 month in retail $0 Before deductible 0% Before deductible YES
Zero cost share preventive drugs 3 month in mail $0 Before deductible 0% Before deductible YES
Zero cost share preventive drugs 3 month in retail $0 Before deductible 0% Before deductible YES

Frequently Asked Questions(FAQ) about Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers), 23552TN0020013 Health Insurance Plan, 23552TN0020013

Does Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) Health Insurance Plan, 23552TN0020013 support Mail Ordering?

Yes, Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) Health Insurance Plan, 23552TN0020013 supports mail ordering for the next drug tiers: Non preferred brand, Non preferred generic, Preferred brand, Preferred generic, Zero cost share preventive drugs

What are the Generic Medications coinsurance & copay options with Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) (23552TN0020013) Health Insurance Plan?

For non preferred generic drug tier copay (Before deductible) is $15.0 and coinsurance (Before deductible) is 0.0%, non preferred generic drug tier copay (Before deductible) is $37.5 and coinsurance (Before deductible) is 0.0%, non preferred generic drug tier copay (Before deductible) is $45.0 and coinsurance (Before deductible) is 0.0%, preferred generic drug tier copay (Before deductible) is $3.0 and coinsurance (Before deductible) is 0.0%, preferred generic drug tier copay (Before deductible) is $7.5 and coinsurance (Before deductible) is 0.0%, preferred generic drug tier copay (Before deductible) is $9.0 and coinsurance (Before deductible) is 0.0%

What are the copay and coinsurance options for Brand Drugs with Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) Health Insurance Plan (23552TN0020013)?

For non preferred brand drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 30.000000000000004%, non preferred brand drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 30.000000000000004%, non preferred brand drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 30.000000000000004%, preferred brand drug tier copay (Before deductible) is $50.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $125.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $150.0 and coinsurance (Before deductible) is 0.0%

What are the copay and coinsurance options for Brand Drugs with Gold Classic ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) Health Insurance Plan (23552TN0020013)?

, non preferred brand drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 30.000000000000004%, non preferred brand drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 30.000000000000004%, non preferred brand drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 30.000000000000004%, preferred brand drug tier copay (Before deductible) is $50.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $125.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $150.0 and coinsurance (Before deductible) is 0.0%

 

Disclaimer: This is based on the import(Date: Fri, 24 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