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Gold Classic- Standard

Field Data
Health Insurance Plan ID23552TN0020053
Health Insurance Plan Year2023
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

23552TN0020053-00

23552TN0020053-01

23552TN0020053-02

23552TN0020053-03

Copay & Coinsurance of Gold Classic- Standard Health Insurance Plan, 23552TN0020053

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order
Non preferred brand 1 month in retail $60.0 Before deductible 0% Before deductible YES
Non preferred brand 3 month in mail $150.0 Before deductible 0% Before deductible YES
Non preferred brand 3 month in retail $180.0 Before deductible 0% Before 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 $250.0 Before deductible 0% Before deductible NO
Preferred brand 1 month in retail $30.0 Before deductible 0% Before deductible YES
Preferred brand 3 month in mail $75.0 Before deductible 0% Before deductible YES
Preferred brand 3 month in retail $90.0 Before deductible 0% Before deductible YES
Preferred generic 1 month in retail $15.0 Before deductible 0% Before deductible YES
Preferred generic 3 month in mail $37.5 Before deductible 0% Before deductible YES
Preferred generic 3 month in retail $45.0 Before deductible 0% Before deductible YES
Specialty drugs 1 month in retail $250.0 Before deductible 0% Before 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- Standard, 23552TN0020053 Health Insurance Plan, 23552TN0020053

Does Gold Classic- Standard Health Insurance Plan, 23552TN0020053 support Mail Ordering?

Yes, Gold Classic- Standard Health Insurance Plan, 23552TN0020053 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- Standard (23552TN0020053) 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 $15.0 and coinsurance (Before deductible) is 0.0%, preferred generic drug tier copay (Before deductible) is $37.5 and coinsurance (Before deductible) is 0.0%, preferred generic drug tier copay (Before deductible) is $45.0 and coinsurance (Before deductible) is 0.0%

What are the copay and coinsurance options for Brand Drugs with Gold Classic- Standard Health Insurance Plan (23552TN0020053)?

For non preferred brand drug tier copay (Before deductible) is $60.0 and coinsurance (Before deductible) is 0.0%, non preferred brand drug tier copay (Before deductible) is $150.0 and coinsurance (Before deductible) is 0.0%, non preferred brand drug tier copay (Before deductible) is $180.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $30.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $75.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $90.0 and coinsurance (Before deductible) is 0.0%

What are the copay and coinsurance options for Brand Drugs with Gold Classic- Standard Health Insurance Plan (23552TN0020053)?

, non preferred brand drug tier copay (Before deductible) is $60.0 and coinsurance (Before deductible) is 0.0%, non preferred brand drug tier copay (Before deductible) is $150.0 and coinsurance (Before deductible) is 0.0%, non preferred brand drug tier copay (Before deductible) is $180.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $30.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $75.0 and coinsurance (Before deductible) is 0.0%, preferred brand drug tier copay (Before deductible) is $90.0 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