Guardian Basics for Families and Individuals - 12846TX0280002 Health Insurance Plan

The Guardian Life Insurance Company health insurance plan with the Plan ID 12846TX0280002. The plan is called Guardian Basics for Families and Individuals .

Health Insurance Plan ID 12846TX0280002
Health Insurance Plan Year 2023
State Texas
Health Insurance Issuer The Guardian Life Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 12846TX0280002-00
Provider Network(s) ['TXN002']
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 Texas 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 - 12846TX0280002-00

Standard On Exchange Plan - 12846TX0280002-01

Last Plan Update Date Sat, 16 Jul 2022 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Benefits of Guardian Basics for Families and Individuals Health Insurance Plan, 12846TX0280002-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult
YES

40.00% Coinsurance after deductible

40.00% Coinsurance after deductible
Basic Dental Care - Child
YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Dental Check-Up for Children
YES

No Charge

No Charge
Major Dental Care - Adult
NO
Major Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child
YES

50.00%

50.00%
Routine Dental Services (Adult)
YES

No Charge after deductible

No Charge after deductible

Guardian Basics for Families and Individuals Health Insurance Plan Variant 12846TX0280002-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1
First Tier Utilization 100%
HIOS Product ID 12846TX028
Import Date 7/16/2022 1:01
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 12846
Issuer Marketplace Marketing Name Guardian
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group $750 per group
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out $375
Medical EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $150 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $150
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
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
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual Not Applicable
Metal Level Low
Multiple In Network Tiers No
National Network Yes
Network ID TXN002
Out of Country Coverage No
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Coverage is provided outside of the Service Area.
Plan Brochure URL
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 12846TX0280002-00
Plan Marketing Name Guardian Basics for Families and Individuals
Plan Type PPO
Plan Variant Marketing Name Guardian Basics for Families and Individuals
QHP/Non QHP Both
Service Area ID TXS001
Source Name HIOS
Plan ID 12846TX0280002
State Code TX
URL for Enrollment Payment URL

Copay & Coinsurance of Guardian Basics for Families and Individuals Health Insurance Plan, 12846TX0280002

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

Frequently Asked Questions(FAQ) about Guardian Basics for Families and Individuals , 12846TX0280002 Health Insurance Plan, 12846TX0280002

  • Does Guardian Basics for Families and Individuals Health Insurance Plan, 12846TX0280002 support Mail Ordering?

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

  • Does (12846TX0280002) Health Insurance Plan, Variant (12846TX0280002-00) have Out Of Country Coverage?

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

    Does (12846TX0280002) Health Insurance Plan, Variant (12846TX0280002-00) have Out of Service Area Coverage?

    Yes. Details: Coverage is provided outside of the Service Area.

 

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