| Field | Data |
|---|---|
| Health Insurance Plan ID | 86443VA0080004 |
| Health Insurance Plan Year | 2023 |
| State | Virginia |
| Health Insurance Issuer | Innovation Health Plan, Inc. |
| Plan Formulary Description URL | Formulary URL |
| Plan Marketing Materials URL | Marketing URL |
| Last Plan Update Date | Fri, 19 May 2023 00:00 GMT |
| Last Import Date | Sun, 28 May 2023 07:51 GMT |
| Health Insurance Plan Variant | 86443VA0080004-05 |
| Available Variants of the Health Plan | |
| 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 | 87% AV Level Silver Plan |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy |
| EHB Percent of Total Premium | 1 |
| First Tier Utilization | 100% |
| Formulary ID | VAF006 |
| Formulary URL | URL |
| HIOS Product ID | 86443VA008 |
| Import Date | 9/16/2022 20:01 |
| Limited Cost Sharing Plan Variation - Estimated Advanced Payment | 0 |
| Inpatient Copayment Maximum Days | 0 |
| HSA Eligible | No |
| New/Existing Plan | Existing |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | Yes |
| Issuer Actuarial Value | 87.36% |
| Issuer ID | 86443 |
| Issuer Marketplace Marketing Name | Innovation Health Plan, Inc. |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Silver |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | VAN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | No |
| Out of Service Area Coverage Description | Except for Emergencies |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2023 |
| Plan ID (Standard Component ID with Variant) | 86443VA0080004-05 |
| Plan Marketing Name | Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) |
| Plan Type | HMO |
| Plan Variant Marketing Name | Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $1,700 |
| SBC Scenario, Having a Baby, Copayment | $0 |
| SBC Scenario, Having a Baby, Deductible | $1,000 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $600 |
| SBC Scenario, Having Diabetes, Deductible | $100 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $400 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $80 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $1,000 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | VAS001 |
| Source Name | SERFF |
| Specialist Requiring a Referral | Referral required for all physicians EXCEPT OB/GYN, ER, Internal Medicine, Family Practice, General Medicine and Pediatrician. |
| Plan ID | 86443VA0080004 |
| State Code | VA |
| 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 | 30.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group | $2000 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $1000 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $1,000 |
| TEHBDedOutOfNetFamilyPerGroup | per group not applicable |
| TEHBDedOutOfNetFamilyPerPerson | 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 | $5400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person | $2700 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $2,700 |
| 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 | Yes |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | Yes |
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS), 86443VA0080004 Health Insurance Plan, 86443VA0080004
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, 86443VA0080004 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (86443VA0080004) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does (86443VA0080004) Health Insurance Plan, Variant (86443VA0080004-05) have Out Of Country Coverage?
No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan).
Does (86443VA0080004) Health Insurance Plan, Variant (86443VA0080004-05) 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: Except for Emergencies
Does (86443VA0080004) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Asthma?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Asthma.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Heart disease?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Heart disease.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Depression?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Depression.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Diabetes?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Diabetes.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for High blood pressure & high cholesterol.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Low back pain?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Low back pain.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Pain management?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Pain management.
Does Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan, Variant (86443VA0080004-05) offer Disease Management Programs for Pregnancy?
Yes, the Innovation Health - Aetna Silver 2 (Telehealth and $0 MinuteClinic Visits at CVS) Health Insurance Plan Variant 86443VA0080004-05 offers Disease Management Program for Pregnancy.
Disclaimer: This is based on the import(Date: Sun, 28 May 2023 07:51 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