McLaren Silver Exchange VCP - 74917MI0020014 Health Insurance Plan

McLaren Health Plan Community health insurance plan with the Plan ID 74917MI0020014. The plan is called McLaren Silver Exchange VCP.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 71.59% (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 28.41% 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 74917MI0020014
Health Insurance Plan Year 2022
State Michigan
Health Insurance Issuer McLaren Health Plan Community
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 74917MI0020014-00
Provider Network(s) ['MIN001']
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 Michigan 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 - 74917MI0020014-00

Standard On Exchange Plan - 74917MI0020014-01

Open to Indians below 300% FPL - 74917MI0020014-02

Open to Indians above 300% FPL - 74917MI0020014-03

73% AV Silver Plan - 74917MI0020014-04

87% AV Silver Plan - 74917MI0020014-05

94% AV Silver Plan - 74917MI0020014-06

Last Plan Update Date Tue, 17 Aug 2021 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

McLaren Silver Exchange VCP Health Insurance Plan Variant 74917MI0020014-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.715921538
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 Silver Off Exchange Plan
Drug EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Drug EHB Deductible, Combined In/Out of Network, Family Per Person per person not applicable
Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 40.00%
Drug EHB Deductible, In Network (Tier 1), Family Per Group $1000 per group
Drug EHB Deductible, In Network (Tier 1), Family Per Person $500 per person
Drug EHB Deductible, In Network (Tier 1), Individual $500
Drug EHB Deductible, Out of Network, Family Per Group per group not applicable
Drug EHB Deductible, Out of Network, Family Per Person per person not applicable
Drug EHB Deductible, Out of Network, Individual Not Applicable
Dental Only Plan No
EHB Percent of Total Premium 0.9987
First Tier Utilization 100%
Formulary ID MIF001
Formulary URL URL
HIOS Product ID 74917MI002
Import Date 8/17/2021 20:00
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 74917
Issuer Marketplace Marketing Name McLaren Health Plan Community
Market Coverage Individual
Medical Drug Deductibles Integrated No
Medical Drug Maximum Out of Pocket Integrated Yes
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 per person not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance 20.00%
Medical EHB Deductible, In Network (Tier 1), Family Per Group $7400 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person $3700 per person
Medical EHB Deductible, In Network (Tier 1), Individual $3,700
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
Metal Level Silver
Multiple In Network Tiers No
National Network Yes
Network ID MIN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency
Plan Effective Date 1/1/2022
Plan ID (Standard Component ID with Variant) 74917MI0020014-00
Plan Marketing Name McLaren Silver Exchange VCP
Plan Type HMO
Plan Variant Marketing Name McLaren Silver Exchange VCP
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,800
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $3,700
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $1,200
SBC Scenario, Having Diabetes, Deductible $1,700
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,800
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID MIS002
Source Name SERFF
Plan ID 74917MI0020014
State Code MI
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
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $16300 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $8150 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $8,150
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 No

Copay & Coinsurance of McLaren Silver Exchange VCP Health Insurance Plan, 74917MI0020014

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

Frequently Asked Questions(FAQ) about McLaren Silver Exchange VCP, 74917MI0020014 Health Insurance Plan, 74917MI0020014

  • Does McLaren Silver Exchange VCP Health Insurance Plan, 74917MI0020014 support Mail Ordering?

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

  • Does (74917MI0020014) Health Insurance Plan, Variant (74917MI0020014-00) have Out Of Country Coverage?

    Yes. Details: Emergency

    Does (74917MI0020014) Health Insurance Plan, Variant (74917MI0020014-00) have Out of Service Area Coverage?

    Yes. Details: Emergency

 

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