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PLUS SG SILVER MT HD

Field Data
Health Insurance Plan ID32225MT0070011
Health Insurance Plan Year2023
StateMontana
Health Insurance IssuerMontana Health Cooperative
Plan Formulary Description URLFormulary URL
Plan Marketing Materials URLMarketing URL
Last Plan Update DateFri, 23 Sep 2022 00:00 GMT
Last Import DateSat, 10 Dec 2022 05:07 GMT
 
Available Variants of the Health Plan

32225MT0070011-00

32225MT0070011-01

Copay & Coinsurance of PLUS SG SILVER MT HD Health Insurance Plan, 32225MT0070011

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order
Non preferred brand 1 month in retail $0 0% After deductible YES
Non preferred brand 1 month out retail $0 0% After deductible YES
Non preferred brand 3 month in mail $0 0% After deductible YES
Non preferred brand 3 month out mail $0 0% After deductible YES
Non preferred generic 1 month in retail $0 0% After deductible YES
Non preferred generic 1 month out retail $0 0% After deductible YES
Non preferred generic 3 month in mail $0 0% After deductible YES
Non preferred generic 3 month out mail $0 0% After deductible YES
Preferred brand 1 month in retail $0 0% After deductible YES
Preferred brand 1 month out retail $0 0% After deductible YES
Preferred brand 3 month in mail $0 0% After deductible YES
Preferred brand 3 month out mail $0 0% After deductible YES
Preferred generic 1 month in retail $0 After deductible 0% After deductible YES
Preferred generic 1 month out retail $0 After deductible 0% After deductible YES
Preferred generic 3 month in mail $0 After deductible 0% After deductible YES
Preferred generic 3 month out mail $0 After deductible 0% After deductible YES
Specialty 1 month in retail $0 0% After deductible NO
Specialty 1 month out retail $0 0% After deductible NO
Zero cost share preventive 1 month in retail $0 Before deductible 0% YES
Zero cost share preventive 1 month out retail $0 After deductible 0% YES
Zero cost share preventive 3 month in mail $0 Before deductible 0% YES
Zero cost share preventive 3 month out mail $0 After deductible 0% YES

Frequently Asked Questions(FAQ) about PLUS SG SILVER MT HD, 32225MT0070011 Health Insurance Plan, 32225MT0070011

Does PLUS SG SILVER MT HD Health Insurance Plan, 32225MT0070011 support Mail Ordering?

Yes, PLUS SG SILVER MT HD Health Insurance Plan, 32225MT0070011 supports mail ordering for the next drug tiers: Non preferred brand, Non preferred generic, Preferred brand, Preferred generic, Zero cost share preventive

What are the Generic Medications coinsurance & copay options with PLUS SG SILVER MT HD (32225MT0070011) Health Insurance Plan?

For non preferred generic drug tier coinsurance (After deductible) is 0.0%, non preferred generic drug tier coinsurance (After deductible) is 0.0%, non preferred generic drug tier coinsurance (After deductible) is 0.0%, non preferred generic drug tier coinsurance (After deductible) is 0.0%, preferred generic drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 0.0%, preferred generic drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 0.0%, preferred generic drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 0.0%, preferred generic drug tier copay (After deductible) is $0.0 and coinsurance (After deductible) is 0.0%

What are the copay and coinsurance options for Brand Drugs with PLUS SG SILVER MT HD Health Insurance Plan (32225MT0070011)?

For non preferred brand drug tier coinsurance (After deductible) is 0.0%, non preferred brand drug tier coinsurance (After deductible) is 0.0%, non preferred brand drug tier coinsurance (After deductible) is 0.0%, non preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%

What are the copay and coinsurance options for Brand Drugs with PLUS SG SILVER MT HD Health Insurance Plan (32225MT0070011)?

, non preferred brand drug tier coinsurance (After deductible) is 0.0%, non preferred brand drug tier coinsurance (After deductible) is 0.0%, non preferred brand drug tier coinsurance (After deductible) is 0.0%, non preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%, preferred brand drug tier coinsurance (After deductible) is 0.0%

 

Disclaimer: This is based on the import(Date: Sat, 10 Dec 2022 05:07 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