Robin Oak $8,700 Catastrophic - 20173WI0130004 Health Insurance Plan

HealthPartners Insurance Company health insurance plan with the Plan ID 20173WI0130004. The plan is called Robin Oak $8,700 Catastrophic.

Health Insurance Plan ID 20173WI0130004
Health Insurance Plan Year 2022
State Wisconsin
Health Insurance Issuer HealthPartners Insurance Company
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 20173WI0130004-01
Provider Network(s) ['WIN002']
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 Wisconsin 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 On Exchange Plan - 20173WI0130004-01

Last Plan Update Date Fri, 13 Aug 2021 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 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 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Catastrophic On Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
EHB Percent of Total Premium 0.9989
First Tier Utilization 100%
Formulary ID WIF001
Formulary URL URL
HIOS Product ID 20173WI013
Import Date 8/13/2021 1:01
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? No
Issuer ID 20173
Issuer Marketplace Marketing Name HealthPartners
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Catastrophic
Multiple In Network Tiers No
National Network No
Network ID WIN002
Out of Country Coverage Yes
Out of Country Coverage Description Coverage for emergency services only
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Out-of-Network benefits will be applied
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 20173WI0130004-01
Plan Marketing Name Robin Oak $8,700 Catastrophic
Plan Type PPO
Plan Variant Marketing Name Robin Oak $8,700 Catastrophic
QHP/Non QHP On the Exchange
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $8,700
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $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 WIS002
Source Name HIOS
Plan ID 20173WI0130004
State Code WI
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 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $17400 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $8700 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $8,700
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group $40000 per group
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person $20000 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $20,000
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $17400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $8700 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $8,700
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 Summary of Benefits & Coverage URL
Wellness Program Offered Yes

Copay & Coinsurance of Robin Oak $8,700 Catastrophic Health Insurance Plan, 20173WI0130004

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

Frequently Asked Questions(FAQ) about Robin Oak $8,700 Catastrophic, 20173WI0130004 Health Insurance Plan, 20173WI0130004

  • Does Robin Oak $8,700 Catastrophic Health Insurance Plan, 20173WI0130004 support Mail Ordering?

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

  • Does (20173WI0130004) Health Insurance Plan, Variant (20173WI0130004-01) 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, Weight Loss Programs

    Does (20173WI0130004) Health Insurance Plan, Variant (20173WI0130004-01) have Out Of Country Coverage?

    Yes. Details: Coverage for emergency services only

    Does (20173WI0130004) Health Insurance Plan, Variant (20173WI0130004-01) have Out of Service Area Coverage?

    Yes. Details: Out-of-Network benefits will be applied

    Does (20173WI0130004) Health Insurance Plan, Variant (20173WI0130004-01) 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, Weight Loss Programs

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Asthma?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Asthma.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Heart disease?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Heart disease.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Depression?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Depression.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Diabetes?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Diabetes.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Low back pain?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Low back pain.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Pregnancy?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Pregnancy.

    Does Robin Oak $8,700 Catastrophic Health Insurance Plan, Variant (20173WI0130004-01) offer Disease Management Programs for Weight loss programs?

    Yes, the Robin Oak $8,700 Catastrophic Health Insurance Plan Variant 20173WI0130004-01 offers Disease Management Program for Weight loss programs.

 

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