Sanford TRUE $8,700 - 31195SD0080015 Health Insurance Plan

Sanford Health Plan health insurance plan with the Plan ID 31195SD0080015. The plan is called Sanford TRUE $8,700.

Health Insurance Plan ID 31195SD0080015
Health Insurance Plan Year 2022
State South Dakota
Health Insurance Issuer Sanford Health Plan
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 31195SD0080015-00
Provider Network(s) ['SDN002']
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 South Dakota 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 - 31195SD0080015-00

Standard On Exchange Plan - 31195SD0080015-01

Last Plan Update Date Thu, 16 Dec 2021 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Sanford TRUE $8,700 Health Insurance Plan Variant 31195SD0080015-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 3
Business Year 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Catastrophic Off Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy
EHB Percent of Total Premium 1
First Tier Utilization 100%
Formulary ID SDF003
Formulary URL URL
HIOS Product ID 31195SD008
Import Date 12/16/2021 20:01
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
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 31195
Issuer Marketplace Marketing Name Sanford Health Plan
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 SDN002
Out of Country Coverage No
Out of Country Coverage Description Emergency Only
Out of Service Area Coverage No
Out of Service Area Coverage Description Emergency or Urgent Care Only or With Plan Certification
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 31195SD0080015-00
Plan Marketing Name Sanford TRUE $8,700
Plan Type HMO
Plan Variant Marketing Name Sanford TRUE $8,700
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $8,500
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $3,500
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 SDS002
Source Name SERFF
Plan ID 31195SD0080015
State Code SD
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $17400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $8700 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $8,700
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group $17400 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person $8700 per person
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $8,700
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 per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person 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 $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 No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of Sanford TRUE $8,700 Health Insurance Plan, 31195SD0080015

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

Frequently Asked Questions(FAQ) about Sanford TRUE $8,700, 31195SD0080015 Health Insurance Plan, 31195SD0080015

  • Does Sanford TRUE $8,700 Health Insurance Plan, 31195SD0080015 support Mail Ordering?

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

  • Does (31195SD0080015) Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

    Does (31195SD0080015) Health Insurance Plan, Variant (31195SD0080015-00) have Out Of Country Coverage?

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

    Does (31195SD0080015) Health Insurance Plan, Variant (31195SD0080015-00) 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: Emergency or Urgent Care Only or With Plan Certification

    Does (31195SD0080015) Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

    Does Sanford TRUE $8,700 Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs for Asthma?

    Yes, the Sanford TRUE $8,700 Health Insurance Plan Variant 31195SD0080015-00 offers Disease Management Program for Asthma.

    Does Sanford TRUE $8,700 Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs for Heart disease?

    Yes, the Sanford TRUE $8,700 Health Insurance Plan Variant 31195SD0080015-00 offers Disease Management Program for Heart disease.

    Does Sanford TRUE $8,700 Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs for Diabetes?

    Yes, the Sanford TRUE $8,700 Health Insurance Plan Variant 31195SD0080015-00 offers Disease Management Program for Diabetes.

    Does Sanford TRUE $8,700 Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Sanford TRUE $8,700 Health Insurance Plan Variant 31195SD0080015-00 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Sanford TRUE $8,700 Health Insurance Plan, Variant (31195SD0080015-00) offer Disease Management Programs for Pregnancy?

    Yes, the Sanford TRUE $8,700 Health Insurance Plan Variant 31195SD0080015-00 offers Disease Management Program for Pregnancy.

 

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