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Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care)

Field Data
Health Insurance Plan ID91908OK0010028
Health Insurance Plan Year2022
StateOklahoma
Health Insurance IssuerOscar Insurance Company
Last Plan Update DateWed, 26 Oct 2022 00:00 GMT
Last Import DateSun, 28 May 2023 07:51 GMT
Health Insurance Plan Variant91908OK0010028-01
 
Available Variants of the Health Plan

91908OK0010028-00

91908OK0010028-01

91908OK0010028-02

91908OK0010028-03

91908OK0010028-04

91908OK0010028-05

91908OK0010028-06

Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.700038858
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 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 1
First Tier Utilization 20%
Formulary ID OKF001
Formulary URLURL
HIOS Product ID 91908OK001
Import Date 8/18/2021 1:01
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
Inpatient Copayment Maximum Days 3
HSA Eligible No
New/Existing Plan New
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer ID 91908
Issuer Marketplace Marketing Name Oscar Insurance Company
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers Yes
National Network No
Network ID OKN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services only.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency and Urgent Services only.
Plan BrochureURL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 91908OK0010028-01
Plan Marketing Name Silver Elite- $0 PCP
Plan Type PPO
Plan Variant Marketing Name Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care)
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $700
SBC Scenario, Having a Baby, Deductible $3,500
SBC Scenario, Having a Baby, Limit $50
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $600
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 $300
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,200
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Second Tier Utilization 80%
Service Area ID OKS001
Source Name HIOS
Plan ID 91908OK0010028
State Code OK
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 50.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $7000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $3500 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $3,500
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Default Coinsurance 50.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Group $7000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Person $3500 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual $3,500
TEHBDedOutOfNetFamilyPerGroup $21000 per group
TEHBDedOutOfNetFamilyPerPerson $10500 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $10,500
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $15000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $7500 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $7,500
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Group $15000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Person $7500 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual $7,500
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 PaymentURL
URL for Summary of Benefits & CoverageURL
Wellness Program Offered No

Copay & Coinsurance of Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, 91908OK0010028

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

Frequently Asked Questions(FAQ) about Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care), 91908OK0010028 Health Insurance Plan, 91908OK0010028

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, 91908OK0010028 support Mail Ordering?

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

Does (91908OK0010028) Health Insurance Plan, Variant (91908OK0010028-01) 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 (91908OK0010028) Health Insurance Plan, Variant (91908OK0010028-01) have Out Of Country Coverage?

Yes. Details: Emergency Services only.

Does (91908OK0010028) Health Insurance Plan, Variant (91908OK0010028-01) have Out of Service Area Coverage?

Yes. Details: Emergency and Urgent Services only.

Does (91908OK0010028) Health Insurance Plan, Variant (91908OK0010028-01) 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 Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Asthma?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Asthma.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Heart disease?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Heart disease.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Depression?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Depression.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Diabetes?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Diabetes.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for High blood pressure & high cholesterol?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for High blood pressure & high cholesterol.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Low back pain?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Low back pain.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Pain management?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Pain management.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Pregnancy?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Pregnancy.

Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-01) offer Disease Management Programs for Weight loss programs?

Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-01 offers Disease Management Program for Weight loss programs.

 

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