| Field | Data |
|---|---|
| Health Insurance Plan ID | 91908OK0010028 |
| Health Insurance Plan Year | 2022 |
| State | Oklahoma |
| Health Insurance Issuer | Oscar Insurance Company |
| Last Plan Update Date | Wed, 26 Oct 2022 00:00 GMT |
| Last Import Date | Sun, 28 May 2023 07:51 GMT |
| Health Insurance Plan Variant | 91908OK0010028-03 |
| Available Variants of the Health Plan | |
| 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 | Limited Cost Sharing Plan Variation |
| 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 URL | URL |
| 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 Brochure | URL |
| Plan Effective Date | 1/1/2022 |
| Plan Expiration Date | 12/31/2022 |
| Plan ID (Standard Component ID with Variant) | 91908OK0010028-03 |
| 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 Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | No |
| 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 (91908OK0010028-03) 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 (91908OK0010028-03) have Out Of Country Coverage?
Yes. Details: Emergency Services only.
Does (91908OK0010028) Health Insurance Plan, Variant (91908OK0010028-03) have Out of Service Area Coverage?
Yes. Details: Emergency and Urgent Services only.
Does (91908OK0010028) Health Insurance Plan, Variant (91908OK0010028-03) 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 (91908OK0010028-03) offer Disease Management Programs for Asthma?
Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-03 offers Disease Management Program for Asthma.
Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-03) 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 91908OK0010028-03 offers Disease Management Program for Heart disease.
Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-03) offer Disease Management Programs for Depression?
Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-03 offers Disease Management Program for Depression.
Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-03) offer Disease Management Programs for Diabetes?
Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-03 offers Disease Management Program for Diabetes.
Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-03) 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 91908OK0010028-03 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 (91908OK0010028-03) 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 91908OK0010028-03 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 (91908OK0010028-03) 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 91908OK0010028-03 offers Disease Management Program for Pain management.
Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-03) offer Disease Management Programs for Pregnancy?
Yes, the Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan Variant 91908OK0010028-03 offers Disease Management Program for Pregnancy.
Does Silver Elite- $0 PCP ($0 Primary Care + $0 Drugs + $0 Virtual Care) Health Insurance Plan, Variant (91908OK0010028-03) 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 91908OK0010028-03 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