WellCare Secure Health Bronze - 44007NC0120001 Health Insurance Plan
Celtic Insurance Company health insurance plan with the Plan ID 44007NC0120001. The plan is called WellCare Secure Health Bronze.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 64.89% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 35.11% of the costs of all covered benefits (according to the Issuer).
Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 65.61% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 34.39% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.
| Health Insurance Plan ID | 44007NC0120001 | ||||||||||||||||||
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| Health Insurance Plan Year | 2022 | ||||||||||||||||||
| State | North Carolina | ||||||||||||||||||
| Health Insurance Issuer | Celtic Insurance Company | ||||||||||||||||||
| Plan Formulary Description URL | Formulary URL | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 44007NC0120001-00 | ||||||||||||||||||
| Provider Network(s) | ['NCN001'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 23 Apr 2024 07:07 GMT). |
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| Available Variants of the Health Plan | Standard Off Exchange Plan - 44007NC0120001-00 Standard On Exchange Plan - 44007NC0120001-01 |
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| Last Plan Update Date | Thu, 22 Jul 2021 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 23 Apr 2024 07:07 GMT |
WellCare Secure Health Bronze Health Insurance Plan Variant 44007NC0120001-00 Attributes
| Plan Attribute | Value |
|---|---|
| AV Calculator Output Number | 0.656115445 |
| 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 Bronze Off Exchange Plan |
| Dental Only Plan | No |
| Disease Management Programs Offered | Asthma, Heart Disease, Diabetes, Pregnancy |
| EHB Percent of Total Premium | 1 |
| First Tier Utilization | 100% |
| Formulary ID | NCF001 |
| Formulary URL | URL |
| HIOS Product ID | 44007NC012 |
| Import Date | 7/22/2021 1:06 |
| Limited Cost Sharing Plan Variation - Estimated Advanced Payment | $0.00 |
| Inpatient Copayment Maximum Days | 0 |
| HSA Eligible | No |
| New/Existing Plan | New |
| Notice Required for Pregnancy | Yes |
| Is a Referral Required for Specialist? | No |
| Issuer Actuarial Value | 64.89% |
| Issuer ID | 44007 |
| Issuer Marketplace Marketing Name | WellCare of North Carolina |
| Market Coverage | Individual |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Expanded Bronze |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | NCN001 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | PPO Plan - out of network limitations apply |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2022 |
| Plan ID (Standard Component ID with Variant) | 44007NC0120001-00 |
| Plan Marketing Name | WellCare Secure Health Bronze |
| Plan Type | PPO |
| Plan Variant Marketing Name | WellCare Secure Health Bronze |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $1,400 |
| SBC Scenario, Having a Baby, Copayment | $50 |
| SBC Scenario, Having a Baby, Deductible | $6,500 |
| SBC Scenario, Having a Baby, Limit | $60 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $600 |
| SBC Scenario, Having Diabetes, Deductible | $4,000 |
| SBC Scenario, Having Diabetes, Limit | $20 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $200 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,500 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | NCS001 |
| Source Name | HIOS |
| Plan ID | 44007NC0120001 |
| State Code | NC |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $97400 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $48700 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $48,700 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $63000 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $31500 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $31,500 |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 40.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group | $13000 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person | $6500 per person |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $6,500 |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group | $50000 per group |
| Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person | $25000 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $25,000 |
| 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 | $80000 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | $40000 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $40,000 |
| Unique Plan Design | Yes |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | No |
Copay & Coinsurance of WellCare Secure Health Bronze Health Insurance Plan, 44007NC0120001
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about WellCare Secure Health Bronze, 44007NC0120001 Health Insurance Plan, 44007NC0120001
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Does WellCare Secure Health Bronze Health Insurance Plan, 44007NC0120001 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (44007NC0120001) Health Insurance Plan, Variant (44007NC0120001-00) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy
Does (44007NC0120001) Health Insurance Plan, Variant (44007NC0120001-00) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (44007NC0120001) Health Insurance Plan, Variant (44007NC0120001-00) have Out of Service Area Coverage?
Yes. Details: PPO Plan - out of network limitations apply
Does (44007NC0120001) Health Insurance Plan, Variant (44007NC0120001-00) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy
Does WellCare Secure Health Bronze Health Insurance Plan, Variant (44007NC0120001-00) offer Disease Management Programs for Asthma?
Yes, the WellCare Secure Health Bronze Health Insurance Plan Variant
44007NC0120001-00 offers Disease
Management Program for Asthma.
Does WellCare Secure Health Bronze Health Insurance Plan, Variant (44007NC0120001-00) offer Disease Management Programs for Heart disease?
Yes, the WellCare Secure Health Bronze Health Insurance Plan Variant
44007NC0120001-00 offers Disease
Management Program for Heart disease.
Does WellCare Secure Health Bronze Health Insurance Plan, Variant (44007NC0120001-00) offer Disease Management Programs for Diabetes?
Yes, the WellCare Secure Health Bronze Health Insurance Plan Variant
44007NC0120001-00 offers Disease
Management Program for Diabetes.
Does WellCare Secure Health Bronze Health Insurance Plan, Variant (44007NC0120001-00) offer Disease Management Programs for Pregnancy?
Yes, the WellCare Secure Health Bronze Health Insurance Plan Variant
44007NC0120001-00 offers Disease
Management Program for Pregnancy.
Disclaimer: This is based on the import(Date: Tue, 23 Apr 2024 07:07 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