WellCare Secure Health Gold - 44007NC0120003 Health Insurance Plan

Celtic Insurance Company health insurance plan with the Plan ID 44007NC0120003. The plan is called WellCare Secure Health Gold.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 81.24% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 18.76% 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 82.98% (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 17.02% 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 44007NC0120003
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 44007NC0120003-00
Provider Network(s) ['NCN001']
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 North Carolina 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 - 44007NC0120003-00

Standard On Exchange Plan - 44007NC0120003-01

Open to Indians below 300% FPL - 44007NC0120003-02

Open to Indians above 300% FPL - 44007NC0120003-03

Last Plan Update Date Thu, 22 Jul 2021 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.829772925
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 Gold 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 NCF003
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 81.24%
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 Gold
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) 44007NC0120003-00
Plan Marketing Name WellCare Secure Health Gold
Plan Type PPO
Plan Variant Marketing Name WellCare Secure Health Gold
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $1,500
SBC Scenario, Having a Baby, Copayment $300
SBC Scenario, Having a Baby, Deductible $1,350
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $800
SBC Scenario, Having Diabetes, Deductible $800
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $200
SBC Scenario, Treatment of a Simple Fracture, Copayment $100
SBC Scenario, Treatment of a Simple Fracture, Deductible $1,350
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID NCS001
Source Name HIOS
Plan ID 44007NC0120003
State Code NC
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group $71700 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person $35850 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual $35,850
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group $32700 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person $16350 per person
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $16,350
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 20.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $2700 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $1350 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $1,350
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group $30000 per group
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person $15000 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $15,000
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $11700 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $5850 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $5,850
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group $60000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person $30000 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $30,000
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 Gold Health Insurance Plan, 44007NC0120003

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

Frequently Asked Questions(FAQ) about WellCare Secure Health Gold, 44007NC0120003 Health Insurance Plan, 44007NC0120003

  • Does WellCare Secure Health Gold Health Insurance Plan, 44007NC0120003 support Mail Ordering?

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

  • Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy

    Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) have Out Of Country Coverage?

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

    Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) have Out of Service Area Coverage?

    Yes. Details: PPO Plan - out of network limitations apply

    Does (44007NC0120003) Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Asthma?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Asthma.

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Heart disease?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Heart disease.

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Diabetes?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 offers Disease Management Program for Diabetes.

    Does WellCare Secure Health Gold Health Insurance Plan, Variant (44007NC0120003-00) offer Disease Management Programs for Pregnancy?

    Yes, the WellCare Secure Health Gold Health Insurance Plan Variant 44007NC0120003-00 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