Connect Ind Catastrophic MT

32225MT0090006
Catastrophic
PPO

Connect Ind Catastrophic MT is a Catastrophic PPO plan by Mountain Health CO-OP.

IMPORTANT: You are viewing the 2023 version of Connect Ind Catastrophic MT 32225MT0090006. You can enroll in this plan if you qualify for special enrollment until the end of 2023.

Locations

Connect Ind Catastrophic MT is offered in the following counties.

No data was found

Plan Overview

This is a plan overview for 2023 version of Connect Ind Catastrophic MT 32225MT0090006.
Insurer: Mountain Health CO-OP
Network Type: PPO
Metal Type: Catastrophic
HSA Eligible?: No
Plan ID: 32225MT0090006

Cost-Sharing Overview

Connect Ind Catastrophic MT offers the following cost-sharing.

Notes:

  • Some plans have separate cost-sharing for medical and drugs, while other plans offer combined cost-sharing. The cost-sharing amounts above are combined medical and drug costs unless otherwise noted.
  • You are viewing the standard version of this plan. Your costs may be lower depending on your income. Use the “get a quote” button below to see your estimated premium and out-of-pocket costs after assistance.
Ready to sign up for Connect Ind Catastrophic MT?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

Plan Features

Connect Ind Catastrophic MT offers the following features and referral requirements.

Wellness Program: Yes
Disease Program: Asthma, Diabetes
Notice Pregnancy: No
Referral Specialist: No
Specialist Requiring Referral:
Plan Exclusions:
Child Only Option?: Allows Adult and Child-Only

Network Details

The following network details will help you understand what Connect Ind Catastrophic MT covers when you are out of the service area or out of the country.

Out of Country Coverage: Yes
Out of Country Coverage Description: Emergent Only
Out of Service Area Coverage: Yes
Out of Service Area Coverage Description: Emergent Only
National Network: No

Additional Benefits and Cost-Sharing

Connect Ind Catastrophic MT includes the following benefits at the cost sharing rates listed below.

Free Preventive Services

There is no copayment or coinsurance for any of the following Connect Ind Catastrophic MT preventive services. This is true even if you haven’t met your yearly deductible.

Please note, these services are free only when delivered by a doctor or other provider in your plan’s network.

Additional Resources

Below are additional resources for Connect Ind Catastrophic MT including the Summary of Benefits & Coverage (SBC), plan brochure, formulary link, and a link to the website to pay your monthly premium after you enroll.

Summary of Benefits: Summary of Benefits Link
Plan Brochure: Plan Brochure Link
Formulary: Formulary Link
Premium Payment Website: Premium Payment Link
Ready to sign up for Connect Ind Catastrophic MT?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

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