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Ambetter Balanced Care 1 (2019) + Vision
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Ambetter Balanced Care 1 (2019) + Vision

Overview
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Ambetter Balanced Care 1 (2019) + Vision is an individual health health plan issued by Celtic Insurance Company and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Osceola county, Florida.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Celtic Insurance Company
Plan ID
21663FL0140001
Coverage area
Osceola County, Florida
Phone
Local Phone: 1-877-687-1169
Toll-Free: 1-877-687-1169
TTY: 1-800-955-8770
Plan type
EPO
Coverage type
Medical deductible
$5,500
Out-of-pocket maximum
$6,500
Generic drug co-pay
$10
Preferred brand drug co-pay
$50
Primary care physician visit cost
$30
Specialist doctor visit cost
$60
Doctor Visits
Primary Care Visit $30
Specialist Visit $60
Emergency Room Visit 20% Coinsurance after deductible
Inpatient Facility Visit 20% Coinsurance after deductible
Inpatient Physician Visit 20% Coinsurance after deductible
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $50
Non-preferred Brand Drugs 20% Coinsurance after deductible
Specialty Drugs 20% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,500
Medical Maximum Out Of Pocket (Individual) $6,500
Medical Deductible (Family) $11,000
Medical Maximum Out Of Pocket (Family) $13,000
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 99.10%
Premium Child Age 0-14 325
Premium Child Age 18 388
Premium Adult Individual Age 21 425
Premium Adult Individual Age 27 446
Premium Adult Individual Age 30 483
Premium Adult Individual Age 40 544
Premium Adult Individual Age 50 760
Premium Adult Individual Age 60 1,156
Premium Couple 21 851
Premium Couple 30 966
Premium Couple 40 1,088
Premium Couple 50 1,521
Premium Couple 60 2,312
Couple+1 child, Age 21 1,177
Couple+1 child, Age 30 1,292
Couple+1 child, Age 40 1,414
Couple+1 child, Age 50 1,847
Couple+2 children, Age 21 1,503
Couple+2 children, Age 30 1,618
Couple+2 children, Age 40 1,740
Couple+2 children, Age 50 2,173
Couple+3 or more Children, Age 21 1,829
Couple+3 or more Children, Age 30 1,944
Couple+3 or more Children, Age 40 2,066
Couple+3 or more Children, Age 50 2,499
Individual+1 child, Age 21 751
Individual+1 child, Age 30 809
Individual+1 child, Age 40 870
Individual+1 child, Age 50 1,086
Individual+2 children, Age 21 1,077
Individual+2 children, Age 30 1,135
Individual+2 children, Age 40 1,196
Individual+2 children, Age 50 1,412
Individual+3 or more children, Age 21 1,403
Individual+3 or more children, Age 30 1,461
Individual+3 or more children, Age 40 1,522
Individual+3 or more children, Age 50 1,738
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types