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Ambetter Balanced Care 11 (2019)
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Ambetter Balanced Care 11 (2019)

Overview
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Ambetter Balanced Care 11 (2019) 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 Woodruff county, Arkansas.

What Type of Health Plan Is This?

This plan is a PPO plan, which is also known as a "Preferred Provider Organization." In this type of insurance plan, you can choose to receive care from doctors, hospitals, and other providers who are in-network or out-of-network. You pay less if you use in-network providers. In a PPO plan, you can visit any doctor without getting a referral.

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
62141AR0080009
Coverage area
Woodruff County, Arkansas
Phone
Local Phone: 1-877-617-0390
Toll-Free: 1-877-617-0390
TTY: 1-877-617-0392
Plan type
PPO
Coverage type
Medical deductible
$6,000
Out-of-pocket maximum
$7,900
Generic drug co-pay
$20
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 40% Coinsurance after deductible
Inpatient Facility Visit 40% Coinsurance after deductible
Inpatient Physician Visit 40% Coinsurance after deductible
Prescription Drugs
Generic Drugs $20
Preferred Brand Drugs $50
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $6,000
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $12,000
Medical Maximum Out Of Pocket (Family) $15,800
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 100.00%
Premium Child Age 0-14 215
Premium Child Age 18 257
Premium Adult Individual Age 21 282
Premium Adult Individual Age 27 295
Premium Adult Individual Age 30 320
Premium Adult Individual Age 40 360
Premium Adult Individual Age 50 503
Premium Adult Individual Age 60 765
Premium Couple 21 564
Premium Couple 30 640
Premium Couple 40 721
Premium Couple 50 1,007
Premium Couple 60 1,531
Couple+1 child, Age 21 779
Couple+1 child, Age 30 856
Couple+1 child, Age 40 936
Couple+1 child, Age 50 1,223
Couple+2 children, Age 21 995
Couple+2 children, Age 30 1,071
Couple+2 children, Age 40 1,152
Couple+2 children, Age 50 1,439
Couple+3 or more Children, Age 21 1,211
Couple+3 or more Children, Age 30 1,287
Couple+3 or more Children, Age 40 1,368
Couple+3 or more Children, Age 50 1,654
Individual+1 child, Age 21 497
Individual+1 child, Age 30 535
Individual+1 child, Age 40 576
Individual+1 child, Age 50 719
Individual+2 children, Age 21 713
Individual+2 children, Age 30 751
Individual+2 children, Age 40 792
Individual+2 children, Age 50 935
Individual+3 or more children, Age 21 929
Individual+3 or more children, Age 30 967
Individual+3 or more children, Age 40 1,007
Individual+3 or more children, Age 50 1,151
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