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Ambetter Balanced Care 2 (2019) + Vision + Adult Dental
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Ambetter Balanced Care 2 (2019) + Vision + Adult Dental

Overview
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Ambetter Balanced Care 2 (2019) + Vision + Adult Dental 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
21663FL0150002
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
$6,500
Out-of-pocket maximum
$6,500
Generic drug co-pay
$15
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 No Charge after Deductible
Inpatient Facility Visit No Charge after Deductible
Inpatient Physician Visit No Charge after Deductible
Prescription Drugs
Generic Drugs $15
Preferred Brand Drugs $50
Non-preferred Brand Drugs No Charge after Deductible
Specialty Drugs No Charge after Deductible
Medical Deductible
Medical Deductible (Individual) $6,500
Medical Maximum Out Of Pocket (Individual) $6,500
Medical Deductible (Family) $13,000
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 97.04%
Premium Child Age 0-14 329
Premium Child Age 18 393
Premium Adult Individual Age 21 430
Premium Adult Individual Age 27 451
Premium Adult Individual Age 30 488
Premium Adult Individual Age 40 550
Premium Adult Individual Age 50 768
Premium Adult Individual Age 60 1,168
Premium Couple 21 860
Premium Couple 30 977
Premium Couple 40 1,100
Premium Couple 50 1,537
Premium Couple 60 2,336
Couple+1 child, Age 21 1,190
Couple+1 child, Age 30 1,306
Couple+1 child, Age 40 1,429
Couple+1 child, Age 50 1,866
Couple+2 children, Age 21 1,519
Couple+2 children, Age 30 1,635
Couple+2 children, Age 40 1,758
Couple+2 children, Age 50 2,196
Couple+3 or more Children, Age 21 1,848
Couple+3 or more Children, Age 30 1,965
Couple+3 or more Children, Age 40 2,088
Couple+3 or more Children, Age 50 2,525
Individual+1 child, Age 21 759
Individual+1 child, Age 30 817
Individual+1 child, Age 40 879
Individual+1 child, Age 50 1,098
Individual+2 children, Age 21 1,089
Individual+2 children, Age 30 1,147
Individual+2 children, Age 40 1,208
Individual+2 children, Age 50 1,427
Individual+3 or more children, Age 21 1,418
Individual+3 or more children, Age 30 1,476
Individual+3 or more children, Age 40 1,538
Individual+3 or more children, Age 50 1,756
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