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Ambetter Balanced Care 4 (2019)
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Ambetter Balanced Care 4 (2019)

Overview
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Ambetter Balanced Care 4 (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
62141AR0080101
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
$7,050
Out-of-pocket maximum
$7,050
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) $7,050
Medical Maximum Out Of Pocket (Individual) $7,050
Medical Deductible (Family) $14,100
Medical Maximum Out Of Pocket (Family) $14,100
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 0-14 230
Premium Child Age 18 275
Premium Adult Individual Age 21 301
Premium Adult Individual Age 27 316
Premium Adult Individual Age 30 342
Premium Adult Individual Age 40 385
Premium Adult Individual Age 50 539
Premium Adult Individual Age 60 819
Premium Couple 21 603
Premium Couple 30 685
Premium Couple 40 771
Premium Couple 50 1,078
Premium Couple 60 1,638
Couple+1 child, Age 21 834
Couple+1 child, Age 30 916
Couple+1 child, Age 40 1,002
Couple+1 child, Age 50 1,309
Couple+2 children, Age 21 1,065
Couple+2 children, Age 30 1,147
Couple+2 children, Age 40 1,233
Couple+2 children, Age 50 1,540
Couple+3 or more Children, Age 21 1,296
Couple+3 or more Children, Age 30 1,378
Couple+3 or more Children, Age 40 1,464
Couple+3 or more Children, Age 50 1,771
Individual+1 child, Age 21 532
Individual+1 child, Age 30 573
Individual+1 child, Age 40 616
Individual+1 child, Age 50 770
Individual+2 children, Age 21 763
Individual+2 children, Age 30 804
Individual+2 children, Age 40 847
Individual+2 children, Age 50 1,001
Individual+3 or more children, Age 21 994
Individual+3 or more children, Age 30 1,035
Individual+3 or more children, Age 40 1,078
Individual+3 or more children, Age 50 1,232
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