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Ambetter Balanced Care 6 (2019)
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Ambetter Balanced Care 6 (2019)

Overview
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Ambetter Balanced Care 6 (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
62141AR0080008
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
$3,000
Out-of-pocket maximum
$6,750
Generic drug co-pay
$25
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 $600 Copay with deductible
Inpatient Facility Visit $750 Copay per Day with deductible
Inpatient Physician Visit $250
Prescription Drugs
Generic Drugs $25
Preferred Brand Drugs $50
Non-preferred Brand Drugs 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $3,000
Medical Maximum Out Of Pocket (Individual) $6,750
Medical Deductible (Family) $6,000
Medical Maximum Out Of Pocket (Family) $13,500
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 0-14 229
Premium Child Age 18 273
Premium Adult Individual Age 21 299
Premium Adult Individual Age 27 314
Premium Adult Individual Age 30 340
Premium Adult Individual Age 40 383
Premium Adult Individual Age 50 535
Premium Adult Individual Age 60 813
Premium Couple 21 599
Premium Couple 30 680
Premium Couple 40 766
Premium Couple 50 1,070
Premium Couple 60 1,627
Couple+1 child, Age 21 828
Couple+1 child, Age 30 909
Couple+1 child, Age 40 995
Couple+1 child, Age 50 1,300
Couple+2 children, Age 21 1,058
Couple+2 children, Age 30 1,139
Couple+2 children, Age 40 1225
Couple+2 children, Age 50 1,529
Couple+3 or more Children, Age 21 1,287
Couple+3 or more Children, Age 30 1,368
Couple+3 or more Children, Age 40 1,454
Couple+3 or more Children, Age 50 1,758
Individual+1 child, Age 21 529
Individual+1 child, Age 30 569
Individual+1 child, Age 40 612
Individual+1 child, Age 50 764
Individual+2 children, Age 21 758
Individual+2 children, Age 30 798
Individual+2 children, Age 40 841
Individual+2 children, Age 50 994
Individual+3 or more children, Age 21 987
Individual+3 or more children, Age 30 1,028
Individual+3 or more children, Age 40 1,071
Individual+3 or more children, Age 50 1,223
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