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Ambetter Balanced Care 6 (2019) + Vision + Adult Dental
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Ambetter Balanced Care 6 (2019) + Vision + Adult Dental

Overview
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Ambetter Balanced Care 6 (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 White 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
62141AR0100008
Coverage area
White 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 93.02%
Premium Child Age 0-14 248
Premium Child Age 18 296
Premium Adult Individual Age 21 324
Premium Adult Individual Age 27 339
Premium Adult Individual Age 30 368
Premium Adult Individual Age 40 414
Premium Adult Individual Age 50 579
Premium Adult Individual Age 60 880
Premium Couple 21 648
Premium Couple 30 736
Premium Couple 40 828
Premium Couple 50 1,158
Premium Couple 60 1,760
Couple+1 child, Age 21 896
Couple+1 child, Age 30 984
Couple+1 child, Age 40 1,076
Couple+1 child, Age 50 1,406
Couple+2 children, Age 21 1,144
Couple+2 children, Age 30 1,232
Couple+2 children, Age 40 1,324
Couple+2 children, Age 50 1,654
Couple+3 or more Children, Age 21 1,392
Couple+3 or more Children, Age 30 1,480
Couple+3 or more Children, Age 40 1,572
Couple+3 or more Children, Age 50 1,902
Individual+1 child, Age 21 572
Individual+1 child, Age 30 616
Individual+1 child, Age 40 662
Individual+1 child, Age 50 827
Individual+2 children, Age 21 820
Individual+2 children, Age 30 864
Individual+2 children, Age 40 910
Individual+2 children, Age 50 1,075
Individual+3 or more children, Age 21 1,068
Individual+3 or more children, Age 30 1,112
Individual+3 or more children, Age 40 1,158
Individual+3 or more children, Age 50 1,323
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