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Ambetter Balanced Care 7 (2019)
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Ambetter Balanced Care 7 (2019)

Overview
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Ambetter Balanced Care 7 (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
62141AR0080007
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
$5,100
Out-of-pocket maximum
$6,450
Generic drug co-pay
$10
Preferred brand drug co-pay
$50
Primary care physician visit cost
$50
Specialist doctor visit cost
$75
Doctor Visits
Primary Care Visit $50
Specialist Visit $75
Emergency Room Visit $250 Copay after deductible
Inpatient Facility Visit $1000 Copay per Day after deductible
Inpatient Physician Visit $300 Copay after deductible
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $50
Non-preferred Brand Drugs $100 Copay after deductible
Specialty Drugs $250 Copay after deductible
Medical Deductible
Medical Deductible (Individual) $5,100
Medical Maximum Out Of Pocket (Individual) $6,450
Medical Deductible (Family) $10,200
Medical Maximum Out Of Pocket (Family) $12,900
Drug Deductible
Drug Deductible (Individual) $1,000
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $2,000
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 233
Premium Child Age 18 279
Premium Adult Individual Age 21 305
Premium Adult Individual Age 27 320
Premium Adult Individual Age 30 346
Premium Adult Individual Age 40 390
Premium Adult Individual Age 50 545
Premium Adult Individual Age 60 829
Premium Couple 21 611
Premium Couple 30 693
Premium Couple 40 781
Premium Couple 50 1,091
Premium Couple 60 1,658
Couple+1 child, Age 21 845
Couple+1 child, Age 30 927
Couple+1 child, Age 40 1,014
Couple+1 child, Age 50 1,325
Couple+2 children, Age 21 1,078
Couple+2 children, Age 30 1,161
Couple+2 children, Age 40 1,248
Couple+2 children, Age 50 1,559
Couple+3 or more Children, Age 21 1,312
Couple+3 or more Children, Age 30 1,395
Couple+3 or more Children, Age 40 1,482
Couple+3 or more Children, Age 50 1,793
Individual+1 child, Age 21 539
Individual+1 child, Age 30 580
Individual+1 child, Age 40 624
Individual+1 child, Age 50 779
Individual+2 children, Age 21 773
Individual+2 children, Age 30 814
Individual+2 children, Age 40 858
Individual+2 children, Age 50 1,013
Individual+3 or more children, Age 21 1,006
Individual+3 or more children, Age 30 1,048
Individual+3 or more children, Age 40 1,091
Individual+3 or more children, Age 50 1,247
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