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Ambetter Balanced Care 7 (2019) + Vision + Adult Dental
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Ambetter Balanced Care 7 (2019) + Vision + Adult Dental

Overview
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Ambetter Balanced Care 7 (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
62141AR0100007
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
$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 93.02%
Premium Child Age 0-14 252
Premium Child Age 18 301
Premium Adult Individual Age 21 330
Premium Adult Individual Age 27 346
Premium Adult Individual Age 30 375
Premium Adult Individual Age 40 422
Premium Adult Individual Age 50 590
Premium Adult Individual Age 60 897
Premium Couple 21 661
Premium Couple 30 750
Premium Couple 40 844
Premium Couple 50 1,180
Premium Couple 60 1,794
Couple+1 child, Age 21 913
Couple+1 child, Age 30 1,003
Couple+1 child, Age 40 1,097
Couple+1 child, Age 50 1,433
Couple+2 children, Age 21 1,166
Couple+2 children, Age 30 1,256
Couple+2 children, Age 40 1,350
Couple+2 children, Age 50 1,686
Couple+3 or more Children, Age 21 1,419
Couple+3 or more Children, Age 30 1,508
Couple+3 or more Children, Age 40 1,603
Couple+3 or more Children, Age 50 1,939
Individual+1 child, Age 21 583
Individual+1 child, Age 30 628
Individual+1 child, Age 40 675
Individual+1 child, Age 50 843
Individual+2 children, Age 21 836
Individual+2 children, Age 30 880
Individual+2 children, Age 40 928
Individual+2 children, Age 50 1,096
Individual+3 or more children, Age 21 1,089
Individual+3 or more children, Age 30 1,133
Individual+3 or more children, Age 40 1,181
Individual+3 or more children, Age 50 1,348
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