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Ambetter Essential Care 1 (2019)
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Ambetter Essential Care 1 (2019)

Overview
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Ambetter Essential Care 1 (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 Marion county, Tennessee.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

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
70111TN0110002
Coverage area
Marion County, Tennessee
Phone
Local Phone: 1-312-332-5401
Toll-Free: 1-800-779-7989
TTY:
Plan type
EPO
Coverage type
Medical deductible
$7,900
Out-of-pocket maximum
$7,900
Generic drug co-pay
$20
Preferred brand drug co-pay
No Charge after Deductible
Primary care physician visit cost
No Charge after Deductible
Specialist doctor visit cost
No Charge after Deductible
Doctor Visits
Primary Care Visit No Charge after Deductible
Specialist Visit No Charge after Deductible
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 $20
Preferred Brand Drugs No Charge after Deductible
Non-preferred Brand Drugs No Charge after Deductible
Specialty Drugs No Charge after Deductible
Medical Deductible
Medical Deductible (Individual) $7,900
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $15,800
Medical Maximum Out Of Pocket (Family) $15,800
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 99.95%
Premium Child Age 0-14 244
Premium Child Age 18 292
Premium Adult Individual Age 21 320
Premium Adult Individual Age 27 335
Premium Adult Individual Age 30 363
Premium Adult Individual Age 40 409
Premium Adult Individual Age 50 571
Premium Adult Individual Age 60 869
Premium Couple 21 640
Premium Couple 30 726
Premium Couple 40 818
Premium Couple 50 1,143
Premium Couple 60 1,738
Couple+1 child, Age 21 885
Couple+1 child, Age 30 971
Couple+1 child, Age 40 1,063
Couple+1 child, Age 50 1,388
Couple+2 children, Age 21 1,130
Couple+2 children, Age 30 1,216
Couple+2 children, Age 40 1,308
Couple+2 children, Age 50 1,633
Couple+3 or more Children, Age 21 1,375
Couple+3 or more Children, Age 30 1,461
Couple+3 or more Children, Age 40 1,553
Couple+3 or more Children, Age 50 1,878
Individual+1 child, Age 21 565
Individual+1 child, Age 30 608
Individual+1 child, Age 40 654
Individual+1 child, Age 50 816
Individual+2 children, Age 21 810
Individual+2 children, Age 30 853
Individual+2 children, Age 40 899
Individual+2 children, Age 50 1,061
Individual+3 or more children, Age 21 1,055
Individual+3 or more children, Age 30 1,098
Individual+3 or more children, Age 40 1,144
Individual+3 or more children, Age 50 1,306
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