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Ambetter Essential Care 2 HSA (2019)
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Ambetter Essential Care 2 HSA (2019)

Overview
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Ambetter Essential Care 2 HSA (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 Madison county, Indiana.

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
76179IN0110052
Coverage area
Madison County, Indiana
Phone
Local Phone: 1-877-687-1182
Toll-Free: 1-877-687-1182
TTY: 1-877-941-9232
Plan type
EPO
Coverage type
Medical deductible
$6,550
Out-of-pocket maximum
$6,550
Generic drug co-pay
No Charge after Deductible
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 No Charge after Deductible
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) $6,550
Medical Maximum Out Of Pocket (Individual) $6,550
Medical Deductible (Family) $13,100
Medical Maximum Out Of Pocket (Family) $13,100
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 0-14 207
Premium Child Age 18 247
Premium Adult Individual Age 21 271
Premium Adult Individual Age 27 284
Premium Adult Individual Age 30 308
Premium Adult Individual Age 40 346
Premium Adult Individual Age 50 484
Premium Adult Individual Age 60 736
Premium Couple 21 542
Premium Couple 30 616
Premium Couple 40 693
Premium Couple 50 969
Premium Couple 60 1,473
Couple+1 child, Age 21 750
Couple+1 child, Age 30 823
Couple+1 child, Age 40 901
Couple+1 child, Age 50 1,177
Couple+2 children, Age 21 958
Couple+2 children, Age 30 1,031
Couple+2 children, Age 40 1,109
Couple+2 children, Age 50 1,384
Couple+3 or more Children, Age 21 1,165
Couple+3 or more Children, Age 30 1,239
Couple+3 or more Children, Age 40 1,316
Couple+3 or more Children, Age 50 1,592
Individual+1 child, Age 21 479
Individual+1 child, Age 30 515
Individual+1 child, Age 40 554
Individual+1 child, Age 50 692
Individual+2 children, Age 21 686
Individual+2 children, Age 30 723
Individual+2 children, Age 40 762
Individual+2 children, Age 50 900
Individual+3 or more children, Age 21 894
Individual+3 or more children, Age 30 930
Individual+3 or more children, Age 40 969
Individual+3 or more children, Age 50 1,107
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