Ambetter Balanced Care 12 (2018)
| Plan Type: | HMO |
| Plan Tier: | Silver |
| Medical Deductible - Individual: | $3,500 |
| Medical Deductible - Family: | $7,000 |
| Drug Deductible - Individual: | $500 |
| Drug Deductible - Family: | $1,000 |
| Out of Pocket Max - Individual: | $7,350 |
| Out of Pocket Max - Family: | $14,700 |
| Primary Care Visit: | $30 |
| Specialist Visit: | $65 |
| Emergency Room: | 20% Coinsurance after deductible |
| Hospital - Physician: | 20% Coinsurance after deductible |
| Hospital - Facility: | 20% Coinsurance after deductible |
| Link to Full SBC: | https://api.centene.com/SBC/2018/41047OH0010024-01.pdf |
| Plan Brochure: | https://api.centene.com/Brochures/2018/41047OH0010024-01.pdf |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $15 |
| Non-Preferred Brand Drugs: | $100 |
| Preferred Brand Drugs: | $50 |
| Specialty Drugs: | 40% Coinsurance after deductible |
| Link to Full Policy Formulary: | https://ambetter.buckeyehealthplan.com/resources/pharmacy-resources.html |
This Carrier Offers:
About The Carrier
AmBetter from Buckeye Community Health Plan provides quality healthcare solutions that help residents of Ohio live better. With a variety of affordable coverage options, they make it easier to stay healthy.
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