Ambetter Balanced Care 10 (2018) + Vision
| Plan Type: | HMO | 
| Plan Tier: | Silver | 
| Medical Deductible - Individual: | $5,000 | 
| Medical Deductible - Family: | $10,000 | 
| Drug Deductible - Individual: | Included in Medical | 
| Drug Deductible - Family: | Included in Medical | 
| Out of Pocket Max - Individual: | $6,700 | 
| Out of Pocket Max - Family: | $13,400 | 
| Primary Care Visit: | $20 | 
| Specialist Visit: | $40 | 
| 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/2018/41047OH0020020-01.pdf | 
| Plan Brochure: | https://api.centene.com/Brochures/2018/41047OH0020020-01.pdf | 
Other Coverage:
| Child Dental: | No | 
| Adult Dental | No | 
Prescription Drug Pricing:
| Generic Drugs: | $10 | 
| Non-Preferred Brand Drugs: | 20% Coinsurance after deductible | 
| Preferred Brand Drugs: | $50 | 
| Specialty Drugs: | 20% 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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