AultCare Bronze Standard Select No Pediatric Dental

Plan Type: PPO
Plan Tier: Expanded Bronze
Medical Deductible - Individual: $6,650
Medical Deductible - Family: $13,300
Drug Deductible - Individual: Included in Medical
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $7,900
Out of Pocket Max - Family: $15,800
Primary Care Visit: $35 Copay with deductible
Specialist Visit: $75 Copay with deductible
Emergency Room: 40% Coinsurance after deductible
Hospital - Physician: 40% Coinsurance after deductible
Hospital - Facility: 40% Coinsurance after deductible
Link to Full SBC:
Plan Brochure:

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $35
Non-Preferred Brand Drugs: 40% Coinsurance after deductible
Preferred Brand Drugs: 35% Coinsurance after deductible
Specialty Drugs: 45% Coinsurance after deductible
Link to Full Policy Formulary:

This Carrier Offers:

About The Carrier

For over 33 years, AultCare has been an industry leader in the competitive Ohio health care market. Through innovative plan designs, superior customer service and a cost effective, high quality network, AultCare has continued to keep enrollees and clients satisfied while remaining committed to providing affordable health care options.

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