AultCare Gold 1200 Select No Pediatric Dental

Plan Type: PPO
Plan Tier: Gold
Medical Deductible - Individual: $1,200
Medical Deductible - Family: $2,400
Drug Deductible - Individual: $0
Drug Deductible - Family: $0
Out of Pocket Max - Individual: $5,800
Out of Pocket Max - Family: $11,600
Primary Care Visit: $20
Specialist Visit: $40
Emergency Room: 10% Coinsurance after deductible
Hospital - Physician: 10% Coinsurance after deductible
Hospital - Facility: 10% Coinsurance after deductible
Link to Full SBC:
Plan Brochure:

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $10
Non-Preferred Brand Drugs: 40%
Preferred Brand Drugs: 30%
Specialty Drugs: 50%
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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