AultCare Silver 5000 Select No Pediatric Dental
Plan Type: | PPO |
Plan Tier: | Silver |
Medical Deductible - Individual: | $5,000 |
Medical Deductible - Family: | $10,000 |
Drug Deductible - Individual: | $0 |
Drug Deductible - Family: | $0 |
Out of Pocket Max - Individual: | $6,000 |
Out of Pocket Max - Family: | $12,000 |
Primary Care Visit: | $35 Copay with deductible |
Specialist Visit: | $50 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: | http://www.aultcas.com/Application/na/getForm.aspx?sbc=sbc6612019.pdf |
Plan Brochure: | http://www.aultcas.com/Application/na/getForm.aspx?sbcbroc=brochure6612019.pdf |
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: | http://www.AultCAS.com/acformularya2019.aspx |
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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