Ambetter Balanced Care 15 + Vision + Adult Dental (2020)

Plan Type: EPO
Plan Tier: Silver
Medical Deductible - Individual: $2950
Medical Deductible - Family: Included in Medical
Drug Deductible - Individual: $2950
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $8150
Out of Pocket Max - Family: $8150
Primary Care Visit: $30
Specialist Visit: $65
Emergency Room: 40% Coinsurance after deductible
Hospital - Physician: 40% Coinsurance after deductible
Hospital - Facility: 40% Coinsurance after deductible
Link to Full SBC: https://api.centene.com/SBC/2020/21663FL0150042-01.pdf
Plan Brochure: https://api.centene.com/Brochures/2020/21663FL0150042-01.pdf

Other Coverage:

Child Dental: No
Adult Dental Yes

Prescription Drug Pricing:

Generic Drugs: $15
Non-Preferred Brand Drugs: 50% Coinsurance after deductible
Preferred Brand Drugs: $60
Specialty Drugs: 50% Coinsurance after deductible
Link to Full Policy Formulary: https://ambetter.sunshinehealth.com/resources/pharmacy-resources.html

About The Carrier

Ambetter plans are certified as Qualified Health Plans offered on the Health Insurance Marketplace.

Established to deliver quality health insurance through local, regional and community-based resources, our Ambetter products are offered by Centene Corporation – a Fortune 500 company with over 27 years of experience in the Managed Care industry and a robust portfolio of specialty health solutions.

Ambetter health insurance plans are designed to deliver high quality, locally-based healthcare services to its members, with our providers benefiting from enhanced collaboration and strategic care coordination programs.

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