Ambetter Balanced Care 11 (2020)
| Plan Type: | EPO |
| Plan Tier: | Silver |
| Medical Deductible - Individual: | $6000 |
| Medical Deductible - Family: | Included in Medical |
| Drug Deductible - Individual: | $6000 |
| Drug Deductible - Family: | Included in Medical |
| Out of Pocket Max - Individual: | $8100 |
| Out of Pocket Max - Family: | $8100 |
| Primary Care Visit: | $30 |
| Specialist Visit: | $60 |
| 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/2020/21663FL0130019-01.pdf |
| Plan Brochure: | https://api.centene.com/Brochures/2020/21663FL0130019-01.pdf |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $20 |
| Non-Preferred Brand Drugs: | 50% Coinsurance after deductible |
| Preferred Brand Drugs: | $50 |
| Specialty Drugs: | 50% Coinsurance after deductible |
| Link to Full Policy Formulary: | https://ambetter.sunshinehealth.com/resources/pharmacy-resources.html |
This Carrier Offers:
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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