Ambetter Essential Care 10 (2020)
| Plan Type: | EPO |
| Plan Tier: | Expanded Bronze |
| Medical Deductible - Individual: | $7200 |
| Medical Deductible - Family: | Included in Medical |
| Drug Deductible - Individual: | $7200 |
| Drug Deductible - Family: | Included in Medical |
| Out of Pocket Max - Individual: | $8150 |
| Out of Pocket Max - Family: | $8150 |
| Primary Care Visit: | $0.50 |
| Specialist Visit: | 50% Coinsurance after deductible |
| Emergency Room: | 50% Coinsurance after deductible |
| Hospital - Physician: | 50% Coinsurance after deductible |
| Hospital - Facility: | 50% Coinsurance after deductible |
| Link to Full SBC: | https://api.centene.com/SBC/2020/21663FL0130028-01.pdf |
| Plan Brochure: | https://api.centene.com/Brochures/2020/21663FL0130028-01.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% Coinsurance after deductible |
| Specialty Drugs: | 50% Coinsurance after deductible |
| Link to Full Policy Formulary: | https://ambetter.sunshinehealth.com/resources/pharmacy-resources.html |
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