Ambetter Ambetter Silver 5 + Vision + Adult Dental MS

Plan Information
Company Ambetter from Magnolia Health Plan
State MS
Metal Tier Silver
Plan Type HMO

Cost Sharing Benefits

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,000 Data Not Available
Deductible (Family) $6,000 Data Not Available
Coinsurance Data Not Available Data Not Available
Out of Pocket Maximum (Individual) $6,350 Data Not Available
Out of Pocket Maximum (Family) $12,700 Data Not Available
Services In Network Out of Network
Primary Care Visit $50 Data Not Available
Specialist Visit $75 Data Not Available
In Patient Hospital Services $1000 Copay per Day Data Not Available
Emergency Room Services $250 Copay after deductible Data Not Available
Mental / Behavioral Health Data Not Available Data Not Available
Imaging (CT/PET Scans, MRIs) Data Not Available Data Not Available
Rehabilitative Speech Therapy Data Not Available Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available Data Not Available
Preventative Care Data Not Available Data Not Available
Laboratory Outpatient and Professional Services Data Not Available Data Not Available
X-ray and Diagnostic Imaging Data Not Available Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $10
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $75 Copay after deductible
Specialty Drugs $250 Copay after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,000.00
Deductible (Family) $6,000.00
Out of Pocket Maximum (Individual) $5,200.00
Out of Pocket Maximum (Family) $10,400.00
Services In Network Out of Network
Primary Care Physician $20
Specialists $30
Emergency Room $150 Copay after deductible
Inpatient Facility $1000 Copay per Day
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $50 Copay after deductible
Specialty Drugs $250 Copay after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $500.00
Deductible (Family) $1,000.00
Out of Pocket Maximum (Individual) $2,250.00
Out of Pocket Maximum (Family) $4,500.00
Services In Network Out of Network
Primary Care Physician $10
Specialists $20
Emergency Room $100 Copay after deductible
Inpatient Facility $250 Copay per Stay
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $40 Copay after deductible
Specialty Drugs $250 Copay after deductible

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $0.00
Deductible (Family) $0.00
Out of Pocket Maximum (Individual) $2,250.0
Out of Pocket Maximum (Family) $4,500.00
Services In Network Out of Network
Primary Care Physician $5
Specialists $10
Emergency Room $100 Copay after deductible
Inpatient Facility $100 Copay per Stay
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $40 Copay after deductible
Specialty Drugs $100 Copay after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Ambetter Bronze 3
Ambetter Bronze 3 + Vision
Ambetter Bronze 3 + Vision + Adult Dental
Ambetter Bronze 4
Ambetter Bronze 4 + Vision
Ambetter Bronze 4 + Vision + Adult Dental
Ambetter Gold 2
Ambetter Gold 2 + Vision
Ambetter Gold 2 + Vision + Adult Dental
Ambetter Gold 4
Ambetter Gold 4 + Vision
Ambetter Gold 4 + Vision + Adult Dental
Ambetter Silver 5
Ambetter Silver 5 + Vision
Ambetter Silver 5 + Vision + Adult Dental
Ambetter Silver 6
Ambetter Silver 6 + Vision
Ambetter Silver 6 + Vision + Adult Dental
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This tool is for research purposes only. The numbers shown are estimates based on the information you have provided and our best efforts to provide accurate data. We try to keep the information up to date however we cannot make warranties about the accuracy of our information. We advise that users confirm any research with the respective health insurance companies and health exchanges.