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Ambetter - Ambetter Balanced Care 2 (2017)

Mississippi, 2017

Plan Type

HMO

Metal Tier

Silver

Out of Pocket Maximum

$6,500

Deductible

$6,500

Enroll
Call (855) 782-0916 to speak with a licensed agent about a new health plan.

Emergency Room Care: No charge after deductible

Cost Sharing Benefits (In Network)

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.

Deductible (Individual) $6,500
Deductible (Family) $13,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,500
Out of Pocket Maximum (Family) $13,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible
Emergency Room Services No charge after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge after deductible

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Available
Pain Management Available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge 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

Deductible (Individual) $5,000
Deductible (Family) $10,000
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge 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

Deductible (Individual) $1,750
Deductible (Family) $3,500
Out of Pocket Maximum (Individual) $1,750
Out of Pocket Maximum (Family) $3,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge 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

Deductible (Individual) $575
Deductible (Family) $1,150
Out of Pocket Maximum (Individual) $575
Out of Pocket Maximum (Family) $1,150

Doctor Visits

Primary Care Physician
Specialists
Emergency Room No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge after deductible

Other Plans in Mississippi

Plan Deductible Coinsurance Out of Pocket
Plan Ambetter Balanced Care 3 (2017) Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 1 (2017) + Vision Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 3 (2017) + Vision + Adult Dental Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 1 (2017) Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 3 (2017) + Vision Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 1 (2017) + Vision + Adult Dental Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 10 (2017) Deductible $4,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 12 (2017) Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Ambetter Balanced Care 10 (2017) + Vision + Adult Dental Deductible $4,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 2 (2017) + Vision Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Essential Care 1 (2017) + Vision Deductible $6,800 Coinsurance Not applicable Out of Pocket $6,800
Plan Ambetter Secure Care 1 (2017) with 3 Free PCP Visits Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,350
Plan Ambetter Essential Care 1 (2017) + Vision + Adult Dental Deductible $6,800 Coinsurance Not applicable Out of Pocket $6,800
Plan Ambetter Balanced Care 10 (2017) + Vision Deductible $4,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Essential Care 1 (2017) Deductible $6,800 Coinsurance Not applicable Out of Pocket $6,800
Plan Ambetter Balanced Care 2 (2017) + Vision + Adult Dental Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500