Celtic - Ambetter Essential Care 1 (2018) + Vision

Texas, 2018

  • Plan Type

    EPO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $6,800

  • Deductible

    $6,800

Enroll Now
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Call (855) 866-5590 to speak with a licensed agent about a new health plan.

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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) $6,800
Deductible (Family) $13,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,800
Out of Pocket Maximum (Family) $13,600

Doctor Visits

Primary Care Visit No charge after deductible
Specialist Visit No charge after deductible
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 Not available
Pregnancy Available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient No charge after deductible
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 No charge after deductible
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge after deductible

Other Plans in Texas

Plan Ambetter Balanced Care 4 (2018) Deductible $7,050 Coinsurance Not applicable Out of Pocket $7,050
Plan Ambetter Balanced Care 5 (2018) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Ambetter Balanced Care 10 (2018) Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Ambetter Balanced Care 2 (2018) Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 2 (2018) + Vision Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 10 (2018) + Vision Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Ambetter Balanced Care 1 (2018) Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 3 (2018) Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Essential Care 1 (2018) Deductible $6,800 Coinsurance Not applicable Out of Pocket $6,800
Plan Ambetter Balanced Care 1 (2018) + Vision Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Secure Care 1 (2018) with 3 Free PCP Visits Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,350
Plan Ambetter Balanced Care 3 (2018) + Vision Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 12 (2018) Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350

Health Insurance Tools

{"onCurrent":true,"type":"tools"}

Health Exchange Guides

{"onCurrent":true,"type":"guides"}

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) $6,800
Deductible (Family) $13,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,800
Out of Pocket Maximum (Family) $13,600

Doctor Visits

Primary Care Visit No charge after deductible
Specialist Visit No charge after deductible
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 Not available
Pregnancy Available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient No charge after deductible
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 No charge after deductible
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge after deductible

Other Plans in Texas

Plan Ambetter Balanced Care 4 (2018) Deductible $7,050 Coinsurance Not applicable Out of Pocket $7,050
Plan Ambetter Balanced Care 5 (2018) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Ambetter Balanced Care 10 (2018) Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Ambetter Balanced Care 2 (2018) Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 2 (2018) + Vision Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 10 (2018) + Vision Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,700
Plan Ambetter Balanced Care 1 (2018) Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 3 (2018) Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Essential Care 1 (2018) Deductible $6,800 Coinsurance Not applicable Out of Pocket $6,800
Plan Ambetter Balanced Care 1 (2018) + Vision Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Secure Care 1 (2018) with 3 Free PCP Visits Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,350
Plan Ambetter Balanced Care 3 (2018) + Vision Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Ambetter Balanced Care 12 (2018) Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350