Ambetter Essential Care 1 (2020) Plan Details for 2020- HealthPocket

Apply For This Plan

Zip Code85364
Applicant7/7/1985 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAmbetter Essential Care 1 (2020)
Plan IDqhp-91450AZ0080053
Plan Year2020
Insurance ProviderHealth Net
Metal LevelBronze
Plan TypeHMO
Deductible$8,150
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or IllnessNo Charge after Deductible
Specialist VisitNo Charge after Deductible
Laboratory Outpatient and Professional ServicesNo Charge after deductible
X-rays and Diagnostic ImagingNo Charge after deductible
Deductible - Family$16300
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

Provider directory URLhttp://ambetter.azcompletehealth.com/findadoc

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

Maternity

Prenatal and Postnatal CareNo Charge after deductible

Mental Health

Mental/Behavioral Health Outpatient ServicesNo Charge after deductible
Mental/Behavioral Health Inpatient ServicesNo Charge after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsDiabetes Care Management
Inherited Metabolic Disorder - PKU
Off Label Prescription Drugs
Prescription Drugs Other
Wigs
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Clinical Trials
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Cosmetic Surgery
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $191
SimpleHealth HMO - PimaFocus Network
$8,150.00Select
from $233
Oscar Simple Secure
$8,150.00Select
from $234
Catastrophic
$8,150.00Select
from $234
SimpleHealth HMO - PimaFocus Network
$8,150.00Select
from $244
SimpleHealth HMO - MaricopaFocus Network
$8,150.00Select
/
Please select the correct zip
Rajesh, Khona
View All Details
Kita, Patel
View All Details
William, Shea
View All Details
Timothy, Graham
View All Details
Jay, Eldridge
View All Details
Oliver, Severino
View All Details
Ghebru Woldemichael Md Llc
View All Details
Nafisah, Naqvi
View All Details
Stephanie, Clark
View All Details
Mina, Tawadrous
View All Details
Lee, Barnwell
View All Details
Marjorie, Bacon
View All Details
Jennifer, Mccumbee
View All Details
James, Lavin
View All Details
Kemell Health Llc
View All Details
Southwestern Palliative Care Associates Plc
View All Details
Ronald D Brooksher Md Pllc
View All Details
Rodante, Beltejar
View All Details
Lisa, Johnson
View All Details
Erika, White
View All Details
Kathryn, Wilson
View All Details
Kaitlyn, Butko
View All Details
Edgar, Valencia
View All Details
Alex, Ritchie
View All Details
Rajesh Khona, M.D.
View All Details
  • Phone Number
    (602) 273-6770
  • Office Locations
    2400 S Avenue A
    Yuma, AZ 85364
2400 S Avenue A Yuma AZ, 85364
  • What is a bronze plan?

    Bronze Plan is a type of Metal Plan on the Health Insurance Marketplace. Bronze Plans qualify for Tax Credits and have low premiums. Generally speaking, a Bronze Plan is intended to have the lowest premium of the 4 new categories of health plans under the Affordable Care Act but charge the highest out-of-pocket costs for healthcare services.

  • How are Bronze Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Bronze Plan pays 60% of the covered medical costs among its enrollees while the other Obamacare health plans pay a higher percentage of these costs.

  • How much does a Bronze Plan cost?

    The monthly premium for a Bronze Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Bronze Plan premiums in your area. Another important factor to remember is Advanced Premium Tax Credits which can subsidize bronze plan premiums if an individual meets eligibility criteria.

  • When Can I Enroll in a Bronze Plan?

    The annual enrollment period for the 2018 plan year will begin on November 1, 2017 and continue through December 15, 2017.

    In 2015 there had been a Special Enrollment Period for many facing the uninsured penalty on their 2014 tax return. There is no guarantee that a similar Special Enrollment Period will be granted in 2017. See our Open Enrollment article for more information.

Read More

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

Health Plans Found

 

HealthPocket.com provides information on insurance products. If you choose to obtain a quote or apply for an insurance plan, you may be transferred to a partner website to complete your request. Always review the privacy and terms of use of the partner website.

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).