Ambetter Balanced Care 32 Plan Details for 2021- HealthPocket

Ambetter Balanced Care 32

$358.06/mo

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Zip Code72209
Applicant6/29/1987 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAmbetter Balanced Care 32
Plan IDhhs-62141AR0080029
Plan Year2021
Insurance ProviderAmbetter
Metal LevelSilver
Plan TypePPO
Deductible$8,100
Out-of-Pocket Maximum$8,700
Plan Highlights

Costs for Medical Care

Deductible - Family$16200 per group
Out-of-Pocket Maximum - Family$17400 per group

Access to doctors and hospitals

Provider directory URLhttps://providersearch.ambetterhealth.com/
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?Yes - PPO Plan - out of network limitations apply
Does this plan cover services outside the country?Not Covered

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Diabetes, Heart Disease, Pregnancy
Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Infertility Treatment
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Routine Foot Care
Applied Behavior Analysis Based Therapies
Cochlear Implants
Dental Anesthesia
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Gastric Electrical Stimulation
Off Label Prescription Drugs
Well Child Care
Craniofacial Surgery
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Preventative Drugs
Mental/Behavioral Health Emergency Room
Mental/Behavioral Health Emergency Transportation/Ambulance
Mental/Behavioral Health ER Physician Fee
Mental/Behavioral Health Outpatient Other Services
Mental/Behavioral Health Urgent Care
Substance Use Disorder Emergency Room
Substance Use Disorder Emergency Transportation/Ambulance
Substance Use Disorder ER Physician Fee
Substance Use Disorder Outpatient Other Services
Substance Use Disorder Urgent Care
More Limited BenefitsSkilled Nursing Facility
Hearing Aids
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Hospice Services
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Cardiac Rehabilitation
More Excluded Benefits[object Object]
PremiumPlan NameDeductible
from $307Ambetter Essential Care 1 (2021)$8,300.00Select
from $321Ambetter Essential Care 1 (2021) + Vision + Adult Dental$8,300.00Select
from $330Ambetter Essential Care 5 (2021)$8,100.00Select
from $344Ambetter Essential Care 5 (2021) + Vision + Adult Dental$8,100.00Select
from $375Ambetter Balanced Care 32 + Vision + Adult Dental$8,100.00Select
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  • Phone Number
    (501) 455-7021
  • Office Locations
    11321 Interstate 30
    Little Rock, AR 72209
11321 Interstate 30 Little Rock AR, 72209
  • What Is the Silver Plan?

    ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.

  • How are Silver 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 Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.

  • How much does a Silver Plan cost?

    The monthly premium for a Silver 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 Silver Plan premiums in your area.

  • When Can I Enroll in a Silver Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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HealthPocket.com is a free information source. 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. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.