Ambetter Essential Care 5 + Vision + Adult Dental Plan Details for 2021- HealthPocket

Ambetter Essential Care 5 + Vision + Adult Dental

$415.92/mo

Apply For This Plan

Zip Code46227
Applicant5/19/1987 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAmbetter Essential Care 5 + Vision + Adult Dental
Plan IDhhs-76179IN0130069
Plan Year2021
Insurance ProviderAmbetter
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$8,300
Out-of-Pocket Maximum$8,700
Plan Highlights

Costs for Medical Care

Deductible - Family$16600 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?Not Covered
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 AdultsIncluded

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 CareIncluded
Adult Dental Coverage - Basic Dental CareIncluded
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
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Hospice Services
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
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
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
Private-Duty Nursing
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Accidental Dental
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Eyeglasses for Adults
More Excluded Benefits[object Object]
PremiumPlan NameDeductible
from $390Ambetter Essential Care 1 (2021)$8,300.00Select
from $398Ambetter Essential Care 5$8,300.00Select
from $407Ambetter Essential Care 1 (2021) + Vision + Adult Dental$8,300.00Select
from $415Ambetter Balanced Care 32$8,100.00Select
from $434Ambetter Balanced Care 32 + Vision + Adult Dental$8,100.00Select
/
Please select the correct zip
Jane, Wilson
View All Details
Carol, Johnson
View All Details
Kevin, Julian
View All Details
Karamchand, Paul
View All Details
Bipinchandra, Patel
View All Details
Wynter, Vik
View All Details
Candelaria, Cordova
View All Details
Amanda, Smith
View All Details
Susan, Tanney
View All Details
Mary, Driskell
View All Details
Anna, Lynch
View All Details
Alyssa, Emata
View All Details
Dylan, Wirick
View All Details
Mariesa, Mclean
View All Details
Elise, Birch
View All Details
Zachry, Skinner
View All Details
Katrina, Morgan
View All Details
Lauren, Ferendo
View All Details
Miranda, Mazza
View All Details
Marisa, Kitt
View All Details
Emma, Engdahl
View All Details
Jane Wilson, MD
View All Details
  • Phone Number
    (317) 780-4080
  • Office Locations
    5550 S East St
    Indianapolis, IN 46227
5550 S East St Indianapolis IN, 46227

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.

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.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.