Ambetter Balanced Care 31 + Vision Plan Details for 2021- HealthPocket

Ambetter Balanced Care 31 + Vision

$509.97/mo

Apply For This Plan

Zip Code79936
Applicant5/19/1987 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAmbetter Balanced Care 31 + Vision
Plan IDhhs-29418TX0150099
Plan Year2021
Insurance ProviderAmbetter
Metal LevelSilver
Plan TypeEPO
Deductible$5,450
Out-of-Pocket Maximum$6,450
Plan Highlights

Costs for Medical Care

Deductible - Family$10900 per group
Out-of-Pocket Maximum - Family$12900 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 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
Hearing Aids
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
Hospice Services
Routine Foot Care
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
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
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Eyeglasses for Adults
More Excluded Benefits[object Object]
PremiumPlan NameDeductible
from $348Aetna CVS Bronze: Low-Cost Walk-In Clinic Visits, Telehealth, Store Discounts, San Antonio$5,500.00Select
from $349Aetna CVS Bronze: Low-Cost Walk-In ClinicVisits,Telehealth, Store Discounts, San Antonio, Ped Dental$5,500.00Select
from $351Aetna CVS Bronze: Low-Cost Walk-In Clinic Visits, Telehealth, Store Discounts, Houston$5,500.00Select
from $353Aetna CVS Bronze: Low-Cost Walk-In Clinic Visits, Telehealth, Store Discounts, Houston, Ped Dental$5,500.00Select
from $375Ambetter Value Silver 31$5,450.00Select
/
Please select the correct zip
Huma, Lodhi
View All Details
Maria, Cardenas
View All Details
Patricia, Azarcon-samonte
View All Details
Thomas, Hoffer
View All Details
Nathaniel, Griffith
View All Details
Eep Internal Medicine Pa
View All Details
Stephanie, Moreno
View All Details
915 Pediatrics Pllc
View All Details
Isabel, Cano
View All Details
Sun Psychiatry Pllc
View All Details
Dc Gastro Konsult
View All Details
Stephanie Gonzalez Dpm Pa
View All Details
Patricia, Montiel Mendez
View All Details
Grace, Rodriguez
View All Details
Irving, Palacios Y Trejo
View All Details
Marisela, Gomez
View All Details
Alyson, Martinez
View All Details
Dawn, Sackett
View All Details
Erin, Ginithan
View All Details
Saranya, Gangupalli
View All Details
Elena, Paul
View All Details
Jose, Ruiz
View All Details
Huma Lodhi, M.D.
View All Details
  • Phone Number
    (915) 225-3807
  • Office Locations
    11351 James Watt Dr
    El Paso, TX 79936
11351 James Watt Dr El Paso TX, 79936
  • 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.

Read More

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.