|Applicant||11/16/1983 Male |
|Insurance Type||ACA (Obamacare)|
|Plan Name||Ambetter Balanced Care 9 (2018)|
|Insurance Provider||Health Net|
Costs for Medical Care
|Primary Care Visit to Treat an Injury or Illness||$30 Copay|
|Specialist Visit||$50 Copay|
|Deductible - Family||$8400|
|Out-of-Pocket Maximum - Family||$14300|
Prescription drug coverage
|Generic Drugs||$20 Copay|
|Preferred Brand Drugs||$40 Copay|
|Non-Preferred Brand Drugs||$70 Copay|
|Specialty Drugs||50% Coinsurance after deductible|
Access to doctors and hospitals
|Provider directory URL||Coming Soon|
|Emergency Room Services||$400 Copay|
|Inpatient Hospital Services (e.g., Hospital Stay)||20% Coinsurance after deductible|
|Inpatient Physician and Surgical Services||20% Coinsurance after deductible|
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.
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.
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.
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.
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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.