Ambetter Health

Ambetter Balanced Care 128

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Links

Summary Of Benefits

Plan Overview

Medical Deductible	Individual: $8,200 Family: $16,400 Per Person: $8,200
Prescription Drug Deductible	Individual: Included in Deductible Family: Included in Deductible Per Person: Included in Deductible
Medical Out-of-Pocket Maximum	Individual: $8,200 Family: $16,400 Per Person: $8,200
Drug Out-of-Pocket Maximum	Individual: Included in Deductible Family: Included in Deductible Per Person: Included in Deductible

Office Visit

Primary Doctor	Standard: $50 Copay
Specialist	Standard: $90 Copay

Prescription Drug Information

Preferred Brand Drugs	Standard: 50% Coinsurance after deductible
Non Preferred Brand Drugs	Standard: 50% Coinsurance after deductible
Generic Drugs	Standard: $30
Specialty Drugs	Standard: 50% Coinsurance after deductible

Inpatient Coverage

Hospital Services	Standard: 50% Coinsurance
Inpatient Services	Standard: 50% Coinsurance

Emergency and Urgent Care

Emergency Room

Standard: 50% Coinsurance

Related Articles

You may be interested in these relevant articles from across the HealthMarkets.com network.

Accidents Happen. Are You Covered?

You may think that accident insurance is only for people who like extreme sports…Read More

Read More

Sick With a Cold, Flu, or Allergies? Symptoms + Tips to Get Well

Is it a cold, flu, or allergies? You’re feeling pretty lousy. You’ve got sniffles,…Read More

Read More

Find an In-Network Provider: 5 Tips To Get Care And Save Money

Looking for a health care provider? There’s something you need to do before you…Read More

Read More