Ambetter Balanced Care 4 (2021) + Vision + Adult Dental

Plan Type: HMO
Plan Tier: Silver
Individual Deductible $7,200
Family Deductible $14,400
Individual Out of Pocket Max $7,200
Family Out of Pocket Max $14,400
Primary Care Visit: $30
Specialist Visit: $60
Emergency Room: No Charge after Deductible
Hospital - Physician: No Charge after Deductible
Hospital - Facility: No Charge after Deductible
Link to Full SBC:
Plan Brochure:

Other Coverage:

Child Dental: No
Adult Dental Yes

Prescription Drug Pricing:

Generic Drugs: $15
Non-Preferred Brand Drugs: No Charge after Deductible
Preferred Brand Drugs: $50
Specialty Drugs: No Charge after Deductible
Summary of Benefits

About The Carrier

AmBetter from Buckeye Community Health Plan provides quality healthcare solutions that help residents of Georgia live better. With a variety of affordable coverage options, they make it easier to stay healthy.

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