AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals
AmeriHealth Caritas Next · 2027 plan year
Silver
- Ind. deductible
- $5,000
- Family deductible
- $10,000
- Ind. OOP max
- $12,000
- Family OOP max
- $24,000
Compare with other Silver plans in IN
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More AmeriHealth Caritas Next plans in IN
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No ReferralsAmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No ReferralsAmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No ReferralsAmeriHealth Caritas Next Silver Copay Focus + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No ReferralsAmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care +No Referrals
Monthly premiums by age
Rating Area 10 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $329 | $329 |
| 21 | $430 | $515 |
| 30 | $488 | $585 |
| 40 | $549 | $659 |
| 50 | $767 | $921 |
| 60 | $1,166 | $1,399 |
| 64 and over | $1,289 | $1,546 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $30.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $100.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 35.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 35.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 35.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $150.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $5.00 |
| Non-Preferred Brand Drugs | 35.00% Coinsurance after deductible |
| Non-Preferred Generic Drugs | $25.00 |
| Non-Preferred Specialty Drugs | 50.00% Coinsurance after deductible |
| Preferred Brand Drugs | $60.00 |
| Specialty Drugs | 40.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 35.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $30.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 35.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | $100.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Bone Marrow Transplant | 35.00% Coinsurance after deductible |
| Cardiac Rehabilitation | 35.00% Coinsurance after deductible |
| Chemotherapy | 35.00% Coinsurance after deductible |
| Child Health Supervision | No charge |
| Chiropractic Care | $100.00 |
| Clinical Trials | 35.00% Coinsurance after deductible |
| Congenital Anomaly, including Cleft Lip/Palate | 35.00% Coinsurance after deductible |
| Contraceptive Injections | 35.00% Coinsurance after deductible |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 35.00% Coinsurance after deductible |
| Dental Anesthesia | 35.00% Coinsurance after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Care Management | 35.00% Coinsurance after deductible |
| Diabetes Education | No charge |
| Dialysis | 35.00% Coinsurance after deductible |
| Doula | $100.00 |
| Durable Medical Equipment | 50.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 35.00% Coinsurance after deductible |
| Enteral Formulas | 35.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | 35.00% Coinsurance after deductible |
| Hearing Aids | Not covered |
| Home Health Care Services | 35.00% Coinsurance after deductible |
| Hospice Services | No Charge after deductible |
| Imaging (CT/PET Scans, MRIs) | 35.00% Coinsurance after deductible |
| Infertility Treatment | Not covered |
| Infusion Therapy | 35.00% Coinsurance after deductible |
| Inherited Metabolic Disorder - PKU | 35.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 35.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 35.00% Coinsurance after deductible |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Mammogram | No charge |
| Mastectomy | 35.00% Coinsurance after deductible |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Orthotic Devices | 50.00% Coinsurance after deductible |
| Osteoporosis | 35.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $30.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 35.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | 35.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | No charge |
| Private-Duty Nursing | 35.00% Coinsurance after deductible |
| Prosthetic Devices | 50.00% Coinsurance after deductible |
| Pulmonary Rehabilitation | 35.00% Coinsurance after deductible |
| Radiation | 35.00% Coinsurance after deductible |
| Reconstructive Surgery | 35.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 35.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 35.00% Coinsurance after deductible |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $100.00 |
| Skilled Nursing Facility | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $30.00 |
| Transplant | 35.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 35.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 35.00% Coinsurance after deductible |
Plan rules
Service area
This plan covers 7 geographic areas.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.