Clear Silver
Ambetter from Meridian · 2026 plan year
Silver
- Ind. deductible
- $7,000
- Family deductible
- $14,000
- Ind. OOP max
- $7,000
- Family OOP max
- $14,000
Compare with other Silver plans in MI
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Ambetter from Meridian plans in MI
Monthly premiums by age
Rating Area 5 — the lowest-priced of the 10 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $230 | $230 |
| 21 | $301 | $346 |
| 30 | $342 | $393 |
| 40 | $385 | $443 |
| 50 | $538 | $619 |
| 60 | $818 | $940 |
| 64 and over | $904 | $1,039 |
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 | $50.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $100.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | No Charge after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | No Charge after deductible |
| Mental/Behavioral Health Emergency Room | No Charge after deductible |
| Mental/Behavioral Health Urgent Care | $50.00 |
| Outpatient Surgery Physician/Surgical Services | No Charge after deductible |
| Substance Use Disorder Emergency Room | No Charge after deductible |
| Substance Use Disorder Urgent Care | $50.00 |
| Urgent Care Centers or Facilities | $75.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | No Charge after deductible |
| Non-Preferred Brand Drugs | No Charge after deductible |
| Preferred Brand Drugs | No Charge after deductible |
| Specialty Drugs | No Charge after deductible |
| Tier 1b Generic Drugs | No Charge after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Emergency Transportation/Ambulance | No Charge after deductible |
| Mental/Behavioral Health ER Physician Fee | No Charge after deductible |
| Mental/Behavioral Health Inpatient Services | No Charge after deductible |
| Mental/Behavioral Health Outpatient Other Services | No Charge after deductible |
| Mental/Behavioral Health Outpatient Services | $50.00 |
| Substance Use Disorder Emergency Transportation/Ambulance | No Charge after deductible |
| Substance Use Disorder ER Physician Fee | No Charge after deductible |
| Substance Use Disorder Outpatient Other Services | No Charge after deductible |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | No Charge after deductible |
| Acupuncture | Not covered |
| Allergy Testing | $100.00 |
| Bariatric Surgery | No Charge after deductible |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | No Charge after deductible |
| Chiropractic Care | $100.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | No Charge after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | $100.00 |
| Dialysis | No Charge after deductible |
| Durable Medical Equipment | No Charge after deductible |
| Emergency Transportation/Ambulance | No Charge after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | No Charge after deductible |
| Hearing Aids | Not covered |
| Home Health Care Services | No Charge after deductible |
| Hospice Services | No Charge after deductible |
| Imaging (CT/PET Scans, MRIs) | No Charge after deductible |
| Infertility Treatment | No Charge after deductible |
| Infusion Therapy | No Charge after deductible |
| Inpatient Physician and Surgical Services | No Charge after deductible |
| Laboratory Outpatient and Professional Services | $25.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Nutritional Counseling | $100.00 |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | No Charge after deductible |
| Outpatient Rehabilitation Services | No Charge after deductible |
| Prenatal and Postnatal Care | $50.00 |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | No Charge after deductible |
| Radiation | No Charge after deductible |
| Reconstructive Surgery | No Charge after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | No Charge after deductible |
| Rehabilitative Speech Therapy | No Charge 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 | No Charge after deductible |
| Specified Sex-trait Modification Procedures | No Charge after deductible |
| Substance Abuse Disorder Inpatient Services | No Charge after deductible |
| Substance Abuse Disorder Outpatient Services | $50.00 |
| Transplant | No Charge after deductible |
| Treatment for Temporomandibular Joint Disorders | No Charge after deductible |
| Weight Loss Programs | $100.00 |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | No Charge after deductible |
Plan rules
Service area
This plan covers 78 geographic areas. 55 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.
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