HA Platinum Standardized

Health Advantage

Platinum
Ind. deductible
$0
Family deductible
$0
Ind. OOP max
$5,200
Family OOP max
$5,200

More Health Advantage plans in AR

Monthly premiums by age

AgeIndividual
21$715
30$811
40$913
50$1,276
60$1,940

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/Immunization$0.00
Primary Care Visit to Treat an Injury or Illness$0.00

Specialist

BenefitIn-network
Specialist Visit$20.00

Hospital

BenefitIn-network
Emergency Room Services$0.00
Inpatient Hospital Services (e.g., Hospital Stay)$350.00 Copay per Stay
Outpatient Surgery Physician/Surgical Services$0.00
Urgent Care Centers or Facilities$15.00

Pharmacy

BenefitIn-network
Generic Drugs$0.00
Non-Preferred Brand Drugs$50.00
Off Label Prescription DrugsNo charge
Preferred Brand Drugs$10.00
Preventive Drugs$0.00
Specialty Drugs$0.00
Specialty Drugs Tier 2$150.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$0.00
Mental/Behavioral Health Outpatient Services$10.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental DentalNo charge
Acquired Brain InjuryNo charge
AcupunctureNot covered
Allergy TestingNo charge
Applied Behavior Analysis Based Therapies$0.00
Bariatric Surgery$0.00
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
BiomarkeNo charge
ChemotherapyNo charge
Chiropractic Care$10.00
Cochlear Implants$0.00
Community Health WorkeNo charge
Cosmetic SurgeryNot covered
Craniofacial SurgeryNo charge
Delivery and All Inpatient Services for Maternity CareNo charge
Dental AnesthesiaNo charge
Dental Check-Up for ChildrenNot covered
Diabetes Care ManagementNo charge
Diabetes EducationNo charge
DialysisNo charge
Doulas$0.00
Durable Medical EquipmentNo charge
Emergency Transportation/Ambulance$0.00
Eye Glasses for Children$0.00
Gastric Electrical StimulationNo charge
Genetic Testing for CanceNo charge
Habilitation Services$10.00
Hearing AidsNo charge
Home Health Care Services$0.00
Hospice Services$0.00
Imaging (CT/PET Scans, MRIs)$100.00
Infertility TreatmentNot covered
Infusion TherapyNo charge
Inherited Metabolic Disorder - PKUNo charge
Inpatient Physician and Surgical ServicesNo charge
Laboratory Outpatient and Professional Services$30.00
Long-Term/Custodial Nursing Home CareNot covered
Lung Cancer ScreeningNo charge
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$10.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$150.00
Outpatient Rehabilitation Services$10.00
PANS/PANDANo charge
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic DevicesNo charge
RadiationNo charge
Reconstructive SurgeryNo charge
Rehabilitative Occupational and Rehabilitative Physical Therapy$10.00
Rehabilitative Speech Therapy$10.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNo charge
Skilled Nursing Facility$150.00 Copay per Stay
Substance Abuse Disorder Inpatient Services$0.00
Substance Abuse Disorder Outpatient Services$10.00
TransplantNo charge
Treatment for Temporomandibular Joint DisordersNo charge
Weight Loss ProgramsNot covered
Weight Loss TreatmentNo charge
Well Baby Visits and CareNo charge
Well Child CareNo charge
X-rays and Diagnostic Imaging$0.00

Plan rules

Service area

This plan covers 1 geographic area.