Ambetter Premier Bronze

Bronze plans offer essential health coverage with lower monthly premiums and higher out-of-pocket costs, making them suitable for individuals who anticipate minimal healthcare needs. T

Ambetter Premier Bronze
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Bronze Plans

Recommended if you:

  • Rarely use your coverage or see the doctor
  • Want a “just in case” plan
  • Prefer very low monthly premiums
  • Are okay with higher out-of-pocket costs

Below is a summary of the three Ambetter Premier Bronze Options. See toggles below for each plan detail or download the available plan summaries.

See toggles below for plan comparisons. Information is based on Participating Providers. For Non-Participating Provider information, please download the plan summaries listed above. 

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Deductibles

Central Bronze Everyday Bronze Standard Expanded Bronze
Overall Deductible Individual/Family
 $5,000 / $10,000 $8,450 / $16,900 $7,500 / $15,000
Are there services covered before you meet deductible
 Yes. Yes. Yes.
Are there other deductibles for specific services
 No. No. No.
Out-of-pocket limit Individual/Family**
 $8,500 / $17,000 $9,200 / $18,400 $9,200 / $18,400
Will you pay less if you use network provider?
 Yes. Yes. Yes.
Referral to see a specialist?
 No. No. No.

**Premiums, balance billing & health care this plan doesn’t cover are not included in the out-of-pocket limit

Office Visit / Testing

Central Bronze Everyday Bronze Standard Expanded Bronze
Primary Care for injury/illness
 50% $40/visit $50/visit
Specialist visit
 50% $90/visit $100/visit
Preventative care/screening
 No Charge No Charge No Charge
Diagnostic test (xray, blood) Freestanding / Hospital
 50% $50 copay / 50% coinsurance $50 copay / 50% coinsurance
Imaging (CT/PET/MRI) Freestanding / Hospital
 50% 50% coinsurance 50%

Generic / Brand / Specialty Drug Comparison

If you need Drugs to treat your illness or condition. For information on whether or not deductibles apply, please download the plan summaries
Central Bronze Everyday Bronze Standard Expanded Bronze
Generic Drugs (Preferred)
 $3 $3 $25 
Generic Drugs (Non Preferred)
 $20 $30 $25
Brand drugs (Preferred)
 $65 45% $50
Brand Drugs Non Preferred
 $300 45% $100
Specialty Drugs 
 $750 50% $500

Outpatient Surgery / Emergency Comparison

Central Bronze Everyday Bronze Standard Expanded Bronze
Facility Fee
 50% 50% 50%
Facility fee Hospital
 50% 50% 50%
Physician/surgeon Fee
 50% 50% 50%
Emergency Room Care
 $50% $50% $50%
Emergency Medical Transportation
 50% 50% 50%
Urgent Care
 50% $50 $75

Hospital Stay / Health Services / Pregnancy

Central Bronze Everyday Bronze Standard Expanded Bronze
Facility Fee for hospital stay
 50% coinsurance 50% coinsurance 50% coinsurance
Physician/surgeon Fees
 50% coinsurance 50% coinsurance 50% coinsurance
Mental health, behavioral health, or substance abuse services: Outpatient
 50% / office visit $40 / office visit $50 / office visit
Mental health, behavioral health, or substance abuse services: Inpatient
 50% coinsurance 50% coinsurance 50% coinsurance
If you are pregnant ? office visit
 50% coinsurance $40/visit $50 / visit
Childbirth/delivery/professional services
 50% coinsurance 50% coinsurance 50% coinsurance
Childbirth/delivery facility services
 50% coinsurance 50% coinsurance 50% coinsurance

Help recovering / other special needs

Central Bronze Everyday Bronze Standard Expanded Bronze
Home Health Care
 50% 50% 50%
Rehabilitation Services
 50% / 50% 50% / 50% $50 / 50%
Habilitation services
 50% / 50% 50% / 50% $50 / 50%
Skilled nursing care
 50% 50% 50%
Durable medical equipment
 50% 50% 50%
Hospice services
 50% 50% 50%

Childrens Dental / Eye care

Central Bronze Everyday Bronze Standard Expanded Bronze
Children?s eye exam
 No Charge No Charge No Charge
Children?s Glasses
 No Charge No Charge No Charge
Children?s Dental check-up
 Not Covered Not Covered Not Covered

Excluded & Other Covered Services

Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
Central Bronze Everyday Bronze Standard Expanded Bronze
Acupuncture
  ?  ?  ?
Dental Care (Adult)
  ?  ?  ?
Long-term Care
  ?  ?  ?
Non-emergency care when traveling outside of US
  ?  ?  ?
Routine eye care (adult)
  ?  ?  ?
Weight loss programs
  ?  ?  ?

Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)

Central Bronze Everyday Bronze Standard Expanded Bronze
Abortion care
  ?  ?  ?
Bariatric surgery
  ?  ?  ?
Chiropractic care
  ?  ?  ?
Cosmetic surgery
  ?  ?  ?
Hearing aids
  ?  ?  ?
Infertility treatment
  ?  ?  ?
Private-duty nursing
  ?  ?  ?
Routine Foot Care
  ?  ?  ?

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