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Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx

Antidote Health Plan of Ohio, Inc.
by Antidote Health Plan of Ohio, Inc.
2026 health insurance plan
Monthly Premium

Add your household and income to see your personalized premium and any subsidy.

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BronzeHMOHSA eligibleSubsidy
Deductible · ind / family $8,700 / $17,400
Max out-of-pocket · ind / family $10,600 / $21,200
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Estimated yearly cost

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Coverage details

Deductible · individual $8,700 /yr
Deductible · family $17,400 /yr
Max out-of-pocket · individual $10,600 /yr
Max out-of-pocket · family $21,200 /yr
Includes child dental Yes
Includes adult dental No

Benefit details and out-of-pocket costs

Doctor visits

Preventive care & screenings No charge
Primary care visit No Charge
Specialist visit $100 Copay

Hospital & emergency

Emergency room 50% Coinsurance after deductible
Inpatient facility 50% Coinsurance after deductible
Inpatient physician 50% Coinsurance after deductible

Prescription drugs

Tier 1 · Generic $35 Copay
Tier 2 · Preferred brand $150 Copay
Tier 3 · Non-preferred brand 50% Coinsurance after deductible
Tier 4 · Specialty 50% Coinsurance after deductible
Drug deductible · ind / family Included in Medical
Drug max out-of-pocket · ind / family Included in Medical

Plan documents & tools

* Figures shown are only for in-network medical costs.

** Please check with the insurance company if copay and coinsurance rates are before or after the deductible.

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