2024 Schedule of Benefits

View Ascension Personalized Care ACA Schedule of Benefits for Indiana, Kansas, Tennessee and Texas.
  • Indiana

    Bronze

    Schedule of Benefits Balanced Bronze

    Schedule of Benefits Balanced Bronze Limited Cost Sharing

    Schedule of Benefits Balanced Bronze Zero Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze

    Schedule of Benefits No Medical Deductible Bronze Limited Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze Zero Cost Sharing

    Schedule of Benefits Standard Expanded Bronze

    Schedule of Benefits Standard Expanded Bronze Limited Cost Sharing

    Schedule of Benefits Standard Expanded Bronze Zero Cost Sharing

     Silver

    Schedule of Benefits Low Premium Silver

    Schedule of Benefits Low Premium Silver Limited Cost Sharing

    Schedule of Benefits Low Premium Silver Zero Cost Sharing

    Schedule of Benefits Low Premium Silver 73

    Schedule of Benefits Low Premium Silver 87

    Schedule of Benefits Low Premium Silver 94

    Schedule of Benefits No Deductible Silver

    Schedule of Benefits No Deductible Silver Limited Cost Sharing

    Schedule of Benefits No Deductible Silver Zero Cost Sharing

    Schedule of Benefits No Deductible Silver 73

    Schedule of Benefits No Deductible Silver 87

    Schedule of Benefits No Deductible Silver 94

    Schedule of Benefits Standard Silver

    Schedule of Benefits Standard Silver Limited Cost Sharing

    Schedule of Benefits Standard Silver Zero Cost Sharing

    Schedule of Benefits Standard Silver 73

    Schedule of Benefits Standard Silver 87

    Schedule of Benefits Standard Silver 94

     Gold

    Schedule of Benefits Standard Gold

    Schedule of Benefits Standard Gold Limited Cost Sharing

    Schedule of Benefits Standard Gold Zero Cost Sharing

  • Kansas

    Bronze

    Schedule of Benefits Balanced Bronze

    Schedule of Benefits Balanced Bronze Limited Cost Sharing

    Schedule of Benefits Balanced Bronze Zero Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze

    Schedule of Benefits No Medical Deductible Bronze Limited Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze Zero Cost Sharing

    Schedule of Benefits Standard Expanded Bronze

    Schedule of Benefits Standard Expanded Bronze Limited Cost Sharing

    Schedule of Benefits Standard Expanded Bronze Zero Cost Sharing

     

    Silver

    Schedule of Benefits Low Premium Silver

    Schedule of Benefits Low Premium Silver Limited Cost Sharing

    Schedule of Benefits Low Premium Silver Zero Cost Sharing

    Schedule of Benefits Low Premium Silver 73

    Schedule of Benefits Low Premium Silver 87

    Schedule of Benefits Low Premium Silver 94

    Schedule of Benefits No Deductible Silver

    Schedule of Benefits No Deductible Silver Limited Cost Sharing

    Schedule of Benefits No Deductible Silver Zero Cost Sharing

    Schedule of Benefits No Deductible Silver 73

    Schedule of Benefits No Deductible Silver 87

    Schedule of Benefits No Deductible Silver 94

    Schedule of Benefits Standard Silver

    Schedule of Benefits Standard Silver Limited Cost Sharing

    Schedule of Benefits Standard Silver Zero Cost Sharing

    Schedule of Benefits Standard Silver 73

    Schedule of Benefits Standard Silver 87

    Schedule of Benefits Standard Silver 94

     

    Gold

    Schedule of Benefits Standard Gold

    Schedule of Benefits Standard Gold Limited Cost Sharing

    Schedule of Benefits Standard Gold Zero Cost Sharing

  • Tennessee

    Bronze

    Schedule of Benefits Balanced Bronze

    Schedule of Benefits Balanced Bronze Limited Cost Sharing

    Schedule of Benefits Balanced Bronze Zero Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze

    Schedule of Benefits No Medical Deductible Bronze Limited Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze Zero Cost Sharing

    Schedule of Benefits Standard Expanded Bronze

    Schedule of Benefits Standard Expanded Bronze Limited Cost Sharing

    Schedule of Benefits Standard Expanded Bronze Zero Cost Sharing

     

    Silver

    Schedule of Benefits Low Premium Silver

    Schedule of Benefits Low Premium Silver Limited Cost Sharing

    Schedule of Benefits Low Premium Silver Zero Cost Sharing

    Schedule of Benefits Low Premium Silver 73

    Schedule of Benefits Low Premium Silver 87

    Schedule of Benefits Low Premium Silver 94

    Schedule of Benefits No Deductible Silver

    Schedule of Benefits No Deductible Silver Limited Cost Sharing

    Schedule of Benefits No Deductible Silver Zero Cost Sharing

    Schedule of Benefits No Deductible Silver 73

    Schedule of Benefits No Deductible Silver 87

    Schedule of Benefits No Deductible Silver 94

    Schedule of Benefits Standard Silver

    Schedule of Benefits Standard Silver Limited Cost Sharing

    Schedule of Benefits Standard Silver Zero Cost Sharing

    Schedule of Benefits Standard Silver 73

    Schedule of Benefits Standard Silver 87

    Schedule of Benefits Standard Silver 94

     

    Gold

    Schedule of Benefits Standard Gold

    Schedule of Benefits Standard Gold Limited Cost Sharing

    Schedule of Benefits Standard Gold Zero Cost Sharing

  • Texas

    Bronze

    Schedule of Benefits Balanced Bronze

    Schedule of Benefits Balanced Bronze Limited Cost Sharing

    Schedule of Benefits Balanced Bronze Zero Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze

    Schedule of Benefits No Medical Deductible Bronze Limited Cost Sharing

    Schedule of Benefits No Medical Deductible Bronze Zero Cost Sharing

    Schedule of Benefits Standard Expanded Bronze

    Schedule of Benefits Standard Expanded Bronze Limited Cost Sharing

    Schedule of Benefits Standard Expanded Bronze Zero Cost Sharing

     

    Silver

    Schedule of Benefits Low Premium Silver

    Schedule of Benefits Low Premium Silver Limited Cost Sharing

    Schedule of Benefits Low Premium Silver Zero Cost Sharing

    Schedule of Benefits Low Premium Silver 73

    Schedule of Benefits Low Premium Silver 87

    Schedule of Benefits Low Premium Silver 94

    Schedule of Benefits No Deductible Silver

    Schedule of Benefits No Deductible Silver Limited Cost Sharing

    Schedule of Benefits No Deductible Silver Zero Cost Sharing

    Schedule of Benefits No Deductible Silver 73

    Schedule of Benefits No Deductible Silver 87

    Schedule of Benefits No Deductible Silver 94

    Schedule of Benefits Standard Silver

    Schedule of Benefits Standard Silver Limited Cost Sharing

    Schedule of Benefits Standard Silver Zero Cost Sharing

    Schedule of Benefits Standard Silver 73

    Schedule of Benefits Standard Silver 87

    Schedule of Benefits Standard Silver 94

     

    Gold

    Schedule of Benefits Standard Gold

    Schedule of Benefits Standard Gold Limited Cost Sharing

    Schedule of Benefits Standard Gold Zero Cost Sharing

     

    Off-Exchange

    Only available in these counties: Bell, Blanco, Bosque, Coryell, Falls, Fayette, Hamilton, Hill, Lampasas, Lee, Limestone, and Llano

    Standard Silver Off Exchange

    Standard Gold Off Exchange