Celtic Insurance Company offers this marketplace health insurance plan (Plan ID 62141AR0100014) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Arkansas). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Zero Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
Variant 62141AR0100014-02 (Open to Indians below 300% FPL) currently displayed.
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Benefits
Covered services & limitations
Everyday care
Office visits, preventive care, labs, imaging, and home health.
Chiropractic Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 30.0 Visit(s) per Year
Limited to a combined 30 visit limit per year for outpatient physical therapy, speech therapy, occupational therapy, and chiropractic care. Note: Limits do not apply when provided for a mental health/substance use disorder diagnosis.
Diabetes Care Management
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Diabetes Education
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Home Health Care Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 50.0 Visit(s) per Year
Prior authorization may be required - please contact the number listed on your ID card.
Laboratory Outpatient and Professional Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card. Laboratory services provided to treat a behavioral health diagnosis fall under mental/behavioral health services. Coverage includes medically necessary genetic/molecular cancer biomarker testing.
Mental/Behavioral Health Urgent Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Benefits include covered services rendered by a certified community health worker within their scope of certification.
Preventive Care/Screening/Immunization
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Covered in accordance with ACA guidelines.
Primary Care Visit to Treat an Injury or Illness
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Primary care visits provided to treat a behavioral health diagnosis fall under mental/behavioral health services.
Rehabilitative Occupational and Rehabilitative Physical Therapy
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 30.0 Visit(s) per Year
60 inpatient days/year. Prior authorization may be required - please contact the number listed on your ID card. Limited to a combined 30 visit limit per year for outpatient physical therapy, speech therapy, occupational therapy, and chiropractic care. Note: Limits do not apply when provided for a mental health/substance use disorder diagnosis.
Rehabilitative Speech Therapy
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 30.0 Visit(s) per Year
Prior authorization may be required - please contact the number listed on your ID card. Limited to a combined 30 visit limit per year for outpatient physical therapy, speech therapy, occupational therapy, and chiropractic care. Note: Limits do not apply when provided for a mental health/substance use disorder diagnosis.
Specialist Visit
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Specialist visits provided to treat a behavioral health diagnosis fall under mental/behavioral health services.
Substance Use Disorder Urgent Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Urgent Care Centers or Facilities
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
X-rays and Diagnostic Imaging
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Hospital & urgent
Emergency room, inpatient stays, ambulance, and surgeries.
Chemotherapy
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Delivery and All Inpatient Services for Maternity Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Dialysis
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Durable Medical Equipment
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Emergency Room Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Emergency Transportation/Ambulance
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization is not required for emergency transport, however, all non-emergent transport requires prior authorization.
Hospice Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Inpatient Hospital Services (e.g., Hospital Stay)
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Inpatient Physician and Surgical Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Mental/Behavioral Health Emergency Room
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Mental/Behavioral Health Emergency Transportation/Ambulance
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization is not required for emergency transport, however, all non-emergent transport requires prior authorization.
Mental/Behavioral Health Inpatient Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Mental/Behavioral Health Outpatient Other Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card. Note: Cost share will be waived for Behavioral Health screening services.
Mental/Behavioral Health Outpatient Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Cost sharing shown applies to outpatient office visits only. See Summary of Benefits and Coverage and the policy for more information on an additional outpatient category, Other Outpatient Services, which may apply a different cost share amount and require prior authorization. Note: Office visits do not require prior authorization. Cost share will be waived for Behavioral Health screening services.
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Outpatient Rehabilitation Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 30.0 Visit(s) per Year
Prior authorization may be required - please contact the number listed on your ID card. Limited to a combined 30 visit limit per year for outpatient physical therapy, speech therapy, occupational therapy, and chiropractic care. Note: Limits do not apply when provided for a mental health/substance use disorder diagnosis.
Outpatient Surgery Physician/Surgical Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Radiation
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Skilled Nursing Facility
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 60.0 Days per Year
Prior authorization may be required - please contact the number listed on your ID card.
Substance Abuse Disorder Inpatient Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Substance Abuse Disorder Outpatient Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Cost sharing shown applies to outpatient office visits only. See Summary of Benefits and Coverage and the policy for more information on an additional outpatient category, Other Outpatient Services, which may apply a different cost share amount and require prior authorization. Note: Office visits do not require prior authorization. Cost share will be waived for Behavioral Health screening services.
Substance Use Disorder Emergency Room
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Substance Use Disorder Emergency Transportation/Ambulance
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization is not required for emergency transport, however, all non-emergent transport requires prior authorization.
Substance Use Disorder Outpatient Other Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card. Note: Cost share will be waived for Behavioral Health screening services.
Transplant
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Mental health & substance use
Behavioral health visits and substance use treatment.
Mental/Behavioral Health ER Physician Fee
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Substance Use Disorder ER Physician Fee
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Pregnancy & family
Maternity, newborn, pediatric dental and vision extras.
Basic Dental Care - Child
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Hearing Aids
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 2.0 Item(s) per 3 Years
Prior authorization may be required - please contact the number listed on your ID card.
Major Dental Care - Child
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Prenatal and Postnatal Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage includes services rendered by a certified community based doula within the scope of their certification.
Routine Eye Exam for Children
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 1.0 Exam(s) per Year
Up to $38.50 OON
Well Baby Visits and Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Pharmacy & drugs
Generic, brand, specialty, and mail order tiers.
Generic Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Cost sharing shown applies to Tier 1a-Preferred Generic Drugs only. See Summary of Benefits and the policy or service agreement for more information on an additional category, Tier 1b-Generic Drugs, which may apply a higher cost share. Up to a 30 day supply at any participating pharmacy or up to a 90 day supply at a 90 day retail pharmacy. Refer to the prescription drug list for more information.
Non-Preferred Brand Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Off Label Prescription Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Preferred Brand Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Preventative Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Specialty Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Tier 1b Generic Drugs
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network100.00%
Up to a 30-day supply at any Participating Pharmacy or up to a 90-day supply at a Designated 90 day Retail Pharmacy. Refer to the prescription drug list for more information.
Prior authorization may be required - please contact the number listed on your ID card.
Basic Dental Care - Adult
50.00%
Tier 1 in-network50.00%
Out-of-network50.00%
Limit: 1000.0 Dollars per Year
$1,000 annual benefit maximum includes all Dental services (Routine, Basic and Major) for Adults
Dental Anesthesia
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Dental Check-Up for Children
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Infusion Therapy
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card. Coverage includes IVG treatment for PANS/PANDA diagnosis.
Major Dental Care - Adult
50.00%
Tier 1 in-network50.00%
Out-of-network50.00%
Limit: 1000.0 Dollars per Year
$1,000 annual benefit maximum includes all Dental services (Routine, Basic and Major) for Adults
Nutritional Counseling
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Nutritional counseling provided to treat a behavioral health diagnosis falls under mental/behavioral health services.
Orthodontia - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Orthodontia - Child
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Prosthetic Devices
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Routine Dental Services (Adult)
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 1000.0 Dollars per Year
$1,000 annual benefit maximum includes all Dental services (Routine, Basic and Major) for Adults
Weight Loss Programs
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Weight Loss Treatment
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for the medically necessary treatment of severy obesity including bariatric surgery, preoperative, and postoperative care.
Additional benefits
Other plan-specific services and limitations.
Abortion for Which Public Funding is Prohibited
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Acquired Brain Injury
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for medically necessary treatments related to an aquired brain injury. See EOC for a list of covered services.
Acupuncture
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Allergy Testing
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Applied Behavior Analysis Based Therapies
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Applied behavior analysis therapies provided to treat a behavioral health diagnosis falls under mental/behavioral health services.
Bariatric Surgery
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for medically necessary expenses for the treatment of diseases and conditions caused by severe obesity, including preoperative and postoperative care. Prior authorization may be required - please contact the number listed on your ID card.
Biomarke
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for medically necessary genetic/molecular cancer biomarker testing.
Cardiac Rehabilitation
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 36.0 Visit(s) per Year
Cochlear Implants
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Community Health Worke
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Covered services must be rendered by a certified community health worker performing services within their scope of certification.
Cosmetic Surgery
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Craniofacial Surgery
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for a diagnosis of craniofacial anomaly where surgery and treatment are medically necessary to improve functional impairment.
Doulas
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage includes services rendered by a certified community based doula within the scope of their certification.
Eye Glasses for Children
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 1.0 Item(s) per Year
OON: Up to $50 for frames, $37.50 for lenses and $91 for contacts in lieu of eyeglasses. See EOC for lens limits.
Gastric Electrical Stimulation
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Habilitation Services
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Limit: 30.0 Visit(s) per Year
Prior authorization may be required - please contact the number listed on your ID card. Limited to a combined 30 visit limit per year for outpatient habilitation services; limited to 180 visits per year for developmental services. Habilitation services provided to treat a behavioral health diagnosis fall under mental/behavioral health services. Limits do not apply to mental/behavioral health services.
Imaging (CT/PET Scans, MRIs)
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Infertility Treatment
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required. Coverage includes testing to diagnose infertility, infertility counseling and planning services. Additionally, in vitro fertilization procedures and restorative reproductive treatments are covered.
Inherited Metabolic Disorder - PKU
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Long-Term/Custodial Nursing Home Care
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
PANS-PANDA
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for off-label use of intravenous immunoglobulin for the diagnosis of PANS, PANDA, or both.
Private-Duty Nursing
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Reconstructive Surgery
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
1. Treatment provided for the correction of defects incurred in an Accidental Injury sustained by the Member; 2. Surgery performed on a child for the correction of a cleft palate or cleft lip, removal of a port-wine stain or hemangioma (only on the face), or correction of a congenital abnormality; 3. Treatment provided when it is incidental to disease or for reconstructive surgery following neoplastic (cancer) surgery; 4. In connection with a mastectomy resulting from cancer surgery, services for (a) reconstruction of the breast on which the cancer-related surgery was performed; (b) surgery to reconstruct the other breast to produce a symmetrical appearance; and (c) prostheses and services to correct physical complications for all stages of the mastectomy, including lymphedemas; 5. Reduction mammoplasty, if such reduction mammoplasty meets Coverage Criteria. Prior Authorization may be required - please contact the number listed on your ID card.
Restorative Reproductive Treatment
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Coverage provided for patients with a history of unexplained infertility of at least 2 years duration, or for medical conditions including endometriosis, in utero exposure to diethylstilbestrol, blockage/removal of one/both fallopian tubes, or abnormal male factors contributing to infertility.
Routine Eye Exam (Adult)
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-networkNo Charge
Limit: 1.0 Exam(s) per Year
OON exam: Up to $38.50. Benefit also includes 1 pair of eye glasses or contacts per year, covered up to $130 In-Network for frames or $130 In-Network for contacts in lieu of eyeglasses. OON eyewear benefit: covered up to $50 for frames, lenses up to $37.50 and contact lenses up to $91.
Routine Foot Care
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Treatment for Temporomandibular Joint Disorders
$0.00, 0.00%
Tier 1 in-network$0.00, 0.00%
Out-of-network$0.00, 0.00%
Prior authorization may be required - please contact the number listed on your ID card.
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
