Obamacare 2022 Rates for Dallas County
Obamacare > Rates > Texas > Dallas County
Obamacare > Rates > Texas > Dallas County
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Oscar Insurance CompanyLocal: 1-855-672-2755 | Toll Free: 1-855-672-2755 |
Toc - Plan #1 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Simple |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$262.34 $297.74 $335.25 $468.52 $711.96 |
$463.02 $498.42 $535.93 $669.20 |
$663.70 $699.10 $736.61 $869.88 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$524.68 $595.48 $670.50 $937.04 $1,423.92 |
$725.36 $796.16 $871.18 $1,137.72 |
$926.04 $996.84 $1,071.86 $1,338.40 |
Toc - Plan #2 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- PCP Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$266.64 $302.62 $340.75 $476.19 $723.62 |
$470.61 $506.59 $544.72 $680.16 |
$674.58 $710.56 $748.69 $884.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$533.28 $605.24 $681.50 $952.38 $1,447.24 |
$737.25 $809.21 $885.47 $1,156.35 |
$941.22 $1,013.18 $1,089.44 $1,360.32 |
Toc - Plan #3 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$262.65 $298.10 $335.66 $469.08 $712.81 |
$463.57 $499.02 $536.58 $670.00 |
$664.49 $699.94 $737.50 $870.92 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$525.30 $596.20 $671.32 $938.16 $1,425.62 |
$726.22 $797.12 $872.24 $1,139.08 |
$927.14 $998.04 $1,073.16 $1,340.00 |
Toc - Plan #4 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+PCP Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$314.17 $356.57 $401.50 $561.09 $852.63 |
$554.50 $596.90 $641.83 $801.42 |
$794.83 $837.23 $882.16 $1,041.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$628.34 $713.14 $803.00 $1,122.18 $1,705.26 |
$868.67 $953.47 $1,043.33 $1,362.51 |
$1,109.00 $1,193.80 $1,283.66 $1,602.84 |
Toc - Plan #5 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$367.20 $416.77 $469.27 $655.81 $996.57 |
$648.10 $697.67 $750.17 $936.71 |
$929.00 $978.57 $1,031.07 $1,217.61 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$734.40 $833.54 $938.54 $1,311.62 $1,993.14 |
$1,015.30 $1,114.44 $1,219.44 $1,592.52 |
$1,296.20 $1,395.34 $1,500.34 $1,873.42 |
Toc - Plan #6 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- Specialist Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$359.78 $408.34 $459.79 $642.55 $976.42 |
$635.00 $683.56 $735.01 $917.77 |
$910.22 $958.78 $1,010.23 $1,192.99 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$719.56 $816.68 $919.58 $1,285.10 $1,952.84 |
$994.78 $1,091.90 $1,194.80 $1,560.32 |
$1,270.00 $1,367.12 $1,470.02 $1,835.54 |
Toc - Plan #7 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- PCP Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$367.55 $417.15 $469.71 $656.42 $997.49 |
$648.71 $698.31 $750.87 $937.58 |
$929.87 $979.47 $1,032.03 $1,218.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$735.10 $834.30 $939.42 $1,312.84 $1,994.98 |
$1,016.26 $1,115.46 $1,220.58 $1,594.00 |
$1,297.42 $1,396.62 $1,501.74 $1,875.16 |
Toc - Plan #8 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Secure |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$217.08 $246.38 $277.42 $387.69 $589.13 |
$383.14 $412.44 $443.48 $553.75 |
$549.20 $578.50 $609.54 $719.81 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$434.16 $492.76 $554.84 $775.38 $1,178.26 |
$600.22 $658.82 $720.90 $941.44 |
$766.28 $824.88 $886.96 $1,107.50 |
Toc - Plan #9 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+Specialist Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$314.25 $356.66 $401.59 $561.22 $852.83 |
$554.64 $597.05 $641.98 $801.61 |
$795.03 $837.44 $882.37 $1,042.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$628.50 $713.32 $803.18 $1,122.44 $1,705.66 |
$868.89 $953.71 $1,043.57 $1,362.83 |
$1,109.28 $1,194.10 $1,283.96 $1,603.22 |
Toc - Plan #10 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$362.14 $411.02 $462.81 $646.77 $982.83 |
$639.17 $688.05 $739.84 $923.80 |
$916.20 $965.08 $1,016.87 $1,200.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$724.28 $822.04 $925.62 $1,293.54 $1,965.66 |
$1,001.31 $1,099.07 $1,202.65 $1,570.57 |
$1,278.34 $1,376.10 $1,479.68 $1,847.60 |
Toc - Plan #11 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Simple- HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$288.17 $327.06 $368.27 $514.66 $782.07 |
$508.61 $547.50 $588.71 $735.10 |
$729.05 $767.94 $809.15 $955.54 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$576.34 $654.12 $736.54 $1,029.32 $1,564.14 |
$796.78 $874.56 $956.98 $1,249.76 |
$1,017.22 $1,095.00 $1,177.42 $1,470.20 |
Toc - Plan #12 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$360.19 $408.81 $460.31 $643.28 $977.53 |
$635.73 $684.35 $735.85 $918.82 |
$911.27 $959.89 $1,011.39 $1,194.36 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$720.38 $817.62 $920.62 $1,286.56 $1,955.06 |
$995.92 $1,093.16 $1,196.16 $1,562.10 |
$1,271.46 $1,368.70 $1,471.70 $1,837.64 |
Toc - Plan #13 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$373.45 $423.86 $477.26 $666.97 $1,013.52 |
$659.13 $709.54 $762.94 $952.65 |
$944.81 $995.22 $1,048.62 $1,238.33 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$746.90 $847.72 $954.52 $1,333.94 $2,027.04 |
$1,032.58 $1,133.40 $1,240.20 $1,619.62 |
$1,318.26 $1,419.08 $1,525.88 $1,905.30 |
Toc - Plan #14 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- $0 Ded |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$388.66 $441.11 $496.69 $694.12 $1,054.79 |
$685.97 $738.42 $794.00 $991.43 |
$983.28 $1,035.73 $1,091.31 $1,288.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$777.32 $882.22 $993.38 $1,388.24 $2,109.58 |
$1,074.63 $1,179.53 $1,290.69 $1,685.55 |
$1,371.94 $1,476.84 $1,588.00 $1,982.86 |
Toc - Plan #15 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- Low Ded |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$369.74 $419.64 $472.52 $660.34 $1,003.45 |
$652.58 $702.48 $755.36 $943.18 |
$935.42 $985.32 $1,038.20 $1,226.02 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$739.48 $839.28 $945.04 $1,320.68 $2,006.90 |
$1,022.32 $1,122.12 $1,227.88 $1,603.52 |
$1,305.16 $1,404.96 $1,510.72 $1,886.36 |
Toc - Plan #16 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $0 PCP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$277.80 $315.29 $355.02 $496.14 $753.93 |
$490.31 $527.80 $567.53 $708.65 |
$702.82 $740.31 $780.04 $921.16 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$555.60 $630.58 $710.04 $992.28 $1,507.86 |
$768.11 $843.09 $922.55 $1,204.79 |
$980.62 $1,055.60 $1,135.06 $1,417.30 |
Toc - Plan #17 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- Specialist Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$301.69 $342.41 $385.55 $538.81 $818.77 |
$532.48 $573.20 $616.34 $769.60 |
$763.27 $803.99 $847.13 $1,000.39 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$603.38 $684.82 $771.10 $1,077.62 $1,637.54 |
$834.17 $915.61 $1,001.89 $1,308.41 |
$1,064.96 $1,146.40 $1,232.68 $1,539.20 |
Toc - Plan #18 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $3250 Ded |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$300.12 $340.62 $383.54 $535.99 $814.49 |
$529.70 $570.20 $613.12 $765.57 |
$759.28 $799.78 $842.70 $995.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$600.24 $681.24 $767.08 $1,071.98 $1,628.98 |
$829.82 $910.82 $996.66 $1,301.56 |
$1,059.40 $1,140.40 $1,226.24 $1,531.14 |
Toc - Plan #19 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4700 Ded |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$276.84 $314.20 $353.79 $494.41 $751.31 |
$488.61 $525.97 $565.56 $706.18 |
$700.38 $737.74 $777.33 $917.95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$553.68 $628.40 $707.58 $988.82 $1,502.62 |
$765.45 $840.17 $919.35 $1,200.59 |
$977.22 $1,051.94 $1,131.12 $1,412.36 |
Toc - Plan #20 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- PCP Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$355.97 $404.01 $454.91 $635.74 $966.07 |
$628.28 $676.32 $727.22 $908.05 |
$900.59 $948.63 $999.53 $1,180.36 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$711.94 $808.02 $909.82 $1,271.48 $1,932.14 |
$984.25 $1,080.33 $1,182.13 $1,543.79 |
$1,256.56 $1,352.64 $1,454.44 $1,816.10 |
Toc - Plan #21 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- Specialist Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$384.84 $436.79 $491.82 $687.31 $1,044.44 |
$679.24 $731.19 $786.22 $981.71 |
$973.64 $1,025.59 $1,080.62 $1,276.11 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$769.68 $873.58 $983.64 $1,374.62 $2,088.88 |
$1,064.08 $1,167.98 $1,278.04 $1,669.02 |
$1,358.48 $1,462.38 $1,572.44 $1,963.42 |
Toc - Plan #22 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- Low Ded |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$370.28 $420.26 $473.21 $661.31 $1,004.92 |
$653.54 $703.52 $756.47 $944.57 |
$936.80 $986.78 $1,039.73 $1,227.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$740.56 $840.52 $946.42 $1,322.62 $2,009.84 |
$1,023.82 $1,123.78 $1,229.68 $1,605.88 |
$1,307.08 $1,407.04 $1,512.94 $1,889.14 |
Toc - Plan #23 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 PCP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$382.30 $433.90 $488.57 $682.78 $1,037.54 |
$674.75 $726.35 $781.02 $975.23 |
$967.20 $1,018.80 $1,073.47 $1,267.68 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.60 $867.80 $977.14 $1,365.56 $2,075.08 |
$1,057.05 $1,160.25 $1,269.59 $1,658.01 |
$1,349.50 $1,452.70 $1,562.04 $1,950.46 |
Toc - Plan #24 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.49 $432.98 $487.53 $681.32 $1,035.33 |
$673.32 $724.81 $779.36 $973.15 |
$965.15 $1,016.64 $1,071.19 $1,264.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.98 $865.96 $975.06 $1,362.64 $2,070.66 |
$1,054.81 $1,157.79 $1,266.89 $1,654.47 |
$1,346.64 $1,449.62 $1,558.72 $1,946.30 |
Toc - Plan #25 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.80 $428.79 $482.81 $674.73 $1,025.32 |
$666.81 $717.80 $771.82 $963.74 |
$955.82 $1,006.81 $1,060.83 $1,252.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.60 $857.58 $965.62 $1,349.46 $2,050.64 |
$1,044.61 $1,146.59 $1,254.63 $1,638.47 |
$1,333.62 $1,435.60 $1,543.64 $1,927.48 |
Toc - Plan #26 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.20 $394.06 $443.70 $620.07 $942.26 |
$612.80 $659.66 $709.30 $885.67 |
$878.40 $925.26 $974.90 $1,151.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.40 $788.12 $887.40 $1,240.14 $1,884.52 |
$960.00 $1,053.72 $1,153.00 $1,505.74 |
$1,225.60 $1,319.32 $1,418.60 $1,771.34 |
Toc - Plan #27 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- $0 PCP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.98 $401.76 $452.38 $632.19 $960.68 |
$624.77 $672.55 $723.17 $902.98 |
$895.56 $943.34 $993.96 $1,173.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.96 $803.52 $904.76 $1,264.38 $1,921.36 |
$978.75 $1,074.31 $1,175.55 $1,535.17 |
$1,249.54 $1,345.10 $1,446.34 $1,805.96 |
Toc - Plan #28 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.12 $459.80 $517.73 $723.53 $1,099.47 |
$715.03 $769.71 $827.64 $1,033.44 |
$1,024.94 $1,079.62 $1,137.55 $1,343.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$810.24 $919.60 $1,035.46 $1,447.06 $2,198.94 |
$1,120.15 $1,229.51 $1,345.37 $1,756.97 |
$1,430.06 $1,539.42 $1,655.28 $2,066.88 |
Toc - Plan #29 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.89 $434.57 $489.32 $683.83 $1,039.14 |
$675.79 $727.47 $782.22 $976.73 |
$968.69 $1,020.37 $1,075.12 $1,269.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.78 $869.14 $978.64 $1,367.66 $2,078.28 |
$1,058.68 $1,162.04 $1,271.54 $1,660.56 |
$1,351.58 $1,454.94 $1,564.44 $1,953.46 |
Toc - Plan #30 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.48 $404.59 $455.57 $636.65 $967.46 |
$629.18 $677.29 $728.27 $909.35 |
$901.88 $949.99 $1,000.97 $1,182.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$712.96 $809.18 $911.14 $1,273.30 $1,934.92 |
$985.66 $1,081.88 $1,183.84 $1,546.00 |
$1,258.36 $1,354.58 $1,456.54 $1,818.70 |
Toc - Plan #31 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4000 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.12 $339.49 $382.27 $534.22 $811.79 |
$527.94 $568.31 $611.09 $763.04 |
$756.76 $797.13 $839.91 $991.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598.24 $678.98 $764.54 $1,068.44 $1,623.58 |
$827.06 $907.80 $993.36 $1,297.26 |
$1,055.88 $1,136.62 $1,222.18 $1,526.08 |
Toc - Plan #32 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$307.38 $348.86 $392.81 $548.96 $834.19 |
$542.52 $584.00 $627.95 $784.10 |
$777.66 $819.14 $863.09 $1,019.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$614.76 $697.72 $785.62 $1,097.92 $1,668.38 |
$849.90 $932.86 $1,020.76 $1,333.06 |
$1,085.04 $1,168.00 $1,255.90 $1,568.20 |
Toc - Plan #33 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $1000 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.29 $349.90 $393.98 $550.59 $836.67 |
$544.12 $585.73 $629.81 $786.42 |
$779.95 $821.56 $865.64 $1,022.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$616.58 $699.80 $787.96 $1,101.18 $1,673.34 |
$852.41 $935.63 $1,023.79 $1,337.01 |
$1,088.24 $1,171.46 $1,259.62 $1,572.84 |
Toc - Plan #34 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- For Diabetes |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$363.78 $412.88 $464.90 $649.69 $987.27 |
$642.06 $691.16 $743.18 $927.97 |
$920.34 $969.44 $1,021.46 $1,206.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$727.56 $825.76 $929.80 $1,299.38 $1,974.54 |
$1,005.84 $1,104.04 $1,208.08 $1,577.66 |
$1,284.12 $1,382.32 $1,486.36 $1,855.94 |
ADVERTISEMENT
Ambetter from Superior HealthPlanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989 |
Toc - Plan #35 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.41 $405.65 $456.76 $638.32 $969.99 |
$630.82 $679.06 $730.17 $911.73 |
$904.23 $952.47 $1,003.58 $1,185.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.82 $811.30 $913.52 $1,276.64 $1,939.98 |
$988.23 $1,084.71 $1,186.93 $1,550.05 |
$1,261.64 $1,358.12 $1,460.34 $1,823.46 |
Toc - Plan #36 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.61 $484.19 $545.19 $761.90 $1,157.78 |
$752.96 $810.54 $871.54 $1,088.25 |
$1,079.31 $1,136.89 $1,197.89 $1,414.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$853.22 $968.38 $1,090.38 $1,523.80 $2,315.56 |
$1,179.57 $1,294.73 $1,416.73 $1,850.15 |
$1,505.92 $1,621.08 $1,743.08 $2,176.50 |
Toc - Plan #37 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$428.99 $486.90 $548.24 $766.17 $1,164.26 |
$757.16 $815.07 $876.41 $1,094.34 |
$1,085.33 $1,143.24 $1,204.58 $1,422.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$857.98 $973.80 $1,096.48 $1,532.34 $2,328.52 |
$1,186.15 $1,301.97 $1,424.65 $1,860.51 |
$1,514.32 $1,630.14 $1,752.82 $2,188.68 |
Toc - Plan #38 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.46 $428.41 $482.38 $674.13 $1,024.40 |
$666.21 $717.16 $771.13 $962.88 |
$954.96 $1,005.91 $1,059.88 $1,251.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$754.92 $856.82 $964.76 $1,348.26 $2,048.80 |
$1,043.67 $1,145.57 $1,253.51 $1,637.01 |
$1,332.42 $1,434.32 $1,542.26 $1,925.76 |
Toc - Plan #39 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$560.09 $635.69 $715.78 $1,000.30 $1,520.05 |
$988.55 $1,064.15 $1,144.24 $1,428.76 |
$1,417.01 $1,492.61 $1,572.70 $1,857.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,120.18 $1,271.38 $1,431.56 $2,000.60 $3,040.10 |
$1,548.64 $1,699.84 $1,860.02 $2,429.06 |
$1,977.10 $2,128.30 $2,288.48 $2,857.52 |
Toc - Plan #40 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.64 $443.37 $499.23 $697.67 $1,060.18 |
$689.47 $742.20 $798.06 $996.50 |
$988.30 $1,041.03 $1,096.89 $1,295.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.28 $886.74 $998.46 $1,395.34 $2,120.36 |
$1,080.11 $1,185.57 $1,297.29 $1,694.17 |
$1,378.94 $1,484.40 $1,596.12 $1,993.00 |
Toc - Plan #41 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$420.85 $477.65 $537.83 $751.61 $1,142.15 |
$742.79 $799.59 $859.77 $1,073.55 |
$1,064.73 $1,121.53 $1,181.71 $1,395.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$841.70 $955.30 $1,075.66 $1,503.22 $2,284.30 |
$1,163.64 $1,277.24 $1,397.60 $1,825.16 |
$1,485.58 $1,599.18 $1,719.54 $2,147.10 |
Toc - Plan #42 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.39 $471.45 $530.85 $741.86 $1,127.33 |
$733.15 $789.21 $848.61 $1,059.62 |
$1,050.91 $1,106.97 $1,166.37 $1,377.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$830.78 $942.90 $1,061.70 $1,483.72 $2,254.66 |
$1,148.54 $1,260.66 $1,379.46 $1,801.48 |
$1,466.30 $1,578.42 $1,697.22 $2,119.24 |
Toc - Plan #43 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$414.96 $470.97 $530.31 $741.10 $1,126.17 |
$732.40 $788.41 $847.75 $1,058.54 |
$1,049.84 $1,105.85 $1,165.19 $1,375.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$829.92 $941.94 $1,060.62 $1,482.20 $2,252.34 |
$1,147.36 $1,259.38 $1,378.06 $1,799.64 |
$1,464.80 $1,576.82 $1,695.50 $2,117.08 |
Toc - Plan #44 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.24 $482.64 $543.44 $759.46 $1,154.07 |
$750.54 $807.94 $868.74 $1,084.76 |
$1,075.84 $1,133.24 $1,194.04 $1,410.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$850.48 $965.28 $1,086.88 $1,518.92 $2,308.14 |
$1,175.78 $1,290.58 $1,412.18 $1,844.22 |
$1,501.08 $1,615.88 $1,737.48 $2,169.52 |
Toc - Plan #45 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$448.62 $509.17 $573.32 $801.21 $1,217.52 |
$791.80 $852.35 $916.50 $1,144.39 |
$1,134.98 $1,195.53 $1,259.68 $1,487.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$897.24 $1,018.34 $1,146.64 $1,602.42 $2,435.04 |
$1,240.42 $1,361.52 $1,489.82 $1,945.60 |
$1,583.60 $1,704.70 $1,833.00 $2,288.78 |
Toc - Plan #46 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.01 $447.19 $503.54 $703.69 $1,069.33 |
$695.42 $748.60 $804.95 $1,005.10 |
$996.83 $1,050.01 $1,106.36 $1,306.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.02 $894.38 $1,007.08 $1,407.38 $2,138.66 |
$1,089.43 $1,195.79 $1,308.49 $1,708.79 |
$1,390.84 $1,497.20 $1,609.90 $2,010.20 |
Toc - Plan #47 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.57 $447.82 $504.25 $704.68 $1,070.83 |
$696.41 $749.66 $806.09 $1,006.52 |
$998.25 $1,051.50 $1,107.93 $1,308.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.14 $895.64 $1,008.50 $1,409.36 $2,141.66 |
$1,090.98 $1,197.48 $1,310.34 $1,711.20 |
$1,392.82 $1,499.32 $1,612.18 $2,013.04 |
Toc - Plan #48 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$407.32 $462.30 $520.55 $727.46 $1,105.45 |
$718.91 $773.89 $832.14 $1,039.05 |
$1,030.50 $1,085.48 $1,143.73 $1,350.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$814.64 $924.60 $1,041.10 $1,454.92 $2,210.90 |
$1,126.23 $1,236.19 $1,352.69 $1,766.51 |
$1,437.82 $1,547.78 $1,664.28 $2,078.10 |
Toc - Plan #49 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$523.91 $594.63 $669.55 $935.69 $1,421.87 |
$924.69 $995.41 $1,070.33 $1,336.47 |
$1,325.47 $1,396.19 $1,471.11 $1,737.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,047.82 $1,189.26 $1,339.10 $1,871.38 $2,843.74 |
$1,448.60 $1,590.04 $1,739.88 $2,272.16 |
$1,849.38 $1,990.82 $2,140.66 $2,672.94 |
Toc - Plan #50 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$565.67 $642.03 $722.92 $1,010.28 $1,535.21 |
$998.40 $1,074.76 $1,155.65 $1,443.01 |
$1,431.13 $1,507.49 $1,588.38 $1,875.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,131.34 $1,284.06 $1,445.84 $2,020.56 $3,070.42 |
$1,564.07 $1,716.79 $1,878.57 $2,453.29 |
$1,996.80 $2,149.52 $2,311.30 $2,886.02 |
Toc - Plan #51 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.98 $409.70 $461.32 $644.69 $979.66 |
$637.12 $685.84 $737.46 $920.83 |
$913.26 $961.98 $1,013.60 $1,196.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$721.96 $819.40 $922.64 $1,289.38 $1,959.32 |
$998.10 $1,095.54 $1,198.78 $1,565.52 |
$1,274.24 $1,371.68 $1,474.92 $1,841.66 |
Toc - Plan #52 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.23 $432.68 $487.19 $680.85 $1,034.62 |
$672.86 $724.31 $778.82 $972.48 |
$964.49 $1,015.94 $1,070.45 $1,264.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.46 $865.36 $974.38 $1,361.70 $2,069.24 |
$1,054.09 $1,156.99 $1,266.01 $1,653.33 |
$1,345.72 $1,448.62 $1,557.64 $1,944.96 |
Toc - Plan #53 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$430.86 $489.02 $550.63 $769.50 $1,169.33 |
$760.46 $818.62 $880.23 $1,099.10 |
$1,090.06 $1,148.22 $1,209.83 $1,428.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$861.72 $978.04 $1,101.26 $1,539.00 $2,338.66 |
$1,191.32 $1,307.64 $1,430.86 $1,868.60 |
$1,520.92 $1,637.24 $1,760.46 $2,198.20 |
Toc - Plan #54 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.27 $491.75 $553.71 $773.81 $1,175.88 |
$764.72 $823.20 $885.16 $1,105.26 |
$1,096.17 $1,154.65 $1,216.61 $1,436.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.54 $983.50 $1,107.42 $1,547.62 $2,351.76 |
$1,197.99 $1,314.95 $1,438.87 $1,879.07 |
$1,529.44 $1,646.40 $1,770.32 $2,210.52 |
Toc - Plan #55 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.54 $447.79 $504.21 $704.63 $1,070.75 |
$696.36 $749.61 $806.03 $1,006.45 |
$998.18 $1,051.43 $1,107.85 $1,308.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.08 $895.58 $1,008.42 $1,409.26 $2,141.50 |
$1,090.90 $1,197.40 $1,310.24 $1,711.08 |
$1,392.72 $1,499.22 $1,612.06 $2,012.90 |
Toc - Plan #56 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.04 $482.41 $543.19 $759.11 $1,153.54 |
$750.19 $807.56 $868.34 $1,084.26 |
$1,075.34 $1,132.71 $1,193.49 $1,409.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$850.08 $964.82 $1,086.38 $1,518.22 $2,307.08 |
$1,175.23 $1,289.97 $1,411.53 $1,843.37 |
$1,500.38 $1,615.12 $1,736.68 $2,168.52 |
Toc - Plan #57 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.10 $475.67 $535.59 $748.49 $1,137.41 |
$739.70 $796.27 $856.19 $1,069.09 |
$1,060.30 $1,116.87 $1,176.79 $1,389.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$838.20 $951.34 $1,071.18 $1,496.98 $2,274.82 |
$1,158.80 $1,271.94 $1,391.78 $1,817.58 |
$1,479.40 $1,592.54 $1,712.38 $2,138.18 |
Toc - Plan #58 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.48 $487.45 $548.86 $767.04 $1,165.59 |
$758.03 $816.00 $877.41 $1,095.59 |
$1,086.58 $1,144.55 $1,205.96 $1,424.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.96 $974.90 $1,097.72 $1,534.08 $2,331.18 |
$1,187.51 $1,303.45 $1,426.27 $1,862.63 |
$1,516.06 $1,632.00 $1,754.82 $2,191.18 |
Toc - Plan #59 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$453.09 $514.25 $579.04 $809.21 $1,229.67 |
$799.70 $860.86 $925.65 $1,155.82 |
$1,146.31 $1,207.47 $1,272.26 $1,502.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$906.18 $1,028.50 $1,158.08 $1,618.42 $2,459.34 |
$1,252.79 $1,375.11 $1,504.69 $1,965.03 |
$1,599.40 $1,721.72 $1,851.30 $2,311.64 |
Toc - Plan #60 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.50 $452.29 $509.27 $711.71 $1,081.51 |
$703.35 $757.14 $814.12 $1,016.56 |
$1,008.20 $1,061.99 $1,118.97 $1,321.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797.00 $904.58 $1,018.54 $1,423.42 $2,163.02 |
$1,101.85 $1,209.43 $1,323.39 $1,728.27 |
$1,406.70 $1,514.28 $1,628.24 $2,033.12 |
Toc - Plan #61 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.39 $466.91 $525.74 $734.72 $1,116.47 |
$726.09 $781.61 $840.44 $1,049.42 |
$1,040.79 $1,096.31 $1,155.14 $1,364.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.78 $933.82 $1,051.48 $1,469.44 $2,232.94 |
$1,137.48 $1,248.52 $1,366.18 $1,784.14 |
$1,452.18 $1,563.22 $1,680.88 $2,098.84 |
Toc - Plan #62 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$529.14 $600.56 $676.23 $945.02 $1,436.05 |
$933.92 $1,005.34 $1,081.01 $1,349.80 |
$1,338.70 $1,410.12 $1,485.79 $1,754.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,058.28 $1,201.12 $1,352.46 $1,890.04 $2,872.10 |
$1,463.06 $1,605.90 $1,757.24 $2,294.82 |
$1,867.84 $2,010.68 $2,162.02 $2,699.60 |
Toc - Plan #63 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.53 $476.15 $536.15 $749.26 $1,138.58 |
$740.46 $797.08 $857.08 $1,070.19 |
$1,061.39 $1,118.01 $1,178.01 $1,391.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.06 $952.30 $1,072.30 $1,498.52 $2,277.16 |
$1,159.99 $1,273.23 $1,393.23 $1,819.45 |
$1,480.92 $1,594.16 $1,714.16 $2,140.38 |
Toc - Plan #64 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$583.30 $662.03 $745.44 $1,041.75 $1,583.04 |
$1,029.52 $1,108.25 $1,191.66 $1,487.97 |
$1,475.74 $1,554.47 $1,637.88 $1,934.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,166.60 $1,324.06 $1,490.88 $2,083.50 $3,166.08 |
$1,612.82 $1,770.28 $1,937.10 $2,529.72 |
$2,059.04 $2,216.50 $2,383.32 $2,975.94 |
Toc - Plan #65 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.22 $422.46 $475.69 $664.77 $1,010.19 |
$656.96 $707.20 $760.43 $949.51 |
$941.70 $991.94 $1,045.17 $1,234.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$744.44 $844.92 $951.38 $1,329.54 $2,020.38 |
$1,029.18 $1,129.66 $1,236.12 $1,614.28 |
$1,313.92 $1,414.40 $1,520.86 $1,899.02 |
Toc - Plan #66 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.10 $446.16 $502.37 $702.07 $1,066.86 |
$693.82 $746.88 $803.09 $1,002.79 |
$994.54 $1,047.60 $1,103.81 $1,303.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$786.20 $892.32 $1,004.74 $1,404.14 $2,133.72 |
$1,086.92 $1,193.04 $1,305.46 $1,704.86 |
$1,387.64 $1,493.76 $1,606.18 $2,005.58 |
Toc - Plan #67 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.28 $504.25 $567.78 $793.47 $1,205.76 |
$784.15 $844.12 $907.65 $1,133.34 |
$1,124.02 $1,183.99 $1,247.52 $1,473.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.56 $1,008.50 $1,135.56 $1,586.94 $2,411.52 |
$1,228.43 $1,348.37 $1,475.43 $1,926.81 |
$1,568.30 $1,688.24 $1,815.30 $2,266.68 |
Toc - Plan #68 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$446.77 $507.08 $570.96 $797.92 $1,212.51 |
$788.54 $848.85 $912.73 $1,139.69 |
$1,130.31 $1,190.62 $1,254.50 $1,481.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$893.54 $1,014.16 $1,141.92 $1,595.84 $2,425.02 |
$1,235.31 $1,355.93 $1,483.69 $1,937.61 |
$1,577.08 $1,697.70 $1,825.46 $2,279.38 |
Toc - Plan #69 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.83 $461.74 $519.92 $726.58 $1,104.12 |
$718.05 $772.96 $831.14 $1,037.80 |
$1,029.27 $1,084.18 $1,142.36 $1,349.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.66 $923.48 $1,039.84 $1,453.16 $2,208.24 |
$1,124.88 $1,234.70 $1,351.06 $1,764.38 |
$1,436.10 $1,545.92 $1,662.28 $2,075.60 |
Toc - Plan #70 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$438.29 $497.44 $560.12 $782.76 $1,189.48 |
$773.57 $832.72 $895.40 $1,118.04 |
$1,108.85 $1,168.00 $1,230.68 $1,453.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$876.58 $994.88 $1,120.24 $1,565.52 $2,378.96 |
$1,211.86 $1,330.16 $1,455.52 $1,900.80 |
$1,547.14 $1,665.44 $1,790.80 $2,236.08 |
Toc - Plan #71 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$432.16 $490.49 $552.28 $771.81 $1,172.84 |
$762.75 $821.08 $882.87 $1,102.40 |
$1,093.34 $1,151.67 $1,213.46 $1,432.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$864.32 $980.98 $1,104.56 $1,543.62 $2,345.68 |
$1,194.91 $1,311.57 $1,435.15 $1,874.21 |
$1,525.50 $1,642.16 $1,765.74 $2,204.80 |
Toc - Plan #72 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$442.86 $502.64 $565.97 $790.94 $1,201.90 |
$781.64 $841.42 $904.75 $1,129.72 |
$1,120.42 $1,180.20 $1,243.53 $1,468.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$885.72 $1,005.28 $1,131.94 $1,581.88 $2,403.80 |
$1,224.50 $1,344.06 $1,470.72 $1,920.66 |
$1,563.28 $1,682.84 $1,809.50 $2,259.44 |
Toc - Plan #73 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$467.21 $530.27 $597.08 $834.42 $1,267.98 |
$824.62 $887.68 $954.49 $1,191.83 |
$1,182.03 $1,245.09 $1,311.90 $1,549.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$934.42 $1,060.54 $1,194.16 $1,668.84 $2,535.96 |
$1,291.83 $1,417.95 $1,551.57 $2,026.25 |
$1,649.24 $1,775.36 $1,908.98 $2,383.66 |
Toc - Plan #74 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.92 $466.38 $525.14 $733.88 $1,115.21 |
$725.27 $780.73 $839.49 $1,048.23 |
$1,039.62 $1,095.08 $1,153.84 $1,362.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.84 $932.76 $1,050.28 $1,467.76 $2,230.42 |
$1,136.19 $1,247.11 $1,364.63 $1,782.11 |
$1,450.54 $1,561.46 $1,678.98 $2,096.46 |
Toc - Plan #75 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.20 $481.46 $542.12 $757.61 $1,151.26 |
$748.71 $805.97 $866.63 $1,082.12 |
$1,073.22 $1,130.48 $1,191.14 $1,406.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$848.40 $962.92 $1,084.24 $1,515.22 $2,302.52 |
$1,172.91 $1,287.43 $1,408.75 $1,839.73 |
$1,497.42 $1,611.94 $1,733.26 $2,164.24 |
Toc - Plan #76 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$545.62 $619.27 $697.29 $974.47 $1,480.80 |
$963.01 $1,036.66 $1,114.68 $1,391.86 |
$1,380.40 $1,454.05 $1,532.07 $1,809.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,091.24 $1,238.54 $1,394.58 $1,948.94 $2,961.60 |
$1,508.63 $1,655.93 $1,811.97 $2,366.33 |
$1,926.02 $2,073.32 $2,229.36 $2,783.72 |
Toc - Plan #77 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$432.60 $490.99 $552.85 $772.61 $1,174.05 |
$763.53 $821.92 $883.78 $1,103.54 |
$1,094.46 $1,152.85 $1,214.71 $1,434.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$865.20 $981.98 $1,105.70 $1,545.22 $2,348.10 |
$1,196.13 $1,312.91 $1,436.63 $1,876.15 |
$1,527.06 $1,643.84 $1,767.56 $2,207.08 |
ADVERTISEMENT
Blue Cross and Blue Shield of TexasLocal: 1-888-697-0683 | Toll Free: 1-888-697-0683 | TTY: 1-800-735-2989 |
Toc - Plan #78 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO? 206 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.57 $460.33 $518.32 $724.36 $1,100.73 |
$715.83 $770.59 $828.58 $1,034.62 |
$1,026.09 $1,080.85 $1,138.84 $1,344.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.14 $920.66 $1,036.64 $1,448.72 $2,201.46 |
$1,121.40 $1,230.92 $1,346.90 $1,758.98 |
$1,431.66 $1,541.18 $1,657.16 $2,069.24 |
Toc - Plan #79 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Catastrophic
(HMO) Blue Advantage Security HMO? 200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$301.66 $342.39 $385.53 $538.77 $818.72 |
$532.43 $573.16 $616.30 $769.54 |
$763.20 $803.93 $847.07 $1,000.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$603.32 $684.78 $771.06 $1,077.54 $1,637.44 |
$834.09 $915.55 $1,001.83 $1,308.31 |
$1,064.86 $1,146.32 $1,232.60 $1,539.08 |
Toc - Plan #80 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Silver HMO? 205 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.63 $489.90 $551.63 $770.90 $1,171.46 |
$761.83 $820.10 $881.83 $1,101.10 |
$1,092.03 $1,150.30 $1,212.03 $1,431.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$863.26 $979.80 $1,103.26 $1,541.80 $2,342.92 |
$1,193.46 $1,310.00 $1,433.46 $1,872.00 |
$1,523.66 $1,640.20 $1,763.66 $2,202.20 |
Toc - Plan #81 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Bronze HMO? 204 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.95 $380.17 $428.07 $598.22 $909.06 |
$591.19 $636.41 $684.31 $854.46 |
$847.43 $892.65 $940.55 $1,110.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$669.90 $760.34 $856.14 $1,196.44 $1,818.12 |
$926.14 $1,016.58 $1,112.38 $1,452.68 |
$1,182.38 $1,272.82 $1,368.62 $1,708.92 |
Toc - Plan #82 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Bronze
(HMO) Blue Advantage Bronze HMO? 301 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.65 $370.75 $417.46 $583.40 $886.53 |
$576.54 $620.64 $667.35 $833.29 |
$826.43 $870.53 $917.24 $1,083.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$653.30 $741.50 $834.92 $1,166.80 $1,773.06 |
$903.19 $991.39 $1,084.81 $1,416.69 |
$1,153.08 $1,241.28 $1,334.70 $1,666.58 |
Toc - Plan #83 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO? 603 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$428.09 $485.89 $547.10 $764.58 $1,161.85 |
$755.58 $813.38 $874.59 $1,092.07 |
$1,083.07 $1,140.87 $1,202.08 $1,419.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$856.18 $971.78 $1,094.20 $1,529.16 $2,323.70 |
$1,183.67 $1,299.27 $1,421.69 $1,856.65 |
$1,511.16 $1,626.76 $1,749.18 $2,184.14 |
Toc - Plan #84 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Plus Gold? 203 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$448.81 $509.40 $573.57 $801.57 $1,218.06 |
$792.15 $852.74 $916.91 $1,144.91 |
$1,135.49 $1,196.08 $1,260.25 $1,488.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$897.62 $1,018.80 $1,147.14 $1,603.14 $2,436.12 |
$1,240.96 $1,362.14 $1,490.48 $1,946.48 |
$1,584.30 $1,705.48 $1,833.82 $2,289.82 |
Toc - Plan #85 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Plus Silver? 202 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$478.78 $543.41 $611.88 $855.10 $1,299.40 |
$845.05 $909.68 $978.15 $1,221.37 |
$1,211.32 $1,275.95 $1,344.42 $1,587.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$957.56 $1,086.82 $1,223.76 $1,710.20 $2,598.80 |
$1,323.83 $1,453.09 $1,590.03 $2,076.47 |
$1,690.10 $1,819.36 $1,956.30 $2,442.74 |
Toc - Plan #86 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Plus Bronze? 303 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.70 $420.75 $473.76 $662.08 $1,006.09 |
$654.29 $704.34 $757.35 $945.67 |
$937.88 $987.93 $1,040.94 $1,229.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.40 $841.50 $947.52 $1,324.16 $2,012.18 |
$1,024.99 $1,125.09 $1,231.11 $1,607.75 |
$1,308.58 $1,408.68 $1,514.70 $1,891.34 |
Toc - Plan #87 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Bronze
(HMO) Blue Advantage Plus Bronze? 305 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.34 $381.74 $429.84 $600.70 $912.82 |
$593.64 $639.04 $687.14 $858.00 |
$850.94 $896.34 $944.44 $1,115.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.68 $763.48 $859.68 $1,201.40 $1,825.64 |
$929.98 $1,020.78 $1,116.98 $1,458.70 |
$1,187.28 $1,278.08 $1,374.28 $1,716.00 |
Toc - Plan #88 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Plus Silver? 605 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$486.96 $552.71 $622.34 $869.72 $1,321.62 |
$859.49 $925.24 $994.87 $1,242.25 |
$1,232.02 $1,297.77 $1,367.40 $1,614.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$973.92 $1,105.42 $1,244.68 $1,739.44 $2,643.24 |
$1,346.45 $1,477.95 $1,617.21 $2,111.97 |
$1,718.98 $1,850.48 $1,989.74 $2,484.50 |
Toc - Plan #89 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) MyBlue Health Bronze? 402 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$263.12 $298.64 $336.26 $469.93 $714.10 |
$464.40 $499.92 $537.54 $671.21 |
$665.68 $701.20 $738.82 $872.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$526.24 $597.28 $672.52 $939.86 $1,428.20 |
$727.52 $798.56 $873.80 $1,141.14 |
$928.80 $999.84 $1,075.08 $1,342.42 |
Toc - Plan #90 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) MyBlue Health Gold? 403 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.74 $358.37 $403.52 $563.91 $856.92 |
$557.28 $599.91 $645.06 $805.45 |
$798.82 $841.45 $886.60 $1,046.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$631.48 $716.74 $807.04 $1,127.82 $1,713.84 |
$873.02 $958.28 $1,048.58 $1,369.36 |
$1,114.56 $1,199.82 $1,290.12 $1,610.90 |
Toc - Plan #91 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) MyBlue Health Silver? 405 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.28 $377.14 $424.66 $593.46 $901.82 |
$586.48 $631.34 $678.86 $847.66 |
$840.68 $885.54 $933.06 $1,101.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$664.56 $754.28 $849.32 $1,186.92 $1,803.64 |
$918.76 $1,008.48 $1,103.52 $1,441.12 |
$1,172.96 $1,262.68 $1,357.72 $1,695.32 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-866-811-2704 | Toll Free: 1-866-811-2704 | TTY: 1-866-811-2704 |
Toc - Plan #92 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ ($1 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$339.45 $385.27 $433.81 $606.25 $921.25 |
$599.13 $644.95 $693.49 $865.93 |
$858.81 $904.63 $953.17 $1,125.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$678.90 $770.54 $867.62 $1,212.50 $1,842.50 |
$938.58 $1,030.22 $1,127.30 $1,472.18 |
$1,198.26 $1,289.90 $1,386.98 $1,731.86 |
Toc - Plan #93 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.33 $389.67 $438.77 $613.18 $931.78 |
$605.97 $652.31 $701.41 $875.82 |
$868.61 $914.95 $964.05 $1,138.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.66 $779.34 $877.54 $1,226.36 $1,863.56 |
$949.30 $1,041.98 $1,140.18 $1,489.00 |
$1,211.94 $1,304.62 $1,402.82 $1,751.64 |
Toc - Plan #94 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($1 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.67 $387.79 $436.65 $610.22 $927.29 |
$603.05 $649.17 $698.03 $871.60 |
$864.43 $910.55 $959.41 $1,132.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.34 $775.58 $873.30 $1,220.44 $1,854.58 |
$944.72 $1,036.96 $1,134.68 $1,481.82 |
$1,206.10 $1,298.34 $1,396.06 $1,743.20 |
Toc - Plan #95 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ Extra ($1 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.52 $401.25 $451.80 $631.39 $959.45 |
$623.96 $671.69 $722.24 $901.83 |
$894.40 $942.13 $992.68 $1,172.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.04 $802.50 $903.60 $1,262.78 $1,918.90 |
$977.48 $1,072.94 $1,174.04 $1,533.22 |
$1,247.92 $1,343.38 $1,444.48 $1,803.66 |
Toc - Plan #96 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ ($5 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.66 $392.33 $441.76 $617.35 $938.13 |
$610.09 $656.76 $706.19 $881.78 |
$874.52 $921.19 $970.62 $1,146.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$691.32 $784.66 $883.52 $1,234.70 $1,876.26 |
$955.75 $1,049.09 $1,147.95 $1,499.13 |
$1,220.18 $1,313.52 $1,412.38 $1,763.56 |
Toc - Plan #97 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ (HSA) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.20 $395.20 $445.00 $621.88 $945.01 |
$614.57 $661.57 $711.37 $888.25 |
$880.94 $927.94 $977.74 $1,154.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.40 $790.40 $890.00 $1,243.76 $1,890.02 |
$962.77 $1,056.77 $1,156.37 $1,510.13 |
$1,229.14 $1,323.14 $1,422.74 $1,776.50 |
Toc - Plan #98 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First ($3 Rx + Unlimited Free App-based Care) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.48 $381.91 $430.02 $600.96 $913.21 |
$593.89 $639.32 $687.43 $858.37 |
$851.30 $896.73 $944.84 $1,115.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.96 $763.82 $860.04 $1,201.92 $1,826.42 |
$930.37 $1,021.23 $1,117.45 $1,459.33 |
$1,187.78 $1,278.64 $1,374.86 $1,716.74 |
Toc - Plan #99 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.32 $395.34 $445.15 $622.10 $945.34 |
$614.78 $661.80 $711.61 $888.56 |
$881.24 $928.26 $978.07 $1,155.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.64 $790.68 $890.30 $1,244.20 $1,890.68 |
$963.10 $1,057.14 $1,156.76 $1,510.66 |
$1,229.56 $1,323.60 $1,423.22 $1,777.12 |
Toc - Plan #100 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ Extra ($3 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$363.90 $413.02 $465.06 $649.92 $987.61 |
$642.28 $691.40 $743.44 $928.30 |
$920.66 $969.78 $1,021.82 $1,206.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$727.80 $826.04 $930.12 $1,299.84 $1,975.22 |
$1,006.18 $1,104.42 $1,208.50 $1,578.22 |
$1,284.56 $1,382.80 $1,486.88 $1,856.60 |
Toc - Plan #101 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$258.52 $293.42 $330.39 $461.72 $701.63 |
$456.29 $491.19 $528.16 $659.49 |
$654.06 $688.96 $725.93 $857.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$517.04 $586.84 $660.78 $923.44 $1,403.26 |
$714.81 $784.61 $858.55 $1,121.21 |
$912.58 $982.38 $1,056.32 $1,318.98 |
Toc - Plan #102 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Essential+ (Low Premium) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$242.97 $275.78 $310.52 $433.95 $659.43 |
$428.85 $461.66 $496.40 $619.83 |
$614.73 $647.54 $682.28 $805.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$485.94 $551.56 $621.04 $867.90 $1,318.86 |
$671.82 $737.44 $806.92 $1,053.78 |
$857.70 $923.32 $992.80 $1,239.66 |
Toc - Plan #103 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First ($3 Rx + Unlimited Free App-based Care) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$252.47 $286.56 $322.66 $450.92 $685.22 |
$445.61 $479.70 $515.80 $644.06 |
$638.75 $672.84 $708.94 $837.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$504.94 $573.12 $645.32 $901.84 $1,370.44 |
$698.08 $766.26 $838.46 $1,094.98 |
$891.22 $959.40 $1,031.60 $1,288.12 |
Toc - Plan #104 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ ($5 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.40 $418.14 $470.82 $657.97 $999.85 |
$650.23 $699.97 $752.65 $939.80 |
$932.06 $981.80 $1,034.48 $1,221.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$736.80 $836.28 $941.64 $1,315.94 $1,999.70 |
$1,018.63 $1,118.11 $1,223.47 $1,597.77 |
$1,300.46 $1,399.94 $1,505.30 $1,879.60 |
ADVERTISEMENT
Scott and White Health PlanLocal: 1-844-633-5325 | Toll Free: 1-844-633-5325 | TTY: 1-800-735-2989 |
Toc - Plan #105 Scott and White Health Plan | ||||||||||||||||||||
Gold
(HMO) BSW Elite Gold HMO 001 ($0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.51 $420.53 $473.52 $661.74 $1,005.57 |
$653.95 $703.97 $756.96 $945.18 |
$937.39 $987.41 $1,040.40 $1,228.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.02 $841.06 $947.04 $1,323.48 $2,011.14 |
$1,024.46 $1,124.50 $1,230.48 $1,606.92 |
$1,307.90 $1,407.94 $1,513.92 $1,890.36 |
Toc - Plan #106 Scott and White Health Plan | ||||||||||||||||||||
Silver
(HMO) BSW Prime Silver HMO 003 ($0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.07 $423.44 $476.79 $666.31 $1,012.52 |
$658.47 $708.84 $762.19 $951.71 |
$943.87 $994.24 $1,047.59 $1,237.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.14 $846.88 $953.58 $1,332.62 $2,025.04 |
$1,031.54 $1,132.28 $1,238.98 $1,618.02 |
$1,316.94 $1,417.68 $1,524.38 $1,903.42 |
Toc - Plan #107 Scott and White Health Plan | ||||||||||||||||||||
Gold
(HMO) BSW Elite Gold HMO 004 ($0 deductible, $15 PCP visit, $0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.13 $460.95 $519.03 $725.34 $1,102.23 |
$716.82 $771.64 $829.72 $1,036.03 |
$1,027.51 $1,082.33 $1,140.41 $1,346.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$812.26 $921.90 $1,038.06 $1,450.68 $2,204.46 |
$1,122.95 $1,232.59 $1,348.75 $1,761.37 |
$1,433.64 $1,543.28 $1,659.44 $2,072.06 |
Toc - Plan #108 Scott and White Health Plan | ||||||||||||||||||||
Silver
(HMO) BSW Prime Silver HMO 005 ($0 deductible copay only, $0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.86 $436.81 $491.85 $687.35 $1,044.50 |
$679.27 $731.22 $786.26 $981.76 |
$973.68 $1,025.63 $1,080.67 $1,276.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.72 $873.62 $983.70 $1,374.70 $2,089.00 |
$1,064.13 $1,168.03 $1,278.11 $1,669.11 |
$1,358.54 $1,462.44 $1,572.52 $1,963.52 |
Toc - Plan #109 Scott and White Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) BSW Savers Bronze HMO H S A 006 ($0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.57 $337.74 $380.29 $531.45 $807.60 |
$525.21 $565.38 $607.93 $759.09 |
$752.85 $793.02 $835.57 $986.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$595.14 $675.48 $760.58 $1,062.90 $1,615.20 |
$822.78 $903.12 $988.22 $1,290.54 |
$1,050.42 $1,130.76 $1,215.86 $1,518.18 |
Toc - Plan #110 Scott and White Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) BSW Vital Bronze HMO 007 ($20 Generic Rx Drugs, $0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$307.36 $348.86 $392.81 $548.95 $834.18 |
$542.49 $583.99 $627.94 $784.08 |
$777.62 $819.12 $863.07 $1,019.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$614.72 $697.72 $785.62 $1,097.90 $1,668.36 |
$849.85 $932.85 $1,020.75 $1,333.03 |
$1,084.98 $1,167.98 $1,255.88 $1,568.16 |
Toc - Plan #111 Scott and White Health Plan | ||||||||||||||||||||
Silver
(HMO) BSW Prime Silver HMO 008 ($35 PCP visit, $0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.99 $400.65 $451.13 $630.45 $958.03 |
$623.03 $670.69 $721.17 $900.49 |
$893.07 $940.73 $991.21 $1,170.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$705.98 $801.30 $902.26 $1,260.90 $1,916.06 |
$976.02 $1,071.34 $1,172.30 $1,530.94 |
$1,246.06 $1,341.38 $1,442.34 $1,800.98 |
Toc - Plan #112 Scott and White Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) BSW Vital Bronze HMO 009 (No limit on PCP visit copay, $0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.87 $331.28 $373.02 $521.29 $792.15 |
$515.15 $554.56 $596.30 $744.57 |
$738.43 $777.84 $819.58 $967.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$583.74 $662.56 $746.04 $1,042.58 $1,584.30 |
$807.02 $885.84 $969.32 $1,265.86 |
$1,030.30 $1,109.12 $1,192.60 $1,489.14 |
Toc - Plan #113 Scott and White Health Plan | ||||||||||||||||||||
Gold
(HMO) BSW Elite Gold HMO 012 ($0 Preventive Care and Preventive Rx Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-633-5325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.82 $414.07 $466.24 $651.57 $990.12 |
$643.91 $693.16 $745.33 $930.66 |
$923.00 $972.25 $1,024.42 $1,209.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.64 $828.14 $932.48 $1,303.14 $1,980.24 |
$1,008.73 $1,107.23 $1,211.57 $1,582.23 |
$1,287.82 $1,386.32 $1,490.66 $1,861.32 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-560-2025 | Toll Free: 1-888-560-2025 |
Toc - Plan #114 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Molina Gold 3 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.60 $435.38 $490.24 $685.10 $1,041.08 |
$677.05 $728.83 $783.69 $978.55 |
$970.50 $1,022.28 $1,077.14 $1,272.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.20 $870.76 $980.48 $1,370.20 $2,082.16 |
$1,060.65 $1,164.21 $1,273.93 $1,663.65 |
$1,354.10 $1,457.66 $1,567.38 $1,957.10 |
Toc - Plan #115 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Molina Silver 3 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.05 $421.14 $474.20 $662.69 $1,007.02 |
$654.90 $704.99 $758.05 $946.54 |
$938.75 $988.84 $1,041.90 $1,230.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.10 $842.28 $948.40 $1,325.38 $2,014.04 |
$1,025.95 $1,126.13 $1,232.25 $1,609.23 |
$1,309.80 $1,409.98 $1,516.10 $1,893.08 |
Toc - Plan #116 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$392.18 $445.12 $501.21 $700.43 $1,064.38 |
$692.20 $745.14 $801.23 $1,000.45 |
$992.22 $1,045.16 $1,101.25 $1,300.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$784.36 $890.24 $1,002.42 $1,400.86 $2,128.76 |
$1,084.38 $1,190.26 $1,302.44 $1,700.88 |
$1,384.40 $1,490.28 $1,602.46 $2,000.90 |
Toc - Plan #117 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.36 $421.49 $474.60 $663.25 $1,007.87 |
$655.45 $705.58 $758.69 $947.34 |
$939.54 $989.67 $1,042.78 $1,231.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.72 $842.98 $949.20 $1,326.50 $2,015.74 |
$1,026.81 $1,127.07 $1,233.29 $1,610.59 |
$1,310.90 $1,411.16 $1,517.38 $1,894.68 |
Toc - Plan #118 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 2 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.15 $423.52 $476.88 $666.44 $1,012.72 |
$658.61 $708.98 $762.34 $951.90 |
$944.07 $994.44 $1,047.80 $1,237.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.30 $847.04 $953.76 $1,332.88 $2,025.44 |
$1,031.76 $1,132.50 $1,239.22 $1,618.34 |
$1,317.22 $1,417.96 $1,524.68 $1,903.80 |
Toc - Plan #119 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 4 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.55 $417.17 $469.73 $656.45 $997.54 |
$648.73 $698.35 $750.91 $937.63 |
$929.91 $979.53 $1,032.09 $1,218.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.10 $834.34 $939.46 $1,312.90 $1,995.08 |
$1,016.28 $1,115.52 $1,220.64 $1,594.08 |
$1,297.46 $1,396.70 $1,501.82 $1,875.26 |
Toc - Plan #120 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 7 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$363.88 $413.00 $465.03 $649.88 $987.56 |
$642.25 $691.37 $743.40 $928.25 |
$920.62 $969.74 $1,021.77 $1,206.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$727.76 $826.00 $930.06 $1,299.76 $1,975.12 |
$1,006.13 $1,104.37 $1,208.43 $1,578.13 |
$1,284.50 $1,382.74 $1,486.80 $1,856.50 |
Toc - Plan #121 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$396.67 $450.22 $506.94 $708.45 $1,076.56 |
$700.12 $753.67 $810.39 $1,011.90 |
$1,003.57 $1,057.12 $1,113.84 $1,315.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$793.34 $900.44 $1,013.88 $1,416.90 $2,153.12 |
$1,096.79 $1,203.89 $1,317.33 $1,720.35 |
$1,400.24 $1,507.34 $1,620.78 $2,023.80 |
Toc - Plan #122 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 250 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$374.41 $424.95 $478.49 $668.69 $1,016.15 |
$660.83 $711.37 $764.91 $955.11 |
$947.25 $997.79 $1,051.33 $1,241.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$748.82 $849.90 $956.98 $1,337.38 $2,032.30 |
$1,035.24 $1,136.32 $1,243.40 $1,623.80 |
$1,321.66 $1,422.74 $1,529.82 $1,910.22 |
ADVERTISEMENT
Friday Health PlansLocal: 1-844-451-4444 | Toll Free: 1-844-451-4444 | TTY: 1-800-659-2656 |
Toc - Plan #123 Friday Health Plans | ||||||||||||||||||||
Catastrophic
(EPO) Catastrophic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$200.73 $227.83 $256.54 $358.51 $544.79 |
$354.29 $381.39 $410.10 $512.07 |
$507.85 $534.95 $563.66 $665.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$401.46 $455.66 $513.08 $717.02 $1,089.58 |
$555.02 $609.22 $666.64 $870.58 |
$708.58 $762.78 $820.20 $1,024.14 |
Toc - Plan #124 Friday Health Plans | ||||||||||||||||||||
Bronze
(EPO) Friday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$220.79 $250.59 $282.16 $394.32 $599.21 |
$389.69 $419.49 $451.06 $563.22 |
$558.59 $588.39 $619.96 $732.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$441.58 $501.18 $564.32 $788.64 $1,198.42 |
$610.48 $670.08 $733.22 $957.54 |
$779.38 $838.98 $902.12 $1,126.44 |
Toc - Plan #125 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Friday Bronze Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$225.75 $256.23 $288.51 $403.20 $612.70 |
$398.45 $428.93 $461.21 $575.90 |
$571.15 $601.63 $633.91 $748.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$451.50 $512.46 $577.02 $806.40 $1,225.40 |
$624.20 $685.16 $749.72 $979.10 |
$796.90 $857.86 $922.42 $1,151.80 |
Toc - Plan #126 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Friday Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$232.41 $263.78 $297.02 $415.08 $630.75 |
$410.20 $441.57 $474.81 $592.87 |
$587.99 $619.36 $652.60 $770.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$464.82 $527.56 $594.04 $830.16 $1,261.50 |
$642.61 $705.35 $771.83 $1,007.95 |
$820.40 $883.14 $949.62 $1,185.74 |
Toc - Plan #127 Friday Health Plans | ||||||||||||||||||||
Silver
(EPO) Friday Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$309.49 $351.27 $395.52 $552.74 $839.95 |
$546.25 $588.03 $632.28 $789.50 |
$783.01 $824.79 $869.04 $1,026.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$618.98 $702.54 $791.04 $1,105.48 $1,679.90 |
$855.74 $939.30 $1,027.80 $1,342.24 |
$1,092.50 $1,176.06 $1,264.56 $1,579.00 |
Toc - Plan #128 Friday Health Plans | ||||||||||||||||||||
Gold
(EPO) Friday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.28 $331.74 $373.53 $522.01 $793.24 |
$515.87 $555.33 $597.12 $745.60 |
$739.46 $778.92 $820.71 $969.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$584.56 $663.48 $747.06 $1,044.02 $1,586.48 |
$808.15 $887.07 $970.65 $1,267.61 |
$1,031.74 $1,110.66 $1,194.24 $1,491.20 |
Toc - Plan #129 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Friday Bronze Plus Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$227.81 $258.56 $291.14 $406.86 $618.27 |
$402.08 $432.83 $465.41 $581.13 |
$576.35 $607.10 $639.68 $755.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$455.62 $517.12 $582.28 $813.72 $1,236.54 |
$629.89 $691.39 $756.55 $987.99 |
$804.16 $865.66 $930.82 $1,162.26 |
Toc - Plan #130 Friday Health Plans | ||||||||||||||||||||
Silver
(EPO) Friday Silver Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$313.44 $355.76 $400.58 $559.81 $850.69 |
$553.22 $595.54 $640.36 $799.59 |
$793.00 $835.32 $880.14 $1,039.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$626.88 $711.52 $801.16 $1,119.62 $1,701.38 |
$866.66 $951.30 $1,040.94 $1,359.40 |
$1,106.44 $1,191.08 $1,280.72 $1,599.18 |
Toc - Plan #131 Friday Health Plans | ||||||||||||||||||||
Gold
(EPO) Friday Gold Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.61 $346.86 $390.57 $545.82 $829.42 |
$539.40 $580.65 $624.36 $779.61 |
$773.19 $814.44 $858.15 $1,013.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$611.22 $693.72 $781.14 $1,091.64 $1,658.84 |
$845.01 $927.51 $1,014.93 $1,325.43 |
$1,078.80 $1,161.30 $1,248.72 $1,559.22 |
ADVERTISEMENT
Ambetter from Superior HealthplanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-877-941-9237 |
Toc - Plan #132 Ambetter from Superior Healthplan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Virtual Access Bronze ($0 Virtual Primary Care + $0 Virtual Urgent Care + $0 Preferred Labs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.57 $434.20 $488.91 $683.25 $1,038.26 |
$675.23 $726.86 $781.57 $975.91 |
$967.89 $1,019.52 $1,074.23 $1,268.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.14 $868.40 $977.82 $1,366.50 $2,076.52 |
$1,057.80 $1,161.06 $1,270.48 $1,659.16 |
$1,350.46 $1,453.72 $1,563.14 $1,951.82 |
Toc - Plan #133 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Virtual Access Silver ($0 Virtual Primary Care + $0 Virtual Urgent Care + $0 Preferred Labs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.56 $467.11 $525.96 $735.03 $1,116.94 |
$726.39 $781.94 $840.79 $1,049.86 |
$1,041.22 $1,096.77 $1,155.62 $1,364.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$823.12 $934.22 $1,051.92 $1,470.06 $2,233.88 |
$1,137.95 $1,249.05 $1,366.75 $1,784.89 |
$1,452.78 $1,563.88 $1,681.58 $2,099.72 |
Toc - Plan #134 Ambetter from Superior Healthplan | ||||||||||||||||||||
Gold
(HMO) Ambetter Virtual Access Gold ($0 Virtual Primary Care + $0 Virtual Urgent Care + $0 Preferred Labs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$547.17 $621.03 $699.28 $977.23 $1,485.00 |
$965.75 $1,039.61 $1,117.86 $1,395.81 |
$1,384.33 $1,458.19 $1,536.44 $1,814.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,094.34 $1,242.06 $1,398.56 $1,954.46 $2,970.00 |
$1,512.92 $1,660.64 $1,817.14 $2,373.04 |
$1,931.50 $2,079.22 $2,235.72 $2,791.62 |
Toc - Plan #135 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 11 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.62 $404.75 $455.75 $636.90 $967.83 |
$629.43 $677.56 $728.56 $909.71 |
$902.24 $950.37 $1,001.37 $1,182.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$713.24 $809.50 $911.50 $1,273.80 $1,935.66 |
$986.05 $1,082.31 $1,184.31 $1,546.61 |
$1,258.86 $1,355.12 $1,457.12 $1,819.42 |
Toc - Plan #136 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329.37 $373.82 $420.92 $588.23 $893.87 |
$581.33 $625.78 $672.88 $840.19 |
$833.29 $877.74 $924.84 $1,092.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$658.74 $747.64 $841.84 $1,176.46 $1,787.74 |
$910.70 $999.60 $1,093.80 $1,428.42 |
$1,162.66 $1,251.56 $1,345.76 $1,680.38 |
Toc - Plan #137 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 31 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329.84 $374.35 $421.52 $589.07 $895.15 |
$582.16 $626.67 $673.84 $841.39 |
$834.48 $878.99 $926.16 $1,093.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$659.68 $748.70 $843.04 $1,178.14 $1,790.30 |
$912.00 $1,001.02 $1,095.36 $1,430.46 |
$1,164.32 $1,253.34 $1,347.68 $1,682.78 |
Toc - Plan #138 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 32 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.51 $386.47 $435.16 $608.14 $924.12 |
$600.99 $646.95 $695.64 $868.62 |
$861.47 $907.43 $956.12 $1,129.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$681.02 $772.94 $870.32 $1,216.28 $1,848.24 |
$941.50 $1,033.42 $1,130.80 $1,476.76 |
$1,201.98 $1,293.90 $1,391.28 $1,737.24 |
Toc - Plan #139 Ambetter from Superior Healthplan | ||||||||||||||||||||
Gold
(HMO) Ambetter Value Gold 20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$437.98 $497.10 $559.73 $782.21 $1,188.65 |
$773.03 $832.15 $894.78 $1,117.26 |
$1,108.08 $1,167.20 $1,229.83 $1,452.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$875.96 $994.20 $1,119.46 $1,564.42 $2,377.30 |
$1,211.01 $1,329.25 $1,454.51 $1,899.47 |
$1,546.06 $1,664.30 $1,789.56 $2,234.52 |
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Toc - Plan #140 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Gold 1000 ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.80 $387.94 $436.81 $610.45 $927.63 |
$603.27 $649.41 $698.28 $871.92 |
$864.74 $910.88 $959.75 $1,133.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.60 $775.88 $873.62 $1,220.90 $1,855.26 |
$945.07 $1,037.35 $1,135.09 $1,482.37 |
$1,206.54 $1,298.82 $1,396.56 $1,743.84 |
Toc - Plan #141 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Gold $0 Deductible + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription L |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.79 $435.60 $490.48 $685.45 $1,041.60 |
$677.39 $729.20 $784.08 $979.05 |
$970.99 $1,022.80 $1,077.68 $1,272.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.58 $871.20 $980.96 $1,370.90 $2,083.20 |
$1,061.18 $1,164.80 $1,274.56 $1,664.50 |
$1,354.78 $1,458.40 $1,568.16 $1,958.10 |
Toc - Plan #142 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 5000 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$350.84 $398.21 $448.38 $626.61 $952.19 |
$619.24 $666.61 $716.78 $895.01 |
$887.64 $935.01 $985.18 $1,163.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$701.68 $796.42 $896.76 $1,253.22 $1,904.38 |
$970.08 $1,064.82 $1,165.16 $1,521.62 |
$1,238.48 $1,333.22 $1,433.56 $1,790.02 |
Toc - Plan #143 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 3000 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.56 $401.29 $451.85 $631.46 $959.56 |
$624.03 $671.76 $722.32 $901.93 |
$894.50 $942.23 $992.79 $1,172.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.12 $802.58 $903.70 $1,262.92 $1,919.12 |
$977.59 $1,073.05 $1,174.17 $1,533.39 |
$1,248.06 $1,343.52 $1,444.64 $1,803.86 |
Toc - Plan #144 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver $0 Deductible ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.26 $414.57 $466.80 $652.35 $991.31 |
$644.68 $693.99 $746.22 $931.77 |
$924.10 $973.41 $1,025.64 $1,211.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.52 $829.14 $933.60 $1,304.70 $1,982.62 |
$1,009.94 $1,108.56 $1,213.02 $1,584.12 |
$1,289.36 $1,387.98 $1,492.44 $1,863.54 |
Toc - Plan #145 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 6700 ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.11 $405.32 $456.39 $637.80 $969.20 |
$630.30 $678.51 $729.58 $910.99 |
$903.49 $951.70 $1,002.77 $1,184.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.22 $810.64 $912.78 $1,275.60 $1,938.40 |
$987.41 $1,083.83 $1,185.97 $1,548.79 |
$1,260.60 $1,357.02 $1,459.16 $1,821.98 |
Toc - Plan #146 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 6700 + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Presc |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.42 $413.61 $465.72 $650.85 $989.03 |
$643.20 $692.39 $744.50 $929.63 |
$921.98 $971.17 $1,023.28 $1,208.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$728.84 $827.22 $931.44 $1,301.70 $1,978.06 |
$1,007.62 $1,106.00 $1,210.22 $1,580.48 |
$1,286.40 $1,384.78 $1,489.00 $1,859.26 |
Toc - Plan #147 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 8700 + $0 Mental Health ($0 Telehealth + $0 Primary Care + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$256.65 $291.30 $328.00 $458.37 $696.54 |
$452.99 $487.64 $524.34 $654.71 |
$649.33 $683.98 $720.68 $851.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$513.30 $582.60 $656.00 $916.74 $1,393.08 |
$709.64 $778.94 $852.34 $1,113.08 |
$905.98 $975.28 $1,048.68 $1,309.42 |
Toc - Plan #148 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 5300 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$277.49 $314.95 $354.63 $495.59 $753.10 |
$489.77 $527.23 $566.91 $707.87 |
$702.05 $739.51 $779.19 $920.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$554.98 $629.90 $709.26 $991.18 $1,506.20 |
$767.26 $842.18 $921.54 $1,203.46 |
$979.54 $1,054.46 $1,133.82 $1,415.74 |
Toc - Plan #149 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7200 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$264.98 $300.75 $338.65 $473.26 $719.16 |
$467.69 $503.46 $541.36 $675.97 |
$670.40 $706.17 $744.07 $878.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$529.96 $601.50 $677.30 $946.52 $1,438.32 |
$732.67 $804.21 $880.01 $1,149.23 |
$935.38 $1,006.92 $1,082.72 $1,351.94 |
Toc - Plan #150 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze $0 Medical Deductible ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.10 $336.07 $378.41 $528.83 $803.61 |
$522.61 $562.58 $604.92 $755.34 |
$749.12 $789.09 $831.43 $981.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$592.20 $672.14 $756.82 $1,057.66 $1,607.22 |
$818.71 $898.65 $983.33 $1,284.17 |
$1,045.22 $1,125.16 $1,209.84 $1,510.68 |
Toc - Plan #151 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7200 + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$272.29 $309.05 $347.98 $486.31 $738.99 |
$480.59 $517.35 $556.28 $694.61 |
$688.89 $725.65 $764.58 $902.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$544.58 $618.10 $695.96 $972.62 $1,477.98 |
$752.88 $826.40 $904.26 $1,180.92 |
$961.18 $1,034.70 $1,112.56 $1,389.22 |
Toc - Plan #152 Bright HealthCare | ||||||||||||||||||||
Catastrophic
(HMO) Catastrophic 8700 ($0 Primary Care) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$219.82 $249.49 $280.93 $392.60 $596.59 |
$387.98 $417.65 $449.09 $560.76 |
$556.14 $585.81 $617.25 $728.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$439.64 $498.98 $561.86 $785.20 $1,193.18 |
$607.80 $667.14 $730.02 $953.36 |
$775.96 $835.30 $898.18 $1,121.52 |
Toc - Plan #153 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Super Gold 1 ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.78 $341.39 $384.40 $537.19 $816.32 |
$530.88 $571.49 $614.50 $767.29 |
$760.98 $801.59 $844.60 $997.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$601.56 $682.78 $768.80 $1,074.38 $1,632.64 |
$831.66 $912.88 $998.90 $1,304.48 |
$1,061.76 $1,142.98 $1,229.00 $1,534.58 |
Toc - Plan #154 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Super Gold 2 + Adult Dental & Vision ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$338.61 $384.32 $432.75 $604.76 $918.99 |
$597.65 $643.36 $691.79 $863.80 |
$856.69 $902.40 $950.83 $1,122.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$677.22 $768.64 $865.50 $1,209.52 $1,837.98 |
$936.26 $1,027.68 $1,124.54 $1,468.56 |
$1,195.30 $1,286.72 $1,383.58 $1,727.60 |
Toc - Plan #155 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 1 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.74 $350.42 $394.57 $551.42 $837.93 |
$544.93 $586.61 $630.76 $787.61 |
$781.12 $822.80 $866.95 $1,023.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$617.48 $700.84 $789.14 $1,102.84 $1,675.86 |
$853.67 $937.03 $1,025.33 $1,339.03 |
$1,089.86 $1,173.22 $1,261.52 $1,575.22 |
Toc - Plan #156 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 2 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Provider Directory
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Annual Out of Pocket Expenses:
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[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$311.13 $353.13 $397.63 $555.68 $844.41 |
$549.15 $591.15 $635.65 $793.70 |
$787.17 $829.17 $873.67 $1,031.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.26 $706.26 $795.26 $1,111.36 $1,688.82 |
$860.28 $944.28 $1,033.28 $1,349.38 |
$1,098.30 $1,182.30 $1,271.30 $1,587.40 |
Toc - Plan #157 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 5 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.43 $364.82 $410.78 $574.07 $872.35 |
$567.32 $610.71 $656.67 $819.96 |
$813.21 $856.60 $902.56 $1,065.85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$642.86 $729.64 $821.56 $1,148.14 $1,744.70 |
$888.75 $975.53 $1,067.45 $1,394.03 |
$1,134.64 $1,221.42 $1,313.34 $1,639.92 |
Toc - Plan #158 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 3 ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$314.26 $356.68 $401.62 $561.26 $852.89 |
$554.67 $597.09 $642.03 $801.67 |
$795.08 $837.50 $882.44 $1,042.08 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628.52 $713.36 $803.24 $1,122.52 $1,705.78 |
$868.93 $953.77 $1,043.65 $1,362.93 |
$1,109.34 $1,194.18 $1,284.06 $1,603.34 |
Toc - Plan #159 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 4 + Adult Dental & Vision ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Pr |
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Benefits & Coverage
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.56 $364.97 $410.96 $574.31 $872.72 |
$567.56 $610.97 $656.96 $820.31 |
$813.56 $856.97 $902.96 $1,066.31 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$643.12 $729.94 $821.92 $1,148.62 $1,745.44 |
$889.12 $975.94 $1,067.92 $1,394.62 |
$1,135.12 $1,221.94 $1,313.92 $1,640.62 |
Toc - Plan #160 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 1 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$225.85 $256.34 $288.64 $403.37 $612.96 |
$398.63 $429.12 $461.42 $576.15 |
$571.41 $601.90 $634.20 $748.93 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$451.70 $512.68 $577.28 $806.74 $1,225.92 |
$624.48 $685.46 $750.06 $979.52 |
$797.26 $858.24 $922.84 $1,152.30 |
Toc - Plan #161 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 5 HSA |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
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|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$244.19 $277.15 $312.07 $436.12 $662.73 |
$430.99 $463.95 $498.87 $622.92 |
$617.79 $650.75 $685.67 $809.72 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$488.38 $554.30 $624.14 $872.24 $1,325.46 |
$675.18 $741.10 $810.94 $1,059.04 |
$861.98 $927.90 $997.74 $1,245.84 |
Toc - Plan #162 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 2 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$233.18 $264.66 $298.01 $416.47 $632.86 |
$411.57 $443.05 $476.40 $594.86 |
$589.96 $621.44 $654.79 $773.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$466.36 $529.32 $596.02 $832.94 $1,265.72 |
$644.75 $707.71 $774.41 $1,011.33 |
$823.14 $886.10 $952.80 $1,189.72 |
Toc - Plan #163 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 4 ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$260.57 $295.74 $333.00 $465.37 $707.17 |
$459.90 $495.07 $532.33 $664.70 |
$659.23 $694.40 $731.66 $864.03 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$521.14 $591.48 $666.00 $930.74 $1,414.34 |
$720.47 $790.81 $865.33 $1,130.07 |
$919.80 $990.14 $1,064.66 $1,329.40 |
Toc - Plan #164 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 3 + Adult Dental & Vision ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$240.49 $272.96 $307.35 $429.52 $652.69 |
$424.46 $456.93 $491.32 $613.49 |
$608.43 $640.90 $675.29 $797.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$480.98 $545.92 $614.70 $859.04 $1,305.38 |
$664.95 $729.89 $798.67 $1,043.01 |
$848.92 $913.86 $982.64 $1,226.98 |
Toc - Plan #165 Bright HealthCare | ||||||||||||||||||||
Catastrophic
(HMO) Super Catastrophic 1 ($0 Primary Care) |
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Benefits & Coverage
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Provider Directory
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Annual Out of Pocket Expenses:
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[show premiums]
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||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$193.44 $219.55 $247.22 $345.48 $525.00 |
$341.42 $367.53 $395.20 $493.46 |
$489.40 $515.51 $543.18 $641.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$386.88 $439.10 $494.44 $690.96 $1,050.00 |
$534.86 $587.08 $642.42 $838.94 |
$682.84 $735.06 $790.40 $986.92 |
Toc - Plan #166 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 8700 ($25 Generic) |
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Benefits & Coverage
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|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$253.20 $287.38 $323.59 $452.21 $687.18 |
$446.90 $481.08 $517.29 $645.91 |
$640.60 $674.78 $710.99 $839.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$506.40 $574.76 $647.18 $904.42 $1,374.36 |
$700.10 $768.46 $840.88 $1,098.12 |
$893.80 $962.16 $1,034.58 $1,291.82 |
Toc - Plan #167 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 4000 ($35 Primary Care + $15 Generic) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$346.21 $392.95 $442.46 $618.34 $939.62 |
$611.06 $657.80 $707.31 $883.19 |
$875.91 $922.65 $972.16 $1,148.04 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$692.42 $785.90 $884.92 $1,236.68 $1,879.24 |
$957.27 $1,050.75 $1,149.77 $1,501.53 |
$1,222.12 $1,315.60 $1,414.62 $1,766.38 |
Toc - Plan #168 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 6 |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$222.81 $252.89 $284.76 $397.95 $604.72 |
$393.26 $423.34 $455.21 $568.40 |
$563.71 $593.79 $625.66 $738.85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$445.62 $505.78 $569.52 $795.90 $1,209.44 |
$616.07 $676.23 $739.97 $966.35 |
$786.52 $846.68 $910.42 $1,136.80 |
Toc - Plan #169 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 7 |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.67 $345.80 $389.36 $544.14 $826.87 |
$537.74 $578.87 $622.43 $777.21 |
$770.81 $811.94 $855.50 $1,010.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$609.34 $691.60 $778.72 $1,088.28 $1,653.74 |
$842.41 $924.67 $1,011.79 $1,321.35 |
$1,075.48 $1,157.74 $1,244.86 $1,554.42 |
‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Dallas County here.
Dallas County is in “Rating Area 8” of Texas.
Currently, there are 169 plans offered in Rating Area 8.