Obamacare 2022 Rates for Waller County
Obamacare > Rates > Texas > Waller County
Obamacare > Rates > Texas > Waller County
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Community Health ChoiceLocal: 1-713-295-6704 | Toll Free: 1-855-315-5386 | TTY: 1-855-315-5386 |
Toc - Plan #1 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Vital Bronze 003 (No Deductible for PCP, Free Preventive Care, 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$277.57 $315.04 $354.74 $495.74 $753.33 |
$489.91 $527.38 $567.08 $708.08 |
$702.25 $739.72 $779.42 $920.42 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$555.14 $630.08 $709.48 $991.48 $1,506.66 |
$767.48 $842.42 $921.82 $1,203.82 |
$979.82 $1,054.76 $1,134.16 $1,416.16 |
Toc - Plan #2 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Advance Preferred Silver 004 (No deductible PCP, Specialists, Urgent Care and Generics, Free 24/7 Telehe |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$389.65 $442.25 $497.97 $695.92 $1,057.51 |
$687.73 $740.33 $796.05 $994.00 |
$985.81 $1,038.41 $1,094.13 $1,292.08 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$779.30 $884.50 $995.94 $1,391.84 $2,115.02 |
$1,077.38 $1,182.58 $1,294.02 $1,689.92 |
$1,375.46 $1,480.66 $1,592.10 $1,988.00 |
Toc - Plan #3 Community Health Choice | ||||||||||||||||||||
Gold
(HMO) Community Enhanced Gold 005 (No Deductible PCP, Specialists & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$362.35 $411.27 $463.09 $647.16 $983.43 |
$639.55 $688.47 $740.29 $924.36 |
$916.75 $965.67 $1,017.49 $1,201.56 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$724.70 $822.54 $926.18 $1,294.32 $1,966.86 |
$1,001.90 $1,099.74 $1,203.38 $1,571.52 |
$1,279.10 $1,376.94 $1,480.58 $1,848.72 |
Toc - Plan #4 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Essential Bronze 008 HSA(No cost after deductible, No referrals for Specialists) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$283.70 $322.00 $362.57 $506.70 $769.97 |
$500.73 $539.03 $579.60 $723.73 |
$717.76 $756.06 $796.63 $940.76 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$567.40 $644.00 $725.14 $1,013.40 $1,539.94 |
$784.43 $861.03 $942.17 $1,230.43 |
$1,001.46 $1,078.06 $1,159.20 $1,447.46 |
Toc - Plan #5 Community Health Choice | ||||||||||||||||||||
Bronze
(HMO) Community Value Bronze 10 (Free Preventive Care, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$263.34 $298.89 $336.55 $470.33 $714.71 |
$464.80 $500.35 $538.01 $671.79 |
$666.26 $701.81 $739.47 $873.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$526.68 $597.78 $673.10 $940.66 $1,429.42 |
$728.14 $799.24 $874.56 $1,142.12 |
$929.60 $1,000.70 $1,076.02 $1,343.58 |
Toc - Plan #6 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Virtual Now Bronze 11 (Unlimited Free 24/7 Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$261.53 $296.83 $334.23 $467.09 $709.79 |
$461.60 $496.90 $534.30 $667.16 |
$661.67 $696.97 $734.37 $867.23 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$523.06 $593.66 $668.46 $934.18 $1,419.58 |
$723.13 $793.73 $868.53 $1,134.25 |
$923.20 $993.80 $1,068.60 $1,334.32 |
Toc - Plan #7 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Standard Silver 12 (No deductible PCP, Urgent Care & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$370.90 $420.97 $474.01 $662.43 $1,006.62 |
$654.64 $704.71 $757.75 $946.17 |
$938.38 $988.45 $1,041.49 $1,229.91 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$741.80 $841.94 $948.02 $1,324.86 $2,013.24 |
$1,025.54 $1,125.68 $1,231.76 $1,608.60 |
$1,309.28 $1,409.42 $1,515.50 $1,892.34 |
Toc - Plan #8 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Advance Silver 13 (No Deductible PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
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 |
$373.37 $423.77 $477.16 $666.83 $1,013.32 |
$659.00 $709.40 $762.79 $952.46 |
$944.63 $995.03 $1,048.42 $1,238.09 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$746.74 $847.54 $954.32 $1,333.66 $2,026.64 |
$1,032.37 $1,133.17 $1,239.95 $1,619.29 |
$1,318.00 $1,418.80 $1,525.58 $1,904.92 |
ADVERTISEMENT
Ambetter from Superior HealthPlanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989 |
Toc - Plan #9 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$322.13 $365.61 $411.67 $575.31 $874.24 |
$568.55 $612.03 $658.09 $821.73 |
$814.97 $858.45 $904.51 $1,068.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$644.26 $731.22 $823.34 $1,150.62 $1,748.48 |
$890.68 $977.64 $1,069.76 $1,397.04 |
$1,137.10 $1,224.06 $1,316.18 $1,643.46 |
Toc - Plan #10 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$384.50 $436.39 $491.37 $686.69 $1,043.50 |
$678.63 $730.52 $785.50 $980.82 |
$972.76 $1,024.65 $1,079.63 $1,274.95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$769.00 $872.78 $982.74 $1,373.38 $2,087.00 |
$1,063.13 $1,166.91 $1,276.87 $1,667.51 |
$1,357.26 $1,461.04 $1,571.00 $1,961.64 |
Toc - Plan #11 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$386.65 $438.84 $494.13 $690.54 $1,049.34 |
$682.43 $734.62 $789.91 $986.32 |
$978.21 $1,030.40 $1,085.69 $1,282.10 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$773.30 $877.68 $988.26 $1,381.08 $2,098.68 |
$1,069.08 $1,173.46 $1,284.04 $1,676.86 |
$1,364.86 $1,469.24 $1,579.82 $1,972.64 |
Toc - Plan #12 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$340.20 $386.12 $434.77 $607.59 $923.29 |
$600.45 $646.37 $695.02 $867.84 |
$860.70 $906.62 $955.27 $1,128.09 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$680.40 $772.24 $869.54 $1,215.18 $1,846.58 |
$940.65 $1,032.49 $1,129.79 $1,475.43 |
$1,200.90 $1,292.74 $1,390.04 $1,735.68 |
Toc - Plan #13 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$504.80 $572.94 $645.12 $901.56 $1,370.01 |
$890.97 $959.11 $1,031.29 $1,287.73 |
$1,277.14 $1,345.28 $1,417.46 $1,673.90 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,009.60 $1,145.88 $1,290.24 $1,803.12 $2,740.02 |
$1,395.77 $1,532.05 $1,676.41 $2,189.29 |
$1,781.94 $1,918.22 $2,062.58 $2,575.46 |
Toc - Plan #14 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$352.08 $399.60 $449.95 $628.80 $955.53 |
$621.42 $668.94 $719.29 $898.14 |
$890.76 $938.28 $988.63 $1,167.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$704.16 $799.20 $899.90 $1,257.60 $1,911.06 |
$973.50 $1,068.54 $1,169.24 $1,526.94 |
$1,242.84 $1,337.88 $1,438.58 $1,796.28 |
Toc - Plan #15 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$379.31 $430.50 $484.74 $677.42 $1,029.41 |
$669.47 $720.66 $774.90 $967.58 |
$959.63 $1,010.82 $1,065.06 $1,257.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$758.62 $861.00 $969.48 $1,354.84 $2,058.82 |
$1,048.78 $1,151.16 $1,259.64 $1,645.00 |
$1,338.94 $1,441.32 $1,549.80 $1,935.16 |
Toc - Plan #16 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$374.38 $424.92 $478.45 $668.63 $1,016.05 |
$660.78 $711.32 $764.85 $955.03 |
$947.18 $997.72 $1,051.25 $1,241.43 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$748.76 $849.84 $956.90 $1,337.26 $2,032.10 |
$1,035.16 $1,136.24 $1,243.30 $1,623.66 |
$1,321.56 $1,422.64 $1,529.70 $1,910.06 |
Toc - Plan #17 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$374.00 $424.48 $477.96 $667.95 $1,015.01 |
$660.10 $710.58 $764.06 $954.05 |
$946.20 $996.68 $1,050.16 $1,240.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$748.00 $848.96 $955.92 $1,335.90 $2,030.02 |
$1,034.10 $1,135.06 $1,242.02 $1,622.00 |
$1,320.20 $1,421.16 $1,528.12 $1,908.10 |
Toc - Plan #18 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$383.27 $435.00 $489.80 $684.50 $1,040.16 |
$676.46 $728.19 $782.99 $977.69 |
$969.65 $1,021.38 $1,076.18 $1,270.88 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$766.54 $870.00 $979.60 $1,369.00 $2,080.32 |
$1,059.73 $1,163.19 $1,272.79 $1,662.19 |
$1,352.92 $1,456.38 $1,565.98 $1,955.38 |
Toc - Plan #19 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$404.34 $458.91 $516.73 $722.13 $1,097.34 |
$713.65 $768.22 $826.04 $1,031.44 |
$1,022.96 $1,077.53 $1,135.35 $1,340.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$808.68 $917.82 $1,033.46 $1,444.26 $2,194.68 |
$1,117.99 $1,227.13 $1,342.77 $1,753.57 |
$1,427.30 $1,536.44 $1,652.08 $2,062.88 |
Toc - Plan #20 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 30 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$355.12 $403.05 $453.83 $634.23 $963.77 |
$626.78 $674.71 $725.49 $905.89 |
$898.44 $946.37 $997.15 $1,177.55 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$710.24 $806.10 $907.66 $1,268.46 $1,927.54 |
$981.90 $1,077.76 $1,179.32 $1,540.12 |
$1,253.56 $1,349.42 $1,450.98 $1,811.78 |
Toc - Plan #21 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$355.62 $403.62 $454.47 $635.12 $965.13 |
$627.66 $675.66 $726.51 $907.16 |
$899.70 $947.70 $998.55 $1,179.20 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$711.24 $807.24 $908.94 $1,270.24 $1,930.26 |
$983.28 $1,079.28 $1,180.98 $1,542.28 |
$1,255.32 $1,351.32 $1,453.02 $1,814.32 |
Toc - Plan #22 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
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 |
$367.12 $416.67 $469.16 $655.65 $996.33 |
$647.96 $697.51 $750.00 $936.49 |
$928.80 $978.35 $1,030.84 $1,217.33 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.24 $833.34 $938.32 $1,311.30 $1,992.66 |
$1,015.08 $1,114.18 $1,219.16 $1,592.14 |
$1,295.92 $1,395.02 $1,500.00 $1,872.98 |
Toc - Plan #23 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 |
$472.20 $535.93 $603.46 $843.33 $1,281.52 |
$833.42 $897.15 $964.68 $1,204.55 |
$1,194.64 $1,258.37 $1,325.90 $1,565.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$944.40 $1,071.86 $1,206.92 $1,686.66 $2,563.04 |
$1,305.62 $1,433.08 $1,568.14 $2,047.88 |
$1,666.84 $1,794.30 $1,929.36 $2,409.10 |
Toc - Plan #24 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 |
$509.84 $578.65 $651.56 $910.55 $1,383.67 |
$899.86 $968.67 $1,041.58 $1,300.57 |
$1,289.88 $1,358.69 $1,431.60 $1,690.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,019.68 $1,157.30 $1,303.12 $1,821.10 $2,767.34 |
$1,409.70 $1,547.32 $1,693.14 $2,211.12 |
$1,799.72 $1,937.34 $2,083.16 $2,601.14 |
Toc - Plan #25 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 |
$325.35 $369.26 $415.78 $581.05 $882.96 |
$574.23 $618.14 $664.66 $829.93 |
$823.11 $867.02 $913.54 $1,078.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$650.70 $738.52 $831.56 $1,162.10 $1,765.92 |
$899.58 $987.40 $1,080.44 $1,410.98 |
$1,148.46 $1,236.28 $1,329.32 $1,659.86 |
Toc - Plan #26 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 |
$343.60 $389.97 $439.10 $613.65 $932.50 |
$606.44 $652.81 $701.94 $876.49 |
$869.28 $915.65 $964.78 $1,139.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$687.20 $779.94 $878.20 $1,227.30 $1,865.00 |
$950.04 $1,042.78 $1,141.04 $1,490.14 |
$1,212.88 $1,305.62 $1,403.88 $1,752.98 |
Toc - Plan #27 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 |
$388.33 $440.75 $496.28 $693.54 $1,053.91 |
$685.40 $737.82 $793.35 $990.61 |
$982.47 $1,034.89 $1,090.42 $1,287.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.66 $881.50 $992.56 $1,387.08 $2,107.82 |
$1,073.73 $1,178.57 $1,289.63 $1,684.15 |
$1,370.80 $1,475.64 $1,586.70 $1,981.22 |
Toc - Plan #28 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 |
$390.51 $443.21 $499.05 $697.43 $1,059.81 |
$689.24 $741.94 $797.78 $996.16 |
$987.97 $1,040.67 $1,096.51 $1,294.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.02 $886.42 $998.10 $1,394.86 $2,119.62 |
$1,079.75 $1,185.15 $1,296.83 $1,693.59 |
$1,378.48 $1,483.88 $1,595.56 $1,992.32 |
Toc - Plan #29 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 |
$355.60 $403.59 $454.44 $635.08 $965.06 |
$627.62 $675.61 $726.46 $907.10 |
$899.64 $947.63 $998.48 $1,179.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.20 $807.18 $908.88 $1,270.16 $1,930.12 |
$983.22 $1,079.20 $1,180.90 $1,542.18 |
$1,255.24 $1,351.22 $1,452.92 $1,814.20 |
Toc - Plan #30 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 |
$383.09 $434.80 $489.58 $684.18 $1,039.68 |
$676.15 $727.86 $782.64 $977.24 |
$969.21 $1,020.92 $1,075.70 $1,270.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766.18 $869.60 $979.16 $1,368.36 $2,079.36 |
$1,059.24 $1,162.66 $1,272.22 $1,661.42 |
$1,352.30 $1,455.72 $1,565.28 $1,954.48 |
Toc - Plan #31 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 |
$377.73 $428.71 $482.73 $674.61 $1,025.13 |
$666.69 $717.67 $771.69 $963.57 |
$955.65 $1,006.63 $1,060.65 $1,252.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.46 $857.42 $965.46 $1,349.22 $2,050.26 |
$1,044.42 $1,146.38 $1,254.42 $1,638.18 |
$1,333.38 $1,435.34 $1,543.38 $1,927.14 |
Toc - Plan #32 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 |
$387.09 $439.33 $494.69 $691.32 $1,050.53 |
$683.21 $735.45 $790.81 $987.44 |
$979.33 $1,031.57 $1,086.93 $1,283.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774.18 $878.66 $989.38 $1,382.64 $2,101.06 |
$1,070.30 $1,174.78 $1,285.50 $1,678.76 |
$1,366.42 $1,470.90 $1,581.62 $1,974.88 |
Toc - Plan #33 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 |
$408.37 $463.49 $521.88 $729.33 $1,108.29 |
$720.76 $775.88 $834.27 $1,041.72 |
$1,033.15 $1,088.27 $1,146.66 $1,354.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$816.74 $926.98 $1,043.76 $1,458.66 $2,216.58 |
$1,129.13 $1,239.37 $1,356.15 $1,771.05 |
$1,441.52 $1,551.76 $1,668.54 $2,083.44 |
Toc - Plan #34 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 |
$359.17 $407.65 $459.01 $641.46 $974.76 |
$633.93 $682.41 $733.77 $916.22 |
$908.69 $957.17 $1,008.53 $1,190.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$718.34 $815.30 $918.02 $1,282.92 $1,949.52 |
$993.10 $1,090.06 $1,192.78 $1,557.68 |
$1,267.86 $1,364.82 $1,467.54 $1,832.44 |
Toc - Plan #35 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 |
$370.78 $420.82 $473.84 $662.19 $1,006.27 |
$654.42 $704.46 $757.48 $945.83 |
$938.06 $988.10 $1,041.12 $1,229.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.56 $841.64 $947.68 $1,324.38 $2,012.54 |
$1,025.20 $1,125.28 $1,231.32 $1,608.02 |
$1,308.84 $1,408.92 $1,514.96 $1,891.66 |
Toc - Plan #36 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 |
$476.91 $541.28 $609.48 $851.74 $1,294.30 |
$841.74 $906.11 $974.31 $1,216.57 |
$1,206.57 $1,270.94 $1,339.14 $1,581.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$953.82 $1,082.56 $1,218.96 $1,703.48 $2,588.60 |
$1,318.65 $1,447.39 $1,583.79 $2,068.31 |
$1,683.48 $1,812.22 $1,948.62 $2,433.14 |
Toc - Plan #37 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 |
$378.12 $429.15 $483.22 $675.30 $1,026.19 |
$667.37 $718.40 $772.47 $964.55 |
$956.62 $1,007.65 $1,061.72 $1,253.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.24 $858.30 $966.44 $1,350.60 $2,052.38 |
$1,045.49 $1,147.55 $1,255.69 $1,639.85 |
$1,334.74 $1,436.80 $1,544.94 $1,929.10 |
Toc - Plan #38 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 |
$525.72 $596.68 $671.86 $938.92 $1,426.78 |
$927.89 $998.85 $1,074.03 $1,341.09 |
$1,330.06 $1,401.02 $1,476.20 $1,743.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,051.44 $1,193.36 $1,343.72 $1,877.84 $2,853.56 |
$1,453.61 $1,595.53 $1,745.89 $2,280.01 |
$1,855.78 $1,997.70 $2,148.06 $2,682.18 |
Toc - Plan #39 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 |
$335.48 $380.76 $428.73 $599.15 $910.47 |
$592.12 $637.40 $685.37 $855.79 |
$848.76 $894.04 $942.01 $1,112.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670.96 $761.52 $857.46 $1,198.30 $1,820.94 |
$927.60 $1,018.16 $1,114.10 $1,454.94 |
$1,184.24 $1,274.80 $1,370.74 $1,711.58 |
Toc - Plan #40 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 |
$354.30 $402.12 $452.79 $632.77 $961.55 |
$625.33 $673.15 $723.82 $903.80 |
$896.36 $944.18 $994.85 $1,174.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.60 $804.24 $905.58 $1,265.54 $1,923.10 |
$979.63 $1,075.27 $1,176.61 $1,536.57 |
$1,250.66 $1,346.30 $1,447.64 $1,807.60 |
Toc - Plan #41 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 |
$400.43 $454.48 $511.74 $715.15 $1,086.74 |
$706.75 $760.80 $818.06 $1,021.47 |
$1,013.07 $1,067.12 $1,124.38 $1,327.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.86 $908.96 $1,023.48 $1,430.30 $2,173.48 |
$1,107.18 $1,215.28 $1,329.80 $1,736.62 |
$1,413.50 $1,521.60 $1,636.12 $2,042.94 |
Toc - Plan #42 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 |
$402.67 $457.02 $514.60 $719.16 $1,092.83 |
$710.71 $765.06 $822.64 $1,027.20 |
$1,018.75 $1,073.10 $1,130.68 $1,335.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.34 $914.04 $1,029.20 $1,438.32 $2,185.66 |
$1,113.38 $1,222.08 $1,337.24 $1,746.36 |
$1,421.42 $1,530.12 $1,645.28 $2,054.40 |
Toc - Plan #43 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 |
$366.68 $416.17 $468.60 $654.86 $995.13 |
$647.18 $696.67 $749.10 $935.36 |
$927.68 $977.17 $1,029.60 $1,215.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.36 $832.34 $937.20 $1,309.72 $1,990.26 |
$1,013.86 $1,112.84 $1,217.70 $1,590.22 |
$1,294.36 $1,393.34 $1,498.20 $1,870.72 |
Toc - Plan #44 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 |
$395.03 $448.34 $504.83 $705.50 $1,072.07 |
$697.22 $750.53 $807.02 $1,007.69 |
$999.41 $1,052.72 $1,109.21 $1,309.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.06 $896.68 $1,009.66 $1,411.00 $2,144.14 |
$1,092.25 $1,198.87 $1,311.85 $1,713.19 |
$1,394.44 $1,501.06 $1,614.04 $2,015.38 |
Toc - Plan #45 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 |
$389.50 $442.07 $497.77 $695.63 $1,057.07 |
$687.46 $740.03 $795.73 $993.59 |
$985.42 $1,037.99 $1,093.69 $1,291.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.00 $884.14 $995.54 $1,391.26 $2,114.14 |
$1,076.96 $1,182.10 $1,293.50 $1,689.22 |
$1,374.92 $1,480.06 $1,591.46 $1,987.18 |
Toc - Plan #46 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 |
$399.15 $453.02 $510.10 $712.86 $1,083.26 |
$704.49 $758.36 $815.44 $1,018.20 |
$1,009.83 $1,063.70 $1,120.78 $1,323.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$798.30 $906.04 $1,020.20 $1,425.72 $2,166.52 |
$1,103.64 $1,211.38 $1,325.54 $1,731.06 |
$1,408.98 $1,516.72 $1,630.88 $2,036.40 |
Toc - Plan #47 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 |
$421.09 $477.93 $538.14 $752.05 $1,142.82 |
$743.22 $800.06 $860.27 $1,074.18 |
$1,065.35 $1,122.19 $1,182.40 $1,396.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$842.18 $955.86 $1,076.28 $1,504.10 $2,285.64 |
$1,164.31 $1,277.99 $1,398.41 $1,826.23 |
$1,486.44 $1,600.12 $1,720.54 $2,148.36 |
Toc - Plan #48 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 |
$370.36 $420.35 $473.31 $661.44 $1,005.13 |
$653.68 $703.67 $756.63 $944.76 |
$937.00 $986.99 $1,039.95 $1,228.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$740.72 $840.70 $946.62 $1,322.88 $2,010.26 |
$1,024.04 $1,124.02 $1,229.94 $1,606.20 |
$1,307.36 $1,407.34 $1,513.26 $1,889.52 |
Toc - Plan #49 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 |
$382.33 $433.94 $488.61 $682.83 $1,037.62 |
$674.81 $726.42 $781.09 $975.31 |
$967.29 $1,018.90 $1,073.57 $1,267.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.66 $867.88 $977.22 $1,365.66 $2,075.24 |
$1,057.14 $1,160.36 $1,269.70 $1,658.14 |
$1,349.62 $1,452.84 $1,562.18 $1,950.62 |
Toc - Plan #50 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 |
$491.77 $558.14 $628.47 $878.28 $1,334.63 |
$867.96 $934.33 $1,004.66 $1,254.47 |
$1,244.15 $1,310.52 $1,380.85 $1,630.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$983.54 $1,116.28 $1,256.94 $1,756.56 $2,669.26 |
$1,359.73 $1,492.47 $1,633.13 $2,132.75 |
$1,735.92 $1,868.66 $2,009.32 $2,508.94 |
Toc - Plan #51 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 |
$389.90 $442.53 $498.28 $696.34 $1,058.16 |
$688.17 $740.80 $796.55 $994.61 |
$986.44 $1,039.07 $1,094.82 $1,292.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.80 $885.06 $996.56 $1,392.68 $2,116.32 |
$1,078.07 $1,183.33 $1,294.83 $1,690.95 |
$1,376.34 $1,481.60 $1,593.10 $1,989.22 |
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 #52 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 |
$379.03 $430.20 $484.40 $676.95 $1,028.69 |
$668.99 $720.16 $774.36 $966.91 |
$958.95 $1,010.12 $1,064.32 $1,256.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.06 $860.40 $968.80 $1,353.90 $2,057.38 |
$1,048.02 $1,150.36 $1,258.76 $1,643.86 |
$1,337.98 $1,440.32 $1,548.72 $1,933.82 |
Toc - Plan #53 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 |
$279.49 $317.22 $357.18 $499.16 $758.52 |
$493.30 $531.03 $570.99 $712.97 |
$707.11 $744.84 $784.80 $926.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$558.98 $634.44 $714.36 $998.32 $1,517.04 |
$772.79 $848.25 $928.17 $1,212.13 |
$986.60 $1,062.06 $1,141.98 $1,425.94 |
Toc - Plan #54 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 |
$401.81 $456.06 $513.52 $717.64 $1,090.52 |
$709.20 $763.45 $820.91 $1,025.03 |
$1,016.59 $1,070.84 $1,128.30 $1,332.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$803.62 $912.12 $1,027.04 $1,435.28 $2,181.04 |
$1,111.01 $1,219.51 $1,334.43 $1,742.67 |
$1,418.40 $1,526.90 $1,641.82 $2,050.06 |
Toc - Plan #55 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 |
$310.92 $352.90 $397.36 $555.31 $843.85 |
$548.78 $590.76 $635.22 $793.17 |
$786.64 $828.62 $873.08 $1,031.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.84 $705.80 $794.72 $1,110.62 $1,687.70 |
$859.70 $943.66 $1,032.58 $1,348.48 |
$1,097.56 $1,181.52 $1,270.44 $1,586.34 |
Toc - Plan #56 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 |
$302.74 $343.61 $386.91 $540.70 $821.64 |
$534.34 $575.21 $618.51 $772.30 |
$765.94 $806.81 $850.11 $1,003.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$605.48 $687.22 $773.82 $1,081.40 $1,643.28 |
$837.08 $918.82 $1,005.42 $1,313.00 |
$1,068.68 $1,150.42 $1,237.02 $1,544.60 |
Toc - Plan #57 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 |
$400.19 $454.22 $511.45 $714.74 $1,086.12 |
$706.34 $760.37 $817.60 $1,020.89 |
$1,012.49 $1,066.52 $1,123.75 $1,327.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.38 $908.44 $1,022.90 $1,429.48 $2,172.24 |
$1,106.53 $1,214.59 $1,329.05 $1,735.63 |
$1,412.68 $1,520.74 $1,635.20 $2,041.78 |
Toc - Plan #58 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 |
$447.74 $508.18 $572.21 $799.66 $1,215.16 |
$790.26 $850.70 $914.73 $1,142.18 |
$1,132.78 $1,193.22 $1,257.25 $1,484.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$895.48 $1,016.36 $1,144.42 $1,599.32 $2,430.32 |
$1,238.00 $1,358.88 $1,486.94 $1,941.84 |
$1,580.52 $1,701.40 $1,829.46 $2,284.36 |
Toc - Plan #59 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 |
$475.76 $539.99 $608.03 $849.72 $1,291.22 |
$839.72 $903.95 $971.99 $1,213.68 |
$1,203.68 $1,267.91 $1,335.95 $1,577.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$951.52 $1,079.98 $1,216.06 $1,699.44 $2,582.44 |
$1,315.48 $1,443.94 $1,580.02 $2,063.40 |
$1,679.44 $1,807.90 $1,943.98 $2,427.36 |
Toc - Plan #60 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 |
$367.46 $417.07 $469.61 $656.28 $997.28 |
$648.57 $698.18 $750.72 $937.39 |
$929.68 $979.29 $1,031.83 $1,218.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.92 $834.14 $939.22 $1,312.56 $1,994.56 |
$1,016.03 $1,115.25 $1,220.33 $1,593.67 |
$1,297.14 $1,396.36 $1,501.44 $1,874.78 |
Toc - Plan #61 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 |
$332.15 $377.00 $424.49 $593.23 $901.47 |
$586.25 $631.10 $678.59 $847.33 |
$840.35 $885.20 $932.69 $1,101.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$664.30 $754.00 $848.98 $1,186.46 $1,802.94 |
$918.40 $1,008.10 $1,103.08 $1,440.56 |
$1,172.50 $1,262.20 $1,357.18 $1,694.66 |
Toc - Plan #62 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 |
$484.06 $549.41 $618.63 $864.54 $1,313.75 |
$854.37 $919.72 $988.94 $1,234.85 |
$1,224.68 $1,290.03 $1,359.25 $1,605.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$968.12 $1,098.82 $1,237.26 $1,729.08 $2,627.50 |
$1,338.43 $1,469.13 $1,607.57 $2,099.39 |
$1,708.74 $1,839.44 $1,977.88 $2,469.70 |
ADVERTISEMENT
Ambetter from Superior HealthplanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-877-941-9237 |
Toc - Plan #63 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 |
$344.79 $391.33 $440.63 $615.78 $935.74 |
$608.55 $655.09 $704.39 $879.54 |
$872.31 $918.85 $968.15 $1,143.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$689.58 $782.66 $881.26 $1,231.56 $1,871.48 |
$953.34 $1,046.42 $1,145.02 $1,495.32 |
$1,217.10 $1,310.18 $1,408.78 $1,759.08 |
Toc - Plan #64 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 |
$370.92 $420.98 $474.02 $662.45 $1,006.65 |
$654.67 $704.73 $757.77 $946.20 |
$938.42 $988.48 $1,041.52 $1,229.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.84 $841.96 $948.04 $1,324.90 $2,013.30 |
$1,025.59 $1,125.71 $1,231.79 $1,608.65 |
$1,309.34 $1,409.46 $1,515.54 $1,892.40 |
Toc - Plan #65 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 |
$493.14 $559.71 $630.22 $880.74 $1,338.36 |
$870.39 $936.96 $1,007.47 $1,257.99 |
$1,247.64 $1,314.21 $1,384.72 $1,635.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$986.28 $1,119.42 $1,260.44 $1,761.48 $2,676.72 |
$1,363.53 $1,496.67 $1,637.69 $2,138.73 |
$1,740.78 $1,873.92 $2,014.94 $2,515.98 |
‡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 Waller County here.
Waller County is in “Rating Area 10” of Texas.
Currently, there are 65 plans offered in Rating Area 10.