Obamacare 2023 Rates for Miami County
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Obamacare > Rates > Kansas > Miami County
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Blue Cross and Blue Shield of Kansas, Inc.Local: 1-785-291-4186 | Toll Free: 1-800-392-7366 | TTY: 1-800-430-1270 |
Toc - Plan #1 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Gold
(EPO) BlueCare EPO Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$462.65 $525.11 $591.27 $826.30 $1,255.64 |
$816.58 $879.04 $945.20 $1,180.23 |
$1,170.51 $1,232.97 $1,299.13 $1,534.16 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$925.30 $1,050.22 $1,182.54 $1,652.60 $2,511.28 |
$1,279.23 $1,404.15 $1,536.47 $2,006.53 |
$1,633.16 $1,758.08 $1,890.40 $2,360.46 |
Toc - Plan #2 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Gold
(EPO) BlueCare EPO Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$462.65 $525.11 $591.27 $826.30 $1,255.64 |
$816.58 $879.04 $945.20 $1,180.23 |
$1,170.51 $1,232.97 $1,299.13 $1,534.16 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$925.30 $1,050.22 $1,182.54 $1,652.60 $2,511.28 |
$1,279.23 $1,404.15 $1,536.47 $2,006.53 |
$1,633.16 $1,758.08 $1,890.40 $2,360.46 |
Toc - Plan #3 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$484.47 $549.87 $619.15 $865.26 $1,314.84 |
$855.09 $920.49 $989.77 $1,235.88 |
$1,225.71 $1,291.11 $1,360.39 $1,606.50 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$968.94 $1,099.74 $1,238.30 $1,730.52 $2,629.68 |
$1,339.56 $1,470.36 $1,608.92 $2,101.14 |
$1,710.18 $1,840.98 $1,979.54 $2,471.76 |
Toc - Plan #4 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$484.47 $549.87 $619.15 $865.26 $1,314.84 |
$855.09 $920.49 $989.77 $1,235.88 |
$1,225.71 $1,291.11 $1,360.39 $1,606.50 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$968.94 $1,099.74 $1,238.30 $1,730.52 $2,629.68 |
$1,339.56 $1,470.36 $1,608.92 $2,101.14 |
$1,710.18 $1,840.98 $1,979.54 $2,471.76 |
Toc - Plan #5 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Simple Silver HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$490.63 $556.86 $627.02 $876.26 $1,331.56 |
$865.96 $932.19 $1,002.35 $1,251.59 |
$1,241.29 $1,307.52 $1,377.68 $1,626.92 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$981.26 $1,113.72 $1,254.04 $1,752.52 $2,663.12 |
$1,356.59 $1,489.05 $1,629.37 $2,127.85 |
$1,731.92 $1,864.38 $2,004.70 $2,503.18 |
Toc - Plan #6 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Simple Silver HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$490.63 $556.86 $627.02 $876.26 $1,331.56 |
$865.96 $932.19 $1,002.35 $1,251.59 |
$1,241.29 $1,307.52 $1,377.68 $1,626.92 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$981.26 $1,113.72 $1,254.04 $1,752.52 $2,663.12 |
$1,356.59 $1,489.05 $1,629.37 $2,127.85 |
$1,731.92 $1,864.38 $2,004.70 $2,503.18 |
Toc - Plan #7 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueCare EPO Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 $417.17 $469.73 $656.44 $997.53 |
$648.73 $698.35 $750.91 $937.62 |
$929.91 $979.53 $1,032.09 $1,218.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$735.10 $834.34 $939.46 $1,312.88 $1,995.06 |
$1,016.28 $1,115.52 $1,220.64 $1,594.06 |
$1,297.46 $1,396.70 $1,501.82 $1,875.24 |
Toc - Plan #8 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueCare EPO Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$367.55 $417.17 $469.73 $656.44 $997.53 |
$648.73 $698.35 $750.91 $937.62 |
$929.91 $979.53 $1,032.09 $1,218.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$735.10 $834.34 $939.46 $1,312.88 $1,995.06 |
$1,016.28 $1,115.52 $1,220.64 $1,594.06 |
$1,297.46 $1,396.70 $1,501.82 $1,875.24 |
Toc - Plan #9 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueCare EPO Simple Bronze HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$367.55 $417.17 $469.73 $656.44 $997.53 |
$648.73 $698.35 $750.91 $937.62 |
$929.91 $979.53 $1,032.09 $1,218.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.10 $834.34 $939.46 $1,312.88 $1,995.06 |
$1,016.28 $1,115.52 $1,220.64 $1,594.06 |
$1,297.46 $1,396.70 $1,501.82 $1,875.24 |
Toc - Plan #10 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueCare EPO Simple Bronze HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$367.55 $417.17 $469.73 $656.44 $997.53 |
$648.73 $698.35 $750.91 $937.62 |
$929.91 $979.53 $1,032.09 $1,218.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$735.10 $834.34 $939.46 $1,312.88 $1,995.06 |
$1,016.28 $1,115.52 $1,220.64 $1,594.06 |
$1,297.46 $1,396.70 $1,501.82 $1,875.24 |
Toc - Plan #11 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Silver Plus |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$466.57 $529.55 $596.27 $833.29 $1,266.26 |
$823.49 $886.47 $953.19 $1,190.21 |
$1,180.41 $1,243.39 $1,310.11 $1,547.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$933.14 $1,059.10 $1,192.54 $1,666.58 $2,532.52 |
$1,290.06 $1,416.02 $1,549.46 $2,023.50 |
$1,646.98 $1,772.94 $1,906.38 $2,380.42 |
Toc - Plan #12 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Silver Plus |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$466.57 $529.55 $596.27 $833.29 $1,266.26 |
$823.49 $886.47 $953.19 $1,190.21 |
$1,180.41 $1,243.39 $1,310.11 $1,547.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$933.14 $1,059.10 $1,192.54 $1,666.58 $2,532.52 |
$1,290.06 $1,416.02 $1,549.46 $2,023.50 |
$1,646.98 $1,772.94 $1,906.38 $2,380.42 |
Toc - Plan #13 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Bronze
(EPO) BlueCare EPO Standardized Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$339.57 $385.42 $433.98 $606.48 $921.60 |
$599.34 $645.19 $693.75 $866.25 |
$859.11 $904.96 $953.52 $1,126.02 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$679.14 $770.84 $867.96 $1,212.96 $1,843.20 |
$938.91 $1,030.61 $1,127.73 $1,472.73 |
$1,198.68 $1,290.38 $1,387.50 $1,732.50 |
Toc - Plan #14 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Bronze
(EPO) BlueCare EPO Standardized Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$339.57 $385.42 $433.98 $606.48 $921.60 |
$599.34 $645.19 $693.75 $866.25 |
$859.11 $904.96 $953.52 $1,126.02 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$679.14 $770.84 $867.96 $1,212.96 $1,843.20 |
$938.91 $1,030.61 $1,127.73 $1,472.73 |
$1,198.68 $1,290.38 $1,387.50 $1,732.50 |
Toc - Plan #15 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueCare EPO Standardized Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$361.96 $410.82 $462.58 $646.45 $982.35 |
$638.86 $687.72 $739.48 $923.35 |
$915.76 $964.62 $1,016.38 $1,200.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$723.92 $821.64 $925.16 $1,292.90 $1,964.70 |
$1,000.82 $1,098.54 $1,202.06 $1,569.80 |
$1,277.72 $1,375.44 $1,478.96 $1,846.70 |
Toc - Plan #16 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueCare EPO Standardized Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$361.96 $410.82 $462.58 $646.45 $982.35 |
$638.86 $687.72 $739.48 $923.35 |
$915.76 $964.62 $1,016.38 $1,200.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$723.92 $821.64 $925.16 $1,292.90 $1,964.70 |
$1,000.82 $1,098.54 $1,202.06 $1,569.80 |
$1,277.72 $1,375.44 $1,478.96 $1,846.70 |
Toc - Plan #17 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Standardized Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$472.16 $535.90 $603.42 $843.28 $1,281.44 |
$833.36 $897.10 $964.62 $1,204.48 |
$1,194.56 $1,258.30 $1,325.82 $1,565.68 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$944.32 $1,071.80 $1,206.84 $1,686.56 $2,562.88 |
$1,305.52 $1,433.00 $1,568.04 $2,047.76 |
$1,666.72 $1,794.20 $1,929.24 $2,408.96 |
Toc - Plan #18 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Silver
(EPO) BlueCare EPO Standardized Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$472.16 $535.90 $603.42 $843.28 $1,281.44 |
$833.36 $897.10 $964.62 $1,204.48 |
$1,194.56 $1,258.30 $1,325.82 $1,565.68 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$944.32 $1,071.80 $1,206.84 $1,686.56 $2,562.88 |
$1,305.52 $1,433.00 $1,568.04 $2,047.76 |
$1,666.72 $1,794.20 $1,929.24 $2,408.96 |
Toc - Plan #19 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Gold
(EPO) BlueCare EPO Standardized Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$438.59 $497.80 $560.52 $783.33 $1,190.34 |
$774.11 $833.32 $896.04 $1,118.85 |
$1,109.63 $1,168.84 $1,231.56 $1,454.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$877.18 $995.60 $1,121.04 $1,566.66 $2,380.68 |
$1,212.70 $1,331.12 $1,456.56 $1,902.18 |
$1,548.22 $1,666.64 $1,792.08 $2,237.70 |
Toc - Plan #20 Blue Cross and Blue Shield of Kansas, Inc. | ||||||||||||||||||||
Gold
(EPO) BlueCare EPO Standardized Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-392-7366
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 |
$438.59 $497.80 $560.52 $783.33 $1,190.34 |
$774.11 $833.32 $896.04 $1,118.85 |
$1,109.63 $1,168.84 $1,231.56 $1,454.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$877.18 $995.60 $1,121.04 $1,566.66 $2,380.68 |
$1,212.70 $1,331.12 $1,456.56 $1,902.18 |
$1,548.22 $1,666.64 $1,792.08 $2,237.70 |
ADVERTISEMENT
Ambetter from Sunflower Health PlanLocal: 1-844-518-9505 | Toll Free: 1-844-518-9505 | TTY: 1-844-546-9713 |
Toc - Plan #21 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Complete Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
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 |
$365.05 $414.32 $466.52 $651.96 $990.72 |
$644.31 $693.58 $745.78 $931.22 |
$923.57 $972.84 $1,025.04 $1,210.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.10 $828.64 $933.04 $1,303.92 $1,981.44 |
$1,009.36 $1,107.90 $1,212.30 $1,583.18 |
$1,288.62 $1,387.16 $1,491.56 $1,862.44 |
Toc - Plan #22 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Complete Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.10 $435.95 $490.87 $685.99 $1,042.43 |
$677.93 $729.78 $784.70 $979.82 |
$971.76 $1,023.61 $1,078.53 $1,273.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$768.20 $871.90 $981.74 $1,371.98 $2,084.86 |
$1,062.03 $1,165.73 $1,275.57 $1,665.81 |
$1,355.86 $1,459.56 $1,569.40 $1,959.64 |
Toc - Plan #23 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.75 $319.77 $360.06 $503.18 $764.64 |
$497.28 $535.30 $575.59 $718.71 |
$712.81 $750.83 $791.12 $934.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$563.50 $639.54 $720.12 $1,006.36 $1,529.28 |
$779.03 $855.07 $935.65 $1,221.89 |
$994.56 $1,070.60 $1,151.18 $1,437.42 |
Toc - Plan #24 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$309.27 $351.01 $395.24 $552.34 $839.34 |
$545.85 $587.59 $631.82 $788.92 |
$782.43 $824.17 $868.40 $1,025.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$618.54 $702.02 $790.48 $1,104.68 $1,678.68 |
$855.12 $938.60 $1,027.06 $1,341.26 |
$1,091.70 $1,175.18 $1,263.64 $1,577.84 |
Toc - Plan #25 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.57 $417.18 $469.74 $656.46 $997.55 |
$648.75 $698.36 $750.92 $937.64 |
$929.93 $979.54 $1,032.10 $1,218.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.14 $834.36 $939.48 $1,312.92 $1,995.10 |
$1,016.32 $1,115.54 $1,220.66 $1,594.10 |
$1,297.50 $1,396.72 $1,501.84 $1,875.28 |
Toc - Plan #26 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$302.12 $342.89 $386.09 $539.56 $819.92 |
$533.23 $574.00 $617.20 $770.67 |
$764.34 $805.11 $848.31 $1,001.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$604.24 $685.78 $772.18 $1,079.12 $1,639.84 |
$835.35 $916.89 $1,003.29 $1,310.23 |
$1,066.46 $1,148.00 $1,234.40 $1,541.34 |
Toc - Plan #27 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.03 $387.06 $435.82 $609.06 $925.53 |
$601.91 $647.94 $696.70 $869.94 |
$862.79 $908.82 $957.58 $1,130.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.06 $774.12 $871.64 $1,218.12 $1,851.06 |
$942.94 $1,035.00 $1,132.52 $1,479.00 |
$1,203.82 $1,295.88 $1,393.40 $1,739.88 |
Toc - Plan #28 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.58 $404.71 $455.70 $636.83 $967.73 |
$629.36 $677.49 $728.48 $909.61 |
$902.14 $950.27 $1,001.26 $1,182.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$713.16 $809.42 $911.40 $1,273.66 $1,935.46 |
$985.94 $1,082.20 $1,184.18 $1,546.44 |
$1,258.72 $1,354.98 $1,456.96 $1,819.22 |
Toc - Plan #29 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.12 $408.73 $460.22 $643.16 $977.34 |
$635.61 $684.22 $735.71 $918.65 |
$911.10 $959.71 $1,011.20 $1,194.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$720.24 $817.46 $920.44 $1,286.32 $1,954.68 |
$995.73 $1,092.95 $1,195.93 $1,561.81 |
$1,271.22 $1,368.44 $1,471.42 $1,837.30 |
Toc - Plan #30 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Premier Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.32 $419.17 $471.98 $659.59 $1,002.31 |
$651.84 $701.69 $754.50 $942.11 |
$934.36 $984.21 $1,037.02 $1,224.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$738.64 $838.34 $943.96 $1,319.18 $2,004.62 |
$1,021.16 $1,120.86 $1,226.48 $1,601.70 |
$1,303.68 $1,403.38 $1,509.00 $1,884.22 |
Toc - Plan #31 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.84 $479.91 $540.37 $755.17 $1,147.55 |
$746.30 $803.37 $863.83 $1,078.63 |
$1,069.76 $1,126.83 $1,187.29 $1,402.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.68 $959.82 $1,080.74 $1,510.34 $2,295.10 |
$1,169.14 $1,283.28 $1,404.20 $1,833.80 |
$1,492.60 $1,606.74 $1,727.66 $2,157.26 |
Toc - Plan #32 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.17 $336.14 $378.49 $528.94 $803.77 |
$522.73 $562.70 $605.05 $755.50 |
$749.29 $789.26 $831.61 $982.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$592.34 $672.28 $756.98 $1,057.88 $1,607.54 |
$818.90 $898.84 $983.54 $1,284.44 |
$1,045.46 $1,125.40 $1,210.10 $1,511.00 |
Toc - Plan #33 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.05 $405.25 $456.30 $637.68 $969.02 |
$630.19 $678.39 $729.44 $910.82 |
$903.33 $951.53 $1,002.58 $1,183.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.10 $810.50 $912.60 $1,275.36 $1,938.04 |
$987.24 $1,083.64 $1,185.74 $1,548.50 |
$1,260.38 $1,356.78 $1,458.88 $1,821.64 |
Toc - Plan #34 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.36 $413.53 $465.63 $650.72 $988.83 |
$643.08 $692.25 $744.35 $929.44 |
$921.80 $970.97 $1,023.07 $1,208.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$728.72 $827.06 $931.26 $1,301.44 $1,977.66 |
$1,007.44 $1,105.78 $1,209.98 $1,580.16 |
$1,286.16 $1,384.50 $1,488.70 $1,858.88 |
Toc - Plan #35 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.10 $331.52 $373.29 $521.67 $792.72 |
$515.55 $554.97 $596.74 $745.12 |
$739.00 $778.42 $820.19 $968.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$584.20 $663.04 $746.58 $1,043.34 $1,585.44 |
$807.65 $886.49 $970.03 $1,266.79 |
$1,031.10 $1,109.94 $1,193.48 $1,490.24 |
Toc - Plan #36 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.21 $451.96 $508.91 $711.19 $1,080.73 |
$702.84 $756.59 $813.54 $1,015.82 |
$1,007.47 $1,061.22 $1,118.17 $1,320.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$796.42 $903.92 $1,017.82 $1,422.38 $2,161.46 |
$1,101.05 $1,208.55 $1,322.45 $1,727.01 |
$1,405.68 $1,513.18 $1,627.08 $2,031.64 |
Toc - Plan #37 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.46 $429.54 $483.66 $675.91 $1,027.11 |
$667.97 $719.05 $773.17 $965.42 |
$957.48 $1,008.56 $1,062.68 $1,254.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.92 $859.08 $967.32 $1,351.82 $2,054.22 |
$1,046.43 $1,148.59 $1,256.83 $1,641.33 |
$1,335.94 $1,438.10 $1,546.34 $1,930.84 |
Toc - Plan #38 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320.63 $363.91 $409.76 $572.63 $870.17 |
$565.91 $609.19 $655.04 $817.91 |
$811.19 $854.47 $900.32 $1,063.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$641.26 $727.82 $819.52 $1,145.26 $1,740.34 |
$886.54 $973.10 $1,064.80 $1,390.54 |
$1,131.82 $1,218.38 $1,310.08 $1,635.82 |
Toc - Plan #39 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.07 $432.50 $487.00 $680.57 $1,034.20 |
$672.58 $724.01 $778.51 $972.08 |
$964.09 $1,015.52 $1,070.02 $1,263.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.14 $865.00 $974.00 $1,361.14 $2,068.40 |
$1,053.65 $1,156.51 $1,265.51 $1,652.65 |
$1,345.16 $1,448.02 $1,557.02 $1,944.16 |
Toc - Plan #40 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$313.21 $355.49 $400.28 $559.38 $850.04 |
$552.81 $595.09 $639.88 $798.98 |
$792.41 $834.69 $879.48 $1,038.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$626.42 $710.98 $800.56 $1,118.76 $1,700.08 |
$866.02 $950.58 $1,040.16 $1,358.36 |
$1,105.62 $1,190.18 $1,279.76 $1,597.96 |
Toc - Plan #41 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.56 $401.28 $451.83 $631.44 $959.53 |
$624.02 $671.74 $722.29 $901.90 |
$894.48 $942.20 $992.75 $1,172.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.12 $802.56 $903.66 $1,262.88 $1,919.06 |
$977.58 $1,073.02 $1,174.12 $1,533.34 |
$1,248.04 $1,343.48 $1,444.58 $1,803.80 |
Toc - Plan #42 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.35 $423.74 $477.13 $666.79 $1,013.25 |
$658.96 $709.35 $762.74 $952.40 |
$944.57 $994.96 $1,048.35 $1,238.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.70 $847.48 $954.26 $1,333.58 $2,026.50 |
$1,032.31 $1,133.09 $1,239.87 $1,619.19 |
$1,317.92 $1,418.70 $1,525.48 $1,904.80 |
Toc - Plan #43 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.68 $419.57 $472.44 $660.23 $1,003.28 |
$652.48 $702.37 $755.24 $943.03 |
$935.28 $985.17 $1,038.04 $1,225.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$739.36 $839.14 $944.88 $1,320.46 $2,006.56 |
$1,022.16 $1,121.94 $1,227.68 $1,603.26 |
$1,304.96 $1,404.74 $1,510.48 $1,886.06 |
Toc - Plan #44 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Premier Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
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 $683.82 $1,039.13 |
$675.79 $727.47 $782.22 $976.72 |
$968.69 $1,020.37 $1,075.12 $1,269.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.78 $869.14 $978.64 $1,367.64 $2,078.26 |
$1,058.68 $1,162.04 $1,271.54 $1,660.54 |
$1,351.58 $1,454.94 $1,564.44 $1,953.44 |
Toc - Plan #45 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$438.37 $497.54 $560.22 $782.91 $1,189.70 |
$773.71 $832.88 $895.56 $1,118.25 |
$1,109.05 $1,168.22 $1,230.90 $1,453.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$876.74 $995.08 $1,120.44 $1,565.82 $2,379.40 |
$1,212.08 $1,330.42 $1,455.78 $1,901.16 |
$1,547.42 $1,665.76 $1,791.12 $2,236.50 |
Toc - Plan #46 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Virtual Access Bronze - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$294.41 $334.15 $376.25 $525.81 $799.01 |
$519.63 $559.37 $601.47 $751.03 |
$744.85 $784.59 $826.69 $976.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$588.82 $668.30 $752.50 $1,051.62 $1,598.02 |
$814.04 $893.52 $977.72 $1,276.84 |
$1,039.26 $1,118.74 $1,202.94 $1,502.06 |
Toc - Plan #47 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Silver
(EPO) Ambetter Virtual Access Silver - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.31 $399.86 $450.24 $629.21 $956.14 |
$621.82 $669.37 $719.75 $898.72 |
$891.33 $938.88 $989.26 $1,168.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.62 $799.72 $900.48 $1,258.42 $1,912.28 |
$974.13 $1,069.23 $1,169.99 $1,527.93 |
$1,243.64 $1,338.74 $1,439.50 $1,797.44 |
Toc - Plan #48 Ambetter from Sunflower Health Plan | ||||||||||||||||||||
Gold
(EPO) Ambetter Virtual Access Gold - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-518-9505
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.04 $423.39 $476.74 $666.24 $1,012.41 |
$658.41 $708.76 $762.11 $951.61 |
$943.78 $994.13 $1,047.48 $1,236.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.08 $846.78 $953.48 $1,332.48 $2,024.82 |
$1,031.45 $1,132.15 $1,238.85 $1,617.85 |
$1,316.82 $1,417.52 $1,524.22 $1,903.22 |
ADVERTISEMENT
MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-866-735-2957 |
Toc - Plan #49 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Select by Medica Bronze HSA ($0 Virtual Care after deductible with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.04 $472.19 $531.69 $743.03 $1,129.10 |
$734.30 $790.45 $849.95 $1,061.29 |
$1,052.56 $1,108.71 $1,168.21 $1,379.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.08 $944.38 $1,063.38 $1,486.06 $2,258.20 |
$1,150.34 $1,262.64 $1,381.64 $1,804.32 |
$1,468.60 $1,580.90 $1,699.90 $2,122.58 |
Toc - Plan #50 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Select by Medica Catastrophic ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$247.06 $280.40 $315.72 $441.22 $670.48 |
$436.05 $469.39 $504.71 $630.21 |
$625.04 $658.38 $693.70 $819.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$494.12 $560.80 $631.44 $882.44 $1,340.96 |
$683.11 $749.79 $820.43 $1,071.43 |
$872.10 $938.78 $1,009.42 $1,260.42 |
Toc - Plan #51 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Select by Medica Bronze Share Plus ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.80 $402.68 $453.42 $633.65 $962.89 |
$626.21 $674.09 $724.83 $905.06 |
$897.62 $945.50 $996.24 $1,176.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$709.60 $805.36 $906.84 $1,267.30 $1,925.78 |
$981.01 $1,076.77 $1,178.25 $1,538.71 |
$1,252.42 $1,348.18 $1,449.66 $1,810.12 |
Toc - Plan #52 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Select by Medica Bronze Copay $0 PCP ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.30 $390.77 $440.01 $614.91 $934.41 |
$607.68 $654.15 $703.39 $878.29 |
$871.06 $917.53 $966.77 $1,141.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.60 $781.54 $880.02 $1,229.82 $1,868.82 |
$951.98 $1,044.92 $1,143.40 $1,493.20 |
$1,215.36 $1,308.30 $1,406.78 $1,756.58 |
Toc - Plan #53 Medica | ||||||||||||||||||||
Gold
(EPO) Select by Medica Gold Copay $0 PCP ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$510.57 $579.49 $652.50 $911.86 $1,385.66 |
$901.15 $970.07 $1,043.08 $1,302.44 |
$1,291.73 $1,360.65 $1,433.66 $1,693.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,021.14 $1,158.98 $1,305.00 $1,823.72 $2,771.32 |
$1,411.72 $1,549.56 $1,695.58 $2,214.30 |
$1,802.30 $1,940.14 $2,086.16 $2,604.88 |
Toc - Plan #54 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Select by Medica Bronze Premier ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.66 $392.31 $441.74 $617.33 $938.10 |
$610.08 $656.73 $706.16 $881.75 |
$874.50 $921.15 $970.58 $1,146.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$691.32 $784.62 $883.48 $1,234.66 $1,876.20 |
$955.74 $1,049.04 $1,147.90 $1,499.08 |
$1,220.16 $1,313.46 $1,412.32 $1,763.50 |
Toc - Plan #55 Medica | ||||||||||||||||||||
Gold
(EPO) Select by Medica Gold Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$484.43 $549.81 $619.09 $865.17 $1,314.71 |
$855.01 $920.39 $989.67 $1,235.75 |
$1,225.59 $1,290.97 $1,360.25 $1,606.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$968.86 $1,099.62 $1,238.18 $1,730.34 $2,629.42 |
$1,339.44 $1,470.20 $1,608.76 $2,100.92 |
$1,710.02 $1,840.78 $1,979.34 $2,471.50 |
Toc - Plan #56 Medica | ||||||||||||||||||||
Silver
(EPO) Select by Medica Silver Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$527.58 $598.79 $674.23 $942.24 $1,431.82 |
$931.17 $1,002.38 $1,077.82 $1,345.83 |
$1,334.76 $1,405.97 $1,481.41 $1,749.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,055.16 $1,197.58 $1,348.46 $1,884.48 $2,863.64 |
$1,458.75 $1,601.17 $1,752.05 $2,288.07 |
$1,862.34 $2,004.76 $2,155.64 $2,691.66 |
Toc - Plan #57 Medica | ||||||||||||||||||||
Bronze
(EPO) Select by Medica Bronze Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.04 $377.99 $425.61 $594.79 $903.85 |
$587.81 $632.76 $680.38 $849.56 |
$842.58 $887.53 $935.15 $1,104.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666.08 $755.98 $851.22 $1,189.58 $1,807.70 |
$920.85 $1,010.75 $1,105.99 $1,444.35 |
$1,175.62 $1,265.52 $1,360.76 $1,699.12 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #58 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 5900 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$404.53 $459.14 $516.99 $722.49 $1,097.90 |
$714.00 $768.61 $826.46 $1,031.96 |
$1,023.47 $1,078.08 $1,135.93 $1,341.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$809.06 $918.28 $1,033.98 $1,444.98 $2,195.80 |
$1,118.53 $1,227.75 $1,343.45 $1,754.45 |
$1,428.00 $1,537.22 $1,652.92 $2,063.92 |
Toc - Plan #59 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 5000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.46 $489.71 $551.41 $770.60 $1,170.99 |
$761.53 $819.78 $881.48 $1,100.67 |
$1,091.60 $1,149.85 $1,211.55 $1,430.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$862.92 $979.42 $1,102.82 $1,541.20 $2,341.98 |
$1,192.99 $1,309.49 $1,432.89 $1,871.27 |
$1,523.06 $1,639.56 $1,762.96 $2,201.34 |
Toc - Plan #60 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$519.39 $589.51 $663.78 $927.63 $1,409.63 |
$916.72 $986.84 $1,061.11 $1,324.96 |
$1,314.05 $1,384.17 $1,458.44 $1,722.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,038.78 $1,179.02 $1,327.56 $1,855.26 $2,819.26 |
$1,436.11 $1,576.35 $1,724.89 $2,252.59 |
$1,833.44 $1,973.68 $2,122.22 $2,649.92 |
Toc - Plan #61 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 3500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$436.07 $494.94 $557.30 $778.82 $1,183.50 |
$769.67 $828.54 $890.90 $1,112.42 |
$1,103.27 $1,162.14 $1,224.50 $1,446.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$872.14 $989.88 $1,114.60 $1,557.64 $2,367.00 |
$1,205.74 $1,323.48 $1,448.20 $1,891.24 |
$1,539.34 $1,657.08 $1,781.80 $2,224.84 |
Toc - Plan #62 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 3800 Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$434.87 $493.57 $555.76 $776.67 $1,180.22 |
$767.54 $826.24 $888.43 $1,109.34 |
$1,100.21 $1,158.91 $1,221.10 $1,442.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$869.74 $987.14 $1,111.52 $1,553.34 $2,360.44 |
$1,202.41 $1,319.81 $1,444.19 $1,886.01 |
$1,535.08 $1,652.48 $1,776.86 $2,218.68 |
Toc - Plan #63 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 6800 Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403.27 $457.71 $515.38 $720.24 $1,094.48 |
$711.77 $766.21 $823.88 $1,028.74 |
$1,020.27 $1,074.71 $1,132.38 $1,337.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$806.54 $915.42 $1,030.76 $1,440.48 $2,188.96 |
$1,115.04 $1,223.92 $1,339.26 $1,748.98 |
$1,423.54 $1,532.42 $1,647.76 $2,057.48 |
Toc - Plan #64 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect HSA 7050 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$404.37 $458.96 $516.78 $722.20 $1,097.45 |
$713.71 $768.30 $826.12 $1,031.54 |
$1,023.05 $1,077.64 $1,135.46 $1,340.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$808.74 $917.92 $1,033.56 $1,444.40 $2,194.90 |
$1,118.08 $1,227.26 $1,342.90 $1,753.74 |
$1,427.42 $1,536.60 $1,652.24 $2,063.08 |
Toc - Plan #65 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 4200 Enhanced Asthma COPD Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.27 $491.77 $553.72 $773.83 $1,175.91 |
$764.72 $823.22 $885.17 $1,105.28 |
$1,096.17 $1,154.67 $1,216.62 $1,436.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.54 $983.54 $1,107.44 $1,547.66 $2,351.82 |
$1,197.99 $1,314.99 $1,438.89 $1,879.11 |
$1,529.44 $1,646.44 $1,770.34 $2,210.56 |
Toc - Plan #66 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 1900 Enhanced Diabetes Care |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$524.11 $594.86 $669.81 $936.06 $1,422.43 |
$925.05 $995.80 $1,070.75 $1,337.00 |
$1,325.99 $1,396.74 $1,471.69 $1,737.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,048.22 $1,189.72 $1,339.62 $1,872.12 $2,844.86 |
$1,449.16 $1,590.66 $1,740.56 $2,273.06 |
$1,850.10 $1,991.60 $2,141.50 $2,674.00 |
Toc - Plan #67 Cigna Healthcare | ||||||||||||||||||||
Bronze
(EPO) Cigna Simple Choice 9100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$385.06 $437.04 $492.11 $687.72 $1,045.05 |
$679.63 $731.61 $786.68 $982.29 |
$974.20 $1,026.18 $1,081.25 $1,276.86 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$770.12 $874.08 $984.22 $1,375.44 $2,090.10 |
$1,064.69 $1,168.65 $1,278.79 $1,670.01 |
$1,359.26 $1,463.22 $1,573.36 $1,964.58 |
Toc - Plan #68 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Simple Choice 7500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.75 $454.85 $512.16 $715.73 $1,087.63 |
$707.32 $761.42 $818.73 $1,022.30 |
$1,013.89 $1,067.99 $1,125.30 $1,328.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$801.50 $909.70 $1,024.32 $1,431.46 $2,175.26 |
$1,108.07 $1,216.27 $1,330.89 $1,738.03 |
$1,414.64 $1,522.84 $1,637.46 $2,044.60 |
Toc - Plan #69 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Simple Choice 5800 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.74 $490.02 $551.76 $771.09 $1,171.74 |
$762.02 $820.30 $882.04 $1,101.37 |
$1,092.30 $1,150.58 $1,212.32 $1,431.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$863.48 $980.04 $1,103.52 $1,542.18 $2,343.48 |
$1,193.76 $1,310.32 $1,433.80 $1,872.46 |
$1,524.04 $1,640.60 $1,764.08 $2,202.74 |
Toc - Plan #70 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Simple Choice 2000 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$520.76 $591.07 $665.54 $930.08 $1,413.35 |
$919.14 $989.45 $1,063.92 $1,328.46 |
$1,317.52 $1,387.83 $1,462.30 $1,726.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,041.52 $1,182.14 $1,331.08 $1,860.16 $2,826.70 |
$1,439.90 $1,580.52 $1,729.46 $2,258.54 |
$1,838.28 $1,978.90 $2,127.84 $2,656.92 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-877-632-4195 | Toll Free: 1-877-632-4195 | TTY: 1-866-761-7748 |
Toc - Plan #71 UnitedHealthcare | ||||||||||||||||||||
Gold
(EPO) UHC Gold Value ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.24 $429.30 $483.39 $675.54 $1,026.55 |
$667.59 $718.65 $772.74 $964.89 |
$956.94 $1,008.00 $1,062.09 $1,254.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.48 $858.60 $966.78 $1,351.08 $2,053.10 |
$1,045.83 $1,147.95 $1,256.13 $1,640.43 |
$1,335.18 $1,437.30 $1,545.48 $1,929.78 |
Toc - Plan #72 UnitedHealthcare | ||||||||||||||||||||
Gold
(EPO) UHC Gold Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.94 $443.72 $499.62 $698.22 $1,061.01 |
$690.01 $742.79 $798.69 $997.29 |
$989.08 $1,041.86 $1,097.76 $1,296.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.88 $887.44 $999.24 $1,396.44 $2,122.02 |
$1,080.95 $1,186.51 $1,298.31 $1,695.51 |
$1,380.02 $1,485.58 $1,597.38 $1,994.58 |
Toc - Plan #73 UnitedHealthcare | ||||||||||||||||||||
Gold
(EPO) UHC Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.80 $434.48 $489.22 $683.68 $1,038.92 |
$675.64 $727.32 $782.06 $976.52 |
$968.48 $1,020.16 $1,074.90 $1,269.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.60 $868.96 $978.44 $1,367.36 $2,077.84 |
$1,058.44 $1,161.80 $1,271.28 $1,660.20 |
$1,351.28 $1,454.64 $1,564.12 $1,953.04 |
Toc - Plan #74 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Value $4,000 Medical Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.72 $418.50 $471.22 $658.53 $1,000.71 |
$650.79 $700.57 $753.29 $940.60 |
$932.86 $982.64 $1,035.36 $1,222.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$737.44 $837.00 $942.44 $1,317.06 $2,001.42 |
$1,019.51 $1,119.07 $1,224.51 $1,599.13 |
$1,301.58 $1,401.14 $1,506.58 $1,881.20 |
Toc - Plan #75 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Advantage ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.92 $414.18 $466.37 $651.75 $990.39 |
$644.08 $693.34 $745.53 $930.91 |
$923.24 $972.50 $1,024.69 $1,210.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.84 $828.36 $932.74 $1,303.50 $1,980.78 |
$1,009.00 $1,107.52 $1,211.90 $1,582.66 |
$1,288.16 $1,386.68 $1,491.06 $1,861.82 |
Toc - Plan #76 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.24 $429.30 $483.39 $675.53 $1,026.53 |
$667.59 $718.65 $772.74 $964.88 |
$956.94 $1,008.00 $1,062.09 $1,254.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.48 $858.60 $966.78 $1,351.06 $2,053.06 |
$1,045.83 $1,147.95 $1,256.13 $1,640.41 |
$1,335.18 $1,437.30 $1,545.48 $1,929.76 |
Toc - Plan #77 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Advantage $0 Medical Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.84 $418.64 $471.38 $658.76 $1,001.04 |
$651.01 $700.81 $753.55 $940.93 |
$933.18 $982.98 $1,035.72 $1,223.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$737.68 $837.28 $942.76 $1,317.52 $2,002.08 |
$1,019.85 $1,119.45 $1,224.93 $1,599.69 |
$1,302.02 $1,401.62 $1,507.10 $1,881.86 |
Toc - Plan #78 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.14 $421.24 $474.31 $662.85 $1,007.26 |
$655.06 $705.16 $758.23 $946.77 |
$938.98 $989.08 $1,042.15 $1,230.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.28 $842.48 $948.62 $1,325.70 $2,014.52 |
$1,026.20 $1,126.40 $1,232.54 $1,609.62 |
$1,310.12 $1,410.32 $1,516.46 $1,893.54 |
Toc - Plan #79 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Value HSA $5,400 Indiv Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.47 $422.75 $476.02 $665.23 $1,010.88 |
$657.41 $707.69 $760.96 $950.17 |
$942.35 $992.63 $1,045.90 $1,235.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$744.94 $845.50 $952.04 $1,330.46 $2,021.76 |
$1,029.88 $1,130.44 $1,236.98 $1,615.40 |
$1,314.82 $1,415.38 $1,521.92 $1,900.34 |
Toc - Plan #80 UnitedHealthcare | ||||||||||||||||||||
Bronze
(EPO) UHC Bronze Essential ($3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$267.51 $303.62 $341.87 $477.77 $726.01 |
$472.15 $508.26 $546.51 $682.41 |
$676.79 $712.90 $751.15 $887.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$535.02 $607.24 $683.74 $955.54 $1,452.02 |
$739.66 $811.88 $888.38 $1,160.18 |
$944.30 $1,016.52 $1,093.02 $1,364.82 |
Toc - Plan #81 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) UHC Bronze Value $6,500 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.83 $310.79 $349.95 $489.05 $743.16 |
$483.31 $520.27 $559.43 $698.53 |
$692.79 $729.75 $768.91 $908.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$547.66 $621.58 $699.90 $978.10 $1,486.32 |
$757.14 $831.06 $909.38 $1,187.58 |
$966.62 $1,040.54 $1,118.86 $1,397.06 |
Toc - Plan #82 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) UHC Bronze Value HSA $6,700 Indiv Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$272.41 $309.18 $348.14 $486.52 $739.32 |
$480.80 $517.57 $556.53 $694.91 |
$689.19 $725.96 $764.92 $903.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$544.82 $618.36 $696.28 $973.04 $1,478.64 |
$753.21 $826.75 $904.67 $1,181.43 |
$961.60 $1,035.14 $1,113.06 $1,389.82 |
Toc - Plan #83 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) UHC Bronze Standard $7,500 Indiv Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$269.44 $305.82 $344.35 $481.23 $731.27 |
$475.56 $511.94 $550.47 $687.35 |
$681.68 $718.06 $756.59 $893.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$538.88 $611.64 $688.70 $962.46 $1,462.54 |
$745.00 $817.76 $894.82 $1,168.58 |
$951.12 $1,023.88 $1,100.94 $1,374.70 |
Toc - Plan #84 UnitedHealthcare | ||||||||||||||||||||
Bronze
(EPO) UHC Bronze Standard $9,100 Indiv Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$260.17 $295.29 $332.49 $464.66 $706.09 |
$459.20 $494.32 $531.52 $663.69 |
$658.23 $693.35 $730.55 $862.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$520.34 $590.58 $664.98 $929.32 $1,412.18 |
$719.37 $789.61 $864.01 $1,128.35 |
$918.40 $988.64 $1,063.04 $1,327.38 |
‡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 Miami County here.
Miami County is in “Rating Area 1” of Kansas.
Currently, there are 84 plans offered in Rating Area 1.