Obamacare 2023 Rates for Stark County
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AultCare Insurance CompanyLocal: 1-330-363-6360 | Toll Free: 1-800-344-8858 | TTY: 1-171-1- |
Toc - Plan #1 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 5750 No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$433.65 $492.18 $554.19 $774.48 $1,176.90 |
$765.38 $823.91 $885.92 $1,106.21 |
$1,097.11 $1,155.64 $1,217.65 $1,437.94 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$867.30 $984.36 $1,108.38 $1,548.96 $2,353.80 |
$1,199.03 $1,316.09 $1,440.11 $1,880.69 |
$1,530.76 $1,647.82 $1,771.84 $2,212.42 |
Toc - Plan #2 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 5000 No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$538.79 $611.52 $688.57 $962.27 $1,462.27 |
$950.96 $1,023.69 $1,100.74 $1,374.44 |
$1,363.13 $1,435.86 $1,512.91 $1,786.61 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,077.58 $1,223.04 $1,377.14 $1,924.54 $2,924.54 |
$1,489.75 $1,635.21 $1,789.31 $2,336.71 |
$1,901.92 $2,047.38 $2,201.48 $2,748.88 |
Toc - Plan #3 AultCare Insurance Company | ||||||||||||||||||||
Gold
(PPO) AultCare Gold 1100 No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$678.56 $770.16 $867.20 $1,211.90 $1,841.60 |
$1,197.66 $1,289.26 $1,386.30 $1,731.00 |
$1,716.76 $1,808.36 $1,905.40 $2,250.10 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,357.12 $1,540.32 $1,734.40 $2,423.80 $3,683.20 |
$1,876.22 $2,059.42 $2,253.50 $2,942.90 |
$2,395.32 $2,578.52 $2,772.60 $3,462.00 |
Toc - Plan #4 AultCare Insurance Company | ||||||||||||||||||||
Catastrophic
(PPO) AultCare Catastrophic Select |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$210.29 $238.67 $268.74 $375.57 $570.71 |
$371.16 $399.54 $429.61 $536.44 |
$532.03 $560.41 $590.48 $697.31 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$420.58 $477.34 $537.48 $751.14 $1,141.42 |
$581.45 $638.21 $698.35 $912.01 |
$742.32 $799.08 $859.22 $1,072.88 |
Toc - Plan #5 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 5750 Select |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$332.15 $376.99 $424.49 $593.22 $901.45 |
$586.24 $631.08 $678.58 $847.31 |
$840.33 $885.17 $932.67 $1,101.40 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$664.30 $753.98 $848.98 $1,186.44 $1,802.90 |
$918.39 $1,008.07 $1,103.07 $1,440.53 |
$1,172.48 $1,262.16 $1,357.16 $1,694.62 |
Toc - Plan #6 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 5000 Select |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$411.74 $467.32 $526.20 $735.36 $1,117.45 |
$726.72 $782.30 $841.18 $1,050.34 |
$1,041.70 $1,097.28 $1,156.16 $1,365.32 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$823.48 $934.64 $1,052.40 $1,470.72 $2,234.90 |
$1,138.46 $1,249.62 $1,367.38 $1,785.70 |
$1,453.44 $1,564.60 $1,682.36 $2,100.68 |
Toc - Plan #7 AultCare Insurance Company | ||||||||||||||||||||
Gold
(PPO) AultCare Gold 1100 Select |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$519.43 $589.55 $663.82 $927.69 $1,409.72 |
$916.79 $986.91 $1,061.18 $1,325.05 |
$1,314.15 $1,384.27 $1,458.54 $1,722.41 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,038.86 $1,179.10 $1,327.64 $1,855.38 $2,819.44 |
$1,436.22 $1,576.46 $1,725.00 $2,252.74 |
$1,833.58 $1,973.82 $2,122.36 $2,650.10 |
Toc - Plan #8 AultCare Insurance Company | ||||||||||||||||||||
Catastrophic
(PPO) AultCare Catastrophic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$277.58 $315.05 $354.74 $495.75 $753.34 |
$489.92 $527.39 $567.08 $708.09 |
$702.26 $739.73 $779.42 $920.43 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$555.16 $630.10 $709.48 $991.50 $1,506.68 |
$767.50 $842.44 $921.82 $1,203.84 |
$979.84 $1,054.78 $1,134.16 $1,416.18 |
Toc - Plan #9 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 5750 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$438.44 $497.62 $560.32 $783.05 $1,189.92 |
$773.84 $833.02 $895.72 $1,118.45 |
$1,109.24 $1,168.42 $1,231.12 $1,453.85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$876.88 $995.24 $1,120.64 $1,566.10 $2,379.84 |
$1,212.28 $1,330.64 $1,456.04 $1,901.50 |
$1,547.68 $1,666.04 $1,791.44 $2,236.90 |
Toc - Plan #10 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 5000 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$543.50 $616.86 $694.58 $970.68 $1,475.04 |
$959.27 $1,032.63 $1,110.35 $1,386.45 |
$1,375.04 $1,448.40 $1,526.12 $1,802.22 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,087.00 $1,233.72 $1,389.16 $1,941.36 $2,950.08 |
$1,502.77 $1,649.49 $1,804.93 $2,357.13 |
$1,918.54 $2,065.26 $2,220.70 $2,772.90 |
Toc - Plan #11 AultCare Insurance Company | ||||||||||||||||||||
Gold
(PPO) AultCare Gold 1100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$685.64 $778.20 $876.25 $1,224.55 $1,860.83 |
$1,210.15 $1,302.71 $1,400.76 $1,749.06 |
$1,734.66 $1,827.22 $1,925.27 $2,273.57 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,371.28 $1,556.40 $1,752.50 $2,449.10 $3,721.66 |
$1,895.79 $2,080.91 $2,277.01 $2,973.61 |
$2,420.30 $2,605.42 $2,801.52 $3,498.12 |
Toc - Plan #12 AultCare Insurance Company | ||||||||||||||||||||
Catastrophic
(PPO) AultCare Catastrophic No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$274.56 $311.63 $350.89 $490.36 $745.16 |
$484.60 $521.67 $560.93 $700.40 |
$694.64 $731.71 $770.97 $910.44 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$549.12 $623.26 $701.78 $980.72 $1,490.32 |
$759.16 $833.30 $911.82 $1,190.76 |
$969.20 $1,043.34 $1,121.86 $1,400.80 |
Toc - Plan #13 AultCare Insurance Company | ||||||||||||||||||||
Gold
(PPO) AultCare Gold 1100 Select No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$514.06 $583.46 $656.97 $918.11 $1,395.15 |
$907.31 $976.71 $1,050.22 $1,311.36 |
$1,300.56 $1,369.96 $1,443.47 $1,704.61 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,028.12 $1,166.92 $1,313.94 $1,836.22 $2,790.30 |
$1,421.37 $1,560.17 $1,707.19 $2,229.47 |
$1,814.62 $1,953.42 $2,100.44 $2,622.72 |
Toc - Plan #14 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 5000 Select No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$408.18 $463.28 $521.64 $729.00 $1,107.78 |
$720.43 $775.53 $833.89 $1,041.25 |
$1,032.68 $1,087.78 $1,146.14 $1,353.50 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$816.36 $926.56 $1,043.28 $1,458.00 $2,215.56 |
$1,128.61 $1,238.81 $1,355.53 $1,770.25 |
$1,440.86 $1,551.06 $1,667.78 $2,082.50 |
Toc - Plan #15 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 5750 Select No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$328.52 $372.86 $419.84 $586.73 $891.59 |
$579.83 $624.17 $671.15 $838.04 |
$831.14 $875.48 $922.46 $1,089.35 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$657.04 $745.72 $839.68 $1,173.46 $1,783.18 |
$908.35 $997.03 $1,090.99 $1,424.77 |
$1,159.66 $1,248.34 $1,342.30 $1,676.08 |
Toc - Plan #16 AultCare Insurance Company | ||||||||||||||||||||
Catastrophic
(PPO) AultCare Catastrophic Select No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$208.00 $236.08 $265.82 $371.49 $564.51 |
$367.12 $395.20 $424.94 $530.61 |
$526.24 $554.32 $584.06 $689.73 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$416.00 $472.16 $531.64 $742.98 $1,129.02 |
$575.12 $631.28 $690.76 $902.10 |
$734.24 $790.40 $849.88 $1,061.22 |
Toc - Plan #17 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 6850 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$478.98 $543.64 $612.13 $855.45 $1,299.94 |
$845.40 $910.06 $978.55 $1,221.87 |
$1,211.82 $1,276.48 $1,344.97 $1,588.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$957.96 $1,087.28 $1,224.26 $1,710.90 $2,599.88 |
$1,324.38 $1,453.70 $1,590.68 $2,077.32 |
$1,690.80 $1,820.12 $1,957.10 $2,443.74 |
Toc - Plan #18 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 6850 Select |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$362.86 $411.85 $463.73 $648.07 $984.80 |
$640.45 $689.44 $741.32 $925.66 |
$918.04 $967.03 $1,018.91 $1,203.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$725.72 $823.70 $927.46 $1,296.14 $1,969.60 |
$1,003.31 $1,101.29 $1,205.05 $1,573.73 |
$1,280.90 $1,378.88 $1,482.64 $1,851.32 |
Toc - Plan #19 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 6850 No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$473.88 $537.85 $605.62 $846.35 $1,286.11 |
$836.40 $900.37 $968.14 $1,208.87 |
$1,198.92 $1,262.89 $1,330.66 $1,571.39 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$947.76 $1,075.70 $1,211.24 $1,692.70 $2,572.22 |
$1,310.28 $1,438.22 $1,573.76 $2,055.22 |
$1,672.80 $1,800.74 $1,936.28 $2,417.74 |
Toc - Plan #20 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 6850 Select No Pediatric Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$359.00 $407.46 $458.80 $641.17 $974.32 |
$633.63 $682.09 $733.43 $915.80 |
$908.26 $956.72 $1,008.06 $1,190.43 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$718.00 $814.92 $917.60 $1,282.34 $1,948.64 |
$992.63 $1,089.55 $1,192.23 $1,556.97 |
$1,267.26 $1,364.18 $1,466.86 $1,831.60 |
Toc - Plan #21 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 6850 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$447.44 $507.84 $571.82 $799.12 $1,214.34 |
$789.73 $850.13 $914.11 $1,141.41 |
$1,132.02 $1,192.42 $1,256.40 $1,483.70 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$894.88 $1,015.68 $1,143.64 $1,598.24 $2,428.68 |
$1,237.17 $1,357.97 $1,485.93 $1,940.53 |
$1,579.46 $1,700.26 $1,828.22 $2,282.82 |
Toc - Plan #22 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 6850 Select |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
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 |
$338.97 $384.73 $433.20 $605.39 $919.95 |
$598.28 $644.04 $692.51 $864.70 |
$857.59 $903.35 $951.82 $1,124.01 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$677.94 $769.46 $866.40 $1,210.78 $1,839.90 |
$937.25 $1,028.77 $1,125.71 $1,470.09 |
$1,196.56 $1,288.08 $1,385.02 $1,729.40 |
Toc - Plan #23 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 6850 No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$442.62 $502.37 $565.66 $790.51 $1,201.26 |
$781.22 $840.97 $904.26 $1,129.11 |
$1,119.82 $1,179.57 $1,242.86 $1,467.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$885.24 $1,004.74 $1,131.32 $1,581.02 $2,402.52 |
$1,223.84 $1,343.34 $1,469.92 $1,919.62 |
$1,562.44 $1,681.94 $1,808.52 $2,258.22 |
Toc - Plan #24 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 6850 Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.32 $380.58 $428.53 $598.87 $910.04 |
$591.84 $637.10 $685.05 $855.39 |
$848.36 $893.62 $941.57 $1,111.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670.64 $761.16 $857.06 $1,197.74 $1,820.08 |
$927.16 $1,017.68 $1,113.58 $1,454.26 |
$1,183.68 $1,274.20 $1,370.10 $1,710.78 |
Toc - Plan #25 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Standard Bronze Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$279.53 $317.26 $357.23 $499.23 $758.63 |
$493.37 $531.10 $571.07 $713.07 |
$707.21 $744.94 $784.91 $926.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$559.06 $634.52 $714.46 $998.46 $1,517.26 |
$772.90 $848.36 $928.30 $1,212.30 |
$986.74 $1,062.20 $1,142.14 $1,426.14 |
Toc - Plan #26 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.16 $425.80 $479.45 $670.03 $1,018.17 |
$662.15 $712.79 $766.44 $957.02 |
$949.14 $999.78 $1,053.43 $1,244.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$750.32 $851.60 $958.90 $1,340.06 $2,036.34 |
$1,037.31 $1,138.59 $1,245.89 $1,627.05 |
$1,324.30 $1,425.58 $1,532.88 $1,914.04 |
Toc - Plan #27 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8250 Select |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.21 $322.58 $363.22 $507.60 $771.34 |
$501.63 $540.00 $580.64 $725.02 |
$719.05 $757.42 $798.06 $942.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$568.42 $645.16 $726.44 $1,015.20 $1,542.68 |
$785.84 $862.58 $943.86 $1,232.62 |
$1,003.26 $1,080.00 $1,161.28 $1,450.04 |
Toc - Plan #28 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8250 No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.97 $421.05 $474.10 $662.55 $1,006.81 |
$654.76 $704.84 $757.89 $946.34 |
$938.55 $988.63 $1,041.68 $1,230.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.94 $842.10 $948.20 $1,325.10 $2,013.62 |
$1,025.73 $1,125.89 $1,231.99 $1,608.89 |
$1,309.52 $1,409.68 $1,515.78 $1,892.68 |
Toc - Plan #29 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8250 Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.04 $318.98 $359.17 $501.93 $762.74 |
$496.03 $533.97 $574.16 $716.92 |
$711.02 $748.96 $789.15 $931.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$562.08 $637.96 $718.34 $1,003.86 $1,525.48 |
$777.07 $852.95 $933.33 $1,218.85 |
$992.06 $1,067.94 $1,148.32 $1,433.84 |
Toc - Plan #30 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8550 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.22 $414.51 $466.74 $652.27 $991.18 |
$644.61 $693.90 $746.13 $931.66 |
$924.00 $973.29 $1,025.52 $1,211.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.44 $829.02 $933.48 $1,304.54 $1,982.36 |
$1,009.83 $1,108.41 $1,212.87 $1,583.93 |
$1,289.22 $1,387.80 $1,492.26 $1,863.32 |
Toc - Plan #31 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8550 Select |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$276.68 $314.03 $353.59 $494.14 $750.90 |
$488.34 $525.69 $565.25 $705.80 |
$700.00 $737.35 $776.91 $917.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$553.36 $628.06 $707.18 $988.28 $1,501.80 |
$765.02 $839.72 $918.84 $1,199.94 |
$976.68 $1,051.38 $1,130.50 $1,411.60 |
Toc - Plan #32 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8550 No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$361.16 $409.91 $461.56 $645.02 $980.17 |
$637.44 $686.19 $737.84 $921.30 |
$913.72 $962.47 $1,014.12 $1,197.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$722.32 $819.82 $923.12 $1,290.04 $1,960.34 |
$998.60 $1,096.10 $1,199.40 $1,566.32 |
$1,274.88 $1,372.38 $1,475.68 $1,842.60 |
Toc - Plan #33 AultCare Insurance Company | ||||||||||||||||||||
Bronze
(PPO) AultCare Bronze 8550 Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.61 $310.54 $349.66 $488.65 $742.56 |
$482.92 $519.85 $558.97 $697.96 |
$692.23 $729.16 $768.28 $907.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$547.22 $621.08 $699.32 $977.30 $1,485.12 |
$756.53 $830.39 $908.63 $1,186.61 |
$965.84 $1,039.70 $1,117.94 $1,395.92 |
Toc - Plan #34 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 7000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.19 $417.89 $470.54 $657.58 $999.26 |
$649.85 $699.55 $752.20 $939.24 |
$931.51 $981.21 $1,033.86 $1,220.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$736.38 $835.78 $941.08 $1,315.16 $1,998.52 |
$1,018.04 $1,117.44 $1,222.74 $1,596.82 |
$1,299.70 $1,399.10 $1,504.40 $1,878.48 |
Toc - Plan #35 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 7000 Select |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278.94 $316.59 $356.47 $498.17 $757.02 |
$492.32 $529.97 $569.85 $711.55 |
$705.70 $743.35 $783.23 $924.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$557.88 $633.18 $712.94 $996.34 $1,514.04 |
$771.26 $846.56 $926.32 $1,209.72 |
$984.64 $1,059.94 $1,139.70 $1,423.10 |
Toc - Plan #36 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 7000 No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.16 $413.32 $465.39 $650.38 $988.32 |
$642.74 $691.90 $743.97 $928.96 |
$921.32 $970.48 $1,022.55 $1,207.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$728.32 $826.64 $930.78 $1,300.76 $1,976.64 |
$1,006.90 $1,105.22 $1,209.36 $1,579.34 |
$1,285.48 $1,383.80 $1,487.94 $1,857.92 |
Toc - Plan #37 AultCare Insurance Company | ||||||||||||||||||||
Expanded Bronze
(PPO) AultCare Bronze 7000 Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$275.88 $313.12 $352.57 $492.71 $748.72 |
$486.92 $524.16 $563.61 $703.75 |
$697.96 $735.20 $774.65 $914.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$551.76 $626.24 $705.14 $985.42 $1,497.44 |
$762.80 $837.28 $916.18 $1,196.46 |
$973.84 $1,048.32 $1,127.22 $1,407.50 |
Toc - Plan #38 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 7900 Premier Select |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.51 $361.51 $407.05 $568.86 $864.43 |
$562.17 $605.17 $650.71 $812.52 |
$805.83 $848.83 $894.37 $1,056.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$637.02 $723.02 $814.10 $1,137.72 $1,728.86 |
$880.68 $966.68 $1,057.76 $1,381.38 |
$1,124.34 $1,210.34 $1,301.42 $1,625.04 |
Toc - Plan #39 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Silver 7900 Premier Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.25 $357.81 $402.89 $563.03 $855.58 |
$556.41 $598.97 $644.05 $804.19 |
$797.57 $840.13 $885.21 $1,045.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$630.50 $715.62 $805.78 $1,126.06 $1,711.16 |
$871.66 $956.78 $1,046.94 $1,367.22 |
$1,112.82 $1,197.94 $1,288.10 $1,608.38 |
Toc - Plan #40 AultCare Insurance Company | ||||||||||||||||||||
Gold
(PPO) AultCare Standard Gold Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$498.57 $565.87 $637.17 $890.44 $1,353.11 |
$879.97 $947.27 $1,018.57 $1,271.84 |
$1,261.37 $1,328.67 $1,399.97 $1,653.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$997.14 $1,131.74 $1,274.34 $1,780.88 $2,706.22 |
$1,378.54 $1,513.14 $1,655.74 $2,162.28 |
$1,759.94 $1,894.54 $2,037.14 $2,543.68 |
Toc - Plan #41 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Standard Silver Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$342.47 $388.69 $437.67 $611.64 $929.44 |
$604.45 $650.67 $699.65 $873.62 |
$866.43 $912.65 $961.63 $1,135.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$684.94 $777.38 $875.34 $1,223.28 $1,858.88 |
$946.92 $1,039.36 $1,137.32 $1,485.26 |
$1,208.90 $1,301.34 $1,399.30 $1,747.24 |
Toc - Plan #42 AultCare Insurance Company | ||||||||||||||||||||
Silver
(PPO) AultCare Standard Silver Premier Select No Pediatric Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-344-8858
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$322.95 $366.54 $412.72 $576.77 $876.46 |
$570.00 $613.59 $659.77 $823.82 |
$817.05 $860.64 $906.82 $1,070.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$645.90 $733.08 $825.44 $1,153.54 $1,752.92 |
$892.95 $980.13 $1,072.49 $1,400.59 |
$1,140.00 $1,227.18 $1,319.54 $1,647.64 |
ADVERTISEMENT
Anthem Blue Cross and Blue ShieldLocal: 1-855-748-1808 | Toll Free: 1-855-748-1808 |
Toc - Plan #43 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.61 $371.84 $418.69 $585.11 $889.13 |
$578.23 $622.46 $669.31 $835.73 |
$828.85 $873.08 $919.93 $1,086.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.22 $743.68 $837.38 $1,170.22 $1,778.26 |
$905.84 $994.30 $1,088.00 $1,420.84 |
$1,156.46 $1,244.92 $1,338.62 $1,671.46 |
Toc - Plan #44 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Pathway X HMO 9100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$309.43 $351.20 $395.45 $552.64 $839.79 |
$546.14 $587.91 $632.16 $789.35 |
$782.85 $824.62 $868.87 $1,026.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$618.86 $702.40 $790.90 $1,105.28 $1,679.58 |
$855.57 $939.11 $1,027.61 $1,341.99 |
$1,092.28 $1,175.82 $1,264.32 $1,578.70 |
Toc - Plan #45 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.76 $468.48 $527.51 $737.19 $1,120.23 |
$728.52 $784.24 $843.27 $1,052.95 |
$1,044.28 $1,100.00 $1,159.03 $1,368.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$825.52 $936.96 $1,055.02 $1,474.38 $2,240.46 |
$1,141.28 $1,252.72 $1,370.78 $1,790.14 |
$1,457.04 $1,568.48 $1,686.54 $2,105.90 |
Toc - Plan #46 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 7450/0% for HSA (+ Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.36 $377.23 $424.76 $593.59 $902.03 |
$586.62 $631.49 $679.02 $847.85 |
$840.88 $885.75 $933.28 $1,102.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$664.72 $754.46 $849.52 $1,187.18 $1,804.06 |
$918.98 $1,008.72 $1,103.78 $1,441.44 |
$1,173.24 $1,262.98 $1,358.04 $1,695.70 |
Toc - Plan #47 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 3200/10% for HSA (+ Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.35 $471.42 $530.82 $741.82 $1,127.26 |
$733.09 $789.16 $848.56 $1,059.56 |
$1,050.83 $1,106.90 $1,166.30 $1,377.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$830.70 $942.84 $1,061.64 $1,483.64 $2,254.52 |
$1,148.44 $1,260.58 $1,379.38 $1,801.38 |
$1,466.18 $1,578.32 $1,697.12 $2,119.12 |
Toc - Plan #48 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 6000/20% for HSA (+ Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.71 $382.17 $430.32 $601.36 $913.83 |
$594.29 $639.75 $687.90 $858.94 |
$851.87 $897.33 $945.48 $1,116.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$673.42 $764.34 $860.64 $1,202.72 $1,827.66 |
$931.00 $1,021.92 $1,118.22 $1,460.30 |
$1,188.58 $1,279.50 $1,375.80 $1,717.88 |
Toc - Plan #49 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 5400/0% for HSA ( + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.59 $479.64 $540.07 $754.75 $1,146.91 |
$745.87 $802.92 $863.35 $1,078.03 |
$1,069.15 $1,126.20 $1,186.63 $1,401.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.18 $959.28 $1,080.14 $1,509.50 $2,293.82 |
$1,168.46 $1,282.56 $1,403.42 $1,832.78 |
$1,491.74 $1,605.84 $1,726.70 $2,156.06 |
Toc - Plan #50 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 3000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.81 $479.89 $540.35 $755.14 $1,147.51 |
$746.26 $803.34 $863.80 $1,078.59 |
$1,069.71 $1,126.79 $1,187.25 $1,402.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.62 $959.78 $1,080.70 $1,510.28 $2,295.02 |
$1,169.07 $1,283.23 $1,404.15 $1,833.73 |
$1,492.52 $1,606.68 $1,727.60 $2,157.18 |
Toc - Plan #51 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$407.16 $462.13 $520.35 $727.19 $1,105.03 |
$718.64 $773.61 $831.83 $1,038.67 |
$1,030.12 $1,085.09 $1,143.31 $1,350.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$814.32 $924.26 $1,040.70 $1,454.38 $2,210.06 |
$1,125.80 $1,235.74 $1,352.18 $1,765.86 |
$1,437.28 $1,547.22 $1,663.66 $2,077.34 |
Toc - Plan #52 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Catastrophic
(HMO) Anthem Catastrophic Pathway X HMO 9100 ( + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$244.87 $277.93 $312.94 $437.34 $664.58 |
$432.20 $465.26 $500.27 $624.67 |
$619.53 $652.59 $687.60 $812.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$489.74 $555.86 $625.88 $874.68 $1,329.16 |
$677.07 $743.19 $813.21 $1,062.01 |
$864.40 $930.52 $1,000.54 $1,249.34 |
Toc - Plan #53 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 6000/25% ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409.79 $465.11 $523.71 $731.88 $1,112.17 |
$723.28 $778.60 $837.20 $1,045.37 |
$1,036.77 $1,092.09 $1,150.69 $1,358.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$819.58 $930.22 $1,047.42 $1,463.76 $2,224.34 |
$1,133.07 $1,243.71 $1,360.91 $1,777.25 |
$1,446.56 $1,557.20 $1,674.40 $2,090.74 |
Toc - Plan #54 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.03 $376.85 $424.33 $593.01 $901.13 |
$586.03 $630.85 $678.33 $847.01 |
$840.03 $884.85 $932.33 $1,101.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$664.06 $753.70 $848.66 $1,186.02 $1,802.26 |
$918.06 $1,007.70 $1,102.66 $1,440.02 |
$1,172.06 $1,261.70 $1,356.66 $1,694.02 |
Toc - Plan #55 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.50 $358.09 $403.21 $563.48 $856.27 |
$556.86 $599.45 $644.57 $804.84 |
$798.22 $840.81 $885.93 $1,046.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$631.00 $716.18 $806.42 $1,126.96 $1,712.54 |
$872.36 $957.54 $1,047.78 $1,368.32 |
$1,113.72 $1,198.90 $1,289.14 $1,609.68 |
Toc - Plan #56 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Pathway X HMO 9100/0% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.12 $351.99 $396.33 $553.87 $841.67 |
$547.36 $589.23 $633.57 $791.11 |
$784.60 $826.47 $870.81 $1,028.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620.24 $703.98 $792.66 $1,107.74 $1,683.34 |
$857.48 $941.22 $1,029.90 $1,344.98 |
$1,094.72 $1,178.46 $1,267.14 $1,582.22 |
Toc - Plan #57 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 7500/50% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$339.53 $385.37 $433.92 $606.40 $921.48 |
$599.27 $645.11 $693.66 $866.14 |
$859.01 $904.85 $953.40 $1,125.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$679.06 $770.74 $867.84 $1,212.80 $1,842.96 |
$938.80 $1,030.48 $1,127.58 $1,472.54 |
$1,198.54 $1,290.22 $1,387.32 $1,732.28 |
Toc - Plan #58 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 5800/40% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$404.89 $459.55 $517.45 $723.13 $1,098.87 |
$714.63 $769.29 $827.19 $1,032.87 |
$1,024.37 $1,079.03 $1,136.93 $1,342.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$809.78 $919.10 $1,034.90 $1,446.26 $2,197.74 |
$1,119.52 $1,228.84 $1,344.64 $1,756.00 |
$1,429.26 $1,538.58 $1,654.38 $2,065.74 |
Toc - Plan #59 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway X HMO 2000/25% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1808
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$587.73 $667.07 $751.12 $1,049.69 $1,595.10 |
$1,037.34 $1,116.68 $1,200.73 $1,499.30 |
$1,486.95 $1,566.29 $1,650.34 $1,948.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,175.46 $1,334.14 $1,502.24 $2,099.38 $3,190.20 |
$1,625.07 $1,783.75 $1,951.85 $2,548.99 |
$2,074.68 $2,233.36 $2,401.46 $2,998.60 |
ADVERTISEMENT
Ambetter from Buckeye Health PlanLocal: 1-877-687-1189 | Toll Free: 1-877-687-1189 | TTY: 1-877-941-9236 |
Toc - Plan #60 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.76 $408.32 $459.76 $642.51 $976.36 |
$634.97 $683.53 $734.97 $917.72 |
$910.18 $958.74 $1,010.18 $1,192.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.52 $816.64 $919.52 $1,285.02 $1,952.72 |
$994.73 $1,091.85 $1,194.73 $1,560.23 |
$1,269.94 $1,367.06 $1,469.94 $1,835.44 |
Toc - Plan #61 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Everyday Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.49 $404.60 $455.58 $636.67 $967.48 |
$629.19 $677.30 $728.28 $909.37 |
$901.89 $950.00 $1,000.98 $1,182.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$712.98 $809.20 $911.16 $1,273.34 $1,934.96 |
$985.68 $1,081.90 $1,183.86 $1,546.04 |
$1,258.38 $1,354.60 $1,456.56 $1,818.74 |
Toc - Plan #62 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.94 $436.90 $491.94 $687.49 $1,044.71 |
$679.41 $731.37 $786.41 $981.96 |
$973.88 $1,025.84 $1,080.88 $1,276.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.88 $873.80 $983.88 $1,374.98 $2,089.42 |
$1,064.35 $1,168.27 $1,278.35 $1,669.45 |
$1,358.82 $1,462.74 $1,572.82 $1,963.92 |
Toc - Plan #63 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.25 $328.29 $369.65 $516.58 $784.99 |
$510.52 $549.56 $590.92 $737.85 |
$731.79 $770.83 $812.19 $959.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578.50 $656.58 $739.30 $1,033.16 $1,569.98 |
$799.77 $877.85 $960.57 $1,254.43 |
$1,021.04 $1,099.12 $1,181.84 $1,475.70 |
Toc - Plan #64 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.66 $359.40 $404.68 $565.54 $859.39 |
$558.90 $601.64 $646.92 $807.78 |
$801.14 $843.88 $889.16 $1,050.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$633.32 $718.80 $809.36 $1,131.08 $1,718.78 |
$875.56 $961.04 $1,051.60 $1,373.32 |
$1,117.80 $1,203.28 $1,293.84 $1,615.56 |
Toc - Plan #65 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.28 $349.89 $393.97 $550.57 $836.64 |
$544.11 $585.72 $629.80 $786.40 |
$779.94 $821.55 $865.63 $1,022.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$616.56 $699.78 $787.94 $1,101.14 $1,673.28 |
$852.39 $935.61 $1,023.77 $1,336.97 |
$1,088.22 $1,171.44 $1,259.60 $1,572.80 |
Toc - Plan #66 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.12 $391.70 $441.05 $616.36 $936.62 |
$609.13 $655.71 $705.06 $880.37 |
$873.14 $919.72 $969.07 $1,144.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.24 $783.40 $882.10 $1,232.72 $1,873.24 |
$954.25 $1,047.41 $1,146.11 $1,496.73 |
$1,218.26 $1,311.42 $1,410.12 $1,760.74 |
Toc - Plan #67 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.74 $400.35 $450.79 $629.98 $957.32 |
$622.58 $670.19 $720.63 $899.82 |
$892.42 $940.03 $990.47 $1,169.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$705.48 $800.70 $901.58 $1,259.96 $1,914.64 |
$975.32 $1,070.54 $1,171.42 $1,529.80 |
$1,245.16 $1,340.38 $1,441.26 $1,799.64 |
Toc - Plan #68 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.30 $403.25 $454.06 $634.55 $964.25 |
$627.10 $675.05 $725.86 $906.35 |
$898.90 $946.85 $997.66 $1,178.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.60 $806.50 $908.12 $1,269.10 $1,928.50 |
$982.40 $1,078.30 $1,179.92 $1,540.90 |
$1,254.20 $1,350.10 $1,451.72 $1,812.70 |
Toc - Plan #69 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.54 $419.42 $472.27 $659.99 $1,002.92 |
$652.23 $702.11 $754.96 $942.68 |
$934.92 $984.80 $1,037.65 $1,225.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$739.08 $838.84 $944.54 $1,319.98 $2,005.84 |
$1,021.77 $1,121.53 $1,227.23 $1,602.67 |
$1,304.46 $1,404.22 $1,509.92 $1,885.36 |
Toc - Plan #70 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Enhanced Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.47 $402.31 $453.00 $633.07 $962.01 |
$625.63 $673.47 $724.16 $904.23 |
$896.79 $944.63 $995.32 $1,175.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.94 $804.62 $906.00 $1,266.14 $1,924.02 |
$980.10 $1,075.78 $1,177.16 $1,537.30 |
$1,251.26 $1,346.94 $1,448.32 $1,808.46 |
Toc - Plan #71 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.76 $413.99 $466.15 $651.44 $989.93 |
$643.79 $693.02 $745.18 $930.47 |
$922.82 $972.05 $1,024.21 $1,209.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.52 $827.98 $932.30 $1,302.88 $1,979.86 |
$1,008.55 $1,107.01 $1,211.33 $1,581.91 |
$1,287.58 $1,386.04 $1,490.36 $1,860.94 |
Toc - Plan #72 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$302.34 $343.15 $386.38 $539.97 $820.53 |
$533.63 $574.44 $617.67 $771.26 |
$764.92 $805.73 $848.96 $1,002.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$604.68 $686.30 $772.76 $1,079.94 $1,641.06 |
$835.97 $917.59 $1,004.05 $1,311.23 |
$1,067.26 $1,148.88 $1,235.34 $1,542.52 |
Toc - Plan #73 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.24 $399.78 $450.15 $629.08 $955.96 |
$621.70 $669.24 $719.61 $898.54 |
$891.16 $938.70 $989.07 $1,168.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.48 $799.56 $900.30 $1,258.16 $1,911.92 |
$973.94 $1,069.02 $1,169.76 $1,527.62 |
$1,243.40 $1,338.48 $1,439.22 $1,797.08 |
Toc - Plan #74 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.99 $416.52 $469.00 $655.43 $995.99 |
$647.73 $697.26 $749.74 $936.17 |
$928.47 $978.00 $1,030.48 $1,216.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.98 $833.04 $938.00 $1,310.86 $1,991.98 |
$1,014.72 $1,113.78 $1,218.74 $1,591.60 |
$1,295.46 $1,394.52 $1,499.48 $1,872.34 |
Toc - Plan #75 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Everyday Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.30 $418.01 $470.68 $657.77 $999.55 |
$650.04 $699.75 $752.42 $939.51 |
$931.78 $981.49 $1,034.16 $1,221.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$736.60 $836.02 $941.36 $1,315.54 $1,999.10 |
$1,018.34 $1,117.76 $1,223.10 $1,597.28 |
$1,300.08 $1,399.50 $1,504.84 $1,879.02 |
Toc - Plan #76 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.69 $421.85 $475.00 $663.81 $1,008.73 |
$656.02 $706.18 $759.33 $948.14 |
$940.35 $990.51 $1,043.66 $1,232.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$743.38 $843.70 $950.00 $1,327.62 $2,017.46 |
$1,027.71 $1,128.03 $1,234.33 $1,611.95 |
$1,312.04 $1,412.36 $1,518.66 $1,896.28 |
Toc - Plan #77 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.70 $451.38 $508.25 $710.28 $1,079.34 |
$701.93 $755.61 $812.48 $1,014.51 |
$1,006.16 $1,059.84 $1,116.71 $1,318.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$795.40 $902.76 $1,016.50 $1,420.56 $2,158.68 |
$1,099.63 $1,206.99 $1,320.73 $1,724.79 |
$1,403.86 $1,511.22 $1,624.96 $2,029.02 |
Toc - Plan #78 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.84 $339.17 $381.90 $533.70 $811.02 |
$527.44 $567.77 $610.50 $762.30 |
$756.04 $796.37 $839.10 $990.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$597.68 $678.34 $763.80 $1,067.40 $1,622.04 |
$826.28 $906.94 $992.40 $1,296.00 |
$1,054.88 $1,135.54 $1,221.00 $1,524.60 |
Toc - Plan #79 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.16 $371.31 $418.10 $584.29 $887.88 |
$577.43 $621.58 $668.37 $834.56 |
$827.70 $871.85 $918.64 $1,084.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$654.32 $742.62 $836.20 $1,168.58 $1,775.76 |
$904.59 $992.89 $1,086.47 $1,418.85 |
$1,154.86 $1,243.16 $1,336.74 $1,669.12 |
Toc - Plan #80 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.50 $361.48 $407.03 $568.82 $864.38 |
$562.14 $605.12 $650.67 $812.46 |
$805.78 $848.76 $894.31 $1,056.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$637.00 $722.96 $814.06 $1,137.64 $1,728.76 |
$880.64 $966.60 $1,057.70 $1,381.28 |
$1,124.28 $1,210.24 $1,301.34 $1,624.92 |
Toc - Plan #81 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.56 $404.68 $455.67 $636.79 $967.67 |
$629.32 $677.44 $728.43 $909.55 |
$902.08 $950.20 $1,001.19 $1,182.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$713.12 $809.36 $911.34 $1,273.58 $1,935.34 |
$985.88 $1,082.12 $1,184.10 $1,546.34 |
$1,258.64 $1,354.88 $1,456.86 $1,819.10 |
Toc - Plan #82 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.44 $413.63 $465.74 $650.87 $989.06 |
$643.23 $692.42 $744.53 $929.66 |
$922.02 $971.21 $1,023.32 $1,208.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$728.88 $827.26 $931.48 $1,301.74 $1,978.12 |
$1,007.67 $1,106.05 $1,210.27 $1,580.53 |
$1,286.46 $1,384.84 $1,489.06 $1,859.32 |
Toc - Plan #83 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.08 $416.62 $469.11 $655.58 $996.22 |
$647.89 $697.43 $749.92 $936.39 |
$928.70 $978.24 $1,030.73 $1,217.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.16 $833.24 $938.22 $1,311.16 $1,992.44 |
$1,014.97 $1,114.05 $1,219.03 $1,591.97 |
$1,295.78 $1,394.86 $1,499.84 $1,872.78 |
Toc - Plan #84 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.79 $433.33 $487.92 $681.87 $1,036.16 |
$673.86 $725.40 $779.99 $973.94 |
$965.93 $1,017.47 $1,072.06 $1,266.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$763.58 $866.66 $975.84 $1,363.74 $2,072.32 |
$1,055.65 $1,158.73 $1,267.91 $1,655.81 |
$1,347.72 $1,450.80 $1,559.98 $1,947.88 |
Toc - Plan #85 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Enhanced Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.22 $415.65 $468.02 $654.05 $993.90 |
$646.37 $695.80 $748.17 $934.20 |
$926.52 $975.95 $1,028.32 $1,214.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$732.44 $831.30 $936.04 $1,308.10 $1,987.80 |
$1,012.59 $1,111.45 $1,216.19 $1,588.25 |
$1,292.74 $1,391.60 $1,496.34 $1,868.40 |
Toc - Plan #86 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.85 $427.72 $481.60 $673.04 $1,022.75 |
$665.13 $716.00 $769.88 $961.32 |
$953.41 $1,004.28 $1,058.16 $1,249.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.70 $855.44 $963.20 $1,346.08 $2,045.50 |
$1,041.98 $1,143.72 $1,251.48 $1,634.36 |
$1,330.26 $1,432.00 $1,539.76 $1,922.64 |
Toc - Plan #87 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Virtual Access Bronze - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$301.91 $342.66 $385.83 $539.20 $819.36 |
$532.87 $573.62 $616.79 $770.16 |
$763.83 $804.58 $847.75 $1,001.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$603.82 $685.32 $771.66 $1,078.40 $1,638.72 |
$834.78 $916.28 $1,002.62 $1,309.36 |
$1,065.74 $1,147.24 $1,233.58 $1,540.32 |
Toc - Plan #88 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Virtual Access Silver - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.61 $395.66 $445.51 $622.60 $946.09 |
$615.29 $662.34 $712.19 $889.28 |
$881.97 $929.02 $978.87 $1,155.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.22 $791.32 $891.02 $1,245.20 $1,892.18 |
$963.90 $1,058.00 $1,157.70 $1,511.88 |
$1,230.58 $1,324.68 $1,424.38 $1,778.56 |
Toc - Plan #89 Ambetter from Buckeye Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Virtual Access Gold - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1189
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.01 $419.95 $472.86 $660.82 $1,004.19 |
$653.06 $703.00 $755.91 $943.87 |
$936.11 $986.05 $1,038.96 $1,226.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$740.02 $839.90 $945.72 $1,321.64 $2,008.38 |
$1,023.07 $1,122.95 $1,228.77 $1,604.69 |
$1,306.12 $1,406.00 $1,511.82 $1,887.74 |
ADVERTISEMENT
Oscar Insurance Corporation of OhioLocal: 1-855-672-2755 | Toll Free: 1-855-672-2755 |
Toc - Plan #90 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.32 $401.01 $451.53 $631.02 $958.89 |
$623.60 $671.29 $721.81 $901.30 |
$893.88 $941.57 $992.09 $1,171.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.64 $802.02 $903.06 $1,262.04 $1,917.78 |
$976.92 $1,072.30 $1,173.34 $1,532.32 |
$1,247.20 $1,342.58 $1,443.62 $1,802.60 |
Toc - Plan #91 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.93 $408.51 $459.98 $642.82 $976.83 |
$635.27 $683.85 $735.32 $918.16 |
$910.61 $959.19 $1,010.66 $1,193.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.86 $817.02 $919.96 $1,285.64 $1,953.66 |
$995.20 $1,092.36 $1,195.30 $1,560.98 |
$1,270.54 $1,367.70 $1,470.64 $1,836.32 |
Toc - Plan #92 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.44 $403.41 $454.24 $634.79 $964.63 |
$627.34 $675.31 $726.14 $906.69 |
$899.24 $947.21 $998.04 $1,178.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.88 $806.82 $908.48 $1,269.58 $1,929.26 |
$982.78 $1,078.72 $1,180.38 $1,541.48 |
$1,254.68 $1,350.62 $1,452.28 $1,813.38 |
Toc - Plan #93 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Elite- Deductible+PCP Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.28 $466.80 $525.61 $734.53 $1,116.20 |
$725.90 $781.42 $840.23 $1,049.15 |
$1,040.52 $1,096.04 $1,154.85 $1,363.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.56 $933.60 $1,051.22 $1,469.06 $2,232.40 |
$1,137.18 $1,248.22 $1,365.84 $1,783.68 |
$1,451.80 $1,562.84 $1,680.46 $2,098.30 |
Toc - Plan #94 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.02 $491.47 $553.39 $773.35 $1,175.19 |
$764.27 $822.72 $884.64 $1,104.60 |
$1,095.52 $1,153.97 $1,215.89 $1,435.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.04 $982.94 $1,106.78 $1,546.70 $2,350.38 |
$1,197.29 $1,314.19 $1,438.03 $1,877.95 |
$1,528.54 $1,645.44 $1,769.28 $2,209.20 |
Toc - Plan #95 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.65 $481.96 $542.69 $758.40 $1,152.47 |
$749.50 $806.81 $867.54 $1,083.25 |
$1,074.35 $1,131.66 $1,192.39 $1,408.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$849.30 $963.92 $1,085.38 $1,516.80 $2,304.94 |
$1,174.15 $1,288.77 $1,410.23 $1,841.65 |
$1,499.00 $1,613.62 $1,735.08 $2,166.50 |
Toc - Plan #96 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Classic- PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$432.94 $491.37 $553.28 $773.21 $1,174.97 |
$764.13 $822.56 $884.47 $1,104.40 |
$1,095.32 $1,153.75 $1,215.66 $1,435.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$865.88 $982.74 $1,106.56 $1,546.42 $2,349.94 |
$1,197.07 $1,313.93 $1,437.75 $1,877.61 |
$1,528.26 $1,645.12 $1,768.94 $2,208.80 |
Toc - Plan #97 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Catastrophic
(HMO) Secure |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$256.15 $290.72 $327.35 $457.47 $695.17 |
$452.10 $486.67 $523.30 $653.42 |
$648.05 $682.62 $719.25 $849.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$512.30 $581.44 $654.70 $914.94 $1,390.34 |
$708.25 $777.39 $850.65 $1,110.89 |
$904.20 $973.34 $1,046.60 $1,306.84 |
Toc - Plan #98 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Elite- Deductible+Specialist Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.74 $467.31 $526.19 $735.35 $1,117.43 |
$726.71 $782.28 $841.16 $1,050.32 |
$1,041.68 $1,097.25 $1,156.13 $1,365.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$823.48 $934.62 $1,052.38 $1,470.70 $2,234.86 |
$1,138.45 $1,249.59 $1,367.35 $1,785.67 |
$1,453.42 $1,564.56 $1,682.32 $2,100.64 |
Toc - Plan #99 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Gold
(HMO) Gold Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$491.72 $558.09 $628.41 $878.20 $1,334.50 |
$867.88 $934.25 $1,004.57 $1,254.36 |
$1,244.04 $1,310.41 $1,380.73 $1,630.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$983.44 $1,116.18 $1,256.82 $1,756.40 $2,669.00 |
$1,359.60 $1,492.34 $1,632.98 $2,132.56 |
$1,735.76 $1,868.50 $2,009.14 $2,508.72 |
Toc - Plan #100 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$386.93 $439.15 $494.48 $691.04 $1,050.10 |
$682.92 $735.14 $790.47 $987.03 |
$978.91 $1,031.13 $1,086.46 $1,283.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$773.86 $878.30 $988.96 $1,382.08 $2,100.20 |
$1,069.85 $1,174.29 $1,284.95 $1,678.07 |
$1,365.84 $1,470.28 $1,580.94 $1,974.06 |
Toc - Plan #101 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Simple- Specialist Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$427.34 $485.02 $546.13 $763.21 $1,159.77 |
$754.25 $811.93 $873.04 $1,090.12 |
$1,081.16 $1,138.84 $1,199.95 $1,417.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$854.68 $970.04 $1,092.26 $1,526.42 $2,319.54 |
$1,181.59 $1,296.95 $1,419.17 $1,853.33 |
$1,508.50 $1,623.86 $1,746.08 $2,180.24 |
Toc - Plan #102 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.76 $500.25 $563.28 $787.18 $1,196.20 |
$777.93 $837.42 $900.45 $1,124.35 |
$1,115.10 $1,174.59 $1,237.62 $1,461.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$881.52 $1,000.50 $1,126.56 $1,574.36 $2,392.40 |
$1,218.69 $1,337.67 $1,463.73 $1,911.53 |
$1,555.86 $1,674.84 $1,800.90 $2,248.70 |
Toc - Plan #103 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Classic- Deductible Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.26 $523.52 $589.48 $823.80 $1,251.84 |
$814.12 $876.38 $942.34 $1,176.66 |
$1,166.98 $1,229.24 $1,295.20 $1,529.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$922.52 $1,047.04 $1,178.96 $1,647.60 $2,503.68 |
$1,275.38 $1,399.90 $1,531.82 $2,000.46 |
$1,628.24 $1,752.76 $1,884.68 $2,353.32 |
Toc - Plan #104 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- PCP Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.62 $419.51 $472.36 $660.13 $1,003.12 |
$652.37 $702.26 $755.11 $942.88 |
$935.12 $985.01 $1,037.86 $1,225.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$739.24 $839.02 $944.72 $1,320.26 $2,006.24 |
$1,021.99 $1,121.77 $1,227.47 $1,603.01 |
$1,304.74 $1,404.52 $1,510.22 $1,885.76 |
Toc - Plan #105 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- Deductible Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.54 $427.36 $481.20 $672.48 $1,021.90 |
$664.58 $715.40 $769.24 $960.52 |
$952.62 $1,003.44 $1,057.28 $1,248.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.08 $854.72 $962.40 $1,344.96 $2,043.80 |
$1,041.12 $1,142.76 $1,250.44 $1,633.00 |
$1,329.16 $1,430.80 $1,538.48 $1,921.04 |
Toc - Plan #106 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Simple- PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.98 $475.53 $535.44 $748.28 $1,137.09 |
$739.49 $796.04 $855.95 $1,068.79 |
$1,060.00 $1,116.55 $1,176.46 $1,389.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$837.96 $951.06 $1,070.88 $1,496.56 $2,274.18 |
$1,158.47 $1,271.57 $1,391.39 $1,817.07 |
$1,478.98 $1,592.08 $1,711.90 $2,137.58 |
Toc - Plan #107 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$455.57 $517.06 $582.20 $813.63 $1,236.39 |
$804.07 $865.56 $930.70 $1,162.13 |
$1,152.57 $1,214.06 $1,279.20 $1,510.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$911.14 $1,034.12 $1,164.40 $1,627.26 $2,472.78 |
$1,259.64 $1,382.62 $1,512.90 $1,975.76 |
$1,608.14 $1,731.12 $1,861.40 $2,324.26 |
Toc - Plan #108 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Elite- Deductible Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.42 $503.27 $566.68 $791.93 $1,203.42 |
$782.63 $842.48 $905.89 $1,131.14 |
$1,121.84 $1,181.69 $1,245.10 $1,470.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$886.84 $1,006.54 $1,133.36 $1,583.86 $2,406.84 |
$1,226.05 $1,345.75 $1,472.57 $1,923.07 |
$1,565.26 $1,684.96 $1,811.78 $2,262.28 |
Toc - Plan #109 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Gold
(HMO) Gold Elite- Deductible Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$537.74 $610.32 $687.22 $960.38 $1,459.39 |
$949.10 $1,021.68 $1,098.58 $1,371.74 |
$1,360.46 $1,433.04 $1,509.94 $1,783.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,075.48 $1,220.64 $1,374.44 $1,920.76 $2,918.78 |
$1,486.84 $1,632.00 $1,785.80 $2,332.12 |
$1,898.20 $2,043.36 $2,197.16 $2,743.48 |
Toc - Plan #110 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Gold
(HMO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$513.73 $583.07 $656.53 $917.51 $1,394.24 |
$906.73 $976.07 $1,049.53 $1,310.51 |
$1,299.73 $1,369.07 $1,442.53 $1,703.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,027.46 $1,166.14 $1,313.06 $1,835.02 $2,788.48 |
$1,420.46 $1,559.14 $1,706.06 $2,228.02 |
$1,813.46 $1,952.14 $2,099.06 $2,621.02 |
Toc - Plan #111 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Simple- For Diabetes |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.22 $481.48 $542.14 $757.64 $1,151.30 |
$748.74 $806.00 $866.66 $1,082.16 |
$1,073.26 $1,130.52 $1,191.18 $1,406.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$848.44 $962.96 $1,084.28 $1,515.28 $2,302.60 |
$1,172.96 $1,287.48 $1,408.80 $1,839.80 |
$1,497.48 $1,612.00 $1,733.32 $2,164.32 |
Toc - Plan #112 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Classic- Specialist Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.97 $483.46 $544.37 $760.76 $1,156.05 |
$751.83 $809.32 $870.23 $1,086.62 |
$1,077.69 $1,135.18 $1,196.09 $1,412.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$851.94 $966.92 $1,088.74 $1,521.52 $2,312.10 |
$1,177.80 $1,292.78 $1,414.60 $1,847.38 |
$1,503.66 $1,618.64 $1,740.46 $2,173.24 |
Toc - Plan #113 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.31 $420.29 $473.24 $661.35 $1,004.99 |
$653.59 $703.57 $756.52 $944.63 |
$936.87 $986.85 $1,039.80 $1,227.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$740.62 $840.58 $946.48 $1,322.70 $2,009.98 |
$1,023.90 $1,123.86 $1,229.76 $1,605.98 |
$1,307.18 $1,407.14 $1,513.04 $1,889.26 |
Toc - Plan #114 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Bronze
(HMO) Bronze Simple- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.34 $391.95 $441.33 $616.76 $937.23 |
$609.52 $656.13 $705.51 $880.94 |
$873.70 $920.31 $969.69 $1,145.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.68 $783.90 $882.66 $1,233.52 $1,874.46 |
$954.86 $1,048.08 $1,146.84 $1,497.70 |
$1,219.04 $1,312.26 $1,411.02 $1,761.88 |
Toc - Plan #115 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Silver
(HMO) Silver Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.20 $475.78 $535.72 $748.66 $1,137.67 |
$739.88 $796.46 $856.40 $1,069.34 |
$1,060.56 $1,117.14 $1,177.08 $1,390.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$838.40 $951.56 $1,071.44 $1,497.32 $2,275.34 |
$1,159.08 $1,272.24 $1,392.12 $1,818.00 |
$1,479.76 $1,592.92 $1,712.80 $2,138.68 |
Toc - Plan #116 Oscar Insurance Corporation of Ohio | ||||||||||||||||||||
Gold
(HMO) Gold Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473.58 $537.50 $605.22 $845.79 $1,285.27 |
$835.86 $899.78 $967.50 $1,208.07 |
$1,198.14 $1,262.06 $1,329.78 $1,570.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$947.16 $1,075.00 $1,210.44 $1,691.58 $2,570.54 |
$1,309.44 $1,437.28 $1,572.72 $2,053.86 |
$1,671.72 $1,799.56 $1,935.00 $2,416.14 |
ADVERTISEMENT
SummaCareLocal: 1-330-996-8675 | Toll Free: 1-888-996-8675 | TTY: 1-800-750-0750 |
Toc - Plan #117 SummaCare | ||||||||||||||||||||
Catastrophic
(HMO) SummaCare Value with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$212.34 $240.99 $271.35 $379.22 $576.26 |
$374.77 $403.42 $433.78 $541.65 |
$537.20 $565.85 $596.21 $704.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$424.68 $481.98 $542.70 $758.44 $1,152.52 |
$587.11 $644.41 $705.13 $920.87 |
$749.54 $806.84 $867.56 $1,083.30 |
Toc - Plan #118 SummaCare | ||||||||||||||||||||
Expanded Bronze
(HMO) SummaCare Bronze 9100 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$285.78 $324.35 $365.21 $510.39 $775.58 |
$504.39 $542.96 $583.82 $729.00 |
$723.00 $761.57 $802.43 $947.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$571.56 $648.70 $730.42 $1,020.78 $1,551.16 |
$790.17 $867.31 $949.03 $1,239.39 |
$1,008.78 $1,085.92 $1,167.64 $1,458.00 |
Toc - Plan #119 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.37 $447.60 $504.00 $704.33 $1,070.30 |
$696.06 $749.29 $805.69 $1,006.02 |
$997.75 $1,050.98 $1,107.38 $1,307.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.74 $895.20 $1,008.00 $1,408.66 $2,140.60 |
$1,090.43 $1,196.89 $1,309.69 $1,710.35 |
$1,392.12 $1,498.58 $1,611.38 $2,012.04 |
Toc - Plan #120 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.23 $432.68 $487.20 $680.85 $1,034.62 |
$672.86 $724.31 $778.83 $972.48 |
$964.49 $1,015.94 $1,070.46 $1,264.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.46 $865.36 $974.40 $1,361.70 $2,069.24 |
$1,054.09 $1,156.99 $1,266.03 $1,653.33 |
$1,345.72 $1,448.62 $1,557.66 $1,944.96 |
Toc - Plan #121 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 5000 40 with SCConnect Network and 3 Free PCP Visits +Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.65 $404.79 $455.79 $636.96 $967.92 |
$629.48 $677.62 $728.62 $909.79 |
$902.31 $950.45 $1,001.45 $1,182.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$713.30 $809.58 $911.58 $1,273.92 $1,935.84 |
$986.13 $1,082.41 $1,184.41 $1,546.75 |
$1,258.96 $1,355.24 $1,457.24 $1,819.58 |
Toc - Plan #122 SummaCare | ||||||||||||||||||||
Gold
(HMO) SummaCare Gold 2000 with SCConnect Network and 3 Free PCP Visits + Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.52 $473.87 $533.58 $745.67 $1,133.12 |
$736.92 $793.27 $852.98 $1,065.07 |
$1,056.32 $1,112.67 $1,172.38 $1,384.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.04 $947.74 $1,067.16 $1,491.34 $2,266.24 |
$1,154.44 $1,267.14 $1,386.56 $1,810.74 |
$1,473.84 $1,586.54 $1,705.96 $2,130.14 |
Toc - Plan #123 SummaCare | ||||||||||||||||||||
Expanded Bronze
(HMO) SummaCare Bronze 7000 HSA with SCConnect Network and Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.93 $359.70 $405.02 $566.02 $860.12 |
$559.37 $602.14 $647.46 $808.46 |
$801.81 $844.58 $889.90 $1,050.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$633.86 $719.40 $810.04 $1,132.04 $1,720.24 |
$876.30 $961.84 $1,052.48 $1,374.48 |
$1,118.74 $1,204.28 $1,294.92 $1,616.92 |
Toc - Plan #124 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 6000 with SCConnect Network and 3 Free PCP Visits +Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$342.08 $388.25 $437.16 $610.93 $928.37 |
$603.76 $649.93 $698.84 $872.61 |
$865.44 $911.61 $960.52 $1,134.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$684.16 $776.50 $874.32 $1,221.86 $1,856.74 |
$945.84 $1,038.18 $1,136.00 $1,483.54 |
$1,207.52 $1,299.86 $1,397.68 $1,745.22 |
Toc - Plan #125 SummaCare | ||||||||||||||||||||
Expanded Bronze
(HMO) SummaCare Bronze 9100 with SCConnect Network and 3 Free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.92 $323.38 $364.12 $508.85 $773.25 |
$502.88 $541.34 $582.08 $726.81 |
$720.84 $759.30 $800.04 $944.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$569.84 $646.76 $728.24 $1,017.70 $1,546.50 |
$787.80 $864.72 $946.20 $1,235.66 |
$1,005.76 $1,082.68 $1,164.16 $1,453.62 |
Toc - Plan #126 SummaCare | ||||||||||||||||||||
Bronze
(HMO) SummaCare Bronze 8000 with SCConnect Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$265.49 $301.32 $339.28 $474.15 $720.51 |
$468.58 $504.41 $542.37 $677.24 |
$671.67 $707.50 $745.46 $880.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$530.98 $602.64 $678.56 $948.30 $1,441.02 |
$734.07 $805.73 $881.65 $1,151.39 |
$937.16 $1,008.82 $1,084.74 $1,354.48 |
Toc - Plan #127 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$380.08 $431.38 $485.74 $678.81 $1,031.52 |
$670.84 $722.14 $776.50 $969.57 |
$961.60 $1,012.90 $1,067.26 $1,260.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$760.16 $862.76 $971.48 $1,357.62 $2,063.04 |
$1,050.92 $1,153.52 $1,262.24 $1,648.38 |
$1,341.68 $1,444.28 $1,553.00 $1,939.14 |
Toc - Plan #128 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 5000 40 with SCConnect Network and 3 Free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.51 $403.49 $454.33 $634.92 $964.82 |
$627.47 $675.45 $726.29 $906.88 |
$899.43 $947.41 $998.25 $1,178.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.02 $806.98 $908.66 $1,269.84 $1,929.64 |
$982.98 $1,078.94 $1,180.62 $1,541.80 |
$1,254.94 $1,350.90 $1,452.58 $1,813.76 |
Toc - Plan #129 SummaCare | ||||||||||||||||||||
Gold
(HMO) SummaCare Gold 2000 with SCConnect Network and 3 Free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.09 $472.25 $531.75 $743.12 $1,129.25 |
$734.39 $790.55 $850.05 $1,061.42 |
$1,052.69 $1,108.85 $1,168.35 $1,379.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.18 $944.50 $1,063.50 $1,486.24 $2,258.50 |
$1,150.48 $1,262.80 $1,381.80 $1,804.54 |
$1,468.78 $1,581.10 $1,700.10 $2,122.84 |
Toc - Plan #130 SummaCare | ||||||||||||||||||||
Expanded Bronze
(HMO) SummaCare Bronze 7000 HSA with SCConnect Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.79 $358.41 $403.56 $563.98 $857.02 |
$557.36 $599.98 $645.13 $805.55 |
$798.93 $841.55 $886.70 $1,047.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$631.58 $716.82 $807.12 $1,127.96 $1,714.04 |
$873.15 $958.39 $1,048.69 $1,369.53 |
$1,114.72 $1,199.96 $1,290.26 $1,611.10 |
Toc - Plan #131 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.23 $446.30 $502.54 $702.29 $1,067.20 |
$694.04 $747.11 $803.35 $1,003.10 |
$994.85 $1,047.92 $1,104.16 $1,303.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$786.46 $892.60 $1,005.08 $1,404.58 $2,134.40 |
$1,087.27 $1,193.41 $1,305.89 $1,705.39 |
$1,388.08 $1,494.22 $1,606.70 $2,006.20 |
Toc - Plan #132 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Silver 6000 with SCConnect Network and 3 Free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.22 $387.27 $436.07 $609.40 $926.04 |
$602.25 $648.30 $697.10 $870.43 |
$863.28 $909.33 $958.13 $1,131.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.44 $774.54 $872.14 $1,218.80 $1,852.08 |
$943.47 $1,035.57 $1,133.17 $1,479.83 |
$1,204.50 $1,296.60 $1,394.20 $1,740.86 |
Toc - Plan #133 SummaCare | ||||||||||||||||||||
Bronze
(HMO) SummaCare Standard Bronze with SCConnect Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$269.21 $305.54 $344.03 $480.78 $730.60 |
$475.14 $511.47 $549.96 $686.71 |
$681.07 $717.40 $755.89 $892.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$538.42 $611.08 $688.06 $961.56 $1,461.20 |
$744.35 $817.01 $893.99 $1,167.49 |
$950.28 $1,022.94 $1,099.92 $1,373.42 |
Toc - Plan #134 SummaCare | ||||||||||||||||||||
Bronze
(HMO) SummaCare Bronze 8000 with SCConnect Network and Travel Assistance + Adult Vision Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$266.35 $302.29 $340.38 $475.68 $722.84 |
$470.10 $506.04 $544.13 $679.43 |
$673.85 $709.79 $747.88 $883.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$532.70 $604.58 $680.76 $951.36 $1,445.68 |
$736.45 $808.33 $884.51 $1,155.11 |
$940.20 $1,012.08 $1,088.26 $1,358.86 |
Toc - Plan #135 SummaCare | ||||||||||||||||||||
Silver
(HMO) SummaCare Standard Silver with SCConnect Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.94 $396.03 $445.93 $623.18 $946.98 |
$615.87 $662.96 $712.86 $890.11 |
$882.80 $929.89 $979.79 $1,157.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.88 $792.06 $891.86 $1,246.36 $1,893.96 |
$964.81 $1,058.99 $1,158.79 $1,513.29 |
$1,231.74 $1,325.92 $1,425.72 $1,780.22 |
Toc - Plan #136 SummaCare | ||||||||||||||||||||
Gold
(HMO) SummaCare Standard Gold with SCConnect Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-996-8675
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$436.10 $494.96 $557.32 $778.85 $1,183.54 |
$769.71 $828.57 $890.93 $1,112.46 |
$1,103.32 $1,162.18 $1,224.54 $1,446.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$872.20 $989.92 $1,114.64 $1,557.70 $2,367.08 |
$1,205.81 $1,323.53 $1,448.25 $1,891.31 |
$1,539.42 $1,657.14 $1,781.86 $2,224.92 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-296-7677 | Toll Free: 1-888-296-7677 |
Toc - Plan #137 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-296-7677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.21 $406.57 $457.79 $639.76 $972.17 |
$632.24 $680.60 $731.82 $913.79 |
$906.27 $954.63 $1,005.85 $1,187.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.42 $813.14 $915.58 $1,279.52 $1,944.34 |
$990.45 $1,087.17 $1,189.61 $1,553.55 |
$1,264.48 $1,361.20 $1,463.64 $1,827.58 |
Toc - Plan #138 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-296-7677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.17 $364.53 $410.46 $573.62 $871.67 |
$566.87 $610.23 $656.16 $819.32 |
$812.57 $855.93 $901.86 $1,065.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$642.34 $729.06 $820.92 $1,147.24 $1,743.34 |
$888.04 $974.76 $1,066.62 $1,392.94 |
$1,133.74 $1,220.46 $1,312.32 $1,638.64 |
Toc - Plan #139 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-296-7677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.39 $419.26 $472.08 $659.73 $1,002.53 |
$651.97 $701.84 $754.66 $942.31 |
$934.55 $984.42 $1,037.24 $1,224.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$738.78 $838.52 $944.16 $1,319.46 $2,005.06 |
$1,021.36 $1,121.10 $1,226.74 $1,602.04 |
$1,303.94 $1,403.68 $1,509.32 $1,884.62 |
Toc - Plan #140 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-296-7677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.56 $371.78 $418.62 $585.02 $888.99 |
$578.14 $622.36 $669.20 $835.60 |
$828.72 $872.94 $919.78 $1,086.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.12 $743.56 $837.24 $1,170.04 $1,777.98 |
$905.70 $994.14 $1,087.82 $1,420.62 |
$1,156.28 $1,244.72 $1,338.40 $1,671.20 |
Toc - Plan #141 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-296-7677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.68 $409.37 $460.95 $644.18 $978.89 |
$636.60 $685.29 $736.87 $920.10 |
$912.52 $961.21 $1,012.79 $1,196.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$721.36 $818.74 $921.90 $1,288.36 $1,957.78 |
$997.28 $1,094.66 $1,197.82 $1,564.28 |
$1,273.20 $1,370.58 $1,473.74 $1,840.20 |
Toc - Plan #142 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-296-7677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.65 $367.35 $413.63 $578.05 $878.40 |
$571.25 $614.95 $661.23 $825.65 |
$818.85 $862.55 $908.83 $1,073.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$647.30 $734.70 $827.26 $1,156.10 $1,756.80 |
$894.90 $982.30 $1,074.86 $1,403.70 |
$1,142.50 $1,229.90 $1,322.46 $1,651.30 |
ADVERTISEMENT
CareSourceLocal: 1-833-230-2099 | Toll Free: 1-833-230-2099 | TTY: 1-800-750-0750 |
Toc - Plan #143 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.22 $423.61 $476.98 $666.57 $1,012.92 |
$658.73 $709.12 $762.49 $952.08 |
$944.24 $994.63 $1,048.00 $1,237.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.44 $847.22 $953.96 $1,333.14 $2,025.84 |
$1,031.95 $1,132.73 $1,239.47 $1,618.65 |
$1,317.46 $1,418.24 $1,524.98 $1,904.16 |
Toc - Plan #144 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$527.96 $599.23 $674.72 $942.92 $1,432.87 |
$931.84 $1,003.11 $1,078.60 $1,346.80 |
$1,335.72 $1,406.99 $1,482.48 $1,750.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,055.92 $1,198.46 $1,349.44 $1,885.84 $2,865.74 |
$1,459.80 $1,602.34 $1,753.32 $2,289.72 |
$1,863.68 $2,006.22 $2,157.20 $2,693.60 |
Toc - Plan #145 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.19 $432.64 $487.15 $680.80 $1,034.53 |
$672.80 $724.25 $778.76 $972.41 |
$964.41 $1,015.86 $1,070.37 $1,264.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.38 $865.28 $974.30 $1,361.60 $2,069.06 |
$1,053.99 $1,156.89 $1,265.91 $1,653.21 |
$1,345.60 $1,448.50 $1,557.52 $1,944.82 |
Toc - Plan #146 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$276.82 $314.18 $353.77 $494.39 $751.27 |
$488.58 $525.94 $565.53 $706.15 |
$700.34 $737.70 $777.29 $917.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$553.64 $628.36 $707.54 $988.78 $1,502.54 |
$765.40 $840.12 $919.30 $1,200.54 |
$977.16 $1,051.88 $1,131.06 $1,412.30 |
Toc - Plan #147 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$270.78 $307.33 $346.05 $483.60 $734.88 |
$477.92 $514.47 $553.19 $690.74 |
$685.06 $721.61 $760.33 $897.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$541.56 $614.66 $692.10 $967.20 $1,469.76 |
$748.70 $821.80 $899.24 $1,174.34 |
$955.84 $1,028.94 $1,106.38 $1,381.48 |
Toc - Plan #148 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Essential Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.74 $484.34 $545.37 $762.15 $1,158.16 |
$753.19 $810.79 $871.82 $1,088.60 |
$1,079.64 $1,137.24 $1,198.27 $1,415.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$853.48 $968.68 $1,090.74 $1,524.30 $2,316.32 |
$1,179.93 $1,295.13 $1,417.19 $1,850.75 |
$1,506.38 $1,621.58 $1,743.64 $2,177.20 |
Toc - Plan #149 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$379.23 $430.42 $484.65 $677.29 $1,029.21 |
$669.34 $720.53 $774.76 $967.40 |
$959.45 $1,010.64 $1,064.87 $1,257.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.46 $860.84 $969.30 $1,354.58 $2,058.42 |
$1,048.57 $1,150.95 $1,259.41 $1,644.69 |
$1,338.68 $1,441.06 $1,549.52 $1,934.80 |
Toc - Plan #150 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$535.23 $607.48 $684.01 $955.91 $1,452.59 |
$944.68 $1,016.93 $1,093.46 $1,365.36 |
$1,354.13 $1,426.38 $1,502.91 $1,774.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,070.46 $1,214.96 $1,368.02 $1,911.82 $2,905.18 |
$1,479.91 $1,624.41 $1,777.47 $2,321.27 |
$1,889.36 $2,033.86 $2,186.92 $2,730.72 |
Toc - Plan #151 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$387.18 $439.45 $494.81 $691.50 $1,050.80 |
$683.37 $735.64 $791.00 $987.69 |
$979.56 $1,031.83 $1,087.19 $1,283.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774.36 $878.90 $989.62 $1,383.00 $2,101.60 |
$1,070.55 $1,175.09 $1,285.81 $1,679.19 |
$1,366.74 $1,471.28 $1,582.00 $1,975.38 |
Toc - Plan #152 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.19 $320.28 $360.64 $503.99 $765.86 |
$498.06 $536.15 $576.51 $719.86 |
$713.93 $752.02 $792.38 $935.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$564.38 $640.56 $721.28 $1,007.98 $1,531.72 |
$780.25 $856.43 $937.15 $1,223.85 |
$996.12 $1,072.30 $1,153.02 $1,439.72 |
Toc - Plan #153 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$275.84 $313.08 $352.52 $492.65 $748.62 |
$486.86 $524.10 $563.54 $703.67 |
$697.88 $735.12 $774.56 $914.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$551.68 $626.16 $705.04 $985.30 $1,497.24 |
$762.70 $837.18 $916.06 $1,196.32 |
$973.72 $1,048.20 $1,127.08 $1,407.34 |
Toc - Plan #154 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Essential Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$432.53 $490.92 $552.77 $772.50 $1,173.89 |
$763.42 $821.81 $883.66 $1,103.39 |
$1,094.31 $1,152.70 $1,214.55 $1,434.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$865.06 $981.84 $1,105.54 $1,545.00 $2,347.78 |
$1,195.95 $1,312.73 $1,436.43 $1,875.89 |
$1,526.84 $1,643.62 $1,767.32 $2,206.78 |
ADVERTISEMENT
MedMutualLocal: 1-888-308-0357 | Toll Free: 1-888-308-0357 |
Toc - Plan #155 MedMutual | ||||||||||||||||||||
Silver
(HMO) Market HMO 3500 - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.02 $473.32 $532.95 $744.80 $1,131.79 |
$736.04 $792.34 $851.97 $1,063.82 |
$1,055.06 $1,111.36 $1,170.99 $1,382.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$834.04 $946.64 $1,065.90 $1,489.60 $2,263.58 |
$1,153.06 $1,265.66 $1,384.92 $1,808.62 |
$1,472.08 $1,584.68 $1,703.94 $2,127.64 |
Toc - Plan #156 MedMutual | ||||||||||||||||||||
Silver
(HMO) Market HMO 4000 HSA - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.02 $473.32 $532.95 $744.80 $1,131.79 |
$736.04 $792.34 $851.97 $1,063.82 |
$1,055.06 $1,111.36 $1,170.99 $1,382.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$834.04 $946.64 $1,065.90 $1,489.60 $2,263.58 |
$1,153.06 $1,265.66 $1,384.92 $1,808.62 |
$1,472.08 $1,584.68 $1,703.94 $2,127.64 |
Toc - Plan #157 MedMutual | ||||||||||||||||||||
Expanded Bronze
(HMO) Market HMO 7000 HSA - Northern Ohio |
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Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317.38 $360.23 $405.62 $566.85 $861.38 |
$560.18 $603.03 $648.42 $809.65 |
$802.98 $845.83 $891.22 $1,052.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$634.76 $720.46 $811.24 $1,133.70 $1,722.76 |
$877.56 $963.26 $1,054.04 $1,376.50 |
$1,120.36 $1,206.06 $1,296.84 $1,619.30 |
Toc - Plan #158 MedMutual | ||||||||||||||||||||
Bronze
(HMO) Market HMO 9100 - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.23 $340.76 $383.69 $536.21 $814.82 |
$529.90 $570.43 $613.36 $765.88 |
$759.57 $800.10 $843.03 $995.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$600.46 $681.52 $767.38 $1,072.42 $1,629.64 |
$830.13 $911.19 $997.05 $1,302.09 |
$1,059.80 $1,140.86 $1,226.72 $1,531.76 |
Toc - Plan #159 MedMutual | ||||||||||||||||||||
Catastrophic
(HMO) Market HMO Young Adult Essentials - Northern Ohio |
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Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$198.28 $225.05 $253.40 $354.13 $538.14 |
$349.97 $376.74 $405.09 $505.82 |
$501.66 $528.43 $556.78 $657.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$396.56 $450.10 $506.80 $708.26 $1,076.28 |
$548.25 $601.79 $658.49 $859.95 |
$699.94 $753.48 $810.18 $1,011.64 |
Toc - Plan #160 MedMutual | ||||||||||||||||||||
Silver
(HMO) Market HMO 6500 - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.70 $471.82 $531.26 $742.44 $1,128.21 |
$733.71 $789.83 $849.27 $1,060.45 |
$1,051.72 $1,107.84 $1,167.28 $1,378.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.40 $943.64 $1,062.52 $1,484.88 $2,256.42 |
$1,149.41 $1,261.65 $1,380.53 $1,802.89 |
$1,467.42 $1,579.66 $1,698.54 $2,120.90 |
Toc - Plan #161 MedMutual | ||||||||||||||||||||
Expanded Bronze
(HMO) Market HMO Select Bronze - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.29 $406.66 $457.90 $639.91 $972.41 |
$632.38 $680.75 $731.99 $914.00 |
$906.47 $954.84 $1,006.08 $1,188.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.58 $813.32 $915.80 $1,279.82 $1,944.82 |
$990.67 $1,087.41 $1,189.89 $1,553.91 |
$1,264.76 $1,361.50 $1,463.98 $1,828.00 |
Toc - Plan #162 MedMutual | ||||||||||||||||||||
Silver
(HMO) Market HMO Select Silver - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$448.36 $508.89 $573.01 $800.77 $1,216.85 |
$791.36 $851.89 $916.01 $1,143.77 |
$1,134.36 $1,194.89 $1,259.01 $1,486.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$896.72 $1,017.78 $1,146.02 $1,601.54 $2,433.70 |
$1,239.72 $1,360.78 $1,489.02 $1,944.54 |
$1,582.72 $1,703.78 $1,832.02 $2,287.54 |
Toc - Plan #163 MedMutual | ||||||||||||||||||||
Expanded Bronze
(HMO) Market HMO 8000 - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.19 $345.25 $388.75 $543.28 $825.56 |
$536.89 $577.95 $621.45 $775.98 |
$769.59 $810.65 $854.15 $1,008.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608.38 $690.50 $777.50 $1,086.56 $1,651.12 |
$841.08 $923.20 $1,010.20 $1,319.26 |
$1,073.78 $1,155.90 $1,242.90 $1,551.96 |
Toc - Plan #164 MedMutual | ||||||||||||||||||||
Gold
(HMO) Market HMO 2500 - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$555.26 $630.21 $709.62 $991.69 $1,506.96 |
$980.03 $1,054.98 $1,134.39 $1,416.46 |
$1,404.80 $1,479.75 $1,559.16 $1,841.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,110.52 $1,260.42 $1,419.24 $1,983.38 $3,013.92 |
$1,535.29 $1,685.19 $1,844.01 $2,408.15 |
$1,960.06 $2,109.96 $2,268.78 $2,832.92 |
Toc - Plan #165 MedMutual | ||||||||||||||||||||
Gold
(HMO) Market HMO Standard Gold - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$534.14 $606.25 $682.63 $953.97 $1,449.66 |
$942.76 $1,014.87 $1,091.25 $1,362.59 |
$1,351.38 $1,423.49 $1,499.87 $1,771.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,068.28 $1,212.50 $1,365.26 $1,907.94 $2,899.32 |
$1,476.90 $1,621.12 $1,773.88 $2,316.56 |
$1,885.52 $2,029.74 $2,182.50 $2,725.18 |
Toc - Plan #166 MedMutual | ||||||||||||||||||||
Silver
(HMO) Market HMO Standard Silver - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.72 $469.57 $528.73 $738.90 $1,122.83 |
$730.22 $786.07 $845.23 $1,055.40 |
$1,046.72 $1,102.57 $1,161.73 $1,371.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.44 $939.14 $1,057.46 $1,477.80 $2,245.66 |
$1,143.94 $1,255.64 $1,373.96 $1,794.30 |
$1,460.44 $1,572.14 $1,690.46 $2,110.80 |
Toc - Plan #167 MedMutual | ||||||||||||||||||||
Expanded Bronze
(HMO) Market HMO Standard Expanded Bronze - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.97 $368.84 $415.31 $580.40 $881.97 |
$573.57 $617.44 $663.91 $829.00 |
$822.17 $866.04 $912.51 $1,077.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$649.94 $737.68 $830.62 $1,160.80 $1,763.94 |
$898.54 $986.28 $1,079.22 $1,409.40 |
$1,147.14 $1,234.88 $1,327.82 $1,658.00 |
Toc - Plan #168 MedMutual | ||||||||||||||||||||
Bronze
(HMO) Market HMO Standard Bronze - Northern Ohio |
||||||||||||||||||||
Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-308-0357
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$303.86 $344.88 $388.33 $542.69 $824.67 |
$536.31 $577.33 $620.78 $775.14 |
$768.76 $809.78 $853.23 $1,007.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$607.72 $689.76 $776.66 $1,085.38 $1,649.34 |
$840.17 $922.21 $1,009.11 $1,317.83 |
$1,072.62 $1,154.66 $1,241.56 $1,550.28 |
‡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 Stark County here.
Stark County is in “Rating Area 15” of Ohio.
Currently, there are 168 plans offered in Rating Area 15.