Providers for Zip Code 22222

Obamacare 2015 Marketplace Rates For Arlington, Virginia 22222

Sunday, November 23rd, 2014

Click for Arlington, Virginia Forecast

The health insurance rates listed below are for calendar year 2015.

2015 Rates and Providers

(click here for 2014)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Arlington, Virginia 22222.

Obamacare Providers, Plans and 2015 Rates for Arlington County

Arlington County is in “” of Virginia.

Currently, there are providers offering plans to .

Below, you’ll find a summary of plans and rates for each of these providers. This chart is designed to give you a preview of your health insurance options. For detailed information, including deductible amounts, annual limits on out-of-pocket costs, and possible subsidies, you must complete an application at HealthCare.gov or contact the provider directly.

The table below shows premiums for the following scenarios for:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Arlington, VA area accept this insurance coverage as within the plan's "network".

CareFirst BlueChoice, Inc.

Local: 1-410-356-8000 | Toll Free: 1-800-544-8703

Plan: (HMO) BlueChoice Silver $2,000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$257.28
$292.01
$328.80
$459.50
$698.26
$514.56
$584.02
$657.60
$919.00
$1396.52
$677.93
$747.39
$820.97
$1082.37
$841.30
$910.76
$984.34
$1245.74
$1004.67
$1074.13
$1147.71
$1409.11
$420.65
$455.38
$492.17
$622.87
$584.02
$618.75
$655.54
$786.24
$747.39
$782.12
$818.91
$949.61
$163.37

Plan: (HMO) BlueChoice Gold $0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$289.92
$329.06
$370.52
$517.80
$786.84
$579.84
$658.12
$741.04
$1035.60
$1573.68
$763.94
$842.22
$925.14
$1219.70
$948.04
$1026.32
$1109.24
$1403.80
$1132.14
$1210.42
$1293.34
$1587.90
$474.02
$513.16
$554.62
$701.90
$658.12
$697.26
$738.72
$886.00
$842.22
$881.36
$922.82
$1070.10
$184.10

Plan: (HMO) BlueChoice Gold $1,000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $3,750 : Family: $7,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$279.86
$317.64
$357.66
$499.83
$759.54
$559.72
$635.28
$715.32
$999.66
$1519.08
$737.43
$812.99
$893.03
$1177.37
$915.14
$990.70
$1070.74
$1355.08
$1092.85
$1168.41
$1248.45
$1532.79
$457.57
$495.35
$535.37
$677.54
$635.28
$673.06
$713.08
$855.25
$812.99
$850.77
$890.79
$1032.96
$177.71

Plan: (HMO) BlueChoice Young Adult $6,600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $6,600 : Family: $13,200
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$139.58
$158.42
$178.38
$249.29
$378.82
$279.16
$316.84
$356.76
$498.58
$757.64
$367.79
$405.47
$445.39
$587.21
$456.42
$494.10
$534.02
$675.84
$545.05
$582.73
$622.65
$764.47
$228.21
$247.05
$267.01
$337.92
$316.84
$335.68
$355.64
$426.55
$405.47
$424.31
$444.27
$515.18
$88.63

Plan: (HMO) BlueChoice HSA Bronze $4,000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$161.35
$183.13
$206.21
$288.17
$437.90
$322.70
$366.26
$412.42
$576.34
$875.80
$425.16
$468.72
$514.88
$678.80
$527.62
$571.18
$617.34
$781.26
$630.08
$673.64
$719.80
$883.72
$263.81
$285.59
$308.67
$390.63
$366.27
$388.05
$411.13
$493.09
$468.73
$490.51
$513.59
$595.55
$102.46

Plan: (HMO) BlueChoice HSA Bronze $6,000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$154.49
$175.35
$197.44
$275.92
$419.29
$308.98
$350.70
$394.88
$551.84
$838.58
$407.08
$448.80
$492.98
$649.94
$505.18
$546.90
$591.08
$748.04
$603.28
$645.00
$689.18
$846.14
$252.59
$273.45
$295.54
$374.02
$350.69
$371.55
$393.64
$472.12
$448.79
$469.65
$491.74
$570.22
$98.10

Plan: (HMO) BlueChoice HSA Silver $1,300

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $1,300 : Family: $2,600
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$257.43
$292.18
$329.00
$459.77
$698.67
$514.86
$584.36
$658.00
$919.54
$1397.34
$678.33
$747.83
$821.47
$1083.01
$841.80
$911.30
$984.94
$1246.48
$1005.27
$1074.77
$1148.41
$1409.95
$420.90
$455.65
$492.47
$623.24
$584.37
$619.12
$655.94
$786.71
$747.84
$782.59
$819.41
$950.18
$163.47

Plan: (POS) BlueChoice Plus Bronze $5,500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$181.48
$205.98
$231.93
$324.12
$492.54
$362.96
$411.96
$463.86
$648.24
$985.08
$478.20
$527.20
$579.10
$763.48
$593.44
$642.44
$694.34
$878.72
$708.68
$757.68
$809.58
$993.96
$296.72
$321.22
$347.17
$439.36
$411.96
$436.46
$462.41
$554.60
$527.20
$551.70
$577.65
$669.84
$115.24

Plan: (POS) BlueChoice Plus Silver $2,500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$253.05
$287.21
$323.40
$451.95
$686.78
$506.10
$574.42
$646.80
$903.90
$1373.56
$666.79
$735.11
$807.49
$1064.59
$827.48
$895.80
$968.18
$1225.28
$988.17
$1056.49
$1128.87
$1385.97
$413.74
$447.90
$484.09
$612.64
$574.43
$608.59
$644.78
$773.33
$735.12
$769.28
$805.47
$934.02
$160.69

Plan: (POS) HealthyBlue Gold $1,500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $3,450 : Family: $6,900

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$318.78
$361.82
$407.40
$569.34
$865.17
$637.56
$723.64
$814.80
$1138.68
$1730.34
$839.99
$926.07
$1017.23
$1341.11
$1042.42
$1128.50
$1219.66
$1543.54
$1244.85
$1330.93
$1422.09
$1745.97
$521.21
$564.25
$609.83
$771.77
$723.64
$766.68
$812.26
$974.20
$926.07
$969.11
$1014.69
$1176.63
$202.43

Plan: (POS) HealthyBlue Platinum $0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Platinum 21
30
40
50
60
$393.86
$447.03
$503.35
$703.43
$1068.94
$787.72
$894.06
$1006.70
$1406.86
$2137.88
$1037.82
$1144.16
$1256.80
$1656.96
$1287.92
$1394.26
$1506.90
$1907.06
$1538.02
$1644.36
$1757.00
$2157.16
$643.96
$697.13
$753.45
$953.53
$894.06
$947.23
$1003.55
$1203.63
$1144.16
$1197.33
$1253.65
$1453.73
$250.10

Innovation Health Insurance Company

Local: 1-866-833-2957 | Toll Free: 1-866-833-2957

TTY: 1-866-833-2957

Plan: (PPO) Innovation Health Aetna-INOVA Bronze $25 Copay

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)

Deductible: Individual: $5,750 : Family: $11,500
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$184.71
$209.65
$236.06
$329.89
$501.31
$369.42
$419.30
$472.12
$659.78
$1002.62
$486.71
$536.59
$589.41
$777.07
$604.00
$653.88
$706.70
$894.36
$721.29
$771.17
$823.99
$1011.65
$302.00
$326.94
$353.35
$447.18
$419.29
$444.23
$470.64
$564.47
$536.58
$561.52
$587.93
$681.76
$117.29

Plan: (PPO) Innovation Health Aetna-INOVA Catastrophic 100%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)

Deductible: Individual: $6,600 : Family: $13,200
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$127.43
$144.64
$162.86
$227.60
$345.86
$254.86
$289.28
$325.72
$455.20
$691.72
$335.78
$370.20
$406.64
$536.12
$416.70
$451.12
$487.56
$617.04
$497.62
$532.04
$568.48
$697.96
$208.35
$225.56
$243.78
$308.52
$289.27
$306.48
$324.70
$389.44
$370.19
$387.40
$405.62
$470.36
$80.92

Plan: (PPO) Innovation Health Aetna-INOVA Silver $10 Copay

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$220.64
$250.42
$281.97
$394.06
$598.81
$441.28
$500.84
$563.94
$788.12
$1197.62
$581.38
$640.94
$704.04
$928.22
$721.48
$781.04
$844.14
$1068.32
$861.58
$921.14
$984.24
$1208.42
$360.74
$390.52
$422.07
$534.16
$500.84
$530.62
$562.17
$674.26
$640.94
$670.72
$702.27
$814.36
$140.10

Plan: (PPO) Innovation Health Aetna-INOVA Bronze Deductible Only HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)

Deductible: Individual: $6,300 : Family: $12,600
Out of Pocket Maximum per year: Individual: $6,300 : Family: $12,600

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$158.61
$180.03
$202.71
$283.29
$430.48
$317.22
$360.06
$405.42
$566.58
$860.96
$417.94
$460.78
$506.14
$667.30
$518.66
$561.50
$606.86
$768.02
$619.38
$662.22
$707.58
$868.74
$259.33
$280.75
$303.43
$384.01
$360.05
$381.47
$404.15
$484.73
$460.77
$482.19
$504.87
$585.45
$100.72

Plan: (PPO) Innovation Health Aetna-INOVA Gold $5 Copay

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)

Deductible: Individual: $1,400 : Family: $2,800
Out of Pocket Maximum per year: Individual: $5,650 : Family: $11,300

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$275.20
$312.36
$351.71
$491.51
$746.90
$550.40
$624.72
$703.42
$983.02
$1493.80
$725.15
$799.47
$878.17
$1157.77
$899.90
$974.22
$1052.92
$1332.52
$1074.65
$1148.97
$1227.67
$1507.27
$449.95
$487.11
$526.46
$666.26
$624.70
$661.86
$701.21
$841.01
$799.45
$836.61
$875.96
$1015.76
$174.75

Plan: (PPO) Innovation Health Aetna-INOVA Silver $5 Copay 2750

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)

Deductible: Individual: $2,750 : Family: $5,500
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$236.91
$268.89
$302.76
$423.11
$642.96
$473.82
$537.78
$605.52
$846.22
$1285.92
$624.25
$688.21
$755.95
$996.65
$774.68
$838.64
$906.38
$1147.08
$925.11
$989.07
$1056.81
$1297.51
$387.34
$419.32
$453.19
$573.54
$537.77
$569.75
$603.62
$723.97
$688.20
$720.18
$754.05
$874.40
$150.43

CareFirst BlueCross BlueShield

Local: 1-410-356-8000 | Toll Free: 1-800-544-8703

Plan: (PPO) BlueCross BlueShield Preferred 500, A Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueCross BlueShield)

Deductible: Individual: $500 : Family: $1,000
Out of Pocket Maximum per year: Individual: $3,750 : Family: $7,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$321.41
$364.80
$410.76
$574.04
$872.31
$642.82
$729.60
$821.52
$1148.08
$1744.62
$846.92
$933.70
$1025.62
$1352.18
$1051.02
$1137.80
$1229.72
$1556.28
$1255.12
$1341.90
$1433.82
$1760.38
$525.51
$568.90
$614.86
$778.14
$729.61
$773.00
$818.96
$982.24
$933.71
$977.10
$1023.06
$1186.34
$204.10

Plan: (PPO) BluePreferred Platinum $0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueCross BlueShield)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $1,800 : Family: $3,600

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Platinum 21
30
40
50
60
$414.81
$470.81
$530.13
$740.85
$1125.79
$829.62
$941.62
$1060.26
$1481.70
$2251.58
$1093.02
$1205.02
$1323.66
$1745.10
$1356.42
$1468.42
$1587.06
$2008.50
$1619.82
$1731.82
$1850.46
$2271.90
$678.21
$734.21
$793.53
$1004.25
$941.61
$997.61
$1056.93
$1267.65
$1205.01
$1261.01
$1320.33
$1531.05
$263.40

Plan: (PPO) BluePreferred HSA Bronze $3,500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueCross BlueShield)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$193.66
$219.80
$247.50
$345.88
$525.59
$387.32
$439.60
$495.00
$691.76
$1051.18
$510.29
$562.57
$617.97
$814.73
$633.26
$685.54
$740.94
$937.70
$756.23
$808.51
$863.91
$1060.67
$316.63
$342.77
$370.47
$468.85
$439.60
$465.74
$493.44
$591.82
$562.57
$588.71
$616.41
$714.79
$122.97

Plan: (PPO) BlueCross BlueShield Preferred 1500, A Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-544-8703 - Provider Directory for This Plan: (CareFirst BlueCross BlueShield)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$271.30
$307.93
$346.72
$484.54
$736.31
$542.60
$615.86
$693.44
$969.08
$1472.62
$714.88
$788.14
$865.72
$1141.36
$887.16
$960.42
$1038.00
$1313.64
$1059.44
$1132.70
$1210.28
$1485.92
$443.58
$480.21
$519.00
$656.82
$615.86
$652.49
$691.28
$829.10
$788.14
$824.77
$863.56
$1001.38
$172.28

Kaiser Permanente

Local: 1-800-807-1140 | Toll Free: 1-800-807-1140

TTY: 1-703-359-7616

Plan: (HMO) KP VA Gold 0/20/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$287.50
$326.31
$367.42
$513.47
$780.26
$575.00
$652.62
$734.84
$1026.94
$1560.52
$757.56
$835.18
$917.40
$1209.50
$940.12
$1017.74
$1099.96
$1392.06
$1122.68
$1200.30
$1282.52
$1574.62
$470.06
$508.87
$549.98
$696.03
$652.62
$691.43
$732.54
$878.59
$835.18
$873.99
$915.10
$1061.15
$182.56

Plan: (HMO) KP VA Gold 1000/20/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$257.95
$292.78
$329.66
$460.70
$700.08
$515.90
$585.56
$659.32
$921.40
$1400.16
$679.70
$749.36
$823.12
$1085.20
$843.50
$913.16
$986.92
$1249.00
$1007.30
$1076.96
$1150.72
$1412.80
$421.75
$456.58
$493.46
$624.50
$585.55
$620.38
$657.26
$788.30
$749.35
$784.18
$821.06
$952.10
$163.80

Plan: (HMO) KP VA Silver 1500/30/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$233.32
$264.81
$298.18
$416.70
$633.22
$466.64
$529.62
$596.36
$833.40
$1266.44
$614.80
$677.78
$744.52
$981.56
$762.96
$825.94
$892.68
$1129.72
$911.12
$974.10
$1040.84
$1277.88
$381.48
$412.97
$446.34
$564.86
$529.64
$561.13
$594.50
$713.02
$677.80
$709.29
$742.66
$861.18
$148.16

Plan: (HMO) KP VA Silver 2500/30/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$224.20
$254.47
$286.53
$400.43
$608.49
$448.40
$508.94
$573.06
$800.86
$1216.98
$590.77
$651.31
$715.43
$943.23
$733.14
$793.68
$857.80
$1085.60
$875.51
$936.05
$1000.17
$1227.97
$366.57
$396.84
$428.90
$542.80
$508.94
$539.21
$571.27
$685.17
$651.31
$681.58
$713.64
$827.54
$142.37

Plan: (HMO) KP VA Silver 1750/25%/HSA/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $1,750 : Family: $3,500
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$213.65
$242.50
$273.05
$381.59
$579.86
$427.30
$485.00
$546.10
$763.18
$1159.72
$562.97
$620.67
$681.77
$898.85
$698.64
$756.34
$817.44
$1034.52
$834.31
$892.01
$953.11
$1170.19
$349.32
$378.17
$408.72
$517.26
$484.99
$513.84
$544.39
$652.93
$620.66
$649.51
$680.06
$788.60
$135.67

Plan: (HMO) KP VA Bronze 4500/50/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$176.03
$199.79
$224.97
$314.39
$477.75
$352.06
$399.58
$449.94
$628.78
$955.50
$463.84
$511.36
$561.72
$740.56
$575.62
$623.14
$673.50
$852.34
$687.40
$734.92
$785.28
$964.12
$287.81
$311.57
$336.75
$426.17
$399.59
$423.35
$448.53
$537.95
$511.37
$535.13
$560.31
$649.73
$111.78

Plan: (HMO) KP VA Bronze 4500/50/HSA/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$170.02
$192.98
$217.29
$303.66
$461.45
$340.04
$385.96
$434.58
$607.32
$922.90
$448.01
$493.93
$542.55
$715.29
$555.98
$601.90
$650.52
$823.26
$663.95
$709.87
$758.49
$931.23
$277.99
$300.95
$325.26
$411.63
$385.96
$408.92
$433.23
$519.60
$493.93
$516.89
$541.20
$627.57
$107.97

Plan: (HMO) KP VA Bronze 5000/30%/HSA/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$165.23
$187.54
$211.17
$295.10
$448.44
$330.46
$375.08
$422.34
$590.20
$896.88
$435.38
$480.00
$527.26
$695.12
$540.30
$584.92
$632.18
$800.04
$645.22
$689.84
$737.10
$904.96
$270.15
$292.46
$316.09
$400.02
$375.07
$397.38
$421.01
$504.94
$479.99
$502.30
$525.93
$609.86
$104.92

Plan: (HMO) KP VA Catastrophic 6600/0/Dental/Ped Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Permanente)

Deductible: Individual: $6,600 : Family: $13,200
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$138.83
$157.57
$177.43
$247.95
$376.79
$277.66
$315.14
$354.86
$495.90
$753.58
$365.82
$403.30
$443.02
$584.06
$453.98
$491.46
$531.18
$672.22
$542.14
$579.62
$619.34
$760.38
$226.99
$245.73
$265.59
$336.11
$315.15
$333.89
$353.75
$424.27
$403.31
$422.05
$441.91
$512.43
$88.16

†Source: Our summary of lowest costs and numbers of providers is based on a government report released September 25, 2013. For more detailed information about specific plans and providers, see HealthCare.gov.

‡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 Arlington County here.

 

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