Obamacare 2021 Rates for Montgomery County
Obamacare > Rates > Texas > Montgomery County
Obamacare > Rates > Texas > Montgomery County
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Oscar Insurance CompanyLocal: 1-855-672-2755 | Toll Free: 1-855-672-2755 |
Toc - Plan #1 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Oscar Bronze Simple |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$264,81 $300,55 $338,41 $472,93 $718,66 |
$467,38 $503,12 $540,98 $675,50 |
$669,95 $705,69 $743,55 $878,07 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$529,62 $601,10 $676,82 $945,86 $1 437,32 |
$732,19 $803,67 $879,39 $1 148,43 |
$934,76 $1 006,24 $1 081,96 $1 351,00 |
Toc - Plan #2 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Oscar Bronze Classic PCP Copay |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$273,46 $310,37 $349,47 $488,39 $742,15 |
$482,65 $519,56 $558,66 $697,58 |
$691,84 $728,75 $767,85 $906,77 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$546,92 $620,74 $698,94 $976,78 $1 484,30 |
$756,11 $829,93 $908,13 $1 185,97 |
$965,30 $1 039,12 $1 117,32 $1 395,16 |
Toc - Plan #3 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Oscar Bronze Classic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$266,42 $302,38 $340,47 $475,81 $723,04 |
$470,22 $506,18 $544,27 $679,61 |
$674,02 $709,98 $748,07 $883,41 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$532,84 $604,76 $680,94 $951,62 $1 446,08 |
$736,64 $808,56 $884,74 $1 155,42 |
$940,44 $1 012,36 $1 088,54 $1 359,22 |
Toc - Plan #4 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Oscar Bronze Classic Next |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$323,88 $367,59 $413,90 $578,42 $878,97 |
$571,64 $615,35 $661,66 $826,18 |
$819,40 $863,11 $909,42 $1 073,94 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$647,76 $735,18 $827,80 $1 156,84 $1 757,94 |
$895,52 $982,94 $1 075,56 $1 404,60 |
$1 143,28 $1 230,70 $1 323,32 $1 652,36 |
Toc - Plan #5 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Oscar Silver Classic |
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Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$365,31 $414,61 $466,85 $652,42 $991,42 |
$644,76 $694,06 $746,30 $931,87 |
$924,21 $973,51 $1 025,75 $1 211,32 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$730,62 $829,22 $933,70 $1 304,84 $1 982,84 |
$1 010,07 $1 108,67 $1 213,15 $1 584,29 |
$1 289,52 $1 388,12 $1 492,60 $1 863,74 |
Toc - Plan #6 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Oscar Silver Saver 2 |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$358,62 $407,03 $458,31 $640,48 $973,28 |
$632,96 $681,37 $732,65 $914,82 |
$907,30 $955,71 $1 006,99 $1 189,16 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$717,24 $814,06 $916,62 $1 280,96 $1 946,56 |
$991,58 $1 088,40 $1 190,96 $1 555,30 |
$1 265,92 $1 362,74 $1 465,30 $1 829,64 |
Toc - Plan #7 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Oscar Silver Classic Next |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$367,23 $416,79 $469,30 $655,85 $996,62 |
$648,15 $697,71 $750,22 $936,77 |
$929,07 $978,63 $1 031,14 $1 217,69 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$734,46 $833,58 $938,60 $1 311,70 $1 993,24 |
$1 015,38 $1 114,50 $1 219,52 $1 592,62 |
$1 296,30 $1 395,42 $1 500,44 $1 873,54 |
Toc - Plan #8 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Oscar Secure |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$218,99 $248,54 $279,85 $391,10 $594,31 |
$386,51 $416,06 $447,37 $558,62 |
$554,03 $583,58 $614,89 $726,14 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$437,98 $497,08 $559,70 $782,20 $1 188,62 |
$605,50 $664,60 $727,22 $949,72 |
$773,02 $832,12 $894,74 $1 117,24 |
Toc - Plan #9 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Oscar Bronze Classic Next 2 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$323,58 $367,25 $413,52 $577,89 $878,16 |
$571,11 $614,78 $661,05 $825,42 |
$818,64 $862,31 $908,58 $1 072,95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$647,16 $734,50 $827,04 $1 155,78 $1 756,32 |
$894,69 $982,03 $1 074,57 $1 403,31 |
$1 142,22 $1 229,56 $1 322,10 $1 650,84 |
Toc - Plan #10 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Oscar Gold Classic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$387,87 $440,22 $495,69 $692,72 $1 052,65 |
$684,58 $736,93 $792,40 $989,43 |
$981,29 $1 033,64 $1 089,11 $1 286,14 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$775,74 $880,44 $991,38 $1 385,44 $2 105,30 |
$1 072,45 $1 177,15 $1 288,09 $1 682,15 |
$1 369,16 $1 473,86 $1 584,80 $1 978,86 |
Toc - Plan #11 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Oscar Bronze HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$284,63 $323,04 $363,74 $508,33 $772,46 |
$502,36 $540,77 $581,47 $726,06 |
$720,09 $758,50 $799,20 $943,79 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$569,26 $646,08 $727,48 $1 016,66 $1 544,92 |
$786,99 $863,81 $945,21 $1 234,39 |
$1 004,72 $1 081,54 $1 162,94 $1 452,12 |
Toc - Plan #12 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Oscar Silver Classic Copay |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$373,72 $424,17 $477,61 $667,45 $1 014,26 |
$659,61 $710,06 $763,50 $953,34 |
$945,50 $995,95 $1 049,39 $1 239,23 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$747,44 $848,34 $955,22 $1 334,90 $2 028,52 |
$1 033,33 $1 134,23 $1 241,11 $1 620,79 |
$1 319,22 $1 420,12 $1 527,00 $1 906,68 |
Toc - Plan #13 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Oscar Silver Classic $0 Ded |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$387,01 $439,24 $494,58 $691,18 $1 050,31 |
$683,06 $735,29 $790,63 $987,23 |
$979,11 $1 031,34 $1 086,68 $1 283,28 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$774,02 $878,48 $989,16 $1 382,36 $2 100,62 |
$1 070,07 $1 174,53 $1 285,21 $1 678,41 |
$1 366,12 $1 470,58 $1 581,26 $1 974,46 |
ADVERTISEMENT
Community Health ChoiceLocal: 1-713-295-6704 | Toll Free: 1-855-315-5386 | TTY: 1-855-315-5386 |
Toc - Plan #14 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Vital Bronze 003 (No Deductible for PCP, Free Preventive Care, 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$301,94 $342,71 $385,88 $539,27 $819,48 |
$532,93 $573,70 $616,87 $770,26 |
$763,92 $804,69 $847,86 $1 001,25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$603,88 $685,42 $771,76 $1 078,54 $1 638,96 |
$834,87 $916,41 $1 002,75 $1 309,53 |
$1 065,86 $1 147,40 $1 233,74 $1 540,52 |
Toc - Plan #15 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Advance Preferred Silver 004 (No deductible PCP, Specialists, Urgent Care and Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$401,98 $456,25 $513,73 $717,94 $1 090,97 |
$709,49 $763,76 $821,24 $1 025,45 |
$1 017,00 $1 071,27 $1 128,75 $1 332,96 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$803,96 $912,50 $1 027,46 $1 435,88 $2 181,94 |
$1 111,47 $1 220,01 $1 334,97 $1 743,39 |
$1 418,98 $1 527,52 $1 642,48 $2 050,90 |
Toc - Plan #16 Community Health Choice | ||||||||||||||||||||
Gold
(HMO) Community Enhanced Gold 005 (No Deductible PCP, Specialists & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$383,95 $435,78 $490,68 $685,73 $1 042,03 |
$677,67 $729,50 $784,40 $979,45 |
$971,39 $1 023,22 $1 078,12 $1 273,17 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$767,90 $871,56 $981,36 $1 371,46 $2 084,06 |
$1 061,62 $1 165,28 $1 275,08 $1 665,18 |
$1 355,34 $1 459,00 $1 568,80 $1 958,90 |
Toc - Plan #17 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Essential Bronze 008 HSA(No cost after deductible, No referrals for Specialists) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$310,05 $351,90 $396,24 $553,75 $841,47 |
$547,24 $589,09 $633,43 $790,94 |
$784,43 $826,28 $870,62 $1 028,13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$620,10 $703,80 $792,48 $1 107,50 $1 682,94 |
$857,29 $940,99 $1 029,67 $1 344,69 |
$1 094,48 $1 178,18 $1 266,86 $1 581,88 |
Toc - Plan #18 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Standard Preferred Silver 009 (No deductible PCP, Urgent Care & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$393,56 $446,69 $502,97 $702,90 $1 068,13 |
$694,64 $747,77 $804,05 $1 003,98 |
$995,72 $1 048,85 $1 105,13 $1 305,06 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$787,12 $893,38 $1 005,94 $1 405,80 $2 136,26 |
$1 088,20 $1 194,46 $1 307,02 $1 706,88 |
$1 389,28 $1 495,54 $1 608,10 $2 007,96 |
Toc - Plan #19 Community Health Choice | ||||||||||||||||||||
Bronze
(HMO) Community Value Bronze 10 (Free Preventive Care, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$297,91 $338,13 $380,73 $532,07 $808,54 |
$525,81 $566,03 $608,63 $759,97 |
$753,71 $793,93 $836,53 $987,87 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$595,82 $676,26 $761,46 $1 064,14 $1 617,08 |
$823,72 $904,16 $989,36 $1 292,04 |
$1 051,62 $1 132,06 $1 217,26 $1 519,94 |
Toc - Plan #20 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Virtual Now Bronze 11 (Unlimited Free 24/7 Virtual Visits) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$297,31 $337,45 $379,96 $530,99 $806,90 |
$524,75 $564,89 $607,40 $758,43 |
$752,19 $792,33 $834,84 $985,87 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$594,62 $674,90 $759,92 $1 061,98 $1 613,80 |
$822,06 $902,34 $987,36 $1 289,42 |
$1 049,50 $1 129,78 $1 214,80 $1 516,86 |
Toc - Plan #21 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Standard Silver 12 (No deductible PCP, Urgent Care & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$384,75 $436,70 $491,71 $687,17 $1 044,22 |
$679,09 $731,04 $786,05 $981,51 |
$973,43 $1 025,38 $1 080,39 $1 275,85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$769,50 $873,40 $983,42 $1 374,34 $2 088,44 |
$1 063,84 $1 167,74 $1 277,76 $1 668,68 |
$1 358,18 $1 462,08 $1 572,10 $1 963,02 |
Toc - Plan #22 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Advance Silver 13 (No Deductible PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$388,98 $441,49 $497,12 $694,72 $1 055,70 |
$686,55 $739,06 $794,69 $992,29 |
$984,12 $1 036,63 $1 092,26 $1 289,86 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$777,96 $882,98 $994,24 $1 389,44 $2 111,40 |
$1 075,53 $1 180,55 $1 291,81 $1 687,01 |
$1 373,10 $1 478,12 $1 589,38 $1 984,58 |
ADVERTISEMENT
Ambetter from Superior HealthPlanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989 |
Toc - Plan #23 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 (2021) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332,52 $377,40 $424,95 $593,87 $902,44 |
$586,89 $631,77 $679,32 $848,24 |
$841,26 $886,14 $933,69 $1 102,61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$665,04 $754,80 $849,90 $1 187,74 $1 804,88 |
$919,41 $1 009,17 $1 104,27 $1 442,11 |
$1 173,78 $1 263,54 $1 358,64 $1 696,48 |
Toc - Plan #24 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$279,95 $317,73 $357,77 $499,98 $759,76 |
$494,11 $531,89 $571,93 $714,14 |
$708,27 $746,05 $786,09 $928,30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$559,90 $635,46 $715,54 $999,96 $1 519,52 |
$774,06 $849,62 $929,70 $1 214,12 |
$988,22 $1 063,78 $1 143,86 $1 428,28 |
Toc - Plan #25 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$290,16 $329,32 $370,81 $518,21 $787,47 |
$512,12 $551,28 $592,77 $740,17 |
$734,08 $773,24 $814,73 $962,13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$580,32 $658,64 $741,62 $1 036,42 $1 574,94 |
$802,28 $880,60 $963,58 $1 258,38 |
$1 024,24 $1 102,56 $1 185,54 $1 480,34 |
Toc - Plan #26 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$442,75 $502,51 $565,82 $790,73 $1 201,59 |
$781,45 $841,21 $904,52 $1 129,43 |
$1 120,15 $1 179,91 $1 243,22 $1 468,13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$885,50 $1 005,02 $1 131,64 $1 581,46 $2 403,18 |
$1 224,20 $1 343,72 $1 470,34 $1 920,16 |
$1 562,90 $1 682,42 $1 809,04 $2 258,86 |
Toc - Plan #27 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$302,60 $343,43 $386,70 $540,42 $821,22 |
$534,08 $574,91 $618,18 $771,90 |
$765,56 $806,39 $849,66 $1 003,38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$605,20 $686,86 $773,40 $1 080,84 $1 642,44 |
$836,68 $918,34 $1 004,88 $1 312,32 |
$1 068,16 $1 149,82 $1 236,36 $1 543,80 |
Toc - Plan #28 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$331,62 $376,38 $423,80 $592,26 $900,00 |
$585,30 $630,06 $677,48 $845,94 |
$838,98 $883,74 $931,16 $1 099,62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$663,24 $752,76 $847,60 $1 184,52 $1 800,00 |
$916,92 $1 006,44 $1 101,28 $1 438,20 |
$1 170,60 $1 260,12 $1 354,96 $1 691,88 |
Toc - Plan #29 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325,67 $369,63 $416,20 $581,63 $883,85 |
$574,80 $618,76 $665,33 $830,76 |
$823,93 $867,89 $914,46 $1 079,89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$651,34 $739,26 $832,40 $1 163,26 $1 767,70 |
$900,47 $988,39 $1 081,53 $1 412,39 |
$1 149,60 $1 237,52 $1 330,66 $1 661,52 |
Toc - Plan #30 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$322,81 $366,38 $412,54 $576,52 $876,09 |
$569,75 $613,32 $659,48 $823,46 |
$816,69 $860,26 $906,42 $1 070,40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$645,62 $732,76 $825,08 $1 153,04 $1 752,18 |
$892,56 $979,70 $1 072,02 $1 399,98 |
$1 139,50 $1 226,64 $1 318,96 $1 646,92 |
Toc - Plan #31 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 25 HSA (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336,28 $381,67 $429,75 $600,58 $912,63 |
$593,53 $638,92 $687,00 $857,83 |
$850,78 $896,17 $944,25 $1 115,08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672,56 $763,34 $859,50 $1 201,16 $1 825,26 |
$929,81 $1 020,59 $1 116,75 $1 458,41 |
$1 187,06 $1 277,84 $1 374,00 $1 715,66 |
Toc - Plan #32 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 27 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355,43 $403,40 $454,23 $634,78 $964,61 |
$627,33 $675,30 $726,13 $906,68 |
$899,23 $947,20 $998,03 $1 178,58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710,86 $806,80 $908,46 $1 269,56 $1 929,22 |
$982,76 $1 078,70 $1 180,36 $1 541,46 |
$1 254,66 $1 350,60 $1 452,26 $1 813,36 |
Toc - Plan #33 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 28 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358,32 $406,69 $457,93 $639,95 $972,47 |
$632,43 $680,80 $732,04 $914,06 |
$906,54 $954,91 $1 006,15 $1 188,17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716,64 $813,38 $915,86 $1 279,90 $1 944,94 |
$990,75 $1 087,49 $1 189,97 $1 554,01 |
$1 264,86 $1 361,60 $1 464,08 $1 828,12 |
Toc - Plan #34 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 15 (2021) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$452,23 $513,26 $577,93 $807,66 $1 227,31 |
$798,18 $859,21 $923,88 $1 153,61 |
$1 144,13 $1 205,16 $1 269,83 $1 499,56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$904,46 $1 026,52 $1 155,86 $1 615,32 $2 454,62 |
$1 250,41 $1 372,47 $1 501,81 $1 961,27 |
$1 596,36 $1 718,42 $1 847,76 $2 307,22 |
Toc - Plan #35 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$447,83 $508,28 $572,32 $799,81 $1 215,39 |
$790,41 $850,86 $914,90 $1 142,39 |
$1 132,99 $1 193,44 $1 257,48 $1 484,97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$895,66 $1 016,56 $1 144,64 $1 599,62 $2 430,78 |
$1 238,24 $1 359,14 $1 487,22 $1 942,20 |
$1 580,82 $1 701,72 $1 829,80 $2 284,78 |
Toc - Plan #36 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$283,17 $321,38 $361,87 $505,72 $768,48 |
$499,78 $537,99 $578,48 $722,33 |
$716,39 $754,60 $795,09 $938,94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$566,34 $642,76 $723,74 $1 011,44 $1 536,96 |
$782,95 $859,37 $940,35 $1 228,05 |
$999,56 $1 075,98 $1 156,96 $1 444,66 |
Toc - Plan #37 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293,49 $333,10 $375,07 $524,16 $796,51 |
$518,00 $557,61 $599,58 $748,67 |
$742,51 $782,12 $824,09 $973,18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586,98 $666,20 $750,14 $1 048,32 $1 593,02 |
$811,49 $890,71 $974,65 $1 272,83 |
$1 036,00 $1 115,22 $1 199,16 $1 497,34 |
Toc - Plan #38 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336,34 $381,73 $429,83 $600,68 $912,80 |
$593,63 $639,02 $687,12 $857,97 |
$850,92 $896,31 $944,41 $1 115,26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672,68 $763,46 $859,66 $1 201,36 $1 825,60 |
$929,97 $1 020,75 $1 116,95 $1 458,65 |
$1 187,26 $1 278,04 $1 374,24 $1 715,94 |
Toc - Plan #39 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306,07 $347,38 $391,14 $546,62 $830,65 |
$540,21 $581,52 $625,28 $780,76 |
$774,35 $815,66 $859,42 $1 014,90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612,14 $694,76 $782,28 $1 093,24 $1 661,30 |
$846,28 $928,90 $1 016,42 $1 327,38 |
$1 080,42 $1 163,04 $1 250,56 $1 561,52 |
Toc - Plan #40 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335,43 $380,70 $428,67 $599,06 $910,33 |
$592,03 $637,30 $685,27 $855,66 |
$848,63 $893,90 $941,87 $1 112,26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670,86 $761,40 $857,34 $1 198,12 $1 820,66 |
$927,46 $1 018,00 $1 113,94 $1 454,72 |
$1 184,06 $1 274,60 $1 370,54 $1 711,32 |
Toc - Plan #41 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329,41 $373,87 $420,97 $588,31 $893,99 |
$581,40 $625,86 $672,96 $840,30 |
$833,39 $877,85 $924,95 $1 092,29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$658,82 $747,74 $841,94 $1 176,62 $1 787,98 |
$910,81 $999,73 $1 093,93 $1 428,61 |
$1 162,80 $1 251,72 $1 345,92 $1 680,60 |
Toc - Plan #42 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 25 HSA (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340,14 $386,05 $434,69 $607,47 $923,11 |
$600,34 $646,25 $694,89 $867,67 |
$860,54 $906,45 $955,09 $1 127,87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$680,28 $772,10 $869,38 $1 214,94 $1 846,22 |
$940,48 $1 032,30 $1 129,58 $1 475,14 |
$1 200,68 $1 292,50 $1 389,78 $1 735,34 |
Toc - Plan #43 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 27 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359,51 $408,03 $459,44 $642,07 $975,69 |
$634,53 $683,05 $734,46 $917,09 |
$909,55 $958,07 $1 009,48 $1 192,11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719,02 $816,06 $918,88 $1 284,14 $1 951,38 |
$994,04 $1 091,08 $1 193,90 $1 559,16 |
$1 269,06 $1 366,10 $1 468,92 $1 834,18 |
Toc - Plan #44 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 28 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362,44 $411,36 $463,18 $647,30 $983,63 |
$639,70 $688,62 $740,44 $924,56 |
$916,96 $965,88 $1 017,70 $1 201,82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724,88 $822,72 $926,36 $1 294,60 $1 967,26 |
$1 002,14 $1 099,98 $1 203,62 $1 571,86 |
$1 279,40 $1 377,24 $1 480,88 $1 849,12 |
Toc - Plan #45 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 15 (2021) + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$457,42 $519,16 $584,57 $816,93 $1 241,40 |
$807,34 $869,08 $934,49 $1 166,85 |
$1 157,26 $1 219,00 $1 284,41 $1 516,77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$914,84 $1 038,32 $1 169,14 $1 633,86 $2 482,80 |
$1 264,76 $1 388,24 $1 519,06 $1 983,78 |
$1 614,68 $1 738,16 $1 868,98 $2 333,70 |
Toc - Plan #46 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$463,88 $526,50 $592,83 $828,48 $1 258,96 |
$818,74 $881,36 $947,69 $1 183,34 |
$1 173,60 $1 236,22 $1 302,55 $1 538,20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$927,76 $1 053,00 $1 185,66 $1 656,96 $2 517,92 |
$1 282,62 $1 407,86 $1 540,52 $2 011,82 |
$1 637,48 $1 762,72 $1 895,38 $2 366,68 |
Toc - Plan #47 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293,32 $332,90 $374,84 $523,84 $796,03 |
$517,70 $557,28 $599,22 $748,22 |
$742,08 $781,66 $823,60 $972,60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586,64 $665,80 $749,68 $1 047,68 $1 592,06 |
$811,02 $890,18 $974,06 $1 272,06 |
$1 035,40 $1 114,56 $1 198,44 $1 496,44 |
Toc - Plan #48 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304,01 $345,04 $388,51 $542,95 $825,06 |
$536,57 $577,60 $621,07 $775,51 |
$769,13 $810,16 $853,63 $1 008,07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608,02 $690,08 $777,02 $1 085,90 $1 650,12 |
$840,58 $922,64 $1 009,58 $1 318,46 |
$1 073,14 $1 155,20 $1 242,14 $1 551,02 |
Toc - Plan #49 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348,39 $395,42 $445,24 $622,22 $945,52 |
$614,90 $661,93 $711,75 $888,73 |
$881,41 $928,44 $978,26 $1 155,24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696,78 $790,84 $890,48 $1 244,44 $1 891,04 |
$963,29 $1 057,35 $1 156,99 $1 510,95 |
$1 229,80 $1 323,86 $1 423,50 $1 777,46 |
Toc - Plan #50 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317,04 $359,83 $405,16 $566,22 $860,42 |
$559,57 $602,36 $647,69 $808,75 |
$802,10 $844,89 $890,22 $1 051,28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$634,08 $719,66 $810,32 $1 132,44 $1 720,84 |
$876,61 $962,19 $1 052,85 $1 374,97 |
$1 119,14 $1 204,72 $1 295,38 $1 617,50 |
Toc - Plan #51 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347,45 $394,35 $444,03 $620,54 $942,96 |
$613,24 $660,14 $709,82 $886,33 |
$879,03 $925,93 $975,61 $1 152,12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694,90 $788,70 $888,06 $1 241,08 $1 885,92 |
$960,69 $1 054,49 $1 153,85 $1 506,87 |
$1 226,48 $1 320,28 $1 419,64 $1 772,66 |
Toc - Plan #52 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341,22 $387,27 $436,06 $609,40 $926,04 |
$602,24 $648,29 $697,08 $870,42 |
$863,26 $909,31 $958,10 $1 131,44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682,44 $774,54 $872,12 $1 218,80 $1 852,08 |
$943,46 $1 035,56 $1 133,14 $1 479,82 |
$1 204,48 $1 296,58 $1 394,16 $1 740,84 |
Toc - Plan #53 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 25 HSA (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352,33 $399,89 $450,27 $629,25 $956,20 |
$621,86 $669,42 $719,80 $898,78 |
$891,39 $938,95 $989,33 $1 168,31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704,66 $799,78 $900,54 $1 258,50 $1 912,40 |
$974,19 $1 069,31 $1 170,07 $1 528,03 |
$1 243,72 $1 338,84 $1 439,60 $1 797,56 |
Toc - Plan #54 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 27 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372,40 $422,66 $475,91 $665,09 $1 010,66 |
$657,28 $707,54 $760,79 $949,97 |
$942,16 $992,42 $1 045,67 $1 234,85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$744,80 $845,32 $951,82 $1 330,18 $2 021,32 |
$1 029,68 $1 130,20 $1 236,70 $1 615,06 |
$1 314,56 $1 415,08 $1 521,58 $1 899,94 |
Toc - Plan #55 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 28 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375,43 $426,10 $479,79 $670,50 $1 018,89 |
$662,63 $713,30 $766,99 $957,70 |
$949,83 $1 000,50 $1 054,19 $1 244,90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$750,86 $852,20 $959,58 $1 341,00 $2 037,78 |
$1 038,06 $1 139,40 $1 246,78 $1 628,20 |
$1 325,26 $1 426,60 $1 533,98 $1 915,40 |
Toc - Plan #56 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 15 (2021) + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473,81 $537,77 $605,52 $846,21 $1 285,90 |
$836,27 $900,23 $967,98 $1 208,67 |
$1 198,73 $1 262,69 $1 330,44 $1 571,13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$947,62 $1 075,54 $1 211,04 $1 692,42 $2 571,80 |
$1 310,08 $1 438,00 $1 573,50 $2 054,88 |
$1 672,54 $1 800,46 $1 935,96 $2 417,34 |
ADVERTISEMENT
Blue Cross and Blue Shield of TexasLocal: 1-888-697-0683 | Toll Free: 1-888-697-0683 | TTY: 1-800-735-2989 |
Toc - Plan #57 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO_ 206 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$387,37 $439,67 $495,06 $691,85 $1 051,33 |
$683,71 $736,01 $791,40 $988,19 |
$980,05 $1 032,35 $1 087,74 $1 284,53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774,74 $879,34 $990,12 $1 383,70 $2 102,66 |
$1 071,08 $1 175,68 $1 286,46 $1 680,04 |
$1 367,42 $1 472,02 $1 582,80 $1 976,38 |
Toc - Plan #58 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Catastrophic
(HMO) Blue Advantage Security HMO_ 200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$264,18 $299,84 $337,62 $471,83 $716,99 |
$466,28 $501,94 $539,72 $673,93 |
$668,38 $704,04 $741,82 $876,03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$528,36 $599,68 $675,24 $943,66 $1 433,98 |
$730,46 $801,78 $877,34 $1 145,76 |
$932,56 $1 003,88 $1 079,44 $1 347,86 |
Toc - Plan #59 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Silver HMO_ 205 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$386,49 $438,67 $493,94 $690,28 $1 048,94 |
$682,16 $734,34 $789,61 $985,95 |
$977,83 $1 030,01 $1 085,28 $1 281,62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$772,98 $877,34 $987,88 $1 380,56 $2 097,88 |
$1 068,65 $1 173,01 $1 283,55 $1 676,23 |
$1 364,32 $1 468,68 $1 579,22 $1 971,90 |
Toc - Plan #60 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Bronze HMO_ 204 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$290,70 $329,95 $371,52 $519,19 $788,96 |
$513,09 $552,34 $593,91 $741,58 |
$735,48 $774,73 $816,30 $963,97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$581,40 $659,90 $743,04 $1 038,38 $1 577,92 |
$803,79 $882,29 $965,43 $1 260,77 |
$1 026,18 $1 104,68 $1 187,82 $1 483,16 |
Toc - Plan #61 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Bronze
(HMO) Blue Advantage Bronze HMO_ 301 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288,28 $327,20 $368,43 $514,87 $782,40 |
$508,82 $547,74 $588,97 $735,41 |
$729,36 $768,28 $809,51 $955,95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$576,56 $654,40 $736,86 $1 029,74 $1 564,80 |
$797,10 $874,94 $957,40 $1 250,28 |
$1 017,64 $1 095,48 $1 177,94 $1 470,82 |
Toc - Plan #62 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Plus Gold_ 203 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$457,69 $519,48 $584,93 $817,43 $1 242,17 |
$807,82 $869,61 $935,06 $1 167,56 |
$1 157,95 $1 219,74 $1 285,19 $1 517,69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$915,38 $1 038,96 $1 169,86 $1 634,86 $2 484,34 |
$1 265,51 $1 389,09 $1 519,99 $1 984,99 |
$1 615,64 $1 739,22 $1 870,12 $2 335,12 |
Toc - Plan #63 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Plus Silver_ 202 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454,07 $515,37 $580,30 $810,96 $1 232,34 |
$801,43 $862,73 $927,66 $1 158,32 |
$1 148,79 $1 210,09 $1 275,02 $1 505,68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$908,14 $1 030,74 $1 160,60 $1 621,92 $2 464,68 |
$1 255,50 $1 378,10 $1 507,96 $1 969,28 |
$1 602,86 $1 725,46 $1 855,32 $2 316,64 |
Toc - Plan #64 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Plus Bronze_ 303 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343,77 $390,18 $439,34 $613,98 $933,00 |
$606,76 $653,17 $702,33 $876,97 |
$869,75 $916,16 $965,32 $1 139,96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$687,54 $780,36 $878,68 $1 227,96 $1 866,00 |
$950,53 $1 043,35 $1 141,67 $1 490,95 |
$1 213,52 $1 306,34 $1 404,66 $1 753,94 |
Toc - Plan #65 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Bronze
(HMO) Blue Advantage Plus Bronze_ 305 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320,94 $364,27 $410,16 $573,20 $871,03 |
$566,46 $609,79 $655,68 $818,72 |
$811,98 $855,31 $901,20 $1 064,24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$641,88 $728,54 $820,32 $1 146,40 $1 742,06 |
$887,40 $974,06 $1 065,84 $1 391,92 |
$1 132,92 $1 219,58 $1 311,36 $1 637,44 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-560-2025 | Toll Free: 1-888-560-2025 |
Toc - Plan #66 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Molina Gold 3 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343,64 $390,03 $439,17 $613,73 $932,63 |
$606,52 $652,91 $702,05 $876,61 |
$869,40 $915,79 $964,93 $1 139,49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$687,28 $780,06 $878,34 $1 227,46 $1 865,26 |
$950,16 $1 042,94 $1 141,22 $1 490,34 |
$1 213,04 $1 305,82 $1 404,10 $1 753,22 |
Toc - Plan #67 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Molina Silver 3 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323,30 $366,95 $413,18 $577,42 $877,45 |
$570,63 $614,28 $660,51 $824,75 |
$817,96 $861,61 $907,84 $1 072,08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646,60 $733,90 $826,36 $1 154,84 $1 754,90 |
$893,93 $981,23 $1 073,69 $1 402,17 |
$1 141,26 $1 228,56 $1 321,02 $1 649,50 |
Toc - Plan #68 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$345,88 $392,57 $442,03 $617,74 $938,71 |
$610,48 $657,17 $706,63 $882,34 |
$875,08 $921,77 $971,23 $1 146,94 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$691,76 $785,14 $884,06 $1 235,48 $1 877,42 |
$956,36 $1 049,74 $1 148,66 $1 500,08 |
$1 220,96 $1 314,34 $1 413,26 $1 764,68 |
Toc - Plan #69 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 250 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$322,46 $365,99 $412,10 $575,91 $875,15 |
$569,14 $612,67 $658,78 $822,59 |
$815,82 $859,35 $905,46 $1 069,27 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$644,92 $731,98 $824,20 $1 151,82 $1 750,30 |
$891,60 $978,66 $1 070,88 $1 398,50 |
$1 138,28 $1 225,34 $1 317,56 $1 645,18 |
Toc - Plan #70 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$228,27 $259,09 $291,73 $407,69 $619,52 |
$402,90 $433,72 $466,36 $582,32 |
$577,53 $608,35 $640,99 $756,95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$456,54 $518,18 $583,46 $815,38 $1 239,04 |
$631,17 $692,81 $758,09 $990,01 |
$805,80 $867,44 $932,72 $1 164,64 |
Toc - Plan #71 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 2 250 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$322,16 $365,65 $411,72 $575,38 $874,35 |
$568,61 $612,10 $658,17 $821,83 |
$815,06 $858,55 $904,62 $1 068,28 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$644,32 $731,30 $823,44 $1 150,76 $1 748,70 |
$890,77 $977,75 $1 069,89 $1 397,21 |
$1 137,22 $1 224,20 $1 316,34 $1 643,66 |
Toc - Plan #72 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 2 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$226,30 $256,85 $289,21 $404,17 $614,17 |
$399,42 $429,97 $462,33 $577,29 |
$572,54 $603,09 $635,45 $750,41 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$452,60 $513,70 $578,42 $808,34 $1 228,34 |
$625,72 $686,82 $751,54 $981,46 |
$798,84 $859,94 $924,66 $1 154,58 |
Toc - Plan #73 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 4 250 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$318,83 $361,88 $407,47 $569,44 $865,32 |
$562,74 $605,79 $651,38 $813,35 |
$806,65 $849,70 $895,29 $1 057,26 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$637,66 $723,76 $814,94 $1 138,88 $1 730,64 |
$881,57 $967,67 $1 058,85 $1 382,79 |
$1 125,48 $1 211,58 $1 302,76 $1 626,70 |
Toc - Plan #74 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 4 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$238,86 $271,11 $305,26 $426,61 $648,27 |
$421,59 $453,84 $487,99 $609,34 |
$604,32 $636,57 $670,72 $792,07 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$477,72 $542,22 $610,52 $853,22 $1 296,54 |
$660,45 $724,95 $793,25 $1 035,95 |
$843,18 $907,68 $975,98 $1 218,68 |
Toc - Plan #75 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 5 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$232,39 $263,76 $296,99 $415,04 $630,70 |
$410,17 $441,54 $474,77 $592,82 |
$587,95 $619,32 $652,55 $770,60 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$464,78 $527,52 $593,98 $830,08 $1 261,40 |
$642,56 $705,30 $771,76 $1 007,86 |
$820,34 $883,08 $949,54 $1 185,64 |
Toc - Plan #76 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$349,24 $396,39 $446,33 $623,74 $947,84 |
$616,41 $663,56 $713,50 $890,91 |
$883,58 $930,73 $980,67 $1 158,08 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$698,48 $792,78 $892,66 $1 247,48 $1 895,68 |
$965,65 $1 059,95 $1 159,83 $1 514,65 |
$1 232,82 $1 327,12 $1 427,00 $1 781,82 |
Toc - Plan #77 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 250 + Vision |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$325,82 $369,80 $416,40 $581,91 $884,27 |
$575,07 $619,05 $665,65 $831,16 |
$824,32 $868,30 $914,90 $1 080,41 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$651,64 $739,60 $832,80 $1 163,82 $1 768,54 |
$900,89 $988,85 $1 082,05 $1 413,07 |
$1 150,14 $1 238,10 $1 331,30 $1 662,32 |
Toc - Plan #78 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 1 + Vision |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
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 |
$231,63 $262,90 $296,02 $413,69 $628,65 |
$408,83 $440,10 $473,22 $590,89 |
$586,03 $617,30 $650,42 $768,09 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$463,26 $525,80 $592,04 $827,38 $1 257,30 |
$640,46 $703,00 $769,24 $1 004,58 |
$817,66 $880,20 $946,44 $1 181,78 |
‡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 Montgomery County here.
Montgomery County is in “Rating Area 10” of Texas.
Currently, there are 78 plans offered in Rating Area 10.