Obamacare 2022 Rates for Monroe County

Obamacare > Rates > Illinois > Monroe County

Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Monroe County, IL.

The health insurance rates listed below are for calendar year 2022.

For information on subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 35 Plans and 2022 Rates for Monroe County, Illinois

Below, you’ll find a summary of the 35 plans for Monroe County, Illinois and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Ambetter of Illinois

Local: 1-855-745-5507 | Toll Free: 1-855-745-5507 | TTY: 1-866-565-8576
Toc - Plan #1 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 4

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$357.47
$405.72
$456.84
$638.43
$970.15 		$630.93
$679.18
$730.30
$911.89 		$904.39
$952.64
$1,003.76
$1,185.35 		$1,177.85
$1,226.10
$1,277.22
$1,458.81 		$273.46
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$714.94
$811.44
$913.68
$1,276.86
$1,940.30 		$988.40
$1,084.90
$1,187.14
$1,550.32 		$1,261.86
$1,358.36
$1,460.60
$1,823.78 		$1,535.32
$1,631.82
$1,734.06
$2,097.24 		$273.46
Toc - Plan #2 Ambetter of Illinois
Gold

(HMO) Ambetter Secure Care 5

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$6,300 $12,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$412.84
$468.56
$527.60
$737.32
$1,120.43 		$728.66
$784.38
$843.42
$1,053.14 		$1,044.48
$1,100.20
$1,159.24
$1,368.96 		$1,360.30
$1,416.02
$1,475.06
$1,684.78 		$315.82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$825.68
$937.12
$1,055.20
$1,474.64
$2,240.86 		$1,141.50
$1,252.94
$1,371.02
$1,790.46 		$1,457.32
$1,568.76
$1,686.84
$2,106.28 		$1,773.14
$1,884.58
$2,002.66
$2,422.10 		$315.82
Toc - Plan #3 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 11

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$348.07
$395.05
$444.82
$621.64
$944.64 		$614.34
$661.32
$711.09
$887.91 		$880.61
$927.59
$977.36
$1,154.18 		$1,146.88
$1,193.86
$1,243.63
$1,420.45 		$266.27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$696.14
$790.10
$889.64
$1,243.28
$1,889.28 		$962.41
$1,056.37
$1,155.91
$1,509.55 		$1,228.68
$1,322.64
$1,422.18
$1,775.82 		$1,494.95
$1,588.91
$1,688.45
$2,042.09 		$266.27
Toc - Plan #4 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care 5

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$8,300 $16,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$297.95
$338.17
$380.77
$532.13
$808.62 		$525.88
$566.10
$608.70
$760.06 		$753.81
$794.03
$836.63
$987.99 		$981.74
$1,021.96
$1,064.56
$1,215.92 		$227.93
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$595.90
$676.34
$761.54
$1,064.26
$1,617.24 		$823.83
$904.27
$989.47
$1,292.19 		$1,051.76
$1,132.20
$1,217.40
$1,520.12 		$1,279.69
$1,360.13
$1,445.33
$1,748.05 		$227.93
Toc - Plan #5 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 12

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$342.35
$388.56
$437.51
$611.42
$929.11 		$604.24
$650.45
$699.40
$873.31 		$866.13
$912.34
$961.29
$1,135.20 		$1,128.02
$1,174.23
$1,223.18
$1,397.09 		$261.89
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$684.70
$777.12
$875.02
$1,222.84
$1,858.22 		$946.59
$1,039.01
$1,136.91
$1,484.73 		$1,208.48
$1,300.90
$1,398.80
$1,746.62 		$1,470.37
$1,562.79
$1,660.69
$2,008.51 		$261.89
Toc - Plan #6 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 28

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$371.13
$421.22
$474.29
$662.81
$1,007.21 		$655.03
$705.12
$758.19
$946.71 		$938.93
$989.02
$1,042.09
$1,230.61 		$1,222.83
$1,272.92
$1,325.99
$1,514.51 		$283.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$742.26
$842.44
$948.58
$1,325.62
$2,014.42 		$1,026.16
$1,126.34
$1,232.48
$1,609.52 		$1,310.06
$1,410.24
$1,516.38
$1,893.42 		$1,593.96
$1,694.14
$1,800.28
$2,177.32 		$283.90
Toc - Plan #7 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care 2 HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$287.44
$326.24
$367.34
$513.36
$780.10 		$507.33
$546.13
$587.23
$733.25 		$727.22
$766.02
$807.12
$953.14 		$947.11
$985.91
$1,027.01
$1,173.03 		$219.89
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$574.88
$652.48
$734.68
$1,026.72
$1,560.20 		$794.77
$872.37
$954.57
$1,246.61 		$1,014.66
$1,092.26
$1,174.46
$1,466.50 		$1,234.55
$1,312.15
$1,394.35
$1,686.39 		$219.89
Toc - Plan #8 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care 22

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$316.29
$358.98
$404.21
$564.88
$858.39 		$558.25
$600.94
$646.17
$806.84 		$800.21
$842.90
$888.13
$1,048.80 		$1,042.17
$1,084.86
$1,130.09
$1,290.76 		$241.96
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$632.58
$717.96
$808.42
$1,129.76
$1,716.78 		$874.54
$959.92
$1,050.38
$1,371.72 		$1,116.50
$1,201.88
$1,292.34
$1,613.68 		$1,358.46
$1,443.84
$1,534.30
$1,855.64 		$241.96
Toc - Plan #9 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care: $1,500 Medical Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$324.69
$368.51
$414.94
$579.88
$881.19 		$573.07
$616.89
$663.32
$828.26 		$821.45
$865.27
$911.70
$1,076.64 		$1,069.83
$1,113.65
$1,160.08
$1,325.02 		$248.38
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$649.38
$737.02
$829.88
$1,159.76
$1,762.38 		$897.76
$985.40
$1,078.26
$1,408.14 		$1,146.14
$1,233.78
$1,326.64
$1,656.52 		$1,394.52
$1,482.16
$1,575.02
$1,904.90 		$248.38
Toc - Plan #10 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care: $0 Medical Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$345.85
$392.53
$441.99
$617.68
$938.62 		$610.42
$657.10
$706.56
$882.25 		$874.99
$921.67
$971.13
$1,146.82 		$1,139.56
$1,186.24
$1,235.70
$1,411.39 		$264.57
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$691.70
$785.06
$883.98
$1,235.36
$1,877.24 		$956.27
$1,049.63
$1,148.55
$1,499.93 		$1,220.84
$1,314.20
$1,413.12
$1,764.50 		$1,485.41
$1,578.77
$1,677.69
$2,029.07 		$264.57
Toc - Plan #11 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 30

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,100 $12,200 Annual Deductible
$6,100 $12,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$319.26
$362.35
$408.00
$570.18
$866.44 		$563.49
$606.58
$652.23
$814.41 		$807.72
$850.81
$896.46
$1,058.64 		$1,051.95
$1,095.04
$1,140.69
$1,302.87 		$244.23
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$638.52
$724.70
$816.00
$1,140.36
$1,732.88 		$882.75
$968.93
$1,060.23
$1,384.59 		$1,126.98
$1,213.16
$1,304.46
$1,628.82 		$1,371.21
$1,457.39
$1,548.69
$1,873.05 		$244.23
Toc - Plan #12 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 31

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$5,450 $10,900 Annual Deductible
$6,450 $12,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$320.01
$363.20
$408.96
$571.52
$868.48 		$564.81
$608.00
$653.76
$816.32 		$809.61
$852.80
$898.56
$1,061.12 		$1,054.41
$1,097.60
$1,143.36
$1,305.92 		$244.80
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$640.02
$726.40
$817.92
$1,143.04
$1,736.96 		$884.82
$971.20
$1,062.72
$1,387.84 		$1,129.62
$1,216.00
$1,307.52
$1,632.64 		$1,374.42
$1,460.80
$1,552.32
$1,877.44 		$244.80
Toc - Plan #13 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 32

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$8,100 $16,200 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$329.98
$374.52
$421.71
$589.33
$895.55 		$582.41
$626.95
$674.14
$841.76 		$834.84
$879.38
$926.57
$1,094.19 		$1,087.27
$1,131.81
$1,179.00
$1,346.62 		$252.43
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$659.96
$749.04
$843.42
$1,178.66
$1,791.10 		$912.39
$1,001.47
$1,095.85
$1,431.09 		$1,164.82
$1,253.90
$1,348.28
$1,683.52 		$1,417.25
$1,506.33
$1,600.71
$1,935.95 		$252.43
Toc - Plan #14 Ambetter of Illinois
Gold

(HMO) Ambetter Secure Care 20

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$385.75
$437.81
$492.97
$688.93
$1,046.89 		$680.84
$732.90
$788.06
$984.02 		$975.93
$1,027.99
$1,083.15
$1,279.11 		$1,271.02
$1,323.08
$1,378.24
$1,574.20 		$295.09
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$771.50
$875.62
$985.94
$1,377.86
$2,093.78 		$1,066.59
$1,170.71
$1,281.03
$1,672.95 		$1,361.68
$1,465.80
$1,576.12
$1,968.04 		$1,656.77
$1,760.89
$1,871.21
$2,263.13 		$295.09
Toc - Plan #15 Ambetter of Illinois
Bronze

(HMO) Ambetter Essential Care 1

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$8,600 $17,200 Annual Deductible
$8,600 $17,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$266.50
$302.46
$340.57
$475.95
$723.25 		$470.36
$506.32
$544.43
$679.81 		$674.22
$710.18
$748.29
$883.67 		$878.08
$914.04
$952.15
$1,087.53 		$203.86
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$533.00
$604.92
$681.14
$951.90
$1,446.50 		$736.86
$808.78
$885.00
$1,155.76 		$940.72
$1,012.64
$1,088.86
$1,359.62 		$1,144.58
$1,216.50
$1,292.72
$1,563.48 		$203.86
Toc - Plan #16 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 4 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$373.64
$424.07
$477.50
$667.30
$1,014.02 		$659.46
$709.89
$763.32
$953.12 		$945.28
$995.71
$1,049.14
$1,238.94 		$1,231.10
$1,281.53
$1,334.96
$1,524.76 		$285.82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$747.28
$848.14
$955.00
$1,334.60
$2,028.04 		$1,033.10
$1,133.96
$1,240.82
$1,620.42 		$1,318.92
$1,419.78
$1,526.64
$1,906.24 		$1,604.74
$1,705.60
$1,812.46
$2,192.06 		$285.82
Toc - Plan #17 Ambetter of Illinois
Gold

(HMO) Ambetter Secure Care 5 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$6,300 $12,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$431.51
$489.76
$551.46
$770.66
$1,171.10 		$761.61
$819.86
$881.56
$1,100.76 		$1,091.71
$1,149.96
$1,211.66
$1,430.86 		$1,421.81
$1,480.06
$1,541.76
$1,760.96 		$330.10
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$863.02
$979.52
$1,102.92
$1,541.32
$2,342.20 		$1,193.12
$1,309.62
$1,433.02
$1,871.42 		$1,523.22
$1,639.72
$1,763.12
$2,201.52 		$1,853.32
$1,969.82
$2,093.22
$2,531.62 		$330.10
Toc - Plan #18 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 11 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$363.81
$412.91
$464.94
$649.75
$987.36 		$642.12
$691.22
$743.25
$928.06 		$920.43
$969.53
$1,021.56
$1,206.37 		$1,198.74
$1,247.84
$1,299.87
$1,484.68 		$278.31
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$727.62
$825.82
$929.88
$1,299.50
$1,974.72 		$1,005.93
$1,104.13
$1,208.19
$1,577.81 		$1,284.24
$1,382.44
$1,486.50
$1,856.12 		$1,562.55
$1,660.75
$1,764.81
$2,134.43 		$278.31
Toc - Plan #19 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care 5 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$8,300 $16,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$311.43
$353.46
$397.99
$556.19
$845.19 		$549.67
$591.70
$636.23
$794.43 		$787.91
$829.94
$874.47
$1,032.67 		$1,026.15
$1,068.18
$1,112.71
$1,270.91 		$238.24
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$622.86
$706.92
$795.98
$1,112.38
$1,690.38 		$861.10
$945.16
$1,034.22
$1,350.62 		$1,099.34
$1,183.40
$1,272.46
$1,588.86 		$1,337.58
$1,421.64
$1,510.70
$1,827.10 		$238.24
Toc - Plan #20 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 28 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$387.91
$440.27
$495.74
$692.79
$1,052.76 		$684.65
$737.01
$792.48
$989.53 		$981.39
$1,033.75
$1,089.22
$1,286.27 		$1,278.13
$1,330.49
$1,385.96
$1,583.01 		$296.74
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$775.82
$880.54
$991.48
$1,385.58
$2,105.52 		$1,072.56
$1,177.28
$1,288.22
$1,682.32 		$1,369.30
$1,474.02
$1,584.96
$1,979.06 		$1,666.04
$1,770.76
$1,881.70
$2,275.80 		$296.74
Toc - Plan #21 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care 2 HSA + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$300.44
$340.99
$383.95
$536.57
$815.38 		$530.27
$570.82
$613.78
$766.40 		$760.10
$800.65
$843.61
$996.23 		$989.93
$1,030.48
$1,073.44
$1,226.06 		$229.83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$600.88
$681.98
$767.90
$1,073.14
$1,630.76 		$830.71
$911.81
$997.73
$1,302.97 		$1,060.54
$1,141.64
$1,227.56
$1,532.80 		$1,290.37
$1,371.47
$1,457.39
$1,762.63 		$229.83
Toc - Plan #22 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care 22 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$330.60
$375.21
$422.49
$590.43
$897.21 		$583.50
$628.11
$675.39
$843.33 		$836.40
$881.01
$928.29
$1,096.23 		$1,089.30
$1,133.91
$1,181.19
$1,349.13 		$252.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$661.20
$750.42
$844.98
$1,180.86
$1,794.42 		$914.10
$1,003.32
$1,097.88
$1,433.76 		$1,167.00
$1,256.22
$1,350.78
$1,686.66 		$1,419.90
$1,509.12
$1,603.68
$1,939.56 		$252.90
Toc - Plan #23 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care: $1,500 Medical Deductible + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$339.38
$385.18
$433.71
$606.11
$921.04 		$598.99
$644.79
$693.32
$865.72 		$858.60
$904.40
$952.93
$1,125.33 		$1,118.21
$1,164.01
$1,212.54
$1,384.94 		$259.61
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$678.76
$770.36
$867.42
$1,212.22
$1,842.08 		$938.37
$1,029.97
$1,127.03
$1,471.83 		$1,197.98
$1,289.58
$1,386.64
$1,731.44 		$1,457.59
$1,549.19
$1,646.25
$1,991.05 		$259.61
Toc - Plan #24 Ambetter of Illinois
Expanded Bronze

(HMO) Ambetter Essential Care: $0 Medical Deductible + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$361.49
$410.28
$461.98
$645.61
$981.07 		$638.03
$686.82
$738.52
$922.15 		$914.57
$963.36
$1,015.06
$1,198.69 		$1,191.11
$1,239.90
$1,291.60
$1,475.23 		$276.54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$722.98
$820.56
$923.96
$1,291.22
$1,962.14 		$999.52
$1,097.10
$1,200.50
$1,567.76 		$1,276.06
$1,373.64
$1,477.04
$1,844.30 		$1,552.60
$1,650.18
$1,753.58
$2,120.84 		$276.54
Toc - Plan #25 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 31 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$5,450 $10,900 Annual Deductible
$6,450 $12,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$334.48
$379.62
$427.45
$597.37
$907.76 		$590.35
$635.49
$683.32
$853.24 		$846.22
$891.36
$939.19
$1,109.11 		$1,102.09
$1,147.23
$1,195.06
$1,364.98 		$255.87
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$668.96
$759.24
$854.90
$1,194.74
$1,815.52 		$924.83
$1,015.11
$1,110.77
$1,450.61 		$1,180.70
$1,270.98
$1,366.64
$1,706.48 		$1,436.57
$1,526.85
$1,622.51
$1,962.35 		$255.87
Toc - Plan #26 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 32 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$8,100 $16,200 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$344.91
$391.46
$440.78
$615.98
$936.05 		$608.76
$655.31
$704.63
$879.83 		$872.61
$919.16
$968.48
$1,143.68 		$1,136.46
$1,183.01
$1,232.33
$1,407.53 		$263.85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$689.82
$782.92
$881.56
$1,231.96
$1,872.10 		$953.67
$1,046.77
$1,145.41
$1,495.81 		$1,217.52
$1,310.62
$1,409.26
$1,759.66 		$1,481.37
$1,574.47
$1,673.11
$2,023.51 		$263.85
Toc - Plan #27 Ambetter of Illinois
Gold

(HMO) Ambetter Secure Care 20 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$403.19
$457.61
$515.27
$720.08
$1,094.23 		$711.62
$766.04
$823.70
$1,028.51 		$1,020.05
$1,074.47
$1,132.13
$1,336.94 		$1,328.48
$1,382.90
$1,440.56
$1,645.37 		$308.43
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$806.38
$915.22
$1,030.54
$1,440.16
$2,188.46 		$1,114.81
$1,223.65
$1,338.97
$1,748.59 		$1,423.24
$1,532.08
$1,647.40
$2,057.02 		$1,731.67
$1,840.51
$1,955.83
$2,365.45 		$308.43
Toc - Plan #28 Ambetter of Illinois
Silver

(HMO) Ambetter Balanced Care 12 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$357.83
$406.13
$457.30
$639.07
$971.13 		$631.56
$679.86
$731.03
$912.80 		$905.29
$953.59
$1,004.76
$1,186.53 		$1,179.02
$1,227.32
$1,278.49
$1,460.26 		$273.73
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$715.66
$812.26
$914.60
$1,278.14
$1,942.26 		$989.39
$1,085.99
$1,188.33
$1,551.87 		$1,263.12
$1,359.72
$1,462.06
$1,825.60 		$1,536.85
$1,633.45
$1,735.79
$2,099.33 		$273.73
Toc - Plan #29 Ambetter of Illinois
Bronze

(HMO) Ambetter Essential Care 1 + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-745-5507

Annual Out of Pocket Expenses:

Individual Family
$8,600 $17,200 Annual Deductible
$8,600 $17,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$278.55
$316.14
$355.97
$497.47
$755.96 		$491.63
$529.22
$569.05
$710.55 		$704.71
$742.30
$782.13
$923.63 		$917.79
$955.38
$995.21
$1,136.71 		$213.08
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$557.10
$632.28
$711.94
$994.94
$1,511.92 		$770.18
$845.36
$925.02
$1,208.02 		$983.26
$1,058.44
$1,138.10
$1,421.10 		$1,196.34
$1,271.52
$1,351.18
$1,634.18 		$213.08

ADVERTISEMENT

Blue Cross and Blue Shield of Illinois

Local: 1-800-538-8833 | Toll Free: 1-800-538-8833 | TTY: 1-800-526-0844
Toc - Plan #30 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 204

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$750 $2,250 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$509.70
$578.51
$651.40
$910.32
$1,383.33 		$899.62
$968.43
$1,041.32
$1,300.24 		$1,289.54
$1,358.35
$1,431.24
$1,690.16 		$1,679.46
$1,748.27
$1,821.16
$2,080.08 		$389.92
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,019.40
$1,157.02
$1,302.80
$1,820.64
$2,766.66 		$1,409.32
$1,546.94
$1,692.72
$2,210.56 		$1,799.24
$1,936.86
$2,082.64
$2,600.48 		$2,189.16
$2,326.78
$2,472.56
$2,990.40 		$389.92
Toc - Plan #31 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 203

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$2,350 $7,050 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$433.84
$492.40
$554.44
$774.83
$1,177.43 		$765.72
$824.28
$886.32
$1,106.71 		$1,097.60
$1,156.16
$1,218.20
$1,438.59 		$1,429.48
$1,488.04
$1,550.08
$1,770.47 		$331.88
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$867.68
$984.80
$1,108.88
$1,549.66
$2,354.86 		$1,199.56
$1,316.68
$1,440.76
$1,881.54 		$1,531.44
$1,648.56
$1,772.64
$2,213.42 		$1,863.32
$1,980.44
$2,104.52
$2,545.30 		$331.88
Toc - Plan #32 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 202

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$4,500 $13,500 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$354.96
$402.88
$453.64
$633.95
$963.35 		$626.50
$674.42
$725.18
$905.49 		$898.04
$945.96
$996.72
$1,177.03 		$1,169.58
$1,217.50
$1,268.26
$1,448.57 		$271.54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$709.92
$805.76
$907.28
$1,267.90
$1,926.70 		$981.46
$1,077.30
$1,178.82
$1,539.44 		$1,253.00
$1,348.84
$1,450.36
$1,810.98 		$1,524.54
$1,620.38
$1,721.90
$2,082.52 		$271.54
Toc - Plan #33 Blue Cross and Blue Shield of Illinois
Catastrophic

(PPO) Blue Choice Preferred Security PPO? 200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$298.48
$338.78
$381.46
$533.09
$810.08 		$526.82
$567.12
$609.80
$761.43 		$755.16
$795.46
$838.14
$989.77 		$983.50
$1,023.80
$1,066.48
$1,218.11 		$228.34
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$596.96
$677.56
$762.92
$1,066.18
$1,620.16 		$825.30
$905.90
$991.26
$1,294.52 		$1,053.64
$1,134.24
$1,219.60
$1,522.86 		$1,281.98
$1,362.58
$1,447.94
$1,751.20 		$228.34
Toc - Plan #34 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 201

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$6,100 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$329.49
$373.97
$421.08
$588.46
$894.22 		$581.55
$626.03
$673.14
$840.52 		$833.61
$878.09
$925.20
$1,092.58 		$1,085.67
$1,130.15
$1,177.26
$1,344.64 		$252.06
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$658.98
$747.94
$842.16
$1,176.92
$1,788.44 		$911.04
$1,000.00
$1,094.22
$1,428.98 		$1,163.10
$1,252.06
$1,346.28
$1,681.04 		$1,415.16
$1,504.12
$1,598.34
$1,933.10 		$252.06
Toc - Plan #35 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 601

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,000 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$316.12
$358.80
$404.00
$564.59
$857.95 		$557.95
$600.63
$645.83
$806.42 		$799.78
$842.46
$887.66
$1,048.25 		$1,041.61
$1,084.29
$1,129.49
$1,290.08 		$241.83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$632.24
$717.60
$808.00
$1,129.18
$1,715.90 		$874.07
$959.43
$1,049.83
$1,371.01 		$1,115.90
$1,201.26
$1,291.66
$1,612.84 		$1,357.73
$1,443.09
$1,533.49
$1,854.67 		$241.83

‡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 Monroe County here.

Monroe County is in “Rating Area 12” of Illinois.

Currently, there are 35 plans offered in Rating Area 12.

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