Obamacare 2022 Rates for Sullivan County
Obamacare > Rates > Indiana > Sullivan County
Obamacare > Rates > Indiana > Sullivan County
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CareSourceLocal: 1-800-479-9502 | Toll Free: 1-877-806-9284 |
Toc - Plan #1 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace HSA Eligible Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$341.82 $387.96 $436.84 $610.49 $927.69 |
$603.31 $649.45 $698.33 $871.98 |
$864.80 $910.94 $959.82 $1,133.47 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$683.64 $775.92 $873.68 $1,220.98 $1,855.38 |
$945.13 $1,037.41 $1,135.17 $1,482.47 |
$1,206.62 $1,298.90 $1,396.66 $1,743.96 |
Toc - Plan #2 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$353.86 $401.62 $452.22 $631.98 $960.36 |
$624.56 $672.32 $722.92 $902.68 |
$895.26 $943.02 $993.62 $1,173.38 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$707.72 $803.24 $904.44 $1,263.96 $1,920.72 |
$978.42 $1,073.94 $1,175.14 $1,534.66 |
$1,249.12 $1,344.64 $1,445.84 $1,805.36 |
Toc - Plan #3 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$552.33 $626.89 $705.87 $986.45 $1,499.01 |
$974.86 $1,049.42 $1,128.40 $1,408.98 |
$1,397.39 $1,471.95 $1,550.93 $1,831.51 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,104.66 $1,253.78 $1,411.74 $1,972.90 $2,998.02 |
$1,527.19 $1,676.31 $1,834.27 $2,395.43 |
$1,949.72 $2,098.84 $2,256.80 $2,817.96 |
Toc - Plan #4 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$374.63 $425.21 $478.78 $669.09 $1,016.75 |
$661.22 $711.80 $765.37 $955.68 |
$947.81 $998.39 $1,051.96 $1,242.27 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$749.26 $850.42 $957.56 $1,338.18 $2,033.50 |
$1,035.85 $1,137.01 $1,244.15 $1,624.77 |
$1,322.44 $1,423.60 $1,530.74 $1,911.36 |
Toc - Plan #5 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$293.57 $333.19 $375.17 $524.30 $796.73 |
$518.14 $557.76 $599.74 $748.87 |
$742.71 $782.33 $824.31 $973.44 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$587.14 $666.38 $750.34 $1,048.60 $1,593.46 |
$811.71 $890.95 $974.91 $1,273.17 |
$1,036.28 $1,115.52 $1,199.48 $1,497.74 |
Toc - Plan #6 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Deductible Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$387.39 $439.69 $495.08 $691.88 $1,051.37 |
$683.74 $736.04 $791.43 $988.23 |
$980.09 $1,032.39 $1,087.78 $1,284.58 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$774.78 $879.38 $990.16 $1,383.76 $2,102.74 |
$1,071.13 $1,175.73 $1,286.51 $1,680.11 |
$1,367.48 $1,472.08 $1,582.86 $1,976.46 |
Toc - Plan #7 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$279.07 $316.74 $356.65 $498.41 $757.39 |
$492.56 $530.23 $570.14 $711.90 |
$706.05 $743.72 $783.63 $925.39 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$558.14 $633.48 $713.30 $996.82 $1,514.78 |
$771.63 $846.97 $926.79 $1,210.31 |
$985.12 $1,060.46 $1,140.28 $1,423.80 |
Toc - Plan #8 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$362.90 $411.89 $463.79 $648.14 $984.91 |
$640.52 $689.51 $741.41 $925.76 |
$918.14 $967.13 $1,019.03 $1,203.38 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$725.80 $823.78 $927.58 $1,296.28 $1,969.82 |
$1,003.42 $1,101.40 $1,205.20 $1,573.90 |
$1,281.04 $1,379.02 $1,482.82 $1,851.52 |
Toc - Plan #9 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-877-806-9284
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 |
$563.18 $639.21 $719.74 $1,005.83 $1,528.46 |
$994.01 $1,070.04 $1,150.57 $1,436.66 |
$1,424.84 $1,500.87 $1,581.40 $1,867.49 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,126.36 $1,278.42 $1,439.48 $2,011.66 $3,056.92 |
$1,557.19 $1,709.25 $1,870.31 $2,442.49 |
$1,988.02 $2,140.08 $2,301.14 $2,873.32 |
Toc - Plan #10 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$383.68 $435.47 $490.34 $685.25 $1,041.30 |
$677.19 $728.98 $783.85 $978.76 |
$970.70 $1,022.49 $1,077.36 $1,272.27 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$767.36 $870.94 $980.68 $1,370.50 $2,082.60 |
$1,060.87 $1,164.45 $1,274.19 $1,664.01 |
$1,354.38 $1,457.96 $1,567.70 $1,957.52 |
Toc - Plan #11 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-877-806-9284
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 |
$301.45 $342.14 $385.25 $538.38 $818.13 |
$532.06 $572.75 $615.86 $768.99 |
$762.67 $803.36 $846.47 $999.60 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$602.90 $684.28 $770.50 $1,076.76 $1,636.26 |
$833.51 $914.89 $1,001.11 $1,307.37 |
$1,064.12 $1,145.50 $1,231.72 $1,537.98 |
Toc - Plan #12 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Deductible Silver Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$396.44 $449.95 $506.64 $708.03 $1,075.93 |
$699.71 $753.22 $809.91 $1,011.30 |
$1,002.98 $1,056.49 $1,113.18 $1,314.57 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$792.88 $899.90 $1,013.28 $1,416.06 $2,151.86 |
$1,096.15 $1,203.17 $1,316.55 $1,719.33 |
$1,399.42 $1,506.44 $1,619.82 $2,022.60 |
Toc - Plan #13 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-806-9284
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 |
$286.56 $325.24 $366.22 $511.79 $777.72 |
$505.78 $544.46 $585.44 $731.01 |
$725.00 $763.68 $804.66 $950.23 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$573.12 $650.48 $732.44 $1,023.58 $1,555.44 |
$792.34 $869.70 $951.66 $1,242.80 |
$1,011.56 $1,088.92 $1,170.88 $1,462.02 |
ADVERTISEMENT
Ambetter from MHSLocal: 1-877-687-1182 | Toll Free: 1-877-687-1182 | TTY: 1-877-941-9232 |
Toc - Plan #14 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$364.99 $414.25 $466.44 $651.85 $990.54 |
$644.20 $693.46 $745.65 $931.06 |
$923.41 $972.67 $1,024.86 $1,210.27 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$729.98 $828.50 $932.88 $1,303.70 $1,981.08 |
$1,009.19 $1,107.71 $1,212.09 $1,582.91 |
$1,288.40 $1,386.92 $1,491.30 $1,862.12 |
Toc - Plan #15 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$361.01 $409.73 $461.35 $644.74 $979.75 |
$637.17 $685.89 $737.51 $920.90 |
$913.33 $962.05 $1,013.67 $1,197.06 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$722.02 $819.46 $922.70 $1,289.48 $1,959.50 |
$998.18 $1,095.62 $1,198.86 $1,565.64 |
$1,274.34 $1,371.78 $1,475.02 $1,841.80 |
Toc - Plan #16 Ambetter from MHS | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$468.38 $531.60 $598.58 $836.52 $1,271.17 |
$826.69 $889.91 $956.89 $1,194.83 |
$1,185.00 $1,248.22 $1,315.20 $1,553.14 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$936.76 $1,063.20 $1,197.16 $1,673.04 $2,542.34 |
$1,295.07 $1,421.51 $1,555.47 $2,031.35 |
$1,653.38 $1,779.82 $1,913.78 $2,389.66 |
Toc - Plan #17 Ambetter from MHS | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$313.93 $356.29 $401.18 $560.65 $851.97 |
$554.08 $596.44 $641.33 $800.80 |
$794.23 $836.59 $881.48 $1,040.95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$627.86 $712.58 $802.36 $1,121.30 $1,703.94 |
$868.01 $952.73 $1,042.51 $1,361.45 |
$1,108.16 $1,192.88 $1,282.66 $1,601.60 |
Toc - Plan #18 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 24 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$372.25 $422.49 $475.72 $664.82 $1,010.26 |
$657.01 $707.25 $760.48 $949.58 |
$941.77 $992.01 $1,045.24 $1,234.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$744.50 $844.98 $951.44 $1,329.64 $2,020.52 |
$1,029.26 $1,129.74 $1,236.20 $1,614.40 |
$1,314.02 $1,414.50 $1,520.96 $1,899.16 |
Toc - Plan #19 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 28 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$383.34 $435.08 $489.90 $684.63 $1,040.37 |
$676.59 $728.33 $783.15 $977.88 |
$969.84 $1,021.58 $1,076.40 $1,271.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$766.68 $870.16 $979.80 $1,369.26 $2,080.74 |
$1,059.93 $1,163.41 $1,273.05 $1,662.51 |
$1,353.18 $1,456.66 $1,566.30 $1,955.76 |
Toc - Plan #20 Ambetter from MHS | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-877-687-1182
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 |
$343.60 $389.97 $439.11 $613.65 $932.50 |
$606.45 $652.82 $701.96 $876.50 |
$869.30 $915.67 $964.81 $1,139.35 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$687.20 $779.94 $878.22 $1,227.30 $1,865.00 |
$950.05 $1,042.79 $1,141.07 $1,490.15 |
$1,212.90 $1,305.64 $1,403.92 $1,753.00 |
Toc - Plan #21 Ambetter from MHS | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 5 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$336.30 $381.69 $429.78 $600.61 $912.69 |
$593.56 $638.95 $687.04 $857.87 |
$850.82 $896.21 $944.30 $1,115.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$672.60 $763.38 $859.56 $1,201.22 $1,825.38 |
$929.86 $1,020.64 $1,116.82 $1,458.48 |
$1,187.12 $1,277.90 $1,374.08 $1,715.74 |
Toc - Plan #22 Ambetter from MHS | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
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 |
$364.69 $413.92 $466.07 $651.33 $989.75 |
$643.67 $692.90 $745.05 $930.31 |
$922.65 $971.88 $1,024.03 $1,209.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$729.38 $827.84 $932.14 $1,302.66 $1,979.50 |
$1,008.36 $1,106.82 $1,211.12 $1,581.64 |
$1,287.34 $1,385.80 $1,490.10 $1,860.62 |
Toc - Plan #23 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.53 $392.17 $441.58 $617.10 $937.75 |
$609.85 $656.49 $705.90 $881.42 |
$874.17 $920.81 $970.22 $1,145.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$691.06 $784.34 $883.16 $1,234.20 $1,875.50 |
$955.38 $1,048.66 $1,147.48 $1,498.52 |
$1,219.70 $1,312.98 $1,411.80 $1,762.84 |
Toc - Plan #24 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.31 $391.92 $441.30 $616.71 $937.15 |
$609.47 $656.08 $705.46 $880.87 |
$873.63 $920.24 $969.62 $1,145.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.62 $783.84 $882.60 $1,233.42 $1,874.30 |
$954.78 $1,048.00 $1,146.76 $1,497.58 |
$1,218.94 $1,312.16 $1,410.92 $1,761.74 |
Toc - Plan #25 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.08 $398.46 $448.67 $627.01 $952.80 |
$619.65 $667.03 $717.24 $895.58 |
$888.22 $935.60 $985.81 $1,164.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.16 $796.92 $897.34 $1,254.02 $1,905.60 |
$970.73 $1,065.49 $1,165.91 $1,522.59 |
$1,239.30 $1,334.06 $1,434.48 $1,791.16 |
Toc - Plan #26 Ambetter from MHS | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.06 $499.46 $562.39 $785.93 $1,194.30 |
$776.70 $836.10 $899.03 $1,122.57 |
$1,113.34 $1,172.74 $1,235.67 $1,459.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$880.12 $998.92 $1,124.78 $1,571.86 $2,388.60 |
$1,216.76 $1,335.56 $1,461.42 $1,908.50 |
$1,553.40 $1,672.20 $1,798.06 $2,245.14 |
Toc - Plan #27 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.01 $427.89 $481.80 $673.31 $1,023.17 |
$665.41 $716.29 $770.20 $961.71 |
$953.81 $1,004.69 $1,058.60 $1,250.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$754.02 $855.78 $963.60 $1,346.62 $2,046.34 |
$1,042.42 $1,144.18 $1,252.00 $1,635.02 |
$1,330.82 $1,432.58 $1,540.40 $1,923.42 |
Toc - Plan #28 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.16 $432.61 $487.11 $680.73 $1,034.44 |
$672.74 $724.19 $778.69 $972.31 |
$964.32 $1,015.77 $1,070.27 $1,263.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.32 $865.22 $974.22 $1,361.46 $2,068.88 |
$1,053.90 $1,156.80 $1,265.80 $1,653.04 |
$1,345.48 $1,448.38 $1,557.38 $1,944.62 |
Toc - Plan #29 Ambetter from MHS | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$489.14 $555.16 $625.11 $873.59 $1,327.50 |
$863.32 $929.34 $999.29 $1,247.77 |
$1,237.50 $1,303.52 $1,373.47 $1,621.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$978.28 $1,110.32 $1,250.22 $1,747.18 $2,655.00 |
$1,352.46 $1,484.50 $1,624.40 $2,121.36 |
$1,726.64 $1,858.68 $1,998.58 $2,495.54 |
Toc - Plan #30 Ambetter from MHS | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.84 $372.08 $418.96 $585.50 $889.72 |
$578.63 $622.87 $669.75 $836.29 |
$829.42 $873.66 $920.54 $1,087.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.68 $744.16 $837.92 $1,171.00 $1,779.44 |
$906.47 $994.95 $1,088.71 $1,421.79 |
$1,157.26 $1,245.74 $1,339.50 $1,672.58 |
Toc - Plan #31 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 24 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.74 $441.21 $496.80 $694.28 $1,055.03 |
$686.12 $738.59 $794.18 $991.66 |
$983.50 $1,035.97 $1,091.56 $1,289.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$777.48 $882.42 $993.60 $1,388.56 $2,110.06 |
$1,074.86 $1,179.80 $1,290.98 $1,685.94 |
$1,372.24 $1,477.18 $1,588.36 $1,983.32 |
Toc - Plan #32 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 28 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.33 $454.37 $511.61 $714.97 $1,086.47 |
$706.58 $760.62 $817.86 $1,021.22 |
$1,012.83 $1,066.87 $1,124.11 $1,327.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.66 $908.74 $1,023.22 $1,429.94 $2,172.94 |
$1,106.91 $1,214.99 $1,329.47 $1,736.19 |
$1,413.16 $1,521.24 $1,635.72 $2,042.44 |
Toc - Plan #33 Ambetter from MHS | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.82 $407.25 $458.57 $640.84 $973.82 |
$633.31 $681.74 $733.06 $915.33 |
$907.80 $956.23 $1,007.55 $1,189.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$717.64 $814.50 $917.14 $1,281.68 $1,947.64 |
$992.13 $1,088.99 $1,191.63 $1,556.17 |
$1,266.62 $1,363.48 $1,466.12 $1,830.66 |
Toc - Plan #34 Ambetter from MHS | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 5 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.20 $398.60 $448.82 $627.23 $953.13 |
$619.86 $667.26 $717.48 $895.89 |
$888.52 $935.92 $986.14 $1,164.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.40 $797.20 $897.64 $1,254.46 $1,906.26 |
$971.06 $1,065.86 $1,166.30 $1,523.12 |
$1,239.72 $1,334.52 $1,434.96 $1,791.78 |
Toc - Plan #35 Ambetter from MHS | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$380.86 $432.26 $486.72 $680.19 $1,033.61 |
$672.21 $723.61 $778.07 $971.54 |
$963.56 $1,014.96 $1,069.42 $1,262.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$761.72 $864.52 $973.44 $1,360.38 $2,067.22 |
$1,053.07 $1,155.87 $1,264.79 $1,651.73 |
$1,344.42 $1,447.22 $1,556.14 $1,943.08 |
Toc - Plan #36 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 30 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.84 $409.55 $461.15 $644.45 $979.31 |
$636.88 $685.59 $737.19 $920.49 |
$912.92 $961.63 $1,013.23 $1,196.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$721.68 $819.10 $922.30 $1,288.90 $1,958.62 |
$997.72 $1,095.14 $1,198.34 $1,564.94 |
$1,273.76 $1,371.18 $1,474.38 $1,840.98 |
Toc - Plan #37 Ambetter from MHS | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.64 $416.12 $468.55 $654.80 $995.03 |
$647.11 $696.59 $749.02 $935.27 |
$927.58 $977.06 $1,029.49 $1,215.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.28 $832.24 $937.10 $1,309.60 $1,990.06 |
$1,013.75 $1,112.71 $1,217.57 $1,590.07 |
$1,294.22 $1,393.18 $1,498.04 $1,870.54 |
Toc - Plan #38 Ambetter from MHS | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1182
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$459.56 $521.59 $587.31 $820.76 $1,247.23 |
$811.12 $873.15 $938.87 $1,172.32 |
$1,162.68 $1,224.71 $1,290.43 $1,523.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$919.12 $1,043.18 $1,174.62 $1,641.52 $2,494.46 |
$1,270.68 $1,394.74 $1,526.18 $1,993.08 |
$1,622.24 $1,746.30 $1,877.74 $2,344.64 |
‡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 Sullivan County here.
Sullivan County is in “” of Indiana.
Currently, there are 38 plans offered in .