Obamacare 2022 Rates for Harris County
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Obamacare > Rates > Texas > Harris 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) 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 |
$259.67 $294.71 $331.84 $463.75 $704.72 |
$458.31 $493.35 $530.48 $662.39 |
$656.95 $691.99 $729.12 $861.03 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$519.34 $589.42 $663.68 $927.50 $1,409.44 |
$717.98 $788.06 $862.32 $1,126.14 |
$916.62 $986.70 $1,060.96 $1,324.78 |
Toc - Plan #2 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- PCP Saver |
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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 |
$263.92 $299.54 $337.28 $471.35 $716.26 |
$465.81 $501.43 $539.17 $673.24 |
$667.70 $703.32 $741.06 $875.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$527.84 $599.08 $674.56 $942.70 $1,432.52 |
$729.73 $800.97 $876.45 $1,144.59 |
$931.62 $1,002.86 $1,078.34 $1,346.48 |
Toc - Plan #3 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) 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 |
$259.98 $295.07 $332.24 $464.31 $705.56 |
$458.86 $493.95 $531.12 $663.19 |
$657.74 $692.83 $730.00 $862.07 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$519.96 $590.14 $664.48 $928.62 $1,411.12 |
$718.84 $789.02 $863.36 $1,127.50 |
$917.72 $987.90 $1,062.24 $1,326.38 |
Toc - Plan #4 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+PCP Saver |
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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 |
$310.98 $352.95 $397.41 $555.39 $843.96 |
$548.87 $590.84 $635.30 $793.28 |
$786.76 $828.73 $873.19 $1,031.17 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$621.96 $705.90 $794.82 $1,110.78 $1,687.92 |
$859.85 $943.79 $1,032.71 $1,348.67 |
$1,097.74 $1,181.68 $1,270.60 $1,586.56 |
Toc - Plan #5 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver 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 |
$363.47 $412.53 $464.50 $649.14 $986.43 |
$641.52 $690.58 $742.55 $927.19 |
$919.57 $968.63 $1,020.60 $1,205.24 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$726.94 $825.06 $929.00 $1,298.28 $1,972.86 |
$1,004.99 $1,103.11 $1,207.05 $1,576.33 |
$1,283.04 $1,381.16 $1,485.10 $1,854.38 |
Toc - Plan #6 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- Specialist Saver |
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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 |
$356.12 $404.19 $455.11 $636.02 $966.49 |
$628.55 $676.62 $727.54 $908.45 |
$900.98 $949.05 $999.97 $1,180.88 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$712.24 $808.38 $910.22 $1,272.04 $1,932.98 |
$984.67 $1,080.81 $1,182.65 $1,544.47 |
$1,257.10 $1,353.24 $1,455.08 $1,816.90 |
Toc - Plan #7 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- PCP Saver |
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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 |
$363.81 $412.91 $464.93 $649.74 $987.34 |
$642.11 $691.21 $743.23 $928.04 |
$920.41 $969.51 $1,021.53 $1,206.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$727.62 $825.82 $929.86 $1,299.48 $1,974.68 |
$1,005.92 $1,104.12 $1,208.16 $1,577.78 |
$1,284.22 $1,382.42 $1,486.46 $1,856.08 |
Toc - Plan #8 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Secure |
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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 |
$214.87 $243.87 $274.59 $383.74 $583.14 |
$379.24 $408.24 $438.96 $548.11 |
$543.61 $572.61 $603.33 $712.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$429.74 $487.74 $549.18 $767.48 $1,166.28 |
$594.11 $652.11 $713.55 $931.85 |
$758.48 $816.48 $877.92 $1,096.22 |
Toc - Plan #9 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+Specialist Saver |
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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 |
$311.05 $353.03 $397.51 $555.52 $844.16 |
$548.99 $590.97 $635.45 $793.46 |
$786.93 $828.91 $873.39 $1,031.40 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$622.10 $706.06 $795.02 $1,111.04 $1,688.32 |
$860.04 $944.00 $1,032.96 $1,348.98 |
$1,097.98 $1,181.94 $1,270.90 $1,586.92 |
Toc - Plan #10 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) 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 |
$358.46 $406.84 $458.10 $640.19 $972.83 |
$632.67 $681.05 $732.31 $914.40 |
$906.88 $955.26 $1,006.52 $1,188.61 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$716.92 $813.68 $916.20 $1,280.38 $1,945.66 |
$991.13 $1,087.89 $1,190.41 $1,554.59 |
$1,265.34 $1,362.10 $1,464.62 $1,828.80 |
Toc - Plan #11 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Simple- HSA |
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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 |
$285.24 $323.74 $364.52 $509.42 $774.12 |
$503.44 $541.94 $582.72 $727.62 |
$721.64 $760.14 $800.92 $945.82 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$570.48 $647.48 $729.04 $1,018.84 $1,548.24 |
$788.68 $865.68 $947.24 $1,237.04 |
$1,006.88 $1,083.88 $1,165.44 $1,455.24 |
Toc - Plan #12 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver 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 |
$356.53 $404.65 $455.63 $636.74 $967.59 |
$629.27 $677.39 $728.37 $909.48 |
$902.01 $950.13 $1,001.11 $1,182.22 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$713.06 $809.30 $911.26 $1,273.48 $1,935.18 |
$985.80 $1,082.04 $1,184.00 $1,546.22 |
$1,258.54 $1,354.78 $1,456.74 $1,818.96 |
Toc - Plan #13 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite |
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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 |
$369.65 $419.55 $472.40 $660.18 $1,003.21 |
$652.43 $702.33 $755.18 $942.96 |
$935.21 $985.11 $1,037.96 $1,225.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$739.30 $839.10 $944.80 $1,320.36 $2,006.42 |
$1,022.08 $1,121.88 $1,227.58 $1,603.14 |
$1,304.86 $1,404.66 $1,510.36 $1,885.92 |
Toc - Plan #14 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) 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 |
$384.70 $436.63 $491.64 $687.06 $1,044.06 |
$678.99 $730.92 $785.93 $981.35 |
$973.28 $1,025.21 $1,080.22 $1,275.64 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$769.40 $873.26 $983.28 $1,374.12 $2,088.12 |
$1,063.69 $1,167.55 $1,277.57 $1,668.41 |
$1,357.98 $1,461.84 $1,571.86 $1,962.70 |
Toc - Plan #15 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- Low 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 |
$365.98 $415.38 $467.71 $653.62 $993.24 |
$645.95 $695.35 $747.68 $933.59 |
$925.92 $975.32 $1,027.65 $1,213.56 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$731.96 $830.76 $935.42 $1,307.24 $1,986.48 |
$1,011.93 $1,110.73 $1,215.39 $1,587.21 |
$1,291.90 $1,390.70 $1,495.36 $1,867.18 |
Toc - Plan #16 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $0 PCP |
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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 |
$274.98 $312.09 $351.41 $491.09 $746.26 |
$485.33 $522.44 $561.76 $701.44 |
$695.68 $732.79 $772.11 $911.79 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$549.96 $624.18 $702.82 $982.18 $1,492.52 |
$760.31 $834.53 $913.17 $1,192.53 |
$970.66 $1,044.88 $1,123.52 $1,402.88 |
Toc - Plan #17 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- Specialist Saver |
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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 |
$298.63 $338.93 $381.63 $533.33 $810.44 |
$527.07 $567.37 $610.07 $761.77 |
$755.51 $795.81 $838.51 $990.21 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$597.26 $677.86 $763.26 $1,066.66 $1,620.88 |
$825.70 $906.30 $991.70 $1,295.10 |
$1,054.14 $1,134.74 $1,220.14 $1,523.54 |
Toc - Plan #18 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $3250 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 |
$297.06 $337.16 $379.63 $530.54 $806.20 |
$524.31 $564.41 $606.88 $757.79 |
$751.56 $791.66 $834.13 $985.04 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$594.12 $674.32 $759.26 $1,061.08 $1,612.40 |
$821.37 $901.57 $986.51 $1,288.33 |
$1,048.62 $1,128.82 $1,213.76 $1,515.58 |
Toc - Plan #19 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4700 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 |
$274.02 $311.00 $350.19 $489.38 $743.67 |
$483.64 $520.62 $559.81 $699.00 |
$693.26 $730.24 $769.43 $908.62 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$548.04 $622.00 $700.38 $978.76 $1,487.34 |
$757.66 $831.62 $910.00 $1,188.38 |
$967.28 $1,041.24 $1,119.62 $1,398.00 |
Toc - Plan #20 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- PCP Saver |
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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 |
$352.35 $399.90 $450.29 $629.27 $956.24 |
$621.89 $669.44 $719.83 $898.81 |
$891.43 $938.98 $989.37 $1,168.35 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$704.70 $799.80 $900.58 $1,258.54 $1,912.48 |
$974.24 $1,069.34 $1,170.12 $1,528.08 |
$1,243.78 $1,338.88 $1,439.66 $1,797.62 |
Toc - Plan #21 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- Specialist Saver |
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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 |
$380.93 $432.34 $486.81 $680.32 $1,033.81 |
$672.33 $723.74 $778.21 $971.72 |
$963.73 $1,015.14 $1,069.61 $1,263.12 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$761.86 $864.68 $973.62 $1,360.64 $2,067.62 |
$1,053.26 $1,156.08 $1,265.02 $1,652.04 |
$1,344.66 $1,447.48 $1,556.42 $1,943.44 |
Toc - Plan #22 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- Low 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 |
$366.52 $415.99 $468.40 $654.58 $994.70 |
$646.90 $696.37 $748.78 $934.96 |
$927.28 $976.75 $1,029.16 $1,215.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$733.04 $831.98 $936.80 $1,309.16 $1,989.40 |
$1,013.42 $1,112.36 $1,217.18 $1,589.54 |
$1,293.80 $1,392.74 $1,497.56 $1,869.92 |
Toc - Plan #23 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 PCP |
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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 |
$378.41 $429.49 $483.60 $675.83 $1,026.99 |
$667.89 $718.97 $773.08 $965.31 |
$957.37 $1,008.45 $1,062.56 $1,254.79 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.82 $858.98 $967.20 $1,351.66 $2,053.98 |
$1,046.30 $1,148.46 $1,256.68 $1,641.14 |
$1,335.78 $1,437.94 $1,546.16 $1,930.62 |
Toc - Plan #24 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.61 $428.57 $482.57 $674.39 $1,024.80 |
$666.47 $717.43 $771.43 $963.25 |
$955.33 $1,006.29 $1,060.29 $1,252.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.22 $857.14 $965.14 $1,348.78 $2,049.60 |
$1,044.08 $1,146.00 $1,254.00 $1,637.64 |
$1,332.94 $1,434.86 $1,542.86 $1,926.50 |
Toc - Plan #25 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.96 $424.43 $477.90 $667.87 $1,014.89 |
$660.03 $710.50 $763.97 $953.94 |
$946.10 $996.57 $1,050.04 $1,240.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$747.92 $848.86 $955.80 $1,335.74 $2,029.78 |
$1,033.99 $1,134.93 $1,241.87 $1,621.81 |
$1,320.06 $1,421.00 $1,527.94 $1,907.88 |
Toc - Plan #26 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.66 $390.05 $439.19 $613.77 $932.68 |
$606.56 $652.95 $702.09 $876.67 |
$869.46 $915.85 $964.99 $1,139.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$687.32 $780.10 $878.38 $1,227.54 $1,865.36 |
$950.22 $1,043.00 $1,141.28 $1,490.44 |
$1,213.12 $1,305.90 $1,404.18 $1,753.34 |
Toc - Plan #27 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- $0 PCP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$350.38 $397.67 $447.77 $625.76 $950.91 |
$618.41 $665.70 $715.80 $893.79 |
$886.44 $933.73 $983.83 $1,161.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$700.76 $795.34 $895.54 $1,251.52 $1,901.82 |
$968.79 $1,063.37 $1,163.57 $1,519.55 |
$1,236.82 $1,331.40 $1,431.60 $1,787.58 |
Toc - Plan #28 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$401.00 $455.12 $512.47 $716.17 $1,088.29 |
$707.76 $761.88 $819.23 $1,022.93 |
$1,014.52 $1,068.64 $1,125.99 $1,329.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$802.00 $910.24 $1,024.94 $1,432.34 $2,176.58 |
$1,108.76 $1,217.00 $1,331.70 $1,739.10 |
$1,415.52 $1,523.76 $1,638.46 $2,045.86 |
Toc - Plan #29 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$379.00 $430.15 $484.35 $676.87 $1,028.57 |
$668.93 $720.08 $774.28 $966.80 |
$958.86 $1,010.01 $1,064.21 $1,256.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.00 $860.30 $968.70 $1,353.74 $2,057.14 |
$1,047.93 $1,150.23 $1,258.63 $1,643.67 |
$1,337.86 $1,440.16 $1,548.56 $1,933.60 |
Toc - Plan #30 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.85 $400.48 $450.93 $630.18 $957.62 |
$622.77 $670.40 $720.85 $900.10 |
$892.69 $940.32 $990.77 $1,170.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$705.70 $800.96 $901.86 $1,260.36 $1,915.24 |
$975.62 $1,070.88 $1,171.78 $1,530.28 |
$1,245.54 $1,340.80 $1,441.70 $1,800.20 |
Toc - Plan #31 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4000 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.08 $336.04 $378.38 $528.78 $803.54 |
$522.57 $562.53 $604.87 $755.27 |
$749.06 $789.02 $831.36 $981.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$592.16 $672.08 $756.76 $1,057.56 $1,607.08 |
$818.65 $898.57 $983.25 $1,284.05 |
$1,045.14 $1,125.06 $1,209.74 $1,510.54 |
Toc - Plan #32 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.25 $345.31 $388.82 $543.37 $825.71 |
$536.99 $578.05 $621.56 $776.11 |
$769.73 $810.79 $854.30 $1,008.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608.50 $690.62 $777.64 $1,086.74 $1,651.42 |
$841.24 $923.36 $1,010.38 $1,319.48 |
$1,073.98 $1,156.10 $1,243.12 $1,552.22 |
Toc - Plan #33 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $1000 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.15 $346.34 $389.97 $544.99 $828.16 |
$538.58 $579.77 $623.40 $778.42 |
$772.01 $813.20 $856.83 $1,011.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$610.30 $692.68 $779.94 $1,089.98 $1,656.32 |
$843.73 $926.11 $1,013.37 $1,323.41 |
$1,077.16 $1,159.54 $1,246.80 $1,556.84 |
Toc - Plan #34 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- For Diabetes |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.08 $408.68 $460.17 $643.09 $977.23 |
$635.53 $684.13 $735.62 $918.54 |
$910.98 $959.58 $1,011.07 $1,193.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$720.16 $817.36 $920.34 $1,286.18 $1,954.46 |
$995.61 $1,092.81 $1,195.79 $1,561.63 |
$1,271.06 $1,368.26 $1,471.24 $1,837.08 |
Toc - Plan #35 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Simple (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.45 $310.36 $349.46 $488.37 $742.12 |
$482.63 $519.54 $558.64 $697.55 |
$691.81 $728.72 $767.82 $906.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$546.90 $620.72 $698.92 $976.74 $1,484.24 |
$756.08 $829.90 $908.10 $1,185.92 |
$965.26 $1,039.08 $1,117.28 $1,395.10 |
Toc - Plan #36 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- PCP Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$277.94 $315.45 $355.20 $496.38 $754.30 |
$490.56 $528.07 $567.82 $709.00 |
$703.18 $740.69 $780.44 $921.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$555.88 $630.90 $710.40 $992.76 $1,508.60 |
$768.50 $843.52 $923.02 $1,205.38 |
$981.12 $1,056.14 $1,135.64 $1,418.00 |
Toc - Plan #37 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.78 $310.73 $349.88 $488.95 $743.01 |
$483.21 $520.16 $559.31 $698.38 |
$692.64 $729.59 $768.74 $907.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$547.56 $621.46 $699.76 $977.90 $1,486.02 |
$756.99 $830.89 $909.19 $1,187.33 |
$966.42 $1,040.32 $1,118.62 $1,396.76 |
Toc - Plan #38 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+PCP Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.58 $371.80 $418.64 $585.05 $889.03 |
$578.17 $622.39 $669.23 $835.64 |
$828.76 $872.98 $919.82 $1,086.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.16 $743.60 $837.28 $1,170.10 $1,778.06 |
$905.75 $994.19 $1,087.87 $1,420.69 |
$1,156.34 $1,244.78 $1,338.46 $1,671.28 |
Toc - Plan #39 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.97 $434.66 $489.42 $683.96 $1,039.34 |
$675.93 $727.62 $782.38 $976.92 |
$968.89 $1,020.58 $1,075.34 $1,269.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.94 $869.32 $978.84 $1,367.92 $2,078.68 |
$1,058.90 $1,162.28 $1,271.80 $1,660.88 |
$1,351.86 $1,455.24 $1,564.76 $1,953.84 |
Toc - Plan #40 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- Specialist Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.21 $425.86 $479.51 $670.11 $1,018.30 |
$662.24 $712.89 $766.54 $957.14 |
$949.27 $999.92 $1,053.57 $1,244.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$750.42 $851.72 $959.02 $1,340.22 $2,036.60 |
$1,037.45 $1,138.75 $1,246.05 $1,627.25 |
$1,324.48 $1,425.78 $1,533.08 $1,914.28 |
Toc - Plan #41 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- PCP Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.32 $435.06 $489.87 $684.60 $1,040.31 |
$676.55 $728.29 $783.10 $977.83 |
$969.78 $1,021.52 $1,076.33 $1,271.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766.64 $870.12 $979.74 $1,369.20 $2,080.62 |
$1,059.87 $1,163.35 $1,272.97 $1,662.43 |
$1,353.10 $1,456.58 $1,566.20 $1,955.66 |
Toc - Plan #42 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Secure (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$226.19 $256.71 $289.06 $403.96 $613.85 |
$399.22 $429.74 $462.09 $576.99 |
$572.25 $602.77 $635.12 $750.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$452.38 $513.42 $578.12 $807.92 $1,227.70 |
$625.41 $686.45 $751.15 $980.95 |
$798.44 $859.48 $924.18 $1,153.98 |
Toc - Plan #43 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+Specialist Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.66 $371.88 $418.74 $585.18 $889.24 |
$578.31 $622.53 $669.39 $835.83 |
$828.96 $873.18 $920.04 $1,086.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.32 $743.76 $837.48 $1,170.36 $1,778.48 |
$905.97 $994.41 $1,088.13 $1,421.01 |
$1,156.62 $1,245.06 $1,338.78 $1,671.66 |
Toc - Plan #44 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.68 $428.66 $482.66 $674.52 $1,025.00 |
$666.60 $717.58 $771.58 $963.44 |
$955.52 $1,006.50 $1,060.50 $1,252.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.36 $857.32 $965.32 $1,349.04 $2,050.00 |
$1,044.28 $1,146.24 $1,254.24 $1,637.96 |
$1,333.20 $1,435.16 $1,543.16 $1,926.88 |
Toc - Plan #45 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Simple- HSA (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.43 $340.98 $383.94 $536.55 $815.34 |
$530.25 $570.80 $613.76 $766.37 |
$760.07 $800.62 $843.58 $996.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$600.86 $681.96 $767.88 $1,073.10 $1,630.68 |
$830.68 $911.78 $997.70 $1,302.92 |
$1,060.50 $1,141.60 $1,227.52 $1,532.74 |
Toc - Plan #46 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.64 $426.34 $480.06 $670.88 $1,019.47 |
$663.00 $713.70 $767.42 $958.24 |
$950.36 $1,001.06 $1,054.78 $1,245.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.28 $852.68 $960.12 $1,341.76 $2,038.94 |
$1,038.64 $1,140.04 $1,247.48 $1,629.12 |
$1,326.00 $1,427.40 $1,534.84 $1,916.48 |
Toc - Plan #47 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.49 $442.06 $497.76 $695.61 $1,057.05 |
$687.44 $740.01 $795.71 $993.56 |
$985.39 $1,037.96 $1,093.66 $1,291.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$778.98 $884.12 $995.52 $1,391.22 $2,114.10 |
$1,076.93 $1,182.07 $1,293.47 $1,689.17 |
$1,374.88 $1,480.02 $1,591.42 $1,987.12 |
Toc - Plan #48 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- $0 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.37 $460.08 $518.05 $723.97 $1,100.15 |
$715.47 $770.18 $828.15 $1,034.07 |
$1,025.57 $1,080.28 $1,138.25 $1,344.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$810.74 $920.16 $1,036.10 $1,447.94 $2,200.30 |
$1,120.84 $1,230.26 $1,346.20 $1,758.04 |
$1,430.94 $1,540.36 $1,656.30 $2,068.14 |
Toc - Plan #49 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- Low Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$385.62 $437.66 $492.80 $688.69 $1,046.53 |
$680.61 $732.65 $787.79 $983.68 |
$975.60 $1,027.64 $1,082.78 $1,278.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$771.24 $875.32 $985.60 $1,377.38 $2,093.06 |
$1,066.23 $1,170.31 $1,280.59 $1,672.37 |
$1,361.22 $1,465.30 $1,575.58 $1,967.36 |
Toc - Plan #50 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $0 PCP (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.60 $328.69 $370.10 $517.21 $785.95 |
$511.14 $550.23 $591.64 $738.75 |
$732.68 $771.77 $813.18 $960.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$579.20 $657.38 $740.20 $1,034.42 $1,571.90 |
$800.74 $878.92 $961.74 $1,255.96 |
$1,022.28 $1,100.46 $1,183.28 $1,477.50 |
Toc - Plan #51 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- Specialist Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314.55 $357.01 $401.98 $561.77 $853.67 |
$555.17 $597.63 $642.60 $802.39 |
$795.79 $838.25 $883.22 $1,043.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$629.10 $714.02 $803.96 $1,123.54 $1,707.34 |
$869.72 $954.64 $1,044.58 $1,364.16 |
$1,110.34 $1,195.26 $1,285.20 $1,604.78 |
Toc - Plan #52 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $3250 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$312.90 $355.14 $399.88 $558.83 $849.20 |
$552.26 $594.50 $639.24 $798.19 |
$791.62 $833.86 $878.60 $1,037.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$625.80 $710.28 $799.76 $1,117.66 $1,698.40 |
$865.16 $949.64 $1,039.12 $1,357.02 |
$1,104.52 $1,189.00 $1,278.48 $1,596.38 |
Toc - Plan #53 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4700 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.59 $327.54 $368.81 $515.41 $783.22 |
$509.36 $548.31 $589.58 $736.18 |
$730.13 $769.08 $810.35 $956.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$577.18 $655.08 $737.62 $1,030.82 $1,566.44 |
$797.95 $875.85 $958.39 $1,251.59 |
$1,018.72 $1,096.62 $1,179.16 $1,472.36 |
Toc - Plan #54 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- PCP Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.23 $421.34 $474.42 $663.00 $1,007.49 |
$655.21 $705.32 $758.40 $946.98 |
$939.19 $989.30 $1,042.38 $1,230.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.46 $842.68 $948.84 $1,326.00 $2,014.98 |
$1,026.44 $1,126.66 $1,232.82 $1,609.98 |
$1,310.42 $1,410.64 $1,516.80 $1,893.96 |
Toc - Plan #55 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- Specialist Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$401.39 $455.56 $512.96 $716.86 $1,089.34 |
$708.44 $762.61 $820.01 $1,023.91 |
$1,015.49 $1,069.66 $1,127.06 $1,330.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$802.78 $911.12 $1,025.92 $1,433.72 $2,178.68 |
$1,109.83 $1,218.17 $1,332.97 $1,740.77 |
$1,416.88 $1,525.22 $1,640.02 $2,047.82 |
Toc - Plan #56 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- Low Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$386.18 $438.31 $493.53 $689.70 $1,048.07 |
$681.60 $733.73 $788.95 $985.12 |
$977.02 $1,029.15 $1,084.37 $1,280.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$772.36 $876.62 $987.06 $1,379.40 $2,096.14 |
$1,067.78 $1,172.04 $1,282.48 $1,674.82 |
$1,363.20 $1,467.46 $1,577.90 $1,970.24 |
Toc - Plan #57 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 PCP (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.73 $452.55 $509.57 $712.12 $1,082.14 |
$703.75 $757.57 $814.59 $1,017.14 |
$1,008.77 $1,062.59 $1,119.61 $1,322.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797.46 $905.10 $1,019.14 $1,424.24 $2,164.28 |
$1,102.48 $1,210.12 $1,324.16 $1,729.26 |
$1,407.50 $1,515.14 $1,629.18 $2,034.28 |
Toc - Plan #58 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- HSA (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.88 $451.58 $508.48 $710.60 $1,079.83 |
$702.25 $755.95 $812.85 $1,014.97 |
$1,006.62 $1,060.32 $1,117.22 $1,319.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$795.76 $903.16 $1,016.96 $1,421.20 $2,159.66 |
$1,100.13 $1,207.53 $1,321.33 $1,725.57 |
$1,404.50 $1,511.90 $1,625.70 $2,029.94 |
Toc - Plan #59 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite- $0 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.03 $447.21 $503.56 $703.72 $1,069.37 |
$695.46 $748.64 $804.99 $1,005.15 |
$996.89 $1,050.07 $1,106.42 $1,306.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.06 $894.42 $1,007.12 $1,407.44 $2,138.74 |
$1,089.49 $1,195.85 $1,308.55 $1,708.87 |
$1,390.92 $1,497.28 $1,609.98 $2,010.30 |
Toc - Plan #60 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Simple (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.07 $410.94 $462.71 $646.64 $982.63 |
$639.05 $687.92 $739.69 $923.62 |
$916.03 $964.90 $1,016.67 $1,200.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724.14 $821.88 $925.42 $1,293.28 $1,965.26 |
$1,001.12 $1,098.86 $1,202.40 $1,570.26 |
$1,278.10 $1,375.84 $1,479.38 $1,847.24 |
Toc - Plan #61 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- $0 PCP (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.16 $418.98 $471.77 $659.30 $1,001.87 |
$651.56 $701.38 $754.17 $941.70 |
$933.96 $983.78 $1,036.57 $1,224.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$738.32 $837.96 $943.54 $1,318.60 $2,003.74 |
$1,020.72 $1,120.36 $1,225.94 $1,601.00 |
$1,303.12 $1,402.76 $1,508.34 $1,883.40 |
Toc - Plan #62 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite- $0 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.56 $479.60 $540.02 $754.68 $1,146.81 |
$745.81 $802.85 $863.27 $1,077.93 |
$1,069.06 $1,126.10 $1,186.52 $1,401.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.12 $959.20 $1,080.04 $1,509.36 $2,293.62 |
$1,168.37 $1,282.45 $1,403.29 $1,832.61 |
$1,491.62 $1,605.70 $1,726.54 $2,155.86 |
Toc - Plan #63 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.35 $453.25 $510.36 $713.22 $1,083.81 |
$704.84 $758.74 $815.85 $1,018.71 |
$1,010.33 $1,064.23 $1,121.34 $1,324.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$798.70 $906.50 $1,020.72 $1,426.44 $2,167.62 |
$1,104.19 $1,211.99 $1,326.21 $1,731.93 |
$1,409.68 $1,517.48 $1,631.70 $2,037.42 |
Toc - Plan #64 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- HSA (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.77 $421.94 $475.10 $663.95 $1,008.94 |
$656.16 $706.33 $759.49 $948.34 |
$940.55 $990.72 $1,043.88 $1,232.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$743.54 $843.88 $950.20 $1,327.90 $2,017.88 |
$1,027.93 $1,128.27 $1,234.59 $1,612.29 |
$1,312.32 $1,412.66 $1,518.98 $1,896.68 |
Toc - Plan #65 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4000 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.87 $353.96 $398.55 $556.98 $846.38 |
$550.44 $592.53 $637.12 $795.55 |
$789.01 $831.10 $875.69 $1,034.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.74 $707.92 $797.10 $1,113.96 $1,692.76 |
$862.31 $946.49 $1,035.67 $1,352.53 |
$1,100.88 $1,185.06 $1,274.24 $1,591.10 |
Toc - Plan #66 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320.49 $363.74 $409.57 $572.37 $869.77 |
$565.65 $608.90 $654.73 $817.53 |
$810.81 $854.06 $899.89 $1,062.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640.98 $727.48 $819.14 $1,144.74 $1,739.54 |
$886.14 $972.64 $1,064.30 $1,389.90 |
$1,131.30 $1,217.80 $1,309.46 $1,635.06 |
Toc - Plan #67 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $1000 Ded (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.44 $364.82 $410.79 $574.07 $872.36 |
$567.33 $610.71 $656.68 $819.96 |
$813.22 $856.60 $902.57 $1,065.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$642.88 $729.64 $821.58 $1,148.14 $1,744.72 |
$888.77 $975.53 $1,067.47 $1,394.03 |
$1,134.66 $1,221.42 $1,313.36 $1,639.92 |
Toc - Plan #68 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- For Diabetes (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$379.39 $430.60 $484.85 $677.57 $1,029.64 |
$669.62 $720.83 $775.08 $967.80 |
$959.85 $1,011.06 $1,065.31 $1,258.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.78 $861.20 $969.70 $1,355.14 $2,059.28 |
$1,049.01 $1,151.43 $1,259.93 $1,645.37 |
$1,339.24 $1,441.66 $1,550.16 $1,935.60 |
ADVERTISEMENT
Community Health ChoiceLocal: 1-713-295-6704 | Toll Free: 1-855-315-5386 | TTY: 1-855-315-5386 |
Toc - Plan #69 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Vital Bronze 003 (No Deductible for PCP, Free Preventive Care, 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$277.57 $315.04 $354.74 $495.74 $753.33 |
$489.91 $527.38 $567.08 $708.08 |
$702.25 $739.72 $779.42 $920.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$555.14 $630.08 $709.48 $991.48 $1,506.66 |
$767.48 $842.42 $921.82 $1,203.82 |
$979.82 $1,054.76 $1,134.16 $1,416.16 |
Toc - Plan #70 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Advance Preferred Silver 004 (No deductible PCP, Specialists, Urgent Care and Generics, Free 24/7 Telehe |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.65 $442.25 $497.97 $695.92 $1,057.51 |
$687.73 $740.33 $796.05 $994.00 |
$985.81 $1,038.41 $1,094.13 $1,292.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.30 $884.50 $995.94 $1,391.84 $2,115.02 |
$1,077.38 $1,182.58 $1,294.02 $1,689.92 |
$1,375.46 $1,480.66 $1,592.10 $1,988.00 |
Toc - Plan #71 Community Health Choice | ||||||||||||||||||||
Gold
(HMO) Community Enhanced Gold 005 (No Deductible PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.35 $411.27 $463.09 $647.16 $983.43 |
$639.55 $688.47 $740.29 $924.36 |
$916.75 $965.67 $1,017.49 $1,201.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724.70 $822.54 $926.18 $1,294.32 $1,966.86 |
$1,001.90 $1,099.74 $1,203.38 $1,571.52 |
$1,279.10 $1,376.94 $1,480.58 $1,848.72 |
Toc - Plan #72 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Essential Bronze 008 HSA(No cost after deductible, No referrals for Specialists) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$283.70 $322.00 $362.57 $506.70 $769.97 |
$500.73 $539.03 $579.60 $723.73 |
$717.76 $756.06 $796.63 $940.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$567.40 $644.00 $725.14 $1,013.40 $1,539.94 |
$784.43 $861.03 $942.17 $1,230.43 |
$1,001.46 $1,078.06 $1,159.20 $1,447.46 |
Toc - Plan #73 Community Health Choice | ||||||||||||||||||||
Bronze
(HMO) Community Value Bronze 10 (Free Preventive Care, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$263.34 $298.89 $336.55 $470.33 $714.71 |
$464.80 $500.35 $538.01 $671.79 |
$666.26 $701.81 $739.47 $873.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$526.68 $597.78 $673.10 $940.66 $1,429.42 |
$728.14 $799.24 $874.56 $1,142.12 |
$929.60 $1,000.70 $1,076.02 $1,343.58 |
Toc - Plan #74 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Virtual Now Bronze 11 (Unlimited Free 24/7 Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$261.53 $296.83 $334.23 $467.09 $709.79 |
$461.60 $496.90 $534.30 $667.16 |
$661.67 $696.97 $734.37 $867.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$523.06 $593.66 $668.46 $934.18 $1,419.58 |
$723.13 $793.73 $868.53 $1,134.25 |
$923.20 $993.80 $1,068.60 $1,334.32 |
Toc - Plan #75 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Standard Silver 12 (No deductible PCP, Urgent Care & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.90 $420.97 $474.01 $662.43 $1,006.62 |
$654.64 $704.71 $757.75 $946.17 |
$938.38 $988.45 $1,041.49 $1,229.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.80 $841.94 $948.02 $1,324.86 $2,013.24 |
$1,025.54 $1,125.68 $1,231.76 $1,608.60 |
$1,309.28 $1,409.42 $1,515.50 $1,892.34 |
Toc - Plan #76 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Advance Silver 13 (No Deductible PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.37 $423.77 $477.16 $666.83 $1,013.32 |
$659.00 $709.40 $762.79 $952.46 |
$944.63 $995.03 $1,048.42 $1,238.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.74 $847.54 $954.32 $1,333.66 $2,026.64 |
$1,032.37 $1,133.17 $1,239.95 $1,619.29 |
$1,318.00 $1,418.80 $1,525.58 $1,904.92 |
Toc - Plan #77 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Silver 15 (Limited Network) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.17 $378.15 $425.79 $595.05 $904.23 |
$588.05 $633.03 $680.67 $849.93 |
$842.93 $887.91 $935.55 $1,104.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666.34 $756.30 $851.58 $1,190.10 $1,808.46 |
$921.22 $1,011.18 $1,106.46 $1,444.98 |
$1,176.10 $1,266.06 $1,361.34 $1,699.86 |
ADVERTISEMENT
Ambetter from Superior HealthPlanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989 |
Toc - Plan #78 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 |
||||||||||||||||||||
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 |
$322.13 $365.61 $411.67 $575.31 $874.24 |
$568.55 $612.03 $658.09 $821.73 |
$814.97 $858.45 $904.51 $1,068.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$644.26 $731.22 $823.34 $1,150.62 $1,748.48 |
$890.68 $977.64 $1,069.76 $1,397.04 |
$1,137.10 $1,224.06 $1,316.18 $1,643.46 |
Toc - Plan #79 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 |
||||||||||||||||||||
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 |
$384.50 $436.39 $491.37 $686.69 $1,043.50 |
$678.63 $730.52 $785.50 $980.82 |
$972.76 $1,024.65 $1,079.63 $1,274.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.00 $872.78 $982.74 $1,373.38 $2,087.00 |
$1,063.13 $1,166.91 $1,276.87 $1,667.51 |
$1,357.26 $1,461.04 $1,571.00 $1,961.64 |
Toc - Plan #80 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 |
||||||||||||||||||||
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 |
$386.65 $438.84 $494.13 $690.54 $1,049.34 |
$682.43 $734.62 $789.91 $986.32 |
$978.21 $1,030.40 $1,085.69 $1,282.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$773.30 $877.68 $988.26 $1,381.08 $2,098.68 |
$1,069.08 $1,173.46 $1,284.04 $1,676.86 |
$1,364.86 $1,469.24 $1,579.82 $1,972.64 |
Toc - Plan #81 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 |
||||||||||||||||||||
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 |
$340.20 $386.12 $434.77 $607.59 $923.29 |
$600.45 $646.37 $695.02 $867.84 |
$860.70 $906.62 $955.27 $1,128.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$680.40 $772.24 $869.54 $1,215.18 $1,846.58 |
$940.65 $1,032.49 $1,129.79 $1,475.43 |
$1,200.90 $1,292.74 $1,390.04 $1,735.68 |
Toc - Plan #82 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 |
||||||||||||||||||||
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 |
$504.80 $572.94 $645.12 $901.56 $1,370.01 |
$890.97 $959.11 $1,031.29 $1,287.73 |
$1,277.14 $1,345.28 $1,417.46 $1,673.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,009.60 $1,145.88 $1,290.24 $1,803.12 $2,740.02 |
$1,395.77 $1,532.05 $1,676.41 $2,189.29 |
$1,781.94 $1,918.22 $2,062.58 $2,575.46 |
Toc - Plan #83 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA |
||||||||||||||||||||
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 |
$352.08 $399.60 $449.95 $628.80 $955.53 |
$621.42 $668.94 $719.29 $898.14 |
$890.76 $938.28 $988.63 $1,167.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.16 $799.20 $899.90 $1,257.60 $1,911.06 |
$973.50 $1,068.54 $1,169.24 $1,526.94 |
$1,242.84 $1,337.88 $1,438.58 $1,796.28 |
Toc - Plan #84 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 |
||||||||||||||||||||
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 |
$379.31 $430.50 $484.74 $677.42 $1,029.41 |
$669.47 $720.66 $774.90 $967.58 |
$959.63 $1,010.82 $1,065.06 $1,257.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.62 $861.00 $969.48 $1,354.84 $2,058.82 |
$1,048.78 $1,151.16 $1,259.64 $1,645.00 |
$1,338.94 $1,441.32 $1,549.80 $1,935.16 |
Toc - Plan #85 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 |
||||||||||||||||||||
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 |
$374.38 $424.92 $478.45 $668.63 $1,016.05 |
$660.78 $711.32 $764.85 $955.03 |
$947.18 $997.72 $1,051.25 $1,241.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$748.76 $849.84 $956.90 $1,337.26 $2,032.10 |
$1,035.16 $1,136.24 $1,243.30 $1,623.66 |
$1,321.56 $1,422.64 $1,529.70 $1,910.06 |
Toc - Plan #86 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 |
||||||||||||||||||||
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 |
$374.00 $424.48 $477.96 $667.95 $1,015.01 |
$660.10 $710.58 $764.06 $954.05 |
$946.20 $996.68 $1,050.16 $1,240.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$748.00 $848.96 $955.92 $1,335.90 $2,030.02 |
$1,034.10 $1,135.06 $1,242.02 $1,622.00 |
$1,320.20 $1,421.16 $1,528.12 $1,908.10 |
Toc - Plan #87 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible |
||||||||||||||||||||
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 |
$383.27 $435.00 $489.80 $684.50 $1,040.16 |
$676.46 $728.19 $782.99 $977.69 |
$969.65 $1,021.38 $1,076.18 $1,270.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766.54 $870.00 $979.60 $1,369.00 $2,080.32 |
$1,059.73 $1,163.19 $1,272.79 $1,662.19 |
$1,352.92 $1,456.38 $1,565.98 $1,955.38 |
Toc - Plan #88 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible |
||||||||||||||||||||
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 |
$404.34 $458.91 $516.73 $722.13 $1,097.34 |
$713.65 $768.22 $826.04 $1,031.44 |
$1,022.96 $1,077.53 $1,135.35 $1,340.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$808.68 $917.82 $1,033.46 $1,444.26 $2,194.68 |
$1,117.99 $1,227.13 $1,342.77 $1,753.57 |
$1,427.30 $1,536.44 $1,652.08 $2,062.88 |
Toc - Plan #89 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 30 |
||||||||||||||||||||
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 |
$355.12 $403.05 $453.83 $634.23 $963.77 |
$626.78 $674.71 $725.49 $905.89 |
$898.44 $946.37 $997.15 $1,177.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.24 $806.10 $907.66 $1,268.46 $1,927.54 |
$981.90 $1,077.76 $1,179.32 $1,540.12 |
$1,253.56 $1,349.42 $1,450.98 $1,811.78 |
Toc - Plan #90 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 |
||||||||||||||||||||
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 |
$355.62 $403.62 $454.47 $635.12 $965.13 |
$627.66 $675.66 $726.51 $907.16 |
$899.70 $947.70 $998.55 $1,179.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.24 $807.24 $908.94 $1,270.24 $1,930.26 |
$983.28 $1,079.28 $1,180.98 $1,542.28 |
$1,255.32 $1,351.32 $1,453.02 $1,814.32 |
Toc - Plan #91 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 |
||||||||||||||||||||
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 |
$367.12 $416.67 $469.16 $655.65 $996.33 |
$647.96 $697.51 $750.00 $936.49 |
$928.80 $978.35 $1,030.84 $1,217.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.24 $833.34 $938.32 $1,311.30 $1,992.66 |
$1,015.08 $1,114.18 $1,219.16 $1,592.14 |
$1,295.92 $1,395.02 $1,500.00 $1,872.98 |
Toc - Plan #92 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 |
||||||||||||||||||||
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 |
$472.20 $535.93 $603.46 $843.33 $1,281.52 |
$833.42 $897.15 $964.68 $1,204.55 |
$1,194.64 $1,258.37 $1,325.90 $1,565.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$944.40 $1,071.86 $1,206.92 $1,686.66 $2,563.04 |
$1,305.62 $1,433.08 $1,568.14 $2,047.88 |
$1,666.84 $1,794.30 $1,929.36 $2,409.10 |
Toc - Plan #93 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 + 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 |
$509.84 $578.65 $651.56 $910.55 $1,383.67 |
$899.86 $968.67 $1,041.58 $1,300.57 |
$1,289.88 $1,358.69 $1,431.60 $1,690.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,019.68 $1,157.30 $1,303.12 $1,821.10 $2,767.34 |
$1,409.70 $1,547.32 $1,693.14 $2,211.12 |
$1,799.72 $1,937.34 $2,083.16 $2,601.14 |
Toc - Plan #94 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 + 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 |
$325.35 $369.26 $415.78 $581.05 $882.96 |
$574.23 $618.14 $664.66 $829.93 |
$823.11 $867.02 $913.54 $1,078.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$650.70 $738.52 $831.56 $1,162.10 $1,765.92 |
$899.58 $987.40 $1,080.44 $1,410.98 |
$1,148.46 $1,236.28 $1,329.32 $1,659.86 |
Toc - Plan #95 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 + 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 |
$343.60 $389.97 $439.10 $613.65 $932.50 |
$606.44 $652.81 $701.94 $876.49 |
$869.28 $915.65 $964.78 $1,139.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$687.20 $779.94 $878.20 $1,227.30 $1,865.00 |
$950.04 $1,042.78 $1,141.04 $1,490.14 |
$1,212.88 $1,305.62 $1,403.88 $1,752.98 |
Toc - Plan #96 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 + 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 |
$388.33 $440.75 $496.28 $693.54 $1,053.91 |
$685.40 $737.82 $793.35 $990.61 |
$982.47 $1,034.89 $1,090.42 $1,287.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.66 $881.50 $992.56 $1,387.08 $2,107.82 |
$1,073.73 $1,178.57 $1,289.63 $1,684.15 |
$1,370.80 $1,475.64 $1,586.70 $1,981.22 |
Toc - Plan #97 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 + 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 |
$390.51 $443.21 $499.05 $697.43 $1,059.81 |
$689.24 $741.94 $797.78 $996.16 |
$987.97 $1,040.67 $1,096.51 $1,294.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.02 $886.42 $998.10 $1,394.86 $2,119.62 |
$1,079.75 $1,185.15 $1,296.83 $1,693.59 |
$1,378.48 $1,483.88 $1,595.56 $1,992.32 |
Toc - Plan #98 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA + 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 |
$355.60 $403.59 $454.44 $635.08 $965.06 |
$627.62 $675.61 $726.46 $907.10 |
$899.64 $947.63 $998.48 $1,179.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.20 $807.18 $908.88 $1,270.16 $1,930.12 |
$983.22 $1,079.20 $1,180.90 $1,542.18 |
$1,255.24 $1,351.22 $1,452.92 $1,814.20 |
Toc - Plan #99 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 + 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 |
$383.09 $434.80 $489.58 $684.18 $1,039.68 |
$676.15 $727.86 $782.64 $977.24 |
$969.21 $1,020.92 $1,075.70 $1,270.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766.18 $869.60 $979.16 $1,368.36 $2,079.36 |
$1,059.24 $1,162.66 $1,272.22 $1,661.42 |
$1,352.30 $1,455.72 $1,565.28 $1,954.48 |
Toc - Plan #100 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 + 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 |
$377.73 $428.71 $482.73 $674.61 $1,025.13 |
$666.69 $717.67 $771.69 $963.57 |
$955.65 $1,006.63 $1,060.65 $1,252.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.46 $857.42 $965.46 $1,349.22 $2,050.26 |
$1,044.42 $1,146.38 $1,254.42 $1,638.18 |
$1,333.38 $1,435.34 $1,543.38 $1,927.14 |
Toc - Plan #101 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible + 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 |
$387.09 $439.33 $494.69 $691.32 $1,050.53 |
$683.21 $735.45 $790.81 $987.44 |
$979.33 $1,031.57 $1,086.93 $1,283.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774.18 $878.66 $989.38 $1,382.64 $2,101.06 |
$1,070.30 $1,174.78 $1,285.50 $1,678.76 |
$1,366.42 $1,470.90 $1,581.62 $1,974.88 |
Toc - Plan #102 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible + 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 |
$408.37 $463.49 $521.88 $729.33 $1,108.29 |
$720.76 $775.88 $834.27 $1,041.72 |
$1,033.15 $1,088.27 $1,146.66 $1,354.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$816.74 $926.98 $1,043.76 $1,458.66 $2,216.58 |
$1,129.13 $1,239.37 $1,356.15 $1,771.05 |
$1,441.52 $1,551.76 $1,668.54 $2,083.44 |
Toc - Plan #103 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 + 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 |
$359.17 $407.65 $459.01 $641.46 $974.76 |
$633.93 $682.41 $733.77 $916.22 |
$908.69 $957.17 $1,008.53 $1,190.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$718.34 $815.30 $918.02 $1,282.92 $1,949.52 |
$993.10 $1,090.06 $1,192.78 $1,557.68 |
$1,267.86 $1,364.82 $1,467.54 $1,832.44 |
Toc - Plan #104 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 + 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 |
$370.78 $420.82 $473.84 $662.19 $1,006.27 |
$654.42 $704.46 $757.48 $945.83 |
$938.06 $988.10 $1,041.12 $1,229.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.56 $841.64 $947.68 $1,324.38 $2,012.54 |
$1,025.20 $1,125.28 $1,231.32 $1,608.02 |
$1,308.84 $1,408.92 $1,514.96 $1,891.66 |
Toc - Plan #105 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 + 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 |
$476.91 $541.28 $609.48 $851.74 $1,294.30 |
$841.74 $906.11 $974.31 $1,216.57 |
$1,206.57 $1,270.94 $1,339.14 $1,581.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$953.82 $1,082.56 $1,218.96 $1,703.48 $2,588.60 |
$1,318.65 $1,447.39 $1,583.79 $2,068.31 |
$1,683.48 $1,812.22 $1,948.62 $2,433.14 |
Toc - Plan #106 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 + 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 |
$378.12 $429.15 $483.22 $675.30 $1,026.19 |
$667.37 $718.40 $772.47 $964.55 |
$956.62 $1,007.65 $1,061.72 $1,253.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.24 $858.30 $966.44 $1,350.60 $2,052.38 |
$1,045.49 $1,147.55 $1,255.69 $1,639.85 |
$1,334.74 $1,436.80 $1,544.94 $1,929.10 |
Toc - Plan #107 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 5 + 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 |
$525.72 $596.68 $671.86 $938.92 $1,426.78 |
$927.89 $998.85 $1,074.03 $1,341.09 |
$1,330.06 $1,401.02 $1,476.20 $1,743.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,051.44 $1,193.36 $1,343.72 $1,877.84 $2,853.56 |
$1,453.61 $1,595.53 $1,745.89 $2,280.01 |
$1,855.78 $1,997.70 $2,148.06 $2,682.18 |
Toc - Plan #108 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Bronze
(EPO) Ambetter Essential Care 1 + 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 |
$335.48 $380.76 $428.73 $599.15 $910.47 |
$592.12 $637.40 $685.37 $855.79 |
$848.76 $894.04 $942.01 $1,112.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670.96 $761.52 $857.46 $1,198.30 $1,820.94 |
$927.60 $1,018.16 $1,114.10 $1,454.94 |
$1,184.24 $1,274.80 $1,370.74 $1,711.58 |
Toc - Plan #109 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 10 + 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 |
$354.30 $402.12 $452.79 $632.77 $961.55 |
$625.33 $673.15 $723.82 $903.80 |
$896.36 $944.18 $994.85 $1,174.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.60 $804.24 $905.58 $1,265.54 $1,923.10 |
$979.63 $1,075.27 $1,176.61 $1,536.57 |
$1,250.66 $1,346.30 $1,447.64 $1,807.60 |
Toc - Plan #110 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 11 + 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 |
$400.43 $454.48 $511.74 $715.15 $1,086.74 |
$706.75 $760.80 $818.06 $1,021.47 |
$1,013.07 $1,067.12 $1,124.38 $1,327.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.86 $908.96 $1,023.48 $1,430.30 $2,173.48 |
$1,107.18 $1,215.28 $1,329.80 $1,736.62 |
$1,413.50 $1,521.60 $1,636.12 $2,042.94 |
Toc - Plan #111 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 5 + 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 |
$402.67 $457.02 $514.60 $719.16 $1,092.83 |
$710.71 $765.06 $822.64 $1,027.20 |
$1,018.75 $1,073.10 $1,130.68 $1,335.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.34 $914.04 $1,029.20 $1,438.32 $2,185.66 |
$1,113.38 $1,222.08 $1,337.24 $1,746.36 |
$1,421.42 $1,530.12 $1,645.28 $2,054.40 |
Toc - Plan #112 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 2 HSA + 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 |
$366.68 $416.17 $468.60 $654.86 $995.13 |
$647.18 $696.67 $749.10 $935.36 |
$927.68 $977.17 $1,029.60 $1,215.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.36 $832.34 $937.20 $1,309.72 $1,990.26 |
$1,013.86 $1,112.84 $1,217.70 $1,590.22 |
$1,294.36 $1,393.34 $1,498.20 $1,870.72 |
Toc - Plan #113 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 12 + 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 |
$395.03 $448.34 $504.83 $705.50 $1,072.07 |
$697.22 $750.53 $807.02 $1,007.69 |
$999.41 $1,052.72 $1,109.21 $1,309.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.06 $896.68 $1,009.66 $1,411.00 $2,144.14 |
$1,092.25 $1,198.87 $1,311.85 $1,713.19 |
$1,394.44 $1,501.06 $1,614.04 $2,015.38 |
Toc - Plan #114 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care 22 + 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 |
$389.50 $442.07 $497.77 $695.63 $1,057.07 |
$687.46 $740.03 $795.73 $993.59 |
$985.42 $1,037.99 $1,093.69 $1,291.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.00 $884.14 $995.54 $1,391.26 $2,114.14 |
$1,076.96 $1,182.10 $1,293.50 $1,689.22 |
$1,374.92 $1,480.06 $1,591.46 $1,987.18 |
Toc - Plan #115 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $1,500 Medical Deductible + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.15 $453.02 $510.10 $712.86 $1,083.26 |
$704.49 $758.36 $815.44 $1,018.20 |
$1,009.83 $1,063.70 $1,120.78 $1,323.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$798.30 $906.04 $1,020.20 $1,425.72 $2,166.52 |
$1,103.64 $1,211.38 $1,325.54 $1,731.06 |
$1,408.98 $1,516.72 $1,630.88 $2,036.40 |
Toc - Plan #116 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Expanded Bronze
(EPO) Ambetter Essential Care: $0 Medical Deductible + 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 |
$421.09 $477.93 $538.14 $752.05 $1,142.82 |
$743.22 $800.06 $860.27 $1,074.18 |
$1,065.35 $1,122.19 $1,182.40 $1,396.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$842.18 $955.86 $1,076.28 $1,504.10 $2,285.64 |
$1,164.31 $1,277.99 $1,398.41 $1,826.23 |
$1,486.44 $1,600.12 $1,720.54 $2,148.36 |
Toc - Plan #117 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 31 + 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 |
$370.36 $420.35 $473.31 $661.44 $1,005.13 |
$653.68 $703.67 $756.63 $944.76 |
$937.00 $986.99 $1,039.95 $1,228.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$740.72 $840.70 $946.62 $1,322.88 $2,010.26 |
$1,024.04 $1,124.02 $1,229.94 $1,606.20 |
$1,307.36 $1,407.34 $1,513.26 $1,889.52 |
Toc - Plan #118 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 32 + 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 |
$382.33 $433.94 $488.61 $682.83 $1,037.62 |
$674.81 $726.42 $781.09 $975.31 |
$967.29 $1,018.90 $1,073.57 $1,267.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.66 $867.88 $977.22 $1,365.66 $2,075.24 |
$1,057.14 $1,160.36 $1,269.70 $1,658.14 |
$1,349.62 $1,452.84 $1,562.18 $1,950.62 |
Toc - Plan #119 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Ambetter Secure Care 20 + 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 |
$491.77 $558.14 $628.47 $878.28 $1,334.63 |
$867.96 $934.33 $1,004.66 $1,254.47 |
$1,244.15 $1,310.52 $1,380.85 $1,630.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$983.54 $1,116.28 $1,256.94 $1,756.56 $2,669.26 |
$1,359.73 $1,492.47 $1,633.13 $2,132.75 |
$1,735.92 $1,868.66 $2,009.32 $2,508.94 |
Toc - Plan #120 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Ambetter Balanced Care 29 + 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 |
$389.90 $442.53 $498.28 $696.34 $1,058.16 |
$688.17 $740.80 $796.55 $994.61 |
$986.44 $1,039.07 $1,094.82 $1,292.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.80 $885.06 $996.56 $1,392.68 $2,116.32 |
$1,078.07 $1,183.33 $1,294.83 $1,690.95 |
$1,376.34 $1,481.60 $1,593.10 $1,989.22 |
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 #121 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 |
$379.03 $430.20 $484.40 $676.95 $1,028.69 |
$668.99 $720.16 $774.36 $966.91 |
$958.95 $1,010.12 $1,064.32 $1,256.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$758.06 $860.40 $968.80 $1,353.90 $2,057.38 |
$1,048.02 $1,150.36 $1,258.76 $1,643.86 |
$1,337.98 $1,440.32 $1,548.72 $1,933.82 |
Toc - Plan #122 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 |
$279.49 $317.22 $357.18 $499.16 $758.52 |
$493.30 $531.03 $570.99 $712.97 |
$707.11 $744.84 $784.80 $926.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$558.98 $634.44 $714.36 $998.32 $1,517.04 |
$772.79 $848.25 $928.17 $1,212.13 |
$986.60 $1,062.06 $1,141.98 $1,425.94 |
Toc - Plan #123 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 |
$401.81 $456.06 $513.52 $717.64 $1,090.52 |
$709.20 $763.45 $820.91 $1,025.03 |
$1,016.59 $1,070.84 $1,128.30 $1,332.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$803.62 $912.12 $1,027.04 $1,435.28 $2,181.04 |
$1,111.01 $1,219.51 $1,334.43 $1,742.67 |
$1,418.40 $1,526.90 $1,641.82 $2,050.06 |
Toc - Plan #124 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 |
$310.92 $352.90 $397.36 $555.31 $843.85 |
$548.78 $590.76 $635.22 $793.17 |
$786.64 $828.62 $873.08 $1,031.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.84 $705.80 $794.72 $1,110.62 $1,687.70 |
$859.70 $943.66 $1,032.58 $1,348.48 |
$1,097.56 $1,181.52 $1,270.44 $1,586.34 |
Toc - Plan #125 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 |
$302.74 $343.61 $386.91 $540.70 $821.64 |
$534.34 $575.21 $618.51 $772.30 |
$765.94 $806.81 $850.11 $1,003.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$605.48 $687.22 $773.82 $1,081.40 $1,643.28 |
$837.08 $918.82 $1,005.42 $1,313.00 |
$1,068.68 $1,150.42 $1,237.02 $1,544.60 |
Toc - Plan #126 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO? 603 |
||||||||||||||||||||
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 |
$400.19 $454.22 $511.45 $714.74 $1,086.12 |
$706.34 $760.37 $817.60 $1,020.89 |
$1,012.49 $1,066.52 $1,123.75 $1,327.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.38 $908.44 $1,022.90 $1,429.48 $2,172.24 |
$1,106.53 $1,214.59 $1,329.05 $1,735.63 |
$1,412.68 $1,520.74 $1,635.20 $2,041.78 |
Toc - Plan #127 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 |
$447.74 $508.18 $572.21 $799.66 $1,215.16 |
$790.26 $850.70 $914.73 $1,142.18 |
$1,132.78 $1,193.22 $1,257.25 $1,484.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$895.48 $1,016.36 $1,144.42 $1,599.32 $2,430.32 |
$1,238.00 $1,358.88 $1,486.94 $1,941.84 |
$1,580.52 $1,701.40 $1,829.46 $2,284.36 |
Toc - Plan #128 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 |
$475.76 $539.99 $608.03 $849.72 $1,291.22 |
$839.72 $903.95 $971.99 $1,213.68 |
$1,203.68 $1,267.91 $1,335.95 $1,577.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$951.52 $1,079.98 $1,216.06 $1,699.44 $2,582.44 |
$1,315.48 $1,443.94 $1,580.02 $2,063.40 |
$1,679.44 $1,807.90 $1,943.98 $2,427.36 |
Toc - Plan #129 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 |
$367.46 $417.07 $469.61 $656.28 $997.28 |
$648.57 $698.18 $750.72 $937.39 |
$929.68 $979.29 $1,031.83 $1,218.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.92 $834.14 $939.22 $1,312.56 $1,994.56 |
$1,016.03 $1,115.25 $1,220.33 $1,593.67 |
$1,297.14 $1,396.36 $1,501.44 $1,874.78 |
Toc - Plan #130 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 |
$332.15 $377.00 $424.49 $593.23 $901.47 |
$586.25 $631.10 $678.59 $847.33 |
$840.35 $885.20 $932.69 $1,101.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$664.30 $754.00 $848.98 $1,186.46 $1,802.94 |
$918.40 $1,008.10 $1,103.08 $1,440.56 |
$1,172.50 $1,262.20 $1,357.18 $1,694.66 |
Toc - Plan #131 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Plus Silver? 605 |
||||||||||||||||||||
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 |
$484.06 $549.41 $618.63 $864.54 $1,313.75 |
$854.37 $919.72 $988.94 $1,234.85 |
$1,224.68 $1,290.03 $1,359.25 $1,605.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$968.12 $1,098.82 $1,237.26 $1,729.08 $2,627.50 |
$1,338.43 $1,469.13 $1,607.57 $2,099.39 |
$1,708.74 $1,839.44 $1,977.88 $2,469.70 |
Toc - Plan #132 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) MyBlue Health Bronze? 402 |
||||||||||||||||||||
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 |
$247.46 $280.86 $316.25 $441.96 $671.60 |
$436.76 $470.16 $505.55 $631.26 |
$626.06 $659.46 $694.85 $820.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$494.92 $561.72 $632.50 $883.92 $1,343.20 |
$684.22 $751.02 $821.80 $1,073.22 |
$873.52 $940.32 $1,011.10 $1,262.52 |
Toc - Plan #133 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) MyBlue Health Gold? 403 |
||||||||||||||||||||
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 |
$297.56 $337.73 $380.28 $531.44 $807.58 |
$525.19 $565.36 $607.91 $759.07 |
$752.82 $792.99 $835.54 $986.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$595.12 $675.46 $760.56 $1,062.88 $1,615.16 |
$822.75 $903.09 $988.19 $1,290.51 |
$1,050.38 $1,130.72 $1,215.82 $1,518.14 |
Toc - Plan #134 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) MyBlue Health Silver? 405 |
||||||||||||||||||||
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 |
$312.77 $354.99 $399.72 $558.61 $848.86 |
$552.04 $594.26 $638.99 $797.88 |
$791.31 $833.53 $878.26 $1,037.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$625.54 $709.98 $799.44 $1,117.22 $1,697.72 |
$864.81 $949.25 $1,038.71 $1,356.49 |
$1,104.08 $1,188.52 $1,277.98 $1,595.76 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-866-811-2704 | Toll Free: 1-866-811-2704 | TTY: 1-866-811-2704 |
Toc - Plan #135 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ ($1 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.41 $386.37 $435.05 $607.98 $923.88 |
$600.83 $646.79 $695.47 $868.40 |
$861.25 $907.21 $955.89 $1,128.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$680.82 $772.74 $870.10 $1,215.96 $1,847.76 |
$941.24 $1,033.16 $1,130.52 $1,476.38 |
$1,201.66 $1,293.58 $1,390.94 $1,736.80 |
Toc - Plan #136 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.30 $390.78 $440.02 $614.93 $934.44 |
$607.69 $654.17 $703.41 $878.32 |
$871.08 $917.56 $966.80 $1,141.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.60 $781.56 $880.04 $1,229.86 $1,868.88 |
$951.99 $1,044.95 $1,143.43 $1,493.25 |
$1,215.38 $1,308.34 $1,406.82 $1,756.64 |
Toc - Plan #137 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($1 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$342.64 $388.90 $437.90 $611.96 $929.93 |
$604.76 $651.02 $700.02 $874.08 |
$866.88 $913.14 $962.14 $1,136.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$685.28 $777.80 $875.80 $1,223.92 $1,859.86 |
$947.40 $1,039.92 $1,137.92 $1,486.04 |
$1,209.52 $1,302.04 $1,400.04 $1,748.16 |
Toc - Plan #138 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ Extra ($1 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.53 $402.39 $453.09 $633.19 $962.19 |
$625.74 $673.60 $724.30 $904.40 |
$896.95 $944.81 $995.51 $1,175.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$709.06 $804.78 $906.18 $1,266.38 $1,924.38 |
$980.27 $1,075.99 $1,177.39 $1,537.59 |
$1,251.48 $1,347.20 $1,448.60 $1,808.80 |
Toc - Plan #139 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ ($5 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$346.65 $393.45 $443.02 $619.11 $940.80 |
$611.84 $658.64 $708.21 $884.30 |
$877.03 $923.83 $973.40 $1,149.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$693.30 $786.90 $886.04 $1,238.22 $1,881.60 |
$958.49 $1,052.09 $1,151.23 $1,503.41 |
$1,223.68 $1,317.28 $1,416.42 $1,768.60 |
Toc - Plan #140 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value+ (HSA) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.19 $396.33 $446.27 $623.65 $947.70 |
$616.32 $663.46 $713.40 $890.78 |
$883.45 $930.59 $980.53 $1,157.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.38 $792.66 $892.54 $1,247.30 $1,895.40 |
$965.51 $1,059.79 $1,159.67 $1,514.43 |
$1,232.64 $1,326.92 $1,426.80 $1,781.56 |
Toc - Plan #141 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First ($3 Rx + Unlimited Free App-based Care) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.44 $383.00 $431.25 $602.67 $915.82 |
$595.58 $641.14 $689.39 $860.81 |
$853.72 $899.28 $947.53 $1,118.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$674.88 $766.00 $862.50 $1,205.34 $1,831.64 |
$933.02 $1,024.14 $1,120.64 $1,463.48 |
$1,191.16 $1,282.28 $1,378.78 $1,721.62 |
Toc - Plan #142 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.31 $396.47 $446.42 $623.87 $948.03 |
$616.53 $663.69 $713.64 $891.09 |
$883.75 $930.91 $980.86 $1,158.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.62 $792.94 $892.84 $1,247.74 $1,896.06 |
$965.84 $1,060.16 $1,160.06 $1,514.96 |
$1,233.06 $1,327.38 $1,427.28 $1,782.18 |
Toc - Plan #143 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ Extra ($3 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.93 $414.20 $466.39 $651.77 $990.43 |
$644.10 $693.37 $745.56 $930.94 |
$923.27 $972.54 $1,024.73 $1,210.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.86 $828.40 $932.78 $1,303.54 $1,980.86 |
$1,009.03 $1,107.57 $1,211.95 $1,582.71 |
$1,288.20 $1,386.74 $1,491.12 $1,861.88 |
Toc - Plan #144 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$259.26 $294.26 $331.34 $463.04 $703.63 |
$457.59 $492.59 $529.67 $661.37 |
$655.92 $690.92 $728.00 $859.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$518.52 $588.52 $662.68 $926.08 $1,407.26 |
$716.85 $786.85 $861.01 $1,124.41 |
$915.18 $985.18 $1,059.34 $1,322.74 |
Toc - Plan #145 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Essential+ (Low Premium) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$243.67 $276.56 $311.41 $435.19 $661.31 |
$430.08 $462.97 $497.82 $621.60 |
$616.49 $649.38 $684.23 $808.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$487.34 $553.12 $622.82 $870.38 $1,322.62 |
$673.75 $739.53 $809.23 $1,056.79 |
$860.16 $925.94 $995.64 $1,243.20 |
Toc - Plan #146 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First ($3 Rx + Unlimited Free App-based Care) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$253.19 $287.38 $323.58 $452.21 $687.17 |
$446.88 $481.07 $517.27 $645.90 |
$640.57 $674.76 $710.96 $839.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$506.38 $574.76 $647.16 $904.42 $1,374.34 |
$700.07 $768.45 $840.85 $1,098.11 |
$893.76 $962.14 $1,034.54 $1,291.80 |
Toc - Plan #147 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value+ ($5 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.45 $419.33 $472.16 $659.84 $1,002.70 |
$652.08 $701.96 $754.79 $942.47 |
$934.71 $984.59 $1,037.42 $1,225.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$738.90 $838.66 $944.32 $1,319.68 $2,005.40 |
$1,021.53 $1,121.29 $1,226.95 $1,602.31 |
$1,304.16 $1,403.92 $1,509.58 $1,884.94 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-560-2025 | Toll Free: 1-888-560-2025 |
Toc - Plan #148 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 |
$371.97 $422.19 $475.38 $664.34 $1,009.53 |
$656.53 $706.75 $759.94 $948.90 |
$941.09 $991.31 $1,044.50 $1,233.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$743.94 $844.38 $950.76 $1,328.68 $2,019.06 |
$1,028.50 $1,128.94 $1,235.32 $1,613.24 |
$1,313.06 $1,413.50 $1,519.88 $1,897.80 |
Toc - Plan #149 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 |
$359.80 $408.38 $459.83 $642.61 $976.50 |
$635.05 $683.63 $735.08 $917.86 |
$910.30 $958.88 $1,010.33 $1,193.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.60 $816.76 $919.66 $1,285.22 $1,953.00 |
$994.85 $1,092.01 $1,194.91 $1,560.47 |
$1,270.10 $1,367.26 $1,470.16 $1,835.72 |
Toc - Plan #150 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
||||||||||||||||||||
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 |
$380.30 $431.64 $486.02 $679.21 $1,032.12 |
$671.23 $722.57 $776.95 $970.14 |
$962.16 $1,013.50 $1,067.88 $1,261.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$760.60 $863.28 $972.04 $1,358.42 $2,064.24 |
$1,051.53 $1,154.21 $1,262.97 $1,649.35 |
$1,342.46 $1,445.14 $1,553.90 $1,940.28 |
Toc - Plan #151 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 250 |
||||||||||||||||||||
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 |
$360.11 $408.72 $460.22 $643.15 $977.33 |
$635.59 $684.20 $735.70 $918.63 |
$911.07 $959.68 $1,011.18 $1,194.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$720.22 $817.44 $920.44 $1,286.30 $1,954.66 |
$995.70 $1,092.92 $1,195.92 $1,561.78 |
$1,271.18 $1,368.40 $1,471.40 $1,837.26 |
Toc - Plan #152 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 2 250 |
||||||||||||||||||||
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 |
$361.84 $410.69 $462.43 $646.24 $982.03 |
$638.65 $687.50 $739.24 $923.05 |
$915.46 $964.31 $1,016.05 $1,199.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$723.68 $821.38 $924.86 $1,292.48 $1,964.06 |
$1,000.49 $1,098.19 $1,201.67 $1,569.29 |
$1,277.30 $1,375.00 $1,478.48 $1,846.10 |
Toc - Plan #153 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 4 250 |
||||||||||||||||||||
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 |
$356.41 $404.53 $455.50 $636.55 $967.31 |
$629.07 $677.19 $728.16 $909.21 |
$901.73 $949.85 $1,000.82 $1,181.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$712.82 $809.06 $911.00 $1,273.10 $1,934.62 |
$985.48 $1,081.72 $1,183.66 $1,545.76 |
$1,258.14 $1,354.38 $1,456.32 $1,818.42 |
Toc - Plan #154 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 7 250 |
||||||||||||||||||||
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 |
$352.85 $400.48 $450.94 $630.19 $957.63 |
$622.78 $670.41 $720.87 $900.12 |
$892.71 $940.34 $990.80 $1,170.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$705.70 $800.96 $901.88 $1,260.38 $1,915.26 |
$975.63 $1,070.89 $1,171.81 $1,530.31 |
$1,245.56 $1,340.82 $1,441.74 $1,800.24 |
Toc - Plan #155 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
||||||||||||||||||||
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 |
$384.65 $436.58 $491.58 $686.98 $1,043.94 |
$678.91 $730.84 $785.84 $981.24 |
$973.17 $1,025.10 $1,080.10 $1,275.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.30 $873.16 $983.16 $1,373.96 $2,087.88 |
$1,063.56 $1,167.42 $1,277.42 $1,668.22 |
$1,357.82 $1,461.68 $1,571.68 $1,962.48 |
Toc - Plan #156 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 250 + Vision |
||||||||||||||||||||
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 |
$363.06 $412.08 $463.99 $648.43 $985.35 |
$640.80 $689.82 $741.73 $926.17 |
$918.54 $967.56 $1,019.47 $1,203.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$726.12 $824.16 $927.98 $1,296.86 $1,970.70 |
$1,003.86 $1,101.90 $1,205.72 $1,574.60 |
$1,281.60 $1,379.64 $1,483.46 $1,852.34 |
ADVERTISEMENT
Friday Health PlansLocal: 1-844-451-4444 | Toll Free: 1-844-451-4444 | TTY: 1-800-659-2656 |
Toc - Plan #157 Friday Health Plans | ||||||||||||||||||||
Catastrophic
(EPO) Catastrophic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$194.10 $220.31 $248.06 $346.67 $526.79 |
$342.59 $368.80 $396.55 $495.16 |
$491.08 $517.29 $545.04 $643.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$388.20 $440.62 $496.12 $693.34 $1,053.58 |
$536.69 $589.11 $644.61 $841.83 |
$685.18 $737.60 $793.10 $990.32 |
Toc - Plan #158 Friday Health Plans | ||||||||||||||||||||
Bronze
(EPO) Friday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$213.49 $242.32 $272.85 $381.30 $579.42 |
$376.81 $405.64 $436.17 $544.62 |
$540.13 $568.96 $599.49 $707.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$426.98 $484.64 $545.70 $762.60 $1,158.84 |
$590.30 $647.96 $709.02 $925.92 |
$753.62 $811.28 $872.34 $1,089.24 |
Toc - Plan #159 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Friday Bronze Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$218.30 $247.77 $278.99 $389.88 $592.46 |
$385.30 $414.77 $445.99 $556.88 |
$552.30 $581.77 $612.99 $723.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$436.60 $495.54 $557.98 $779.76 $1,184.92 |
$603.60 $662.54 $724.98 $946.76 |
$770.60 $829.54 $891.98 $1,113.76 |
Toc - Plan #160 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Friday Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$224.73 $255.07 $287.21 $401.37 $609.92 |
$396.65 $426.99 $459.13 $573.29 |
$568.57 $598.91 $631.05 $745.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$449.46 $510.14 $574.42 $802.74 $1,219.84 |
$621.38 $682.06 $746.34 $974.66 |
$793.30 $853.98 $918.26 $1,146.58 |
Toc - Plan #161 Friday Health Plans | ||||||||||||||||||||
Silver
(EPO) Friday Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.26 $339.67 $382.46 $534.49 $812.20 |
$528.20 $568.61 $611.40 $763.43 |
$757.14 $797.55 $840.34 $992.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598.52 $679.34 $764.92 $1,068.98 $1,624.40 |
$827.46 $908.28 $993.86 $1,297.92 |
$1,056.40 $1,137.22 $1,222.80 $1,526.86 |
Toc - Plan #162 Friday Health Plans | ||||||||||||||||||||
Gold
(EPO) Friday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.62 $320.78 $361.19 $504.77 $767.04 |
$498.83 $536.99 $577.40 $720.98 |
$715.04 $753.20 $793.61 $937.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$565.24 $641.56 $722.38 $1,009.54 $1,534.08 |
$781.45 $857.77 $938.59 $1,225.75 |
$997.66 $1,073.98 $1,154.80 $1,441.96 |
Toc - Plan #163 Friday Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Friday Bronze Plus Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$220.28 $250.02 $281.52 $393.42 $597.85 |
$388.80 $418.54 $450.04 $561.94 |
$557.32 $587.06 $618.56 $730.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$440.56 $500.04 $563.04 $786.84 $1,195.70 |
$609.08 $668.56 $731.56 $955.36 |
$777.60 $837.08 $900.08 $1,123.88 |
Toc - Plan #164 Friday Health Plans | ||||||||||||||||||||
Silver
(EPO) Friday Silver Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$303.09 $344.01 $387.35 $541.32 $822.59 |
$534.95 $575.87 $619.21 $773.18 |
$766.81 $807.73 $851.07 $1,005.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$606.18 $688.02 $774.70 $1,082.64 $1,645.18 |
$838.04 $919.88 $1,006.56 $1,314.50 |
$1,069.90 $1,151.74 $1,238.42 $1,546.36 |
Toc - Plan #165 Friday Health Plans | ||||||||||||||||||||
Gold
(EPO) Friday Gold Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-451-4444
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$295.51 $335.41 $377.67 $527.79 $802.03 |
$521.58 $561.48 $603.74 $753.86 |
$747.65 $787.55 $829.81 $979.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$591.02 $670.82 $755.34 $1,055.58 $1,604.06 |
$817.09 $896.89 $981.41 $1,281.65 |
$1,043.16 $1,122.96 $1,207.48 $1,507.72 |
ADVERTISEMENT
Aetna Life Insurance CompanyLocal: 1-877-336-3915 | Toll Free: 1-877-336-3915 |
Toc - Plan #166 Aetna Life Insurance Company | ||||||||||||||||||||
Expanded Bronze
(HMO) Aetna CVS Bronze: Low-Cost Walk-In Clinic Visits, Telehealth, Store Discounts, Houston |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.03 $326.92 $368.10 $514.42 $781.72 |
$508.37 $547.26 $588.44 $734.76 |
$728.71 $767.60 $808.78 $955.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$576.06 $653.84 $736.20 $1,028.84 $1,563.44 |
$796.40 $874.18 $956.54 $1,249.18 |
$1,016.74 $1,094.52 $1,176.88 $1,469.52 |
Toc - Plan #167 Aetna Life Insurance Company | ||||||||||||||||||||
Bronze
(HMO) Aetna CVS Bronze: $0 Walk-In Clinic Visits, Telehealth, Store Discounts, Houston |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$258.83 $293.77 $330.79 $462.27 $702.47 |
$456.84 $491.78 $528.80 $660.28 |
$654.85 $689.79 $726.81 $858.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$517.66 $587.54 $661.58 $924.54 $1,404.94 |
$715.67 $785.55 $859.59 $1,122.55 |
$913.68 $983.56 $1,057.60 $1,320.56 |
Toc - Plan #168 Aetna Life Insurance Company | ||||||||||||||||||||
Gold
(HMO) Aetna CVS Gold: $0 Walk-In Clinic Visits, Telehealth, Store Discounts, Houston |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.04 $452.92 $509.98 $712.69 $1,083.01 |
$704.31 $758.19 $815.25 $1,017.96 |
$1,009.58 $1,063.46 $1,120.52 $1,323.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$798.08 $905.84 $1,019.96 $1,425.38 $2,166.02 |
$1,103.35 $1,211.11 $1,325.23 $1,730.65 |
$1,408.62 $1,516.38 $1,630.50 $2,035.92 |
Toc - Plan #169 Aetna Life Insurance Company | ||||||||||||||||||||
Silver
(HMO) Aetna CVS Silver 2: $0 Walk-In Clinic Visits, Telehealth, Store Discounts, Houston |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$346.35 $393.11 $442.63 $618.58 $939.99 |
$611.31 $658.07 $707.59 $883.54 |
$876.27 $923.03 $972.55 $1,148.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$692.70 $786.22 $885.26 $1,237.16 $1,879.98 |
$957.66 $1,051.18 $1,150.22 $1,502.12 |
$1,222.62 $1,316.14 $1,415.18 $1,767.08 |
Toc - Plan #170 Aetna Life Insurance Company | ||||||||||||||||||||
Silver
(HMO) Aetna CVS Silver 1: $0 Walk-In Clinic Visits, Telehealth, Store Discounts, Houston |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.96 $453.96 $511.15 $714.33 $1,085.49 |
$705.93 $759.93 $817.12 $1,020.30 |
$1,011.90 $1,065.90 $1,123.09 $1,326.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$799.92 $907.92 $1,022.30 $1,428.66 $2,170.98 |
$1,105.89 $1,213.89 $1,328.27 $1,734.63 |
$1,411.86 $1,519.86 $1,634.24 $2,040.60 |
ADVERTISEMENT
Ambetter from Superior HealthplanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-877-941-9237 |
Toc - Plan #171 Ambetter from Superior Healthplan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Virtual Access Bronze ($0 Virtual Primary Care + $0 Virtual Urgent Care + $0 Preferred Labs) |
||||||||||||||||||||
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 |
$344.79 $391.33 $440.63 $615.78 $935.74 |
$608.55 $655.09 $704.39 $879.54 |
$872.31 $918.85 $968.15 $1,143.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$689.58 $782.66 $881.26 $1,231.56 $1,871.48 |
$953.34 $1,046.42 $1,145.02 $1,495.32 |
$1,217.10 $1,310.18 $1,408.78 $1,759.08 |
Toc - Plan #172 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Virtual Access Silver ($0 Virtual Primary Care + $0 Virtual Urgent Care + $0 Preferred Labs) |
||||||||||||||||||||
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 |
$370.92 $420.98 $474.02 $662.45 $1,006.65 |
$654.67 $704.73 $757.77 $946.20 |
$938.42 $988.48 $1,041.52 $1,229.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.84 $841.96 $948.04 $1,324.90 $2,013.30 |
$1,025.59 $1,125.71 $1,231.79 $1,608.65 |
$1,309.34 $1,409.46 $1,515.54 $1,892.40 |
Toc - Plan #173 Ambetter from Superior Healthplan | ||||||||||||||||||||
Gold
(HMO) Ambetter Virtual Access Gold ($0 Virtual Primary Care + $0 Virtual Urgent Care + $0 Preferred Labs) |
||||||||||||||||||||
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 |
$493.14 $559.71 $630.22 $880.74 $1,338.36 |
$870.39 $936.96 $1,007.47 $1,257.99 |
$1,247.64 $1,314.21 $1,384.72 $1,635.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$986.28 $1,119.42 $1,260.44 $1,761.48 $2,676.72 |
$1,363.53 $1,496.67 $1,637.69 $2,138.73 |
$1,740.78 $1,873.92 $2,014.94 $2,515.98 |
Toc - Plan #174 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 11 |
||||||||||||||||||||
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 |
$332.56 $377.44 $425.00 $593.93 $902.54 |
$586.96 $631.84 $679.40 $848.33 |
$841.36 $886.24 $933.80 $1,102.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$665.12 $754.88 $850.00 $1,187.86 $1,805.08 |
$919.52 $1,009.28 $1,104.40 $1,442.26 |
$1,173.92 $1,263.68 $1,358.80 $1,696.66 |
Toc - Plan #175 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 30 |
||||||||||||||||||||
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 |
$307.15 $348.60 $392.52 $548.55 $833.58 |
$542.11 $583.56 $627.48 $783.51 |
$777.07 $818.52 $862.44 $1,018.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$614.30 $697.20 $785.04 $1,097.10 $1,667.16 |
$849.26 $932.16 $1,020.00 $1,332.06 |
$1,084.22 $1,167.12 $1,254.96 $1,567.02 |
Toc - Plan #176 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 31 |
||||||||||||||||||||
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 |
$307.57 $349.09 $393.07 $549.31 $834.73 |
$542.86 $584.38 $628.36 $784.60 |
$778.15 $819.67 $863.65 $1,019.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$615.14 $698.18 $786.14 $1,098.62 $1,669.46 |
$850.43 $933.47 $1,021.43 $1,333.91 |
$1,085.72 $1,168.76 $1,256.72 $1,569.20 |
Toc - Plan #177 Ambetter from Superior Healthplan | ||||||||||||||||||||
Silver
(HMO) Ambetter Value Silver 32 |
||||||||||||||||||||
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 |
$317.52 $360.38 $405.78 $567.08 $861.73 |
$560.42 $603.28 $648.68 $809.98 |
$803.32 $846.18 $891.58 $1,052.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$635.04 $720.76 $811.56 $1,134.16 $1,723.46 |
$877.94 $963.66 $1,054.46 $1,377.06 |
$1,120.84 $1,206.56 $1,297.36 $1,619.96 |
Toc - Plan #178 Ambetter from Superior Healthplan | ||||||||||||||||||||
Gold
(HMO) Ambetter Value Gold 20 |
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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 |
$408.40 $463.52 $521.92 $729.38 $1,108.37 |
$720.82 $775.94 $834.34 $1,041.80 |
$1,033.24 $1,088.36 $1,146.76 $1,354.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$816.80 $927.04 $1,043.84 $1,458.76 $2,216.74 |
$1,129.22 $1,239.46 $1,356.26 $1,771.18 |
$1,441.64 $1,551.88 $1,668.68 $2,083.60 |
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Toc - Plan #179 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Gold 1000 ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.02 $366.63 $412.82 $576.92 $876.68 |
$570.13 $613.74 $659.93 $824.03 |
$817.24 $860.85 $907.04 $1,071.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646.04 $733.26 $825.64 $1,153.84 $1,753.36 |
$893.15 $980.37 $1,072.75 $1,400.95 |
$1,140.26 $1,227.48 $1,319.86 $1,648.06 |
Toc - Plan #180 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Gold $0 Deductible + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription L |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.70 $411.67 $463.53 $647.79 $984.37 |
$640.17 $689.14 $741.00 $925.26 |
$917.64 $966.61 $1,018.47 $1,202.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$725.40 $823.34 $927.06 $1,295.58 $1,968.74 |
$1,002.87 $1,100.81 $1,204.53 $1,573.05 |
$1,280.34 $1,378.28 $1,482.00 $1,850.52 |
Toc - Plan #181 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 5000 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.37 $378.38 $426.05 $595.41 $904.78 |
$588.40 $633.41 $681.08 $850.44 |
$843.43 $888.44 $936.11 $1,105.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666.74 $756.76 $852.10 $1,190.82 $1,809.56 |
$921.77 $1,011.79 $1,107.13 $1,445.85 |
$1,176.80 $1,266.82 $1,362.16 $1,700.88 |
Toc - Plan #182 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 3000 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.89 $381.23 $429.27 $599.90 $911.60 |
$592.85 $638.19 $686.23 $856.86 |
$849.81 $895.15 $943.19 $1,113.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$671.78 $762.46 $858.54 $1,199.80 $1,823.20 |
$928.74 $1,019.42 $1,115.50 $1,456.76 |
$1,185.70 $1,276.38 $1,372.46 $1,713.72 |
Toc - Plan #183 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver $0 Deductible ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$346.76 $393.58 $443.16 $619.32 $941.12 |
$612.03 $658.85 $708.43 $884.59 |
$877.30 $924.12 $973.70 $1,149.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$693.52 $787.16 $886.32 $1,238.64 $1,882.24 |
$958.79 $1,052.43 $1,151.59 $1,503.91 |
$1,224.06 $1,317.70 $1,416.86 $1,769.18 |
Toc - Plan #184 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 6700 ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$339.35 $385.17 $433.69 $606.09 $921.01 |
$598.96 $644.78 $693.30 $865.70 |
$858.57 $904.39 $952.91 $1,125.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$678.70 $770.34 $867.38 $1,212.18 $1,842.02 |
$938.31 $1,029.95 $1,126.99 $1,471.79 |
$1,197.92 $1,289.56 $1,386.60 $1,731.40 |
Toc - Plan #185 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 6700 + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Presc |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.94 $392.64 $442.11 $617.85 $938.88 |
$610.58 $657.28 $706.75 $882.49 |
$875.22 $921.92 $971.39 $1,147.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$691.88 $785.28 $884.22 $1,235.70 $1,877.76 |
$956.52 $1,049.92 $1,148.86 $1,500.34 |
$1,221.16 $1,314.56 $1,413.50 $1,764.98 |
Toc - Plan #186 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 8700 + $0 Mental Health ($0 Telehealth + $0 Primary Care + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$243.46 $276.32 $311.14 $434.82 $660.74 |
$429.71 $462.57 $497.39 $621.07 |
$615.96 $648.82 $683.64 $807.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$486.92 $552.64 $622.28 $869.64 $1,321.48 |
$673.17 $738.89 $808.53 $1,055.89 |
$859.42 $925.14 $994.78 $1,242.14 |
Toc - Plan #187 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 5300 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$263.22 $298.76 $336.40 $470.12 $714.39 |
$464.59 $500.13 $537.77 $671.49 |
$665.96 $701.50 $739.14 $872.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$526.44 $597.52 $672.80 $940.24 $1,428.78 |
$727.81 $798.89 $874.17 $1,141.61 |
$929.18 $1,000.26 $1,075.54 $1,342.98 |
Toc - Plan #188 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7200 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$251.36 $285.30 $321.24 $448.93 $682.20 |
$443.65 $477.59 $513.53 $641.22 |
$635.94 $669.88 $705.82 $833.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$502.72 $570.60 $642.48 $897.86 $1,364.40 |
$695.01 $762.89 $834.77 $1,090.15 |
$887.30 $955.18 $1,027.06 $1,282.44 |
Toc - Plan #189 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze $0 Medical Deductible ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.17 $319.12 $359.33 $502.16 $763.08 |
$496.26 $534.21 $574.42 $717.25 |
$711.35 $749.30 $789.51 $932.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$562.34 $638.24 $718.66 $1,004.32 $1,526.16 |
$777.43 $853.33 $933.75 $1,219.41 |
$992.52 $1,068.42 $1,148.84 $1,434.50 |
Toc - Plan #190 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7200 + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$257.95 $292.77 $329.66 $460.70 $700.07 |
$455.28 $490.10 $526.99 $658.03 |
$652.61 $687.43 $724.32 $855.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$515.90 $585.54 $659.32 $921.40 $1,400.14 |
$713.23 $782.87 $856.65 $1,118.73 |
$910.56 $980.20 $1,053.98 $1,316.06 |
Toc - Plan #191 Bright HealthCare | ||||||||||||||||||||
Catastrophic
(HMO) Catastrophic 8700 ($0 Primary Care) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$208.45 $236.59 $266.40 $372.29 $565.74 |
$367.92 $396.06 $425.87 $531.76 |
$527.39 $555.53 $585.34 $691.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$416.90 $473.18 $532.80 $744.58 $1,131.48 |
$576.37 $632.65 $692.27 $904.05 |
$735.84 $792.12 $851.74 $1,063.52 |
Toc - Plan #192 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Super Gold 1 ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.26 $322.63 $363.28 $507.69 $771.48 |
$501.72 $540.09 $580.74 $725.15 |
$719.18 $757.55 $798.20 $942.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$568.52 $645.26 $726.56 $1,015.38 $1,542.96 |
$785.98 $862.72 $944.02 $1,232.84 |
$1,003.44 $1,080.18 $1,161.48 $1,450.30 |
Toc - Plan #193 Bright HealthCare | ||||||||||||||||||||
Gold
(HMO) Super Gold 2 + Adult Dental & Vision ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$319.97 $363.16 $408.92 $571.46 $868.39 |
$564.75 $607.94 $653.70 $816.24 |
$809.53 $852.72 $898.48 $1,061.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$639.94 $726.32 $817.84 $1,142.92 $1,736.78 |
$884.72 $971.10 $1,062.62 $1,387.70 |
$1,129.50 $1,215.88 $1,307.40 $1,632.48 |
Toc - Plan #194 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 1 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.37 $332.97 $374.93 $523.96 $796.20 |
$517.80 $557.40 $599.36 $748.39 |
$742.23 $781.83 $823.79 $972.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586.74 $665.94 $749.86 $1,047.92 $1,592.40 |
$811.17 $890.37 $974.29 $1,272.35 |
$1,035.60 $1,114.80 $1,198.72 $1,496.78 |
Toc - Plan #195 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 2 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$295.58 $335.49 $377.75 $527.91 $802.21 |
$521.70 $561.61 $603.87 $754.03 |
$747.82 $787.73 $829.99 $980.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$591.16 $670.98 $755.50 $1,055.82 $1,604.42 |
$817.28 $897.10 $981.62 $1,281.94 |
$1,043.40 $1,123.22 $1,207.74 $1,508.06 |
Toc - Plan #196 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 5 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.15 $346.35 $389.98 $545.00 $828.18 |
$538.59 $579.79 $623.42 $778.44 |
$772.03 $813.23 $856.86 $1,011.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$610.30 $692.70 $779.96 $1,090.00 $1,656.36 |
$843.74 $926.14 $1,013.40 $1,323.44 |
$1,077.18 $1,159.58 $1,246.84 $1,556.88 |
Toc - Plan #197 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 3 ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.63 $338.95 $381.65 $533.36 $810.49 |
$527.08 $567.40 $610.10 $761.81 |
$755.53 $795.85 $838.55 $990.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$597.26 $677.90 $763.30 $1,066.72 $1,620.98 |
$825.71 $906.35 $991.75 $1,295.17 |
$1,054.16 $1,134.80 $1,220.20 $1,523.62 |
Toc - Plan #198 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 4 + Adult Dental & Vision ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Pr |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.22 $346.42 $390.07 $545.12 $828.36 |
$538.71 $579.91 $623.56 $778.61 |
$772.20 $813.40 $857.05 $1,012.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$610.44 $692.84 $780.14 $1,090.24 $1,656.72 |
$843.93 $926.33 $1,013.63 $1,323.73 |
$1,077.42 $1,159.82 $1,247.12 $1,557.22 |
Toc - Plan #199 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 1 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$214.24 $243.17 $273.80 $382.64 $581.46 |
$378.14 $407.07 $437.70 $546.54 |
$542.04 $570.97 $601.60 $710.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$428.48 $486.34 $547.60 $765.28 $1,162.92 |
$592.38 $650.24 $711.50 $929.18 |
$756.28 $814.14 $875.40 $1,093.08 |
Toc - Plan #200 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 4 ($0 Primary Care + $0 Telehealth + $0 Specialist + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$231.64 $262.91 $296.03 $413.71 $628.67 |
$408.84 $440.11 $473.23 $590.91 |
$586.04 $617.31 $650.43 $768.11 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$463.28 $525.82 $592.06 $827.42 $1,257.34 |
$640.48 $703.02 $769.26 $1,004.62 |
$817.68 $880.22 $946.46 $1,181.82 |
Toc - Plan #201 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 2 ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$221.20 $251.06 $282.69 $395.06 $600.33 |
$390.42 $420.28 $451.91 $564.28 |
$559.64 $589.50 $621.13 $733.50 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$442.40 $502.12 $565.38 $790.12 $1,200.66 |
$611.62 $671.34 $734.60 $959.34 |
$780.84 $840.56 $903.82 $1,128.56 |
Toc - Plan #202 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 5 HSA |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$247.43 $280.83 $316.21 $441.90 $671.51 |
$436.71 $470.11 $505.49 $631.18 |
$625.99 $659.39 $694.77 $820.46 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$494.86 $561.66 $632.42 $883.80 $1,343.02 |
$684.14 $750.94 $821.70 $1,073.08 |
$873.42 $940.22 $1,010.98 $1,262.36 |
Toc - Plan #203 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 3 + Adult Dental & Vision ($0 Primary Care + $0 Telehealth + $0 Mental Health + $0 Prescription List) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$227.78 $258.54 $291.11 $406.82 $618.21 |
$402.04 $432.80 $465.37 $581.08 |
$576.30 $607.06 $639.63 $755.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$455.56 $517.08 $582.22 $813.64 $1,236.42 |
$629.82 $691.34 $756.48 $987.90 |
$804.08 $865.60 $930.74 $1,162.16 |
Toc - Plan #204 Bright HealthCare | ||||||||||||||||||||
Catastrophic
(HMO) Super Catastrophic 1 ($0 Primary Care) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$183.44 $208.20 $234.43 $327.62 $497.85 |
$323.77 $348.53 $374.76 $467.95 |
$464.10 $488.86 $515.09 $608.28 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$366.88 $416.40 $468.86 $655.24 $995.70 |
$507.21 $556.73 $609.19 $795.57 |
$647.54 $697.06 $749.52 $935.90 |
Toc - Plan #205 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 8700 ($25 Generic) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$240.18 $272.61 $306.96 $428.97 $651.86 |
$423.92 $456.35 $490.70 $612.71 |
$607.66 $640.09 $674.44 $796.45 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$480.36 $545.22 $613.92 $857.94 $1,303.72 |
$664.10 $728.96 $797.66 $1,041.68 |
$847.84 $912.70 $981.40 $1,225.42 |
Toc - Plan #206 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Silver 4000 ($35 Primary Care + $15 Generic) |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$329.17 $373.60 $420.67 $587.89 $893.35 |
$580.98 $625.41 $672.48 $839.70 |
$832.79 $877.22 $924.29 $1,091.51 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$658.34 $747.20 $841.34 $1,175.78 $1,786.70 |
$910.15 $999.01 $1,093.15 $1,427.59 |
$1,161.96 $1,250.82 $1,344.96 $1,679.40 |
Toc - Plan #207 Bright HealthCare | ||||||||||||||||||||
Expanded Bronze
(HMO) Super Bronze 6 |
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Benefits & Coverage
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$211.36 $239.90 $270.12 $377.49 $573.64 |
$373.05 $401.59 $431.81 $539.18 |
$534.74 $563.28 $593.50 $700.87 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$422.72 $479.80 $540.24 $754.98 $1,147.28 |
$584.41 $641.49 $701.93 $916.67 |
$746.10 $803.18 $863.62 $1,078.36 |
Toc - Plan #208 Bright HealthCare | ||||||||||||||||||||
Silver
(HMO) Super Silver 7 |
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Benefits & Coverage
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Provider Directory
Customer Service Phone:
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 |
$289.67 $328.77 $370.19 $517.34 $786.15 |
$511.26 $550.36 $591.78 $738.93 |
$732.85 $771.95 $813.37 $960.52 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$579.34 $657.54 $740.38 $1,034.68 $1,572.30 |
$800.93 $879.13 $961.97 $1,256.27 |
$1,022.52 $1,100.72 $1,183.56 $1,477.86 |
‡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 Harris County here.
Harris County is in “Rating Area 10” of Texas.
Currently, there are 208 plans offered in Rating Area 10.