Obamacare 2023 Rates for Saint Louis County
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Obamacare > Rates > Missouri > Saint Louis County
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Anthem Blue Cross and Blue ShieldLocal: 1-855-738-6677 | Toll Free: 1-855-738-6677 |
Toc - Plan #1 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$324.74 $368.58 $415.02 $579.99 $881.34 |
$573.17 $617.01 $663.45 $828.42 |
$821.60 $865.44 $911.88 $1,076.85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$649.48 $737.16 $830.04 $1,159.98 $1,762.68 |
$897.91 $985.59 $1,078.47 $1,408.41 |
$1,146.34 $1,234.02 $1,326.90 $1,656.84 |
Toc - Plan #2 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 6800 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$268.30 $304.52 $342.89 $479.18 $728.17 |
$473.55 $509.77 $548.14 $684.43 |
$678.80 $715.02 $753.39 $889.68 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$536.60 $609.04 $685.78 $958.36 $1,456.34 |
$741.85 $814.29 $891.03 $1,163.61 |
$947.10 $1,019.54 $1,096.28 $1,368.86 |
Toc - Plan #3 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 0% for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$267.33 $303.42 $341.65 $477.45 $725.53 |
$471.84 $507.93 $546.16 $681.96 |
$676.35 $712.44 $750.67 $886.47 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$534.66 $606.84 $683.30 $954.90 $1,451.06 |
$739.17 $811.35 $887.81 $1,159.41 |
$943.68 $1,015.86 $1,092.32 $1,363.92 |
Toc - Plan #4 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 20% for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$270.50 $307.02 $345.70 $483.11 $734.14 |
$477.43 $513.95 $552.63 $690.04 |
$684.36 $720.88 $759.56 $896.97 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$541.00 $614.04 $691.40 $966.22 $1,468.28 |
$747.93 $820.97 $898.33 $1,173.15 |
$954.86 $1,027.90 $1,105.26 $1,380.08 |
Toc - Plan #5 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 3900 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$323.10 $366.72 $412.92 $577.06 $876.89 |
$570.27 $613.89 $660.09 $824.23 |
$817.44 $861.06 $907.26 $1,071.40 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$646.20 $733.44 $825.84 $1,154.12 $1,753.78 |
$893.37 $980.61 $1,073.01 $1,401.29 |
$1,140.54 $1,227.78 $1,320.18 $1,648.46 |
Toc - Plan #6 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 3000 for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$324.13 $367.89 $414.24 $578.90 $879.69 |
$572.09 $615.85 $662.20 $826.86 |
$820.05 $863.81 $910.16 $1,074.82 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$648.26 $735.78 $828.48 $1,157.80 $1,759.38 |
$896.22 $983.74 $1,076.44 $1,405.76 |
$1,144.18 $1,231.70 $1,324.40 $1,653.72 |
Toc - Plan #7 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 6500 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$266.43 $302.40 $340.50 $475.84 $723.09 |
$470.25 $506.22 $544.32 $679.66 |
$674.07 $710.04 $748.14 $883.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$532.86 $604.80 $681.00 $951.68 $1,446.18 |
$736.68 $808.62 $884.82 $1,155.50 |
$940.50 $1,012.44 $1,088.64 $1,359.32 |
Toc - Plan #8 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 5400 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$317.63 $360.51 $405.93 $567.29 $862.05 |
$560.62 $603.50 $648.92 $810.28 |
$803.61 $846.49 $891.91 $1,053.27 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$635.26 $721.02 $811.86 $1,134.58 $1,724.10 |
$878.25 $964.01 $1,054.85 $1,377.57 |
$1,121.24 $1,207.00 $1,297.84 $1,620.56 |
Toc - Plan #9 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 6500 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$315.57 $358.17 $403.30 $563.61 $856.46 |
$556.98 $599.58 $644.71 $805.02 |
$798.39 $840.99 $886.12 $1,046.43 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$631.14 $716.34 $806.60 $1,127.22 $1,712.92 |
$872.55 $957.75 $1,048.01 $1,368.63 |
$1,113.96 $1,199.16 $1,289.42 $1,610.04 |
Toc - Plan #10 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Catastrophic
(EPO) Anthem Catastrophic Pathway X 9100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$194.90 $221.21 $249.08 $348.09 $528.96 |
$344.00 $370.31 $398.18 $497.19 |
$493.10 $519.41 $547.28 $646.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$389.80 $442.42 $498.16 $696.18 $1,057.92 |
$538.90 $591.52 $647.26 $845.28 |
$688.00 $740.62 $796.36 $994.38 |
Toc - Plan #11 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 4350 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$277.23 $314.66 $354.30 $495.13 $752.40 |
$489.31 $526.74 $566.38 $707.21 |
$701.39 $738.82 $778.46 $919.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$554.46 $629.32 $708.60 $990.26 $1,504.80 |
$766.54 $841.40 $920.68 $1,202.34 |
$978.62 $1,053.48 $1,132.76 $1,414.42 |
Toc - Plan #12 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(EPO) Anthem Bronze Pathway X 9100/0% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$251.66 $285.63 $321.62 $449.46 $683.01 |
$444.18 $478.15 $514.14 $641.98 |
$636.70 $670.67 $706.66 $834.50 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$503.32 $571.26 $643.24 $898.92 $1,366.02 |
$695.84 $763.78 $835.76 $1,091.44 |
$888.36 $956.30 $1,028.28 $1,283.96 |
Toc - Plan #13 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(EPO) Anthem Bronze Pathway X 7500/50% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$275.83 $313.07 $352.51 $492.63 $748.60 |
$486.84 $524.08 $563.52 $703.64 |
$697.85 $735.09 $774.53 $914.65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$551.66 $626.14 $705.02 $985.26 $1,497.20 |
$762.67 $837.15 $916.03 $1,196.27 |
$973.68 $1,048.16 $1,127.04 $1,407.28 |
Toc - Plan #14 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(EPO) Anthem Silver Pathway X 5800/40% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$314.81 $357.31 $402.33 $562.25 $854.39 |
$555.64 $598.14 $643.16 $803.08 |
$796.47 $838.97 $883.99 $1,043.91 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$629.62 $714.62 $804.66 $1,124.50 $1,708.78 |
$870.45 $955.45 $1,045.49 $1,365.33 |
$1,111.28 $1,196.28 $1,286.32 $1,606.16 |
Toc - Plan #15 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(EPO) Anthem Gold Pathway X 2000/25% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6677
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 |
$483.47 $548.74 $617.87 $863.48 $1,312.14 |
$853.32 $918.59 $987.72 $1,233.33 |
$1,223.17 $1,288.44 $1,357.57 $1,603.18 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$966.94 $1,097.48 $1,235.74 $1,726.96 $2,624.28 |
$1,336.79 $1,467.33 $1,605.59 $2,096.81 |
$1,706.64 $1,837.18 $1,975.44 $2,466.66 |
ADVERTISEMENT
WellFirst HealthLocal: 1-866-514-4194 | Toll Free: 1-866-514-4194 | TTY: 1-866-514-4194 |
Toc - Plan #16 WellFirst Health | ||||||||||||||||||||
Gold
(EPO) WellFirst Gold Copay Plus 1500X (Free Virtual Visits & Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
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 |
$434.70 $493.39 $555.55 $776.38 $1,179.78 |
$767.25 $825.94 $888.10 $1,108.93 |
$1,099.80 $1,158.49 $1,220.65 $1,441.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$869.40 $986.78 $1,111.10 $1,552.76 $2,359.56 |
$1,201.95 $1,319.33 $1,443.65 $1,885.31 |
$1,534.50 $1,651.88 $1,776.20 $2,217.86 |
Toc - Plan #17 WellFirst Health | ||||||||||||||||||||
Silver
(EPO) WellFirst Silver Copay Plus 4800X (Free Virtual Visits & Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
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 |
$404.72 $459.36 $517.24 $722.84 $1,098.42 |
$714.33 $768.97 $826.85 $1,032.45 |
$1,023.94 $1,078.58 $1,136.46 $1,342.06 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$809.44 $918.72 $1,034.48 $1,445.68 $2,196.84 |
$1,119.05 $1,228.33 $1,344.09 $1,755.29 |
$1,428.66 $1,537.94 $1,653.70 $2,064.90 |
Toc - Plan #18 WellFirst Health | ||||||||||||||||||||
Expanded Bronze
(EPO) WellFirst Bronze Copay Plus 9050X (Free Virtual Visits & Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
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 |
$269.77 $306.19 $344.76 $481.80 $732.15 |
$476.14 $512.56 $551.13 $688.17 |
$682.51 $718.93 $757.50 $894.54 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$539.54 $612.38 $689.52 $963.60 $1,464.30 |
$745.91 $818.75 $895.89 $1,169.97 |
$952.28 $1,025.12 $1,102.26 $1,376.34 |
Toc - Plan #19 WellFirst Health | ||||||||||||||||||||
Gold
(EPO) WellFirst Gold Value Copay 4000X (Free Virtual Visits & Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
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 |
$413.18 $468.96 $528.04 $737.94 $1,121.36 |
$729.26 $785.04 $844.12 $1,054.02 |
$1,045.34 $1,101.12 $1,160.20 $1,370.10 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$826.36 $937.92 $1,056.08 $1,475.88 $2,242.72 |
$1,142.44 $1,254.00 $1,372.16 $1,791.96 |
$1,458.52 $1,570.08 $1,688.24 $2,108.04 |
Toc - Plan #20 WellFirst Health | ||||||||||||||||||||
Silver
(EPO) WellFirst Silver Value Copay 4100X (Free Virtual Visits & Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
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 |
$403.57 $458.05 $515.76 $720.78 $1,095.29 |
$712.30 $766.78 $824.49 $1,029.51 |
$1,021.03 $1,075.51 $1,133.22 $1,338.24 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$807.14 $916.10 $1,031.52 $1,441.56 $2,190.58 |
$1,115.87 $1,224.83 $1,340.25 $1,750.29 |
$1,424.60 $1,533.56 $1,648.98 $2,059.02 |
Toc - Plan #21 WellFirst Health | ||||||||||||||||||||
Bronze
(EPO) WellFirst Bronze Value Copay 9050X (Free Virtual Visits & Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$264.11 $299.76 $337.53 $471.69 $716.78 |
$466.15 $501.80 $539.57 $673.73 |
$668.19 $703.84 $741.61 $875.77 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$528.22 $599.52 $675.06 $943.38 $1,433.56 |
$730.26 $801.56 $877.10 $1,145.42 |
$932.30 $1,003.60 $1,079.14 $1,347.46 |
Toc - Plan #22 WellFirst Health | ||||||||||||||||||||
Silver
(EPO) WellFirst Silver HSA-E HDHP 3550X (Free Transportation) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
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 |
$390.95 $443.72 $499.63 $698.23 $1,061.03 |
$690.02 $742.79 $798.70 $997.30 |
$989.09 $1,041.86 $1,097.77 $1,296.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.90 $887.44 $999.26 $1,396.46 $2,122.06 |
$1,080.97 $1,186.51 $1,298.33 $1,695.53 |
$1,380.04 $1,485.58 $1,597.40 $1,994.60 |
Toc - Plan #23 WellFirst Health | ||||||||||||||||||||
Expanded Bronze
(EPO) WellFirst Bronze HSA-E HDHP 7000X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.26 $332.86 $374.79 $523.77 $795.92 |
$517.61 $557.21 $599.14 $748.12 |
$741.96 $781.56 $823.49 $972.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586.52 $665.72 $749.58 $1,047.54 $1,591.84 |
$810.87 $890.07 $973.93 $1,271.89 |
$1,035.22 $1,114.42 $1,198.28 $1,496.24 |
Toc - Plan #24 WellFirst Health | ||||||||||||||||||||
Catastrophic
(EPO) WellFirst Catastrophic Safety Net (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$214.58 $243.54 $274.23 $383.23 $582.36 |
$378.73 $407.69 $438.38 $547.38 |
$542.88 $571.84 $602.53 $711.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$429.16 $487.08 $548.46 $766.46 $1,164.72 |
$593.31 $651.23 $712.61 $930.61 |
$757.46 $815.38 $876.76 $1,094.76 |
Toc - Plan #25 WellFirst Health | ||||||||||||||||||||
Gold
(EPO) WellFirst Gold HSA HDHP 2000X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.99 $436.96 $492.01 $687.59 $1,044.86 |
$679.51 $731.48 $786.53 $982.11 |
$974.03 $1,026.00 $1,081.05 $1,276.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.98 $873.92 $984.02 $1,375.18 $2,089.72 |
$1,064.50 $1,168.44 $1,278.54 $1,669.70 |
$1,359.02 $1,462.96 $1,573.06 $1,964.22 |
Toc - Plan #26 WellFirst Health | ||||||||||||||||||||
Expanded Bronze
(EPO) WellFirst Bronze Copay PCP 8000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$262.77 $298.24 $335.81 $469.30 $713.15 |
$463.79 $499.26 $536.83 $670.32 |
$664.81 $700.28 $737.85 $871.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$525.54 $596.48 $671.62 $938.60 $1,426.30 |
$726.56 $797.50 $872.64 $1,139.62 |
$927.58 $998.52 $1,073.66 $1,340.64 |
Toc - Plan #27 WellFirst Health | ||||||||||||||||||||
Silver
(EPO) WellFirst Silver Copay PCP 4500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.54 $428.51 $482.49 $674.28 $1,024.64 |
$666.36 $717.33 $771.31 $963.10 |
$955.18 $1,006.15 $1,060.13 $1,251.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.08 $857.02 $964.98 $1,348.56 $2,049.28 |
$1,043.90 $1,145.84 $1,253.80 $1,637.38 |
$1,332.72 $1,434.66 $1,542.62 $1,926.20 |
Toc - Plan #28 WellFirst Health | ||||||||||||||||||||
Gold
(EPO) WellFirst Gold Copay PCP 2000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.64 $449.05 $505.63 $706.61 $1,073.76 |
$698.30 $751.71 $808.29 $1,009.27 |
$1,000.96 $1,054.37 $1,110.95 $1,311.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$791.28 $898.10 $1,011.26 $1,413.22 $2,147.52 |
$1,093.94 $1,200.76 $1,313.92 $1,715.88 |
$1,396.60 $1,503.42 $1,616.58 $2,018.54 |
Toc - Plan #29 WellFirst Health | ||||||||||||||||||||
Gold
(EPO) WellFirst Gold Standard 2000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.60 $472.85 $532.42 $744.05 $1,130.66 |
$735.30 $791.55 $851.12 $1,062.75 |
$1,054.00 $1,110.25 $1,169.82 $1,381.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$833.20 $945.70 $1,064.84 $1,488.10 $2,261.32 |
$1,151.90 $1,264.40 $1,383.54 $1,806.80 |
$1,470.60 $1,583.10 $1,702.24 $2,125.50 |
Toc - Plan #30 WellFirst Health | ||||||||||||||||||||
Silver
(EPO) WellFirst Silver Standard 5800X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.47 $436.37 $491.35 $686.66 $1,043.44 |
$678.59 $730.49 $785.47 $980.78 |
$972.71 $1,024.61 $1,079.59 $1,274.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$768.94 $872.74 $982.70 $1,373.32 $2,086.88 |
$1,063.06 $1,166.86 $1,276.82 $1,667.44 |
$1,357.18 $1,460.98 $1,570.94 $1,961.56 |
Toc - Plan #31 WellFirst Health | ||||||||||||||||||||
Expanded Bronze
(EPO) WellFirst Bronze Standard 7500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$268.87 $305.17 $343.62 $480.21 $729.72 |
$474.56 $510.86 $549.31 $685.90 |
$680.25 $716.55 $755.00 $891.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$537.74 $610.34 $687.24 $960.42 $1,459.44 |
$743.43 $816.03 $892.93 $1,166.11 |
$949.12 $1,021.72 $1,098.62 $1,371.80 |
Toc - Plan #32 WellFirst Health | ||||||||||||||||||||
Bronze
(EPO) WellFirst Bronze Standard 9100X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-514-4194
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$249.95 $283.70 $319.44 $446.42 $678.38 |
$441.17 $474.92 $510.66 $637.64 |
$632.39 $666.14 $701.88 $828.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$499.90 $567.40 $638.88 $892.84 $1,356.76 |
$691.12 $758.62 $830.10 $1,084.06 |
$882.34 $949.84 $1,021.32 $1,275.28 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-877-336-3915 | Toll Free: 1-877-336-3915 | TTY: 1-877-336-3915 |
Toc - Plan #33 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze: Aetna network of doctors & hospitals + Low-cost MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$296.56 $336.60 $379.01 $529.66 $804.87 |
$523.43 $563.47 $605.88 $756.53 |
$750.30 $790.34 $832.75 $983.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$593.12 $673.20 $758.02 $1,059.32 $1,609.74 |
$819.99 $900.07 $984.89 $1,286.19 |
$1,046.86 $1,126.94 $1,211.76 $1,513.06 |
Toc - Plan #34 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$296.94 $337.02 $379.49 $530.33 $805.89 |
$524.10 $564.18 $606.65 $757.49 |
$751.26 $791.34 $833.81 $984.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$593.88 $674.04 $758.98 $1,060.66 $1,611.78 |
$821.04 $901.20 $986.14 $1,287.82 |
$1,048.20 $1,128.36 $1,213.30 $1,514.98 |
Toc - Plan #35 Aetna CVS Health | ||||||||||||||||||||
Gold
(EPO) Gold: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$457.65 $519.44 $584.88 $817.37 $1,242.07 |
$807.75 $869.54 $934.98 $1,167.47 |
$1,157.85 $1,219.64 $1,285.08 $1,517.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$915.30 $1,038.88 $1,169.76 $1,634.74 $2,484.14 |
$1,265.40 $1,388.98 $1,519.86 $1,984.84 |
$1,615.50 $1,739.08 $1,869.96 $2,334.94 |
Toc - Plan #36 Aetna CVS Health | ||||||||||||||||||||
Silver
(EPO) Silver 2: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$368.78 $418.56 $471.30 $658.64 $1,000.86 |
$650.89 $700.67 $753.41 $940.75 |
$933.00 $982.78 $1,035.52 $1,222.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$737.56 $837.12 $942.60 $1,317.28 $2,001.72 |
$1,019.67 $1,119.23 $1,224.71 $1,599.39 |
$1,301.78 $1,401.34 $1,506.82 $1,881.50 |
Toc - Plan #37 Aetna CVS Health | ||||||||||||||||||||
Silver
(EPO) Silver 1: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$370.90 $420.97 $474.01 $662.43 $1,006.63 |
$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 $2,013.26 |
$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 #38 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$287.17 $325.94 $367.00 $512.89 $779.38 |
$506.86 $545.63 $586.69 $732.58 |
$726.55 $765.32 $806.38 $952.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$574.34 $651.88 $734.00 $1,025.78 $1,558.76 |
$794.03 $871.57 $953.69 $1,245.47 |
$1,013.72 $1,091.26 $1,173.38 $1,465.16 |
Toc - Plan #39 Aetna CVS Health | ||||||||||||||||||||
Gold
(EPO) Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$417.61 $473.99 $533.71 $745.85 $1,133.40 |
$737.08 $793.46 $853.18 $1,065.32 |
$1,056.55 $1,112.93 $1,172.65 $1,384.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.22 $947.98 $1,067.42 $1,491.70 $2,266.80 |
$1,154.69 $1,267.45 $1,386.89 $1,811.17 |
$1,474.16 $1,586.92 $1,706.36 $2,130.64 |
Toc - Plan #40 Aetna CVS Health | ||||||||||||||||||||
Silver
(EPO) Silver 3: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$351.01 $398.39 $448.59 $626.90 $952.63 |
$619.53 $666.91 $717.11 $895.42 |
$888.05 $935.43 $985.63 $1,163.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.02 $796.78 $897.18 $1,253.80 $1,905.26 |
$970.54 $1,065.30 $1,165.70 $1,522.32 |
$1,239.06 $1,333.82 $1,434.22 $1,790.84 |
Toc - Plan #41 Aetna CVS Health | ||||||||||||||||||||
Silver
(EPO) Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 Telehealth 24/7 |
||||||||||||||||||||
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 |
$344.14 $390.60 $439.82 $614.64 $934.01 |
$607.41 $653.87 $703.09 $877.91 |
$870.68 $917.14 $966.36 $1,141.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.28 $781.20 $879.64 $1,229.28 $1,868.02 |
$951.55 $1,044.47 $1,142.91 $1,492.55 |
$1,214.82 $1,307.74 $1,406.18 $1,755.82 |
ADVERTISEMENT
MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-676-3777 |
Toc - Plan #42 Medica | ||||||||||||||||||||
Catastrophic
(EPO) Balance by Medica Catastrophic ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$205.33 $233.04 $262.40 $366.71 $557.25 |
$362.40 $390.11 $419.47 $523.78 |
$519.47 $547.18 $576.54 $680.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$410.66 $466.08 $524.80 $733.42 $1,114.50 |
$567.73 $623.15 $681.87 $890.49 |
$724.80 $780.22 $838.94 $1,047.56 |
Toc - Plan #43 Medica | ||||||||||||||||||||
Silver
(EPO) Balance by Medica Silver Share ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.99 $460.78 $518.84 $725.07 $1,101.82 |
$716.56 $771.35 $829.41 $1,035.64 |
$1,027.13 $1,081.92 $1,139.98 $1,346.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.98 $921.56 $1,037.68 $1,450.14 $2,203.64 |
$1,122.55 $1,232.13 $1,348.25 $1,760.71 |
$1,433.12 $1,542.70 $1,658.82 $2,071.28 |
Toc - Plan #44 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Balance by Medica Bronze Share Plus ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.38 $336.38 $378.76 $529.32 $804.35 |
$523.10 $563.10 $605.48 $756.04 |
$749.82 $789.82 $832.20 $982.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$592.76 $672.76 $757.52 $1,058.64 $1,608.70 |
$819.48 $899.48 $984.24 $1,285.36 |
$1,046.20 $1,126.20 $1,210.96 $1,512.08 |
Toc - Plan #45 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Balance by Medica Bronze Copay $0 PCP ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$287.95 $326.81 $367.99 $514.26 $781.47 |
$508.23 $547.09 $588.27 $734.54 |
$728.51 $767.37 $808.55 $954.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$575.90 $653.62 $735.98 $1,028.52 $1,562.94 |
$796.18 $873.90 $956.26 $1,248.80 |
$1,016.46 $1,094.18 $1,176.54 $1,469.08 |
Toc - Plan #46 Medica | ||||||||||||||||||||
Gold
(EPO) Balance by Medica Gold Copay $0 PCP ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.65 $487.64 $549.08 $767.33 $1,166.04 |
$758.32 $816.31 $877.75 $1,096.00 |
$1,086.99 $1,144.98 $1,206.42 $1,424.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$859.30 $975.28 $1,098.16 $1,534.66 $2,332.08 |
$1,187.97 $1,303.95 $1,426.83 $1,863.33 |
$1,516.64 $1,632.62 $1,755.50 $2,192.00 |
Toc - Plan #47 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Balance by Medica Bronze Premier ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.98 $327.98 $369.30 $516.10 $784.27 |
$510.04 $549.04 $590.36 $737.16 |
$731.10 $770.10 $811.42 $958.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$577.96 $655.96 $738.60 $1,032.20 $1,568.54 |
$799.02 $877.02 $959.66 $1,253.26 |
$1,020.08 $1,098.08 $1,180.72 $1,474.32 |
Toc - Plan #48 Medica | ||||||||||||||||||||
Gold
(EPO) Balance by Medica Gold Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.64 $463.79 $522.22 $729.81 $1,109.01 |
$721.24 $776.39 $834.82 $1,042.41 |
$1,033.84 $1,088.99 $1,147.42 $1,355.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.28 $927.58 $1,044.44 $1,459.62 $2,218.02 |
$1,129.88 $1,240.18 $1,357.04 $1,772.22 |
$1,442.48 $1,552.78 $1,669.64 $2,084.82 |
Toc - Plan #49 Medica | ||||||||||||||||||||
Silver
(EPO) Balance by Medica Silver Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.77 $441.25 $496.84 $694.33 $1,055.10 |
$686.17 $738.65 $794.24 $991.73 |
$983.57 $1,036.05 $1,091.64 $1,289.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$777.54 $882.50 $993.68 $1,388.66 $2,110.20 |
$1,074.94 $1,179.90 $1,291.08 $1,686.06 |
$1,372.34 $1,477.30 $1,588.48 $1,983.46 |
Toc - Plan #50 Medica | ||||||||||||||||||||
Bronze
(EPO) Balance by Medica Bronze Standard ($0 Virtual Care with Designated Providers) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$276.83 $314.19 $353.78 $494.41 $751.30 |
$488.60 $525.96 $565.55 $706.18 |
$700.37 $737.73 $777.32 $917.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$553.66 $628.38 $707.56 $988.82 $1,502.60 |
$765.43 $840.15 $919.33 $1,200.59 |
$977.20 $1,051.92 $1,131.10 $1,412.36 |
ADVERTISEMENT
Oscar Insurance CompanyLocal: 1-855-672-2755 | Toll Free: 1-855-672-2755 |
Toc - Plan #51 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic |
||||||||||||||||||||
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 |
$300.54 $341.10 $384.07 $536.74 $815.62 |
$530.44 $571.00 $613.97 $766.64 |
$760.34 $800.90 $843.87 $996.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$601.08 $682.20 $768.14 $1,073.48 $1,631.24 |
$830.98 $912.10 $998.04 $1,303.38 |
$1,060.88 $1,142.00 $1,227.94 $1,533.28 |
Toc - Plan #52 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- $0 Ded+PCP Saver |
||||||||||||||||||||
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 |
$343.34 $389.68 $438.77 $613.19 $931.80 |
$605.99 $652.33 $701.42 $875.84 |
$868.64 $914.98 $964.07 $1,138.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.68 $779.36 $877.54 $1,226.38 $1,863.60 |
$949.33 $1,042.01 $1,140.19 $1,489.03 |
$1,211.98 $1,304.66 $1,402.84 $1,751.68 |
Toc - Plan #53 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic |
||||||||||||||||||||
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 |
$376.63 $427.47 $481.32 $672.65 $1,022.15 |
$664.75 $715.59 $769.44 $960.77 |
$952.87 $1,003.71 $1,057.56 $1,248.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.26 $854.94 $962.64 $1,345.30 $2,044.30 |
$1,041.38 $1,143.06 $1,250.76 $1,633.42 |
$1,329.50 $1,431.18 $1,538.88 $1,921.54 |
Toc - Plan #54 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- Specialist Saver |
||||||||||||||||||||
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 |
$371.28 $421.40 $474.49 $663.10 $1,007.64 |
$655.30 $705.42 $758.51 $947.12 |
$939.32 $989.44 $1,042.53 $1,231.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.56 $842.80 $948.98 $1,326.20 $2,015.28 |
$1,026.58 $1,126.82 $1,233.00 $1,610.22 |
$1,310.60 $1,410.84 $1,517.02 $1,894.24 |
Toc - Plan #55 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Secure |
||||||||||||||||||||
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 |
$249.87 $283.59 $319.32 $446.25 $678.11 |
$441.01 $474.73 $510.46 $637.39 |
$632.15 $665.87 $701.60 $828.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$499.74 $567.18 $638.64 $892.50 $1,356.22 |
$690.88 $758.32 $829.78 $1,083.64 |
$882.02 $949.46 $1,020.92 $1,274.78 |
Toc - Plan #56 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze 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 |
$320.35 $363.59 $409.40 $572.13 $869.41 |
$565.41 $608.65 $654.46 $817.19 |
$810.47 $853.71 $899.52 $1,062.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640.70 $727.18 $818.80 $1,144.26 $1,738.82 |
$885.76 $972.24 $1,063.86 $1,389.32 |
$1,130.82 $1,217.30 $1,308.92 $1,634.38 |
Toc - Plan #57 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze 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 |
$320.39 $363.64 $409.45 $572.21 $869.52 |
$565.48 $608.73 $654.54 $817.30 |
$810.57 $853.82 $899.63 $1,062.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640.78 $727.28 $818.90 $1,144.42 $1,739.04 |
$885.87 $972.37 $1,063.99 $1,389.51 |
$1,130.96 $1,217.46 $1,309.08 $1,634.60 |
Toc - Plan #58 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- $4700 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 |
$326.28 $370.31 $416.97 $582.71 $885.48 |
$575.87 $619.90 $666.56 $832.30 |
$825.46 $869.49 $916.15 $1,081.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.56 $740.62 $833.94 $1,165.42 $1,770.96 |
$902.15 $990.21 $1,083.53 $1,415.01 |
$1,151.74 $1,239.80 $1,333.12 $1,664.60 |
Toc - Plan #59 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple- PCP Saver |
||||||||||||||||||||
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 |
$361.56 $410.36 $462.06 $645.73 $981.25 |
$638.15 $686.95 $738.65 $922.32 |
$914.74 $963.54 $1,015.24 $1,198.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$723.12 $820.72 $924.12 $1,291.46 $1,962.50 |
$999.71 $1,097.31 $1,200.71 $1,568.05 |
$1,276.30 $1,373.90 $1,477.30 $1,844.64 |
Toc - Plan #60 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 |
$380.67 $432.05 $486.49 $679.87 $1,033.12 |
$671.88 $723.26 $777.70 $971.08 |
$963.09 $1,014.47 $1,068.91 $1,262.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$761.34 $864.10 $972.98 $1,359.74 $2,066.24 |
$1,052.55 $1,155.31 $1,264.19 $1,650.95 |
$1,343.76 $1,446.52 $1,555.40 $1,942.16 |
Toc - Plan #61 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 |
$372.80 $423.12 $476.43 $665.80 $1,011.75 |
$657.98 $708.30 $761.61 $950.98 |
$943.16 $993.48 $1,046.79 $1,236.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745.60 $846.24 $952.86 $1,331.60 $2,023.50 |
$1,030.78 $1,131.42 $1,238.04 $1,616.78 |
$1,315.96 $1,416.60 $1,523.22 $1,901.96 |
Toc - Plan #62 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- Standard |
||||||||||||||||||||
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 |
$318.47 $361.45 $406.99 $568.77 $864.29 |
$562.09 $605.07 $650.61 $812.39 |
$805.71 $848.69 $894.23 $1,056.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.94 $722.90 $813.98 $1,137.54 $1,728.58 |
$880.56 $966.52 $1,057.60 $1,381.16 |
$1,124.18 $1,210.14 $1,301.22 $1,624.78 |
Toc - Plan #63 Oscar Insurance Company | ||||||||||||||||||||
Bronze
(EPO) Bronze Simple- Standard |
||||||||||||||||||||
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 |
$285.84 $324.42 $365.29 $510.49 $775.74 |
$504.50 $543.08 $583.95 $729.15 |
$723.16 $761.74 $802.61 $947.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$571.68 $648.84 $730.58 $1,020.98 $1,551.48 |
$790.34 $867.50 $949.24 $1,239.64 |
$1,009.00 $1,086.16 $1,167.90 $1,458.30 |
Toc - Plan #64 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic- Standard |
||||||||||||||||||||
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 |
$365.04 $414.31 $466.51 $651.95 $990.69 |
$644.29 $693.56 $745.76 $931.20 |
$923.54 $972.81 $1,025.01 $1,210.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.08 $828.62 $933.02 $1,303.90 $1,981.38 |
$1,009.33 $1,107.87 $1,212.27 $1,583.15 |
$1,288.58 $1,387.12 $1,491.52 $1,862.40 |
Toc - Plan #65 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic- Standard |
||||||||||||||||||||
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 |
$427.29 $484.97 $546.07 $763.13 $1,159.65 |
$754.16 $811.84 $872.94 $1,090.00 |
$1,081.03 $1,138.71 $1,199.81 $1,416.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$854.58 $969.94 $1,092.14 $1,526.26 $2,319.30 |
$1,181.45 $1,296.81 $1,419.01 $1,853.13 |
$1,508.32 $1,623.68 $1,745.88 $2,180.00 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #66 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 6250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.89 $417.56 $470.17 $657.05 $998.46 |
$649.33 $699.00 $751.61 $938.49 |
$930.77 $980.44 $1,033.05 $1,219.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.78 $835.12 $940.34 $1,314.10 $1,996.92 |
$1,017.22 $1,116.56 $1,221.78 $1,595.54 |
$1,298.66 $1,398.00 $1,503.22 $1,876.98 |
Toc - Plan #67 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 2800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.20 $463.30 $521.68 $729.04 $1,107.85 |
$720.47 $775.57 $833.95 $1,041.31 |
$1,032.74 $1,087.84 $1,146.22 $1,353.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$816.40 $926.60 $1,043.36 $1,458.08 $2,215.70 |
$1,128.67 $1,238.87 $1,355.63 $1,770.35 |
$1,440.94 $1,551.14 $1,667.90 $2,082.62 |
Toc - Plan #68 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 1250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$577.16 $655.07 $737.61 $1,030.80 $1,566.40 |
$1,018.68 $1,096.59 $1,179.13 $1,472.32 |
$1,460.20 $1,538.11 $1,620.65 $1,913.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,154.32 $1,310.14 $1,475.22 $2,061.60 $3,132.80 |
$1,595.84 $1,751.66 $1,916.74 $2,503.12 |
$2,037.36 $2,193.18 $2,358.26 $2,944.64 |
Toc - Plan #69 Cigna Healthcare | ||||||||||||||||||||
Bronze
(EPO) Cigna Simple Choice 9100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.81 $400.44 $450.89 $630.11 $957.52 |
$622.71 $670.34 $720.79 $900.01 |
$892.61 $940.24 $990.69 $1,169.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$705.62 $800.88 $901.78 $1,260.22 $1,915.04 |
$975.52 $1,070.78 $1,171.68 $1,530.12 |
$1,245.42 $1,340.68 $1,441.58 $1,800.02 |
Toc - Plan #70 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Simple Choice 5800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.75 $460.52 $518.55 $724.67 $1,101.20 |
$716.15 $770.92 $828.95 $1,035.07 |
$1,026.55 $1,081.32 $1,139.35 $1,345.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.50 $921.04 $1,037.10 $1,449.34 $2,202.40 |
$1,121.90 $1,231.44 $1,347.50 $1,759.74 |
$1,432.30 $1,541.84 $1,657.90 $2,070.14 |
Toc - Plan #71 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Simple Choice 2000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$575.05 $652.68 $734.91 $1,027.04 $1,560.69 |
$1,014.96 $1,092.59 $1,174.82 $1,466.95 |
$1,454.87 $1,532.50 $1,614.73 $1,906.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,150.10 $1,305.36 $1,469.82 $2,054.08 $3,121.38 |
$1,590.01 $1,745.27 $1,909.73 $2,493.99 |
$2,029.92 $2,185.18 $2,349.64 $2,933.90 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-877-632-4195 | Toll Free: 1-877-632-4195 | TTY: 1-877-940-4172 |
Toc - Plan #72 UnitedHealthcare | ||||||||||||||||||||
Gold
(EPO) UHC Gold Value (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $1 T1 Preferred Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.67 $426.39 $480.11 $670.95 $1,019.57 |
$663.06 $713.78 $767.50 $958.34 |
$950.45 $1,001.17 $1,054.89 $1,245.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.34 $852.78 $960.22 $1,341.90 $2,039.14 |
$1,038.73 $1,140.17 $1,247.61 $1,629.29 |
$1,326.12 $1,427.56 $1,535.00 $1,916.68 |
Toc - Plan #73 UnitedHealthcare | ||||||||||||||||||||
Gold
(EPO) UHC Gold Advantage+ (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $1 T1 Preferred Rx, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.45 $448.84 $505.39 $706.27 $1,073.25 |
$697.97 $751.36 $807.91 $1,008.79 |
$1,000.49 $1,053.88 $1,110.43 $1,311.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.90 $897.68 $1,010.78 $1,412.54 $2,146.50 |
$1,093.42 $1,200.20 $1,313.30 $1,715.06 |
$1,395.94 $1,502.72 $1,615.82 $2,017.58 |
Toc - Plan #74 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Value $4,000 Deductible (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $3 T1 Preferred Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.85 $395.94 $445.83 $623.04 $946.77 |
$615.72 $662.81 $712.70 $889.91 |
$882.59 $929.68 $979.57 $1,156.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.70 $791.88 $891.66 $1,246.08 $1,893.54 |
$964.57 $1,058.75 $1,158.53 $1,512.95 |
$1,231.44 $1,325.62 $1,425.40 $1,779.82 |
Toc - Plan #75 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Advantage (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $3 T1 Preferred Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.95 $391.52 $440.85 $616.08 $936.20 |
$608.84 $655.41 $704.74 $879.97 |
$872.73 $919.30 $968.63 $1,143.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$689.90 $783.04 $881.70 $1,232.16 $1,872.40 |
$953.79 $1,046.93 $1,145.59 $1,496.05 |
$1,217.68 $1,310.82 $1,409.48 $1,759.94 |
Toc - Plan #76 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Advantage+ (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $3 T1 Preferred Rx, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.57 $408.12 $459.54 $642.20 $975.88 |
$634.64 $683.19 $734.61 $917.27 |
$909.71 $958.26 $1,009.68 $1,192.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.14 $816.24 $919.08 $1,284.40 $1,951.76 |
$994.21 $1,091.31 $1,194.15 $1,559.47 |
$1,269.28 $1,366.38 $1,469.22 $1,834.54 |
Toc - Plan #77 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Advantage $0 Deductible (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $3 T1 Preferred Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.61 $401.34 $451.91 $631.54 $959.68 |
$624.12 $671.85 $722.42 $902.05 |
$894.63 $942.36 $992.93 $1,172.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.22 $802.68 $903.82 $1,263.08 $1,919.36 |
$977.73 $1,073.19 $1,174.33 $1,533.59 |
$1,248.24 $1,343.70 $1,444.84 $1,804.10 |
Toc - Plan #78 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Value HSA $5,400 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.60 $399.07 $449.35 $627.96 $954.24 |
$620.57 $668.04 $718.32 $896.93 |
$889.54 $937.01 $987.29 $1,165.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$703.20 $798.14 $898.70 $1,255.92 $1,908.48 |
$972.17 $1,067.11 $1,167.67 $1,524.89 |
$1,241.14 $1,336.08 $1,436.64 $1,793.86 |
Toc - Plan #79 UnitedHealthcare | ||||||||||||||||||||
Silver
(EPO) UHC Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$350.64 $397.98 $448.12 $626.25 $951.65 |
$618.88 $666.22 $716.36 $894.49 |
$887.12 $934.46 $984.60 $1,162.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$701.28 $795.96 $896.24 $1,252.50 $1,903.30 |
$969.52 $1,064.20 $1,164.48 $1,520.74 |
$1,237.76 $1,332.44 $1,432.72 $1,788.98 |
Toc - Plan #80 UnitedHealthcare | ||||||||||||||||||||
Gold
(EPO) UHC Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.77 $436.71 $491.73 $687.19 $1,044.26 |
$679.12 $731.06 $786.08 $981.54 |
$973.47 $1,025.41 $1,080.43 $1,275.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.54 $873.42 $983.46 $1,374.38 $2,088.52 |
$1,063.89 $1,167.77 $1,277.81 $1,668.73 |
$1,358.24 $1,462.12 $1,572.16 $1,963.08 |
Toc - Plan #81 UnitedHealthcare | ||||||||||||||||||||
Bronze
(EPO) UHC Bronze Essential ($3 T1 Preferred Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.69 $327.67 $368.95 $515.61 $783.51 |
$509.54 $548.52 $589.80 $736.46 |
$730.39 $769.37 $810.65 $957.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$577.38 $655.34 $737.90 $1,031.22 $1,567.02 |
$798.23 $876.19 $958.75 $1,252.07 |
$1,019.08 $1,097.04 $1,179.60 $1,472.92 |
Toc - Plan #82 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) UHC Bronze Value $6,500 Deductible (Unlimited $0 Virtual Urgent Care + $0 Primary Care Visits, $3 T1 Preferred Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.63 $341.22 $384.21 $536.93 $815.92 |
$530.62 $571.21 $614.20 $766.92 |
$760.61 $801.20 $844.19 $996.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$601.26 $682.44 $768.42 $1,073.86 $1,631.84 |
$831.25 $912.43 $998.41 $1,303.85 |
$1,061.24 $1,142.42 $1,228.40 $1,533.84 |
Toc - Plan #83 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) UHC Bronze Value HSA $6,700 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.26 $339.66 $382.45 $534.47 $812.18 |
$528.19 $568.59 $611.38 $763.40 |
$757.12 $797.52 $840.31 $992.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598.52 $679.32 $764.90 $1,068.94 $1,624.36 |
$827.45 $908.25 $993.83 $1,297.87 |
$1,056.38 $1,137.18 $1,222.76 $1,526.80 |
Toc - Plan #84 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) UHC Bronze Standard $7,500 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$302.63 $343.48 $386.75 $540.49 $821.32 |
$534.14 $574.99 $618.26 $772.00 |
$765.65 $806.50 $849.77 $1,003.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$605.26 $686.96 $773.50 $1,080.98 $1,642.64 |
$836.77 $918.47 $1,005.01 $1,312.49 |
$1,068.28 $1,149.98 $1,236.52 $1,544.00 |
Toc - Plan #85 UnitedHealthcare | ||||||||||||||||||||
Bronze
(EPO) UHC Bronze Standard $9,100 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-632-4195
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.07 $319.01 $359.20 $501.98 $762.81 |
$496.09 $534.03 $574.22 $717.00 |
$711.11 $749.05 $789.24 $932.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$562.14 $638.02 $718.40 $1,003.96 $1,525.62 |
$777.16 $853.04 $933.42 $1,218.98 |
$992.18 $1,068.06 $1,148.44 $1,434.00 |
ADVERTISEMENT
Ambetter from Home State HealthLocal: 1-855-650-3789 | Toll Free: 1-855-650-3789 | TTY: 1-855-650-3789 |
Toc - Plan #86 Ambetter from Home State Health | ||||||||||||||||||||
Bronze
(EPO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$307.19 $348.65 $392.58 $548.63 $833.70 |
$542.19 $583.65 $627.58 $783.63 |
$777.19 $818.65 $862.58 $1,018.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$614.38 $697.30 $785.16 $1,097.26 $1,667.40 |
$849.38 $932.30 $1,020.16 $1,332.26 |
$1,084.38 $1,167.30 $1,255.16 $1,567.26 |
Toc - Plan #87 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Premier Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.80 $403.82 $454.69 $635.43 $965.60 |
$627.98 $676.00 $726.87 $907.61 |
$900.16 $948.18 $999.05 $1,179.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.60 $807.64 $909.38 $1,270.86 $1,931.20 |
$983.78 $1,079.82 $1,181.56 $1,543.04 |
$1,255.96 $1,352.00 $1,453.74 $1,815.22 |
Toc - Plan #88 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.48 $402.32 $453.01 $633.08 $962.03 |
$625.65 $673.49 $724.18 $904.25 |
$896.82 $944.66 $995.35 $1,175.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.96 $804.64 $906.02 $1,266.16 $1,924.06 |
$980.13 $1,075.81 $1,177.19 $1,537.33 |
$1,251.30 $1,346.98 $1,448.36 $1,808.50 |
Toc - Plan #89 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.76 $500.25 $563.27 $787.17 $1,196.19 |
$777.93 $837.42 $900.44 $1,124.34 |
$1,115.10 $1,174.59 $1,237.61 $1,461.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$881.52 $1,000.50 $1,126.54 $1,574.34 $2,392.38 |
$1,218.69 $1,337.67 $1,463.71 $1,911.51 |
$1,555.86 $1,674.84 $1,800.88 $2,248.68 |
Toc - Plan #90 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.63 $377.53 $425.09 $594.07 $902.74 |
$587.09 $631.99 $679.55 $848.53 |
$841.55 $886.45 $934.01 $1,102.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$665.26 $755.06 $850.18 $1,188.14 $1,805.48 |
$919.72 $1,009.52 $1,104.64 $1,442.60 |
$1,174.18 $1,263.98 $1,359.10 $1,697.06 |
Toc - Plan #91 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.65 $383.22 $431.50 $603.03 $916.36 |
$595.94 $641.51 $689.79 $861.32 |
$854.23 $899.80 $948.08 $1,119.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$675.30 $766.44 $863.00 $1,206.06 $1,832.72 |
$933.59 $1,024.73 $1,121.29 $1,464.35 |
$1,191.88 $1,283.02 $1,379.58 $1,722.64 |
Toc - Plan #92 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.55 $422.84 $476.11 $665.36 $1,011.08 |
$657.55 $707.84 $761.11 $950.36 |
$942.55 $992.84 $1,046.11 $1,235.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745.10 $845.68 $952.22 $1,330.72 $2,022.16 |
$1,030.10 $1,130.68 $1,237.22 $1,615.72 |
$1,315.10 $1,415.68 $1,522.22 $1,900.72 |
Toc - Plan #93 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.02 $389.32 $438.37 $612.62 $930.94 |
$605.42 $651.72 $700.77 $875.02 |
$867.82 $914.12 $963.17 $1,137.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.04 $778.64 $876.74 $1,225.24 $1,861.88 |
$948.44 $1,041.04 $1,139.14 $1,487.64 |
$1,210.84 $1,303.44 $1,401.54 $1,750.04 |
Toc - Plan #94 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.46 $396.63 $446.60 $624.12 $948.41 |
$616.79 $663.96 $713.93 $891.45 |
$884.12 $931.29 $981.26 $1,158.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.92 $793.26 $893.20 $1,248.24 $1,896.82 |
$966.25 $1,060.59 $1,160.53 $1,515.57 |
$1,233.58 $1,327.92 $1,427.86 $1,782.90 |
Toc - Plan #95 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.15 $479.13 $539.49 $753.94 $1,145.69 |
$745.09 $802.07 $862.43 $1,076.88 |
$1,068.03 $1,125.01 $1,185.37 $1,399.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$844.30 $958.26 $1,078.98 $1,507.88 $2,291.38 |
$1,167.24 $1,281.20 $1,401.92 $1,830.82 |
$1,490.18 $1,604.14 $1,724.86 $2,153.76 |
Toc - Plan #96 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.89 $472.02 $531.49 $742.76 $1,128.69 |
$734.04 $790.17 $849.64 $1,060.91 |
$1,052.19 $1,108.32 $1,167.79 $1,379.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.78 $944.04 $1,062.98 $1,485.52 $2,257.38 |
$1,149.93 $1,262.19 $1,381.13 $1,803.67 |
$1,468.08 $1,580.34 $1,699.28 $2,121.82 |
Toc - Plan #97 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$482.42 $547.53 $616.52 $861.58 $1,309.26 |
$851.46 $916.57 $985.56 $1,230.62 |
$1,220.50 $1,285.61 $1,354.60 $1,599.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$964.84 $1,095.06 $1,233.04 $1,723.16 $2,618.52 |
$1,333.88 $1,464.10 $1,602.08 $2,092.20 |
$1,702.92 $1,833.14 $1,971.12 $2,461.24 |
Toc - Plan #98 Ambetter from Home State Health | ||||||||||||||||||||
Bronze
(EPO) CMS Standard Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.86 $332.38 $374.26 $523.02 $794.79 |
$516.89 $556.41 $598.29 $747.05 |
$740.92 $780.44 $822.32 $971.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$585.72 $664.76 $748.52 $1,046.04 $1,589.58 |
$809.75 $888.79 $972.55 $1,270.07 |
$1,033.78 $1,112.82 $1,196.58 $1,494.10 |
Toc - Plan #99 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$322.17 $365.66 $411.72 $575.38 $874.35 |
$568.63 $612.12 $658.18 $821.84 |
$815.09 $858.58 $904.64 $1,068.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$644.34 $731.32 $823.44 $1,150.76 $1,748.70 |
$890.80 $977.78 $1,069.90 $1,397.22 |
$1,137.26 $1,224.24 $1,316.36 $1,643.68 |
Toc - Plan #100 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$342.38 $388.59 $437.55 $611.48 $929.20 |
$604.29 $650.50 $699.46 $873.39 |
$866.20 $912.41 $961.37 $1,135.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$684.76 $777.18 $875.10 $1,222.96 $1,858.40 |
$946.67 $1,039.09 $1,137.01 $1,484.87 |
$1,208.58 $1,301.00 $1,398.92 $1,746.78 |
Toc - Plan #101 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.17 $472.34 $531.85 $743.27 $1,129.46 |
$734.53 $790.70 $850.21 $1,061.63 |
$1,052.89 $1,109.06 $1,168.57 $1,379.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.34 $944.68 $1,063.70 $1,486.54 $2,258.92 |
$1,150.70 $1,263.04 $1,382.06 $1,804.90 |
$1,469.06 $1,581.40 $1,700.42 $2,123.26 |
Toc - Plan #102 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317.20 $360.01 $405.36 $566.49 $860.84 |
$559.85 $602.66 $648.01 $809.14 |
$802.50 $845.31 $890.66 $1,051.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$634.40 $720.02 $810.72 $1,132.98 $1,721.68 |
$877.05 $962.67 $1,053.37 $1,375.63 |
$1,119.70 $1,205.32 $1,296.02 $1,618.28 |
Toc - Plan #103 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.46 $389.82 $438.93 $613.41 $932.13 |
$606.20 $652.56 $701.67 $876.15 |
$868.94 $915.30 $964.41 $1,138.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$686.92 $779.64 $877.86 $1,226.82 $1,864.26 |
$949.66 $1,042.38 $1,140.60 $1,489.56 |
$1,212.40 $1,305.12 $1,403.34 $1,752.30 |
Toc - Plan #104 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$455.11 $516.53 $581.61 $812.80 $1,235.13 |
$803.26 $864.68 $929.76 $1,160.95 |
$1,151.41 $1,212.83 $1,277.91 $1,509.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$910.22 $1,033.06 $1,163.22 $1,625.60 $2,470.26 |
$1,258.37 $1,381.21 $1,511.37 $1,973.75 |
$1,606.52 $1,729.36 $1,859.52 $2,321.90 |
Toc - Plan #105 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.02 $415.42 $467.76 $653.69 $993.35 |
$646.02 $695.42 $747.76 $933.69 |
$926.02 $975.42 $1,027.76 $1,213.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$732.04 $830.84 $935.52 $1,307.38 $1,986.70 |
$1,012.04 $1,110.84 $1,215.52 $1,587.38 |
$1,292.04 $1,390.84 $1,495.52 $1,867.38 |
Toc - Plan #106 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Premier Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.38 $416.96 $469.50 $656.12 $997.04 |
$648.42 $698.00 $750.54 $937.16 |
$929.46 $979.04 $1,031.58 $1,218.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.76 $833.92 $939.00 $1,312.24 $1,994.08 |
$1,015.80 $1,114.96 $1,220.04 $1,593.28 |
$1,296.84 $1,396.00 $1,501.08 $1,874.32 |
Toc - Plan #107 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.64 $395.70 $445.55 $622.66 $946.19 |
$615.34 $662.40 $712.25 $889.36 |
$882.04 $929.10 $978.95 $1,156.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.28 $791.40 $891.10 $1,245.32 $1,892.38 |
$963.98 $1,058.10 $1,157.80 $1,512.02 |
$1,230.68 $1,324.80 $1,424.50 $1,778.72 |
Toc - Plan #108 Ambetter from Home State Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.68 $436.60 $491.61 $687.02 $1,044.00 |
$678.95 $730.87 $785.88 $981.29 |
$973.22 $1,025.14 $1,080.15 $1,275.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.36 $873.20 $983.22 $1,374.04 $2,088.00 |
$1,063.63 $1,167.47 $1,277.49 $1,668.31 |
$1,357.90 $1,461.74 $1,571.76 $1,962.58 |
Toc - Plan #109 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.84 $409.54 $461.14 $644.44 $979.29 |
$636.87 $685.57 $737.17 $920.47 |
$912.90 $961.60 $1,013.20 $1,196.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$721.68 $819.08 $922.28 $1,288.88 $1,958.58 |
$997.71 $1,095.11 $1,198.31 $1,564.91 |
$1,273.74 $1,371.14 $1,474.34 $1,840.94 |
Toc - Plan #110 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$435.89 $494.73 $557.06 $778.49 $1,182.98 |
$769.34 $828.18 $890.51 $1,111.94 |
$1,102.79 $1,161.63 $1,223.96 $1,445.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$871.78 $989.46 $1,114.12 $1,556.98 $2,365.96 |
$1,205.23 $1,322.91 $1,447.57 $1,890.43 |
$1,538.68 $1,656.36 $1,781.02 $2,223.88 |
Toc - Plan #111 Ambetter from Home State Health | ||||||||||||||||||||
Silver
(EPO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.19 $401.99 $452.64 $632.56 $961.24 |
$625.14 $672.94 $723.59 $903.51 |
$896.09 $943.89 $994.54 $1,174.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.38 $803.98 $905.28 $1,265.12 $1,922.48 |
$979.33 $1,074.93 $1,176.23 $1,536.07 |
$1,250.28 $1,345.88 $1,447.18 $1,807.02 |
Toc - Plan #112 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.43 $487.39 $548.79 $766.94 $1,165.44 |
$757.93 $815.89 $877.29 $1,095.44 |
$1,086.43 $1,144.39 $1,205.79 $1,423.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.86 $974.78 $1,097.58 $1,533.88 $2,330.88 |
$1,187.36 $1,303.28 $1,426.08 $1,862.38 |
$1,515.86 $1,631.78 $1,754.58 $2,190.88 |
Toc - Plan #113 Ambetter from Home State Health | ||||||||||||||||||||
Gold
(EPO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-650-3789
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$498.12 $565.36 $636.59 $889.63 $1,351.88 |
$879.18 $946.42 $1,017.65 $1,270.69 |
$1,260.24 $1,327.48 $1,398.71 $1,651.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$996.24 $1,130.72 $1,273.18 $1,779.26 $2,703.76 |
$1,377.30 $1,511.78 $1,654.24 $2,160.32 |
$1,758.36 $1,892.84 $2,035.30 $2,541.38 |
‡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 Saint Louis County here.
Saint Louis County is in “Rating Area 6” of Missouri.
Currently, there are 113 plans offered in Rating Area 6.