Obamacare 2023 Rates for Orange County
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Obamacare > Rates > Florida > Orange County
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Florida Blue (BlueCross BlueShield FL)Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771 |
Toc - Plan #1 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueOptions Silver 1423 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$801.81 $910.05 $1,024.71 $1,432.03 $2,176.11 |
$1,415.19 $1,523.43 $1,638.09 $2,045.41 |
$2,028.57 $2,136.81 $2,251.47 $2,658.79 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,603.62 $1,820.10 $2,049.42 $2,864.06 $4,352.22 |
$2,217.00 $2,433.48 $2,662.80 $3,477.44 |
$2,830.38 $3,046.86 $3,276.18 $4,090.82 |
Toc - Plan #2 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueOptions Bronze 1419 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$518.75 $588.78 $662.96 $926.49 $1,407.89 |
$915.59 $985.62 $1,059.80 $1,323.33 |
$1,312.43 $1,382.46 $1,456.64 $1,720.17 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,037.50 $1,177.56 $1,325.92 $1,852.98 $2,815.78 |
$1,434.34 $1,574.40 $1,722.76 $2,249.82 |
$1,831.18 $1,971.24 $2,119.60 $2,646.66 |
Toc - Plan #3 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueOptions Silver 1431 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$806.22 $915.06 $1,030.35 $1,439.91 $2,188.08 |
$1,422.98 $1,531.82 $1,647.11 $2,056.67 |
$2,039.74 $2,148.58 $2,263.87 $2,673.43 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,612.44 $1,830.12 $2,060.70 $2,879.82 $4,376.16 |
$2,229.20 $2,446.88 $2,677.46 $3,496.58 |
$2,845.96 $3,063.64 $3,294.22 $4,113.34 |
Toc - Plan #4 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Platinum
(EPO) BlueOptions Platinum 1418 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$1,014.57 $1,151.54 $1,296.62 $1,812.02 $2,753.54 |
$1,790.72 $1,927.69 $2,072.77 $2,588.17 |
$2,566.87 $2,703.84 $2,848.92 $3,364.32 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$2,029.14 $2,303.08 $2,593.24 $3,624.04 $5,507.08 |
$2,805.29 $3,079.23 $3,369.39 $4,400.19 |
$3,581.44 $3,855.38 $4,145.54 $5,176.34 |
Toc - Plan #5 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueOptions Bronze 1416 ($0 Virtual Visits / 3 PCP Visits for $0 / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$540.34 $613.29 $690.55 $965.05 $1,466.48 |
$953.70 $1,026.65 $1,103.91 $1,378.41 |
$1,367.06 $1,440.01 $1,517.27 $1,791.77 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,080.68 $1,226.58 $1,381.10 $1,930.10 $2,932.96 |
$1,494.04 $1,639.94 $1,794.46 $2,343.46 |
$1,907.40 $2,053.30 $2,207.82 $2,756.82 |
Toc - Plan #6 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Platinum
(EPO) BlueOptions Platinum 1424 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$1,063.09 $1,206.61 $1,358.63 $1,898.68 $2,885.23 |
$1,876.35 $2,019.87 $2,171.89 $2,711.94 |
$2,689.61 $2,833.13 $2,985.15 $3,525.20 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$2,126.18 $2,413.22 $2,717.26 $3,797.36 $5,770.46 |
$2,939.44 $3,226.48 $3,530.52 $4,610.62 |
$3,752.70 $4,039.74 $4,343.78 $5,423.88 |
Toc - Plan #7 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueOptions Silver 1410 ($0 Virtual Visits / $0 Lab / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$752.63 $854.24 $961.86 $1,344.20 $2,042.64 |
$1,328.39 $1,430.00 $1,537.62 $1,919.96 |
$1,904.15 $2,005.76 $2,113.38 $2,495.72 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,505.26 $1,708.48 $1,923.72 $2,688.40 $4,085.28 |
$2,081.02 $2,284.24 $2,499.48 $3,264.16 |
$2,656.78 $2,860.00 $3,075.24 $3,839.92 |
Toc - Plan #8 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Gold
(EPO) BlueOptions Gold 1505 ($0 Virtual Visits / $20 PCP Visits / $15 Generic Meds / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$871.33 $988.96 $1,113.56 $1,556.20 $2,364.79 |
$1,537.90 $1,655.53 $1,780.13 $2,222.77 |
$2,204.47 $2,322.10 $2,446.70 $2,889.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,742.66 $1,977.92 $2,227.12 $3,112.40 $4,729.58 |
$2,409.23 $2,644.49 $2,893.69 $3,778.97 |
$3,075.80 $3,311.06 $3,560.26 $4,445.54 |
Toc - Plan #9 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueOptions Bronze (HSA) 1705 (Rewards $$$ / $4 Condition Care Rx) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$525.28 $596.19 $671.31 $938.15 $1,425.61 |
$927.12 $998.03 $1,073.15 $1,339.99 |
$1,328.96 $1,399.87 $1,474.99 $1,741.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,050.56 $1,192.38 $1,342.62 $1,876.30 $2,851.22 |
$1,452.40 $1,594.22 $1,744.46 $2,278.14 |
$1,854.24 $1,996.06 $2,146.30 $2,679.98 |
Toc - Plan #10 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Gold
(EPO) BlueOptions Gold 1805 ($0 Virtual Visits / $20 Labs / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$843.00 $956.81 $1,077.35 $1,505.60 $2,287.90 |
$1,487.90 $1,601.71 $1,722.25 $2,150.50 |
$2,132.80 $2,246.61 $2,367.15 $2,795.40 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,686.00 $1,913.62 $2,154.70 $3,011.20 $4,575.80 |
$2,330.90 $2,558.52 $2,799.60 $3,656.10 |
$2,975.80 $3,203.42 $3,444.50 $4,301.00 |
Toc - Plan #11 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueOptions Bronze 2119 ($0 Deductible / $0 Virtual Visits / $50 PCP Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$572.26 $649.52 $731.35 $1,022.06 $1,553.11 |
$1,010.04 $1,087.30 $1,169.13 $1,459.84 |
$1,447.82 $1,525.08 $1,606.91 $1,897.62 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,144.52 $1,299.04 $1,462.70 $2,044.12 $3,106.22 |
$1,582.30 $1,736.82 $1,900.48 $2,481.90 |
$2,020.08 $2,174.60 $2,338.26 $2,919.68 |
Toc - Plan #12 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Bronze
(EPO) BlueOptions Bronze 2301S (Multilingual Available / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$495.82 $562.76 $633.66 $885.53 $1,345.66 |
$875.12 $942.06 $1,012.96 $1,264.83 |
$1,254.42 $1,321.36 $1,392.26 $1,644.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$991.64 $1,125.52 $1,267.32 $1,771.06 $2,691.32 |
$1,370.94 $1,504.82 $1,646.62 $2,150.36 |
$1,750.24 $1,884.12 $2,025.92 $2,529.66 |
Toc - Plan #13 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueOptions Bronze 2302S (Multilingual Available / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$533.01 $604.97 $681.19 $951.96 $1,446.59 |
$940.76 $1,012.72 $1,088.94 $1,359.71 |
$1,348.51 $1,420.47 $1,496.69 $1,767.46 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,066.02 $1,209.94 $1,362.38 $1,903.92 $2,893.18 |
$1,473.77 $1,617.69 $1,770.13 $2,311.67 |
$1,881.52 $2,025.44 $2,177.88 $2,719.42 |
Toc - Plan #14 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueOptions Silver 2303S ($40 PCP Visits / Multilingual Available/ Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$793.62 $900.76 $1,014.25 $1,417.41 $2,153.88 |
$1,400.74 $1,507.88 $1,621.37 $2,024.53 |
$2,007.86 $2,115.00 $2,228.49 $2,631.65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,587.24 $1,801.52 $2,028.50 $2,834.82 $4,307.76 |
$2,194.36 $2,408.64 $2,635.62 $3,441.94 |
$2,801.48 $3,015.76 $3,242.74 $4,049.06 |
Toc - Plan #15 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Gold
(EPO) BlueOptions Gold 2304S ($30 PCP Visits / Multilingual Available / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$810.02 $919.37 $1,035.21 $1,446.70 $2,198.39 |
$1,429.69 $1,539.04 $1,654.88 $2,066.37 |
$2,049.36 $2,158.71 $2,274.55 $2,686.04 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,620.04 $1,838.74 $2,070.42 $2,893.40 $4,396.78 |
$2,239.71 $2,458.41 $2,690.09 $3,513.07 |
$2,859.38 $3,078.08 $3,309.76 $4,132.74 |
Toc - Plan #16 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Platinum
(EPO) BlueOptions Platinum 2305S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
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 |
$1,060.42 $1,203.58 $1,355.22 $1,893.91 $2,877.98 |
$1,871.64 $2,014.80 $2,166.44 $2,705.13 |
$2,682.86 $2,826.02 $2,977.66 $3,516.35 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$2,120.84 $2,407.16 $2,710.44 $3,787.82 $5,755.96 |
$2,932.06 $3,218.38 $3,521.66 $4,599.04 |
$3,743.28 $4,029.60 $4,332.88 $5,410.26 |
Toc - Plan #17 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueOptions Bronze 2319 ($0 Deductible / $0 Virtual Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$561.01 $636.75 $716.97 $1,001.96 $1,522.58 |
$990.18 $1,065.92 $1,146.14 $1,431.13 |
$1,419.35 $1,495.09 $1,575.31 $1,860.30 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,122.02 $1,273.50 $1,433.94 $2,003.92 $3,045.16 |
$1,551.19 $1,702.67 $1,863.11 $2,433.09 |
$1,980.36 $2,131.84 $2,292.28 $2,862.26 |
Toc - Plan #18 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueSelect Silver 1456 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$524.31 $595.09 $670.07 $936.42 $1,422.98 |
$925.41 $996.19 $1,071.17 $1,337.52 |
$1,326.51 $1,397.29 $1,472.27 $1,738.62 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,048.62 $1,190.18 $1,340.14 $1,872.84 $2,845.96 |
$1,449.72 $1,591.28 $1,741.24 $2,273.94 |
$1,850.82 $1,992.38 $2,142.34 $2,675.04 |
Toc - Plan #19 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueSelect Bronze 1452 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.78 $448.08 $504.53 $705.08 $1,071.43 |
$696.79 $750.09 $806.54 $1,007.09 |
$998.80 $1,052.10 $1,108.55 $1,309.10 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.56 $896.16 $1,009.06 $1,410.16 $2,142.86 |
$1,091.57 $1,198.17 $1,311.07 $1,712.17 |
$1,393.58 $1,500.18 $1,613.08 $2,014.18 |
Toc - Plan #20 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueSelect Silver 1464 ($0 Virtual Visits / Rewards $$$) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$522.68 $593.24 $667.99 $933.51 $1,418.55 |
$922.53 $993.09 $1,067.84 $1,333.36 |
$1,322.38 $1,392.94 $1,467.69 $1,733.21 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,045.36 $1,186.48 $1,335.98 $1,867.02 $2,837.10 |
$1,445.21 $1,586.33 $1,735.83 $2,266.87 |
$1,845.06 $1,986.18 $2,135.68 $2,666.72 |
Toc - Plan #21 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Platinum
(EPO) BlueSelect Platinum 1451 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$663.22 $752.75 $847.60 $1,184.51 $1,799.98 |
$1,170.58 $1,260.11 $1,354.96 $1,691.87 |
$1,677.94 $1,767.47 $1,862.32 $2,199.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,326.44 $1,505.50 $1,695.20 $2,369.02 $3,599.96 |
$1,833.80 $2,012.86 $2,202.56 $2,876.38 |
$2,341.16 $2,520.22 $2,709.92 $3,383.74 |
Toc - Plan #22 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueSelect Bronze 1449 ($0 Virtual Visits / 3 PCP Visits for $0 / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$407.79 $462.84 $521.16 $728.31 $1,106.74 |
$719.75 $774.80 $833.12 $1,040.27 |
$1,031.71 $1,086.76 $1,145.08 $1,352.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$815.58 $925.68 $1,042.32 $1,456.62 $2,213.48 |
$1,127.54 $1,237.64 $1,354.28 $1,768.58 |
$1,439.50 $1,549.60 $1,666.24 $2,080.54 |
Toc - Plan #23 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Platinum
(EPO) BlueSelect Platinum 1457 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$694.05 $787.75 $887.00 $1,239.57 $1,883.65 |
$1,225.00 $1,318.70 $1,417.95 $1,770.52 |
$1,755.95 $1,849.65 $1,948.90 $2,301.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,388.10 $1,575.50 $1,774.00 $2,479.14 $3,767.30 |
$1,919.05 $2,106.45 $2,304.95 $3,010.09 |
$2,450.00 $2,637.40 $2,835.90 $3,541.04 |
Toc - Plan #24 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueSelect Silver 1443 ($0 Virtual Visits / $0 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$490.65 $556.89 $627.05 $876.30 $1,331.62 |
$866.00 $932.24 $1,002.40 $1,251.65 |
$1,241.35 $1,307.59 $1,377.75 $1,627.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$981.30 $1,113.78 $1,254.10 $1,752.60 $2,663.24 |
$1,356.65 $1,489.13 $1,629.45 $2,127.95 |
$1,732.00 $1,864.48 $2,004.80 $2,503.30 |
Toc - Plan #25 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Gold
(EPO) BlueSelect Gold 1535 ($0 Virtual Visits / $20 PCP Visit / $15 Generic Meds / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$578.93 $657.09 $739.87 $1,033.97 $1,571.22 |
$1,021.81 $1,099.97 $1,182.75 $1,476.85 |
$1,464.69 $1,542.85 $1,625.63 $1,919.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,157.86 $1,314.18 $1,479.74 $2,067.94 $3,142.44 |
$1,600.74 $1,757.06 $1,922.62 $2,510.82 |
$2,043.62 $2,199.94 $2,365.50 $2,953.70 |
Toc - Plan #26 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueSelect Bronze (HSA) 1735 (Rewards $$$ / $4 Condition Care Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.03 $452.90 $509.96 $712.67 $1,082.97 |
$704.29 $758.16 $815.22 $1,017.93 |
$1,009.55 $1,063.42 $1,120.48 $1,323.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$798.06 $905.80 $1,019.92 $1,425.34 $2,165.94 |
$1,103.32 $1,211.06 $1,325.18 $1,730.60 |
$1,408.58 $1,516.32 $1,630.44 $2,035.86 |
Toc - Plan #27 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Gold
(EPO) BlueSelect Gold 1835 ($0 Virtual Visits / $20 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$560.06 $635.67 $715.76 $1,000.27 $1,520.00 |
$988.51 $1,064.12 $1,144.21 $1,428.72 |
$1,416.96 $1,492.57 $1,572.66 $1,857.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,120.12 $1,271.34 $1,431.52 $2,000.54 $3,040.00 |
$1,548.57 $1,699.79 $1,859.97 $2,428.99 |
$1,977.02 $2,128.24 $2,288.42 $2,857.44 |
Toc - Plan #28 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueSelect Bronze 2139 ($0 Deductible / $0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$432.07 $490.40 $552.19 $771.68 $1,172.64 |
$762.60 $820.93 $882.72 $1,102.21 |
$1,093.13 $1,151.46 $1,213.25 $1,432.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$864.14 $980.80 $1,104.38 $1,543.36 $2,345.28 |
$1,194.67 $1,311.33 $1,434.91 $1,873.89 |
$1,525.20 $1,641.86 $1,765.44 $2,204.42 |
Toc - Plan #29 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Bronze
(EPO) BlueSelect Bronze 2341S (Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$374.48 $425.03 $478.59 $668.82 $1,016.34 |
$660.96 $711.51 $765.07 $955.30 |
$947.44 $997.99 $1,051.55 $1,241.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$748.96 $850.06 $957.18 $1,337.64 $2,032.68 |
$1,035.44 $1,136.54 $1,243.66 $1,624.12 |
$1,321.92 $1,423.02 $1,530.14 $1,910.60 |
Toc - Plan #30 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueSelect Bronze 2342S (Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.62 $456.97 $514.55 $719.08 $1,092.71 |
$710.62 $764.97 $822.55 $1,027.08 |
$1,018.62 $1,072.97 $1,130.55 $1,335.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.24 $913.94 $1,029.10 $1,438.16 $2,185.42 |
$1,113.24 $1,221.94 $1,337.10 $1,746.16 |
$1,421.24 $1,529.94 $1,645.10 $2,054.16 |
Toc - Plan #31 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Silver
(EPO) BlueSelect Silver 2343S ($40 PCP Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$517.42 $587.27 $661.26 $924.11 $1,404.28 |
$913.25 $983.10 $1,057.09 $1,319.94 |
$1,309.08 $1,378.93 $1,452.92 $1,715.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,034.84 $1,174.54 $1,322.52 $1,848.22 $2,808.56 |
$1,430.67 $1,570.37 $1,718.35 $2,244.05 |
$1,826.50 $1,966.20 $2,114.18 $2,639.88 |
Toc - Plan #32 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Gold
(EPO) BlueSelect Gold 2344S ($30 PCP Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$538.24 $610.90 $687.87 $961.30 $1,460.78 |
$949.99 $1,022.65 $1,099.62 $1,373.05 |
$1,361.74 $1,434.40 $1,511.37 $1,784.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,076.48 $1,221.80 $1,375.74 $1,922.60 $2,921.56 |
$1,488.23 $1,633.55 $1,787.49 $2,334.35 |
$1,899.98 $2,045.30 $2,199.24 $2,746.10 |
Toc - Plan #33 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Platinum
(EPO) BlueSelect Platinum 2345S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$692.28 $785.74 $884.73 $1,236.41 $1,878.85 |
$1,221.87 $1,315.33 $1,414.32 $1,766.00 |
$1,751.46 $1,844.92 $1,943.91 $2,295.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,384.56 $1,571.48 $1,769.46 $2,472.82 $3,757.70 |
$1,914.15 $2,101.07 $2,299.05 $3,002.41 |
$2,443.74 $2,630.66 $2,828.64 $3,532.00 |
Toc - Plan #34 Florida Blue (BlueCross BlueShield FL) | ||||||||||||||||||||
Expanded Bronze
(EPO) BlueSelect Bronze 2339 ($0 Deductible / $0 Virtual Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.73 $480.93 $541.53 $756.78 $1,150.00 |
$747.88 $805.08 $865.68 $1,080.93 |
$1,072.03 $1,129.23 $1,189.83 $1,405.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.46 $961.86 $1,083.06 $1,513.56 $2,300.00 |
$1,171.61 $1,286.01 $1,407.21 $1,837.71 |
$1,495.76 $1,610.16 $1,731.36 $2,161.86 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-877-336-3915 | Toll Free: 1-877-336-3915 | TTY: 1-877-336-3915 |
Toc - Plan #35 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver S: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
||||||||||||||||||||
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 |
$387.90 $440.27 $495.74 $692.79 $1,052.76 |
$684.64 $737.01 $792.48 $989.53 |
$981.38 $1,033.75 $1,089.22 $1,286.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$775.80 $880.54 $991.48 $1,385.58 $2,105.52 |
$1,072.54 $1,177.28 $1,288.22 $1,682.32 |
$1,369.28 $1,474.02 $1,584.96 $1,979.06 |
Toc - Plan #36 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 2: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
||||||||||||||||||||
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 |
$418.82 $475.36 $535.25 $748.01 $1,136.67 |
$739.21 $795.75 $855.64 $1,068.40 |
$1,059.60 $1,116.14 $1,176.03 $1,388.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$837.64 $950.72 $1,070.50 $1,496.02 $2,273.34 |
$1,158.03 $1,271.11 $1,390.89 $1,816.41 |
$1,478.42 $1,591.50 $1,711.28 $2,136.80 |
Toc - Plan #37 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 3: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
||||||||||||||||||||
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 |
$403.55 $458.03 $515.74 $720.74 $1,095.24 |
$712.27 $766.75 $824.46 $1,029.46 |
$1,020.99 $1,075.47 $1,133.18 $1,338.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$807.10 $916.06 $1,031.48 $1,441.48 $2,190.48 |
$1,115.82 $1,224.78 $1,340.20 $1,750.20 |
$1,424.54 $1,533.50 $1,648.92 $2,058.92 |
Toc - Plan #38 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze S: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
||||||||||||||||||||
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 |
$318.33 $361.30 $406.83 $568.54 $863.95 |
$561.85 $604.82 $650.35 $812.06 |
$805.37 $848.34 $893.87 $1,055.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.66 $722.60 $813.66 $1,137.08 $1,727.90 |
$880.18 $966.12 $1,057.18 $1,380.60 |
$1,123.70 $1,209.64 $1,300.70 $1,624.12 |
Toc - Plan #39 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 1: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
||||||||||||||||||||
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 |
$415.88 $472.02 $531.49 $742.75 $1,128.69 |
$734.02 $790.16 $849.63 $1,060.89 |
$1,052.16 $1,108.30 $1,167.77 $1,379.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.76 $944.04 $1,062.98 $1,485.50 $2,257.38 |
$1,149.90 $1,262.18 $1,381.12 $1,803.64 |
$1,468.04 $1,580.32 $1,699.26 $2,121.78 |
Toc - Plan #40 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
||||||||||||||||||||
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 |
$472.80 $536.63 $604.24 $844.43 $1,283.19 |
$834.49 $898.32 $965.93 $1,206.12 |
$1,196.18 $1,260.01 $1,327.62 $1,567.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$945.60 $1,073.26 $1,208.48 $1,688.86 $2,566.38 |
$1,307.29 $1,434.95 $1,570.17 $2,050.55 |
$1,668.98 $1,796.64 $1,931.86 $2,412.24 |
Toc - Plan #41 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold S: Aetna network of doctors & hospitals + $0 walk-in & telemedicine via MinuteClinic at CVS |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
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 |
$444.53 $504.54 $568.11 $793.93 $1,206.45 |
$784.59 $844.60 $908.17 $1,133.99 |
$1,124.65 $1,184.66 $1,248.23 $1,474.05 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$889.06 $1,009.08 $1,136.22 $1,587.86 $2,412.90 |
$1,229.12 $1,349.14 $1,476.28 $1,927.92 |
$1,569.18 $1,689.20 $1,816.34 $2,267.98 |
ADVERTISEMENT
AvMedLocal: 1-800-477-8768 | Toll Free: |
Toc - Plan #42 AvMed | ||||||||||||||||||||
Platinum
(HMO) AvMed Entrust Platinum 25 (2023) |
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$754.51 $856.37 $964.27 $1,347.56 $2,047.75 |
$1,331.71 $1,433.57 $1,541.47 $1,924.76 |
$1,908.91 $2,010.77 $2,118.67 $2,501.96 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,509.02 $1,712.74 $1,928.54 $2,695.12 $4,095.50 |
$2,086.22 $2,289.94 $2,505.74 $3,272.32 |
$2,663.42 $2,867.14 $3,082.94 $3,849.52 |
Toc - Plan #43 AvMed | ||||||||||||||||||||
Gold
(HMO) AvMed Entrust Gold 125 (2023) |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
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[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$527.12 $598.28 $673.66 $941.44 $1,430.61 |
$930.37 $1,001.53 $1,076.91 $1,344.69 |
$1,333.62 $1,404.78 $1,480.16 $1,747.94 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,054.24 $1,196.56 $1,347.32 $1,882.88 $2,861.22 |
$1,457.49 $1,599.81 $1,750.57 $2,286.13 |
$1,860.74 $2,003.06 $2,153.82 $2,689.38 |
Toc - Plan #44 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 300 (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$514.41 $583.85 $657.41 $918.73 $1,396.10 |
$907.93 $977.37 $1,050.93 $1,312.25 |
$1,301.45 $1,370.89 $1,444.45 $1,705.77 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,028.82 $1,167.70 $1,314.82 $1,837.46 $2,792.20 |
$1,422.34 $1,561.22 $1,708.34 $2,230.98 |
$1,815.86 $1,954.74 $2,101.86 $2,624.50 |
Toc - Plan #45 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 350 (2023) |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$495.10 $561.94 $632.74 $884.25 $1,343.71 |
$873.85 $940.69 $1,011.49 $1,263.00 |
$1,252.60 $1,319.44 $1,390.24 $1,641.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$990.20 $1,123.88 $1,265.48 $1,768.50 $2,687.42 |
$1,368.95 $1,502.63 $1,644.23 $2,147.25 |
$1,747.70 $1,881.38 $2,022.98 $2,526.00 |
Toc - Plan #46 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 500 (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$492.21 $558.66 $629.05 $879.09 $1,335.86 |
$868.75 $935.20 $1,005.59 $1,255.63 |
$1,245.29 $1,311.74 $1,382.13 $1,632.17 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$984.42 $1,117.32 $1,258.10 $1,758.18 $2,671.72 |
$1,360.96 $1,493.86 $1,634.64 $2,134.72 |
$1,737.50 $1,870.40 $2,011.18 $2,511.26 |
Toc - Plan #47 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 550 (2023) |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
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[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$489.25 $555.30 $625.26 $873.80 $1,327.82 |
$863.52 $929.57 $999.53 $1,248.07 |
$1,237.79 $1,303.84 $1,373.80 $1,622.34 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$978.50 $1,110.60 $1,250.52 $1,747.60 $2,655.64 |
$1,352.77 $1,484.87 $1,624.79 $2,121.87 |
$1,727.04 $1,859.14 $1,999.06 $2,496.14 |
Toc - Plan #48 AvMed | ||||||||||||||||||||
Expanded Bronze
(HMO) AvMed Entrust Bronze 600 (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$403.80 $458.31 $516.05 $721.18 $1,095.91 |
$712.71 $767.22 $824.96 $1,030.09 |
$1,021.62 $1,076.13 $1,133.87 $1,339.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$807.60 $916.62 $1,032.10 $1,442.36 $2,191.82 |
$1,116.51 $1,225.53 $1,341.01 $1,751.27 |
$1,425.42 $1,534.44 $1,649.92 $2,060.18 |
Toc - Plan #49 AvMed | ||||||||||||||||||||
Expanded Bronze
(HMO) AvMed Entrust Bronze 650 (2023) |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$389.74 $442.35 $498.09 $696.07 $1,057.75 |
$687.89 $740.50 $796.24 $994.22 |
$986.04 $1,038.65 $1,094.39 $1,292.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$779.48 $884.70 $996.18 $1,392.14 $2,115.50 |
$1,077.63 $1,182.85 $1,294.33 $1,690.29 |
$1,375.78 $1,481.00 $1,592.48 $1,988.44 |
Toc - Plan #50 AvMed | ||||||||||||||||||||
Catastrophic
(HMO) AvMed Entrust Catastrophic 100 (2023) |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$318.97 $362.03 $407.64 $569.68 $865.69 |
$562.98 $606.04 $651.65 $813.69 |
$806.99 $850.05 $895.66 $1,057.70 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$637.94 $724.06 $815.28 $1,139.36 $1,731.38 |
$881.95 $968.07 $1,059.29 $1,383.37 |
$1,125.96 $1,212.08 $1,303.30 $1,627.38 |
Toc - Plan #51 AvMed | ||||||||||||||||||||
Platinum
(HMO) AvMed Entrust Platinum Standard (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$755.31 $857.27 $965.28 $1,348.98 $2,049.91 |
$1,333.12 $1,435.08 $1,543.09 $1,926.79 |
$1,910.93 $2,012.89 $2,120.90 $2,504.60 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,510.62 $1,714.54 $1,930.56 $2,697.96 $4,099.82 |
$2,088.43 $2,292.35 $2,508.37 $3,275.77 |
$2,666.24 $2,870.16 $3,086.18 $3,853.58 |
Toc - Plan #52 AvMed | ||||||||||||||||||||
Gold
(HMO) AvMed Entrust Gold Standard (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$523.57 $594.25 $669.12 $935.09 $1,420.96 |
$924.10 $994.78 $1,069.65 $1,335.62 |
$1,324.63 $1,395.31 $1,470.18 $1,736.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,047.14 $1,188.50 $1,338.24 $1,870.18 $2,841.92 |
$1,447.67 $1,589.03 $1,738.77 $2,270.71 |
$1,848.20 $1,989.56 $2,139.30 $2,671.24 |
Toc - Plan #53 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver Standard (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$474.72 $538.81 $606.69 $847.85 $1,288.39 |
$837.88 $901.97 $969.85 $1,211.01 |
$1,201.04 $1,265.13 $1,333.01 $1,574.17 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$949.44 $1,077.62 $1,213.38 $1,695.70 $2,576.78 |
$1,312.60 $1,440.78 $1,576.54 $2,058.86 |
$1,675.76 $1,803.94 $1,939.70 $2,422.02 |
Toc - Plan #54 AvMed | ||||||||||||||||||||
Expanded Bronze
(HMO) AvMed Entrust Expanded Bronze Standard (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$401.08 $455.23 $512.58 $716.33 $1,088.53 |
$707.91 $762.06 $819.41 $1,023.16 |
$1,014.74 $1,068.89 $1,126.24 $1,329.99 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$802.16 $910.46 $1,025.16 $1,432.66 $2,177.06 |
$1,108.99 $1,217.29 $1,331.99 $1,739.49 |
$1,415.82 $1,524.12 $1,638.82 $2,046.32 |
Toc - Plan #55 AvMed | ||||||||||||||||||||
Platinum
(HMO) AvMed Entrust Platinum 25 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$759.42 $861.94 $970.54 $1,356.33 $2,061.07 |
$1,340.38 $1,442.90 $1,551.50 $1,937.29 |
$1,921.34 $2,023.86 $2,132.46 $2,518.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,518.84 $1,723.88 $1,941.08 $2,712.66 $4,122.14 |
$2,099.80 $2,304.84 $2,522.04 $3,293.62 |
$2,680.76 $2,885.80 $3,103.00 $3,874.58 |
Toc - Plan #56 AvMed | ||||||||||||||||||||
Gold
(HMO) AvMed Entrust Gold 125 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$532.23 $604.08 $680.19 $950.57 $1,444.48 |
$939.39 $1,011.24 $1,087.35 $1,357.73 |
$1,346.55 $1,418.40 $1,494.51 $1,764.89 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,064.46 $1,208.16 $1,360.38 $1,901.14 $2,888.96 |
$1,471.62 $1,615.32 $1,767.54 $2,308.30 |
$1,878.78 $2,022.48 $2,174.70 $2,715.46 |
Toc - Plan #57 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 300 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$519.50 $589.63 $663.92 $927.82 $1,409.91 |
$916.91 $987.04 $1,061.33 $1,325.23 |
$1,314.32 $1,384.45 $1,458.74 $1,722.64 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,039.00 $1,179.26 $1,327.84 $1,855.64 $2,819.82 |
$1,436.41 $1,576.67 $1,725.25 $2,253.05 |
$1,833.82 $1,974.08 $2,122.66 $2,650.46 |
Toc - Plan #58 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 350 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$500.20 $567.73 $639.26 $893.36 $1,357.55 |
$882.86 $950.39 $1,021.92 $1,276.02 |
$1,265.52 $1,333.05 $1,404.58 $1,658.68 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,000.40 $1,135.46 $1,278.52 $1,786.72 $2,715.10 |
$1,383.06 $1,518.12 $1,661.18 $2,169.38 |
$1,765.72 $1,900.78 $2,043.84 $2,552.04 |
Toc - Plan #59 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 500 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$497.28 $564.41 $635.52 $888.14 $1,349.62 |
$877.70 $944.83 $1,015.94 $1,268.56 |
$1,258.12 $1,325.25 $1,396.36 $1,648.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$994.56 $1,128.82 $1,271.04 $1,776.28 $2,699.24 |
$1,374.98 $1,509.24 $1,651.46 $2,156.70 |
$1,755.40 $1,889.66 $2,031.88 $2,537.12 |
Toc - Plan #60 AvMed | ||||||||||||||||||||
Silver
(HMO) AvMed Entrust Silver 550 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$494.34 $561.07 $631.76 $882.89 $1,341.63 |
$872.51 $939.24 $1,009.93 $1,261.06 |
$1,250.68 $1,317.41 $1,388.10 $1,639.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$988.68 $1,122.14 $1,263.52 $1,765.78 $2,683.26 |
$1,366.85 $1,500.31 $1,641.69 $2,143.95 |
$1,745.02 $1,878.48 $2,019.86 $2,522.12 |
Toc - Plan #61 AvMed | ||||||||||||||||||||
Expanded Bronze
(HMO) AvMed Entrust Bronze 625 Dental+Vision (2023) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$500.68 $568.27 $639.87 $894.22 $1,358.85 |
$883.70 $951.29 $1,022.89 $1,277.24 |
$1,266.72 $1,334.31 $1,405.91 $1,660.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,001.36 $1,136.54 $1,279.74 $1,788.44 $2,717.70 |
$1,384.38 $1,519.56 $1,662.76 $2,171.46 |
$1,767.40 $1,902.58 $2,045.78 $2,554.48 |
ADVERTISEMENT
Ambetter from Sunshine HealthLocal: 1-877-687-1169 | Toll Free: 1-877-687-1169 | TTY: 1-800-955-8770 |
Toc - Plan #62 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) Complete Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.78 $448.06 $504.51 $705.05 $1,071.40 |
$696.78 $750.06 $806.51 $1,007.05 |
$998.78 $1,052.06 $1,108.51 $1,309.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.56 $896.12 $1,009.02 $1,410.10 $2,142.80 |
$1,091.56 $1,198.12 $1,311.02 $1,712.10 |
$1,393.56 $1,500.12 $1,613.02 $2,014.10 |
Toc - Plan #63 Ambetter from Sunshine Health | ||||||||||||||||||||
Bronze
(EPO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$294.36 $334.08 $376.17 $525.70 $798.86 |
$519.53 $559.25 $601.34 $750.87 |
$744.70 $784.42 $826.51 $976.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$588.72 $668.16 $752.34 $1,051.40 $1,597.72 |
$813.89 $893.33 $977.51 $1,276.57 |
$1,039.06 $1,118.50 $1,202.68 $1,501.74 |
Toc - Plan #64 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.17 $367.92 $414.28 $578.95 $879.78 |
$572.15 $615.90 $662.26 $826.93 |
$820.13 $863.88 $910.24 $1,074.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$648.34 $735.84 $828.56 $1,157.90 $1,759.56 |
$896.32 $983.82 $1,076.54 $1,405.88 |
$1,144.30 $1,231.80 $1,324.52 $1,653.86 |
Toc - Plan #65 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Everyday Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.99 $452.84 $509.90 $712.58 $1,082.84 |
$704.21 $758.06 $815.12 $1,017.80 |
$1,009.43 $1,063.28 $1,120.34 $1,323.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797.98 $905.68 $1,019.80 $1,425.16 $2,165.68 |
$1,103.20 $1,210.90 $1,325.02 $1,730.38 |
$1,408.42 $1,516.12 $1,630.24 $2,035.60 |
Toc - Plan #66 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.50 $359.22 $404.47 $565.25 $858.95 |
$558.61 $601.33 $646.58 $807.36 |
$800.72 $843.44 $888.69 $1,049.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$633.00 $718.44 $808.94 $1,130.50 $1,717.90 |
$875.11 $960.55 $1,051.05 $1,372.61 |
$1,117.22 $1,202.66 $1,293.16 $1,614.72 |
Toc - Plan #67 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.74 $411.69 $463.56 $647.83 $984.44 |
$640.22 $689.17 $741.04 $925.31 |
$917.70 $966.65 $1,018.52 $1,202.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$725.48 $823.38 $927.12 $1,295.66 $1,968.88 |
$1,002.96 $1,100.86 $1,204.60 $1,573.14 |
$1,280.44 $1,378.34 $1,482.08 $1,850.62 |
Toc - Plan #68 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.22 $447.43 $503.80 $704.06 $1,069.89 |
$695.79 $749.00 $805.37 $1,005.63 |
$997.36 $1,050.57 $1,106.94 $1,307.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.44 $894.86 $1,007.60 $1,408.12 $2,139.78 |
$1,090.01 $1,196.43 $1,309.17 $1,709.69 |
$1,391.58 $1,498.00 $1,610.74 $2,011.26 |
Toc - Plan #69 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.56 $451.22 $508.07 $710.03 $1,078.95 |
$701.69 $755.35 $812.20 $1,014.16 |
$1,005.82 $1,059.48 $1,116.33 $1,318.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$795.12 $902.44 $1,016.14 $1,420.06 $2,157.90 |
$1,099.25 $1,206.57 $1,320.27 $1,724.19 |
$1,403.38 $1,510.70 $1,624.40 $2,028.32 |
Toc - Plan #70 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.73 $427.58 $481.45 $672.82 $1,022.41 |
$664.92 $715.77 $769.64 $961.01 |
$953.11 $1,003.96 $1,057.83 $1,249.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.46 $855.16 $962.90 $1,345.64 $2,044.82 |
$1,041.65 $1,143.35 $1,251.09 $1,633.83 |
$1,329.84 $1,431.54 $1,539.28 $1,922.02 |
Toc - Plan #71 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Enhanced Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.91 $453.88 $511.07 $714.21 $1,085.32 |
$705.83 $759.80 $816.99 $1,020.13 |
$1,011.75 $1,065.72 $1,122.91 $1,326.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$799.82 $907.76 $1,022.14 $1,428.42 $2,170.64 |
$1,105.74 $1,213.68 $1,328.06 $1,734.34 |
$1,411.66 $1,519.60 $1,633.98 $2,040.26 |
Toc - Plan #72 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$438.35 $497.51 $560.20 $782.87 $1,189.65 |
$773.68 $832.84 $895.53 $1,118.20 |
$1,109.01 $1,168.17 $1,230.86 $1,453.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$876.70 $995.02 $1,120.40 $1,565.74 $2,379.30 |
$1,212.03 $1,330.35 $1,455.73 $1,901.07 |
$1,547.36 $1,665.68 $1,791.06 $2,236.40 |
Toc - Plan #73 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.58 $352.49 $396.90 $554.67 $842.88 |
$548.16 $590.07 $634.48 $792.25 |
$785.74 $827.65 $872.06 $1,029.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.16 $704.98 $793.80 $1,109.34 $1,685.76 |
$858.74 $942.56 $1,031.38 $1,346.92 |
$1,096.32 $1,180.14 $1,268.96 $1,584.50 |
Toc - Plan #74 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.98 $447.16 $503.50 $703.63 $1,069.24 |
$695.37 $748.55 $804.89 $1,005.02 |
$996.76 $1,049.94 $1,106.28 $1,306.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$787.96 $894.32 $1,007.00 $1,407.26 $2,138.48 |
$1,089.35 $1,195.71 $1,308.39 $1,708.65 |
$1,390.74 $1,497.10 $1,609.78 $2,010.04 |
Toc - Plan #75 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.94 $418.73 $471.49 $658.90 $1,001.27 |
$651.17 $700.96 $753.72 $941.13 |
$933.40 $983.19 $1,035.95 $1,223.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$737.88 $837.46 $942.98 $1,317.80 $2,002.54 |
$1,020.11 $1,119.69 $1,225.21 $1,600.03 |
$1,302.34 $1,401.92 $1,507.44 $1,882.26 |
Toc - Plan #76 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Everyday Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.79 $469.64 $528.81 $739.01 $1,123.00 |
$730.33 $786.18 $845.35 $1,055.55 |
$1,046.87 $1,102.72 $1,161.89 $1,372.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.58 $939.28 $1,057.62 $1,478.02 $2,246.00 |
$1,144.12 $1,255.82 $1,374.16 $1,794.56 |
$1,460.66 $1,572.36 $1,690.70 $2,111.10 |
Toc - Plan #77 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.20 $381.57 $429.65 $600.43 $912.41 |
$593.38 $638.75 $686.83 $857.61 |
$850.56 $895.93 $944.01 $1,114.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.40 $763.14 $859.30 $1,200.86 $1,824.82 |
$929.58 $1,020.32 $1,116.48 $1,458.04 |
$1,186.76 $1,277.50 $1,373.66 $1,715.22 |
Toc - Plan #78 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409.42 $464.68 $523.23 $731.21 $1,111.14 |
$722.62 $777.88 $836.43 $1,044.41 |
$1,035.82 $1,091.08 $1,149.63 $1,357.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$818.84 $929.36 $1,046.46 $1,462.42 $2,222.28 |
$1,132.04 $1,242.56 $1,359.66 $1,775.62 |
$1,445.24 $1,555.76 $1,672.86 $2,088.82 |
Toc - Plan #79 Ambetter from Sunshine Health | ||||||||||||||||||||
Bronze
(EPO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.28 $346.48 $390.13 $545.20 $828.49 |
$538.81 $580.01 $623.66 $778.73 |
$772.34 $813.54 $857.19 $1,012.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$610.56 $692.96 $780.26 $1,090.40 $1,656.98 |
$844.09 $926.49 $1,013.79 $1,323.93 |
$1,077.62 $1,160.02 $1,247.32 $1,557.46 |
Toc - Plan #80 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.84 $464.03 $522.49 $730.18 $1,109.58 |
$721.60 $776.79 $835.25 $1,042.94 |
$1,034.36 $1,089.55 $1,148.01 $1,355.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.68 $928.06 $1,044.98 $1,460.36 $2,219.16 |
$1,130.44 $1,240.82 $1,357.74 $1,773.12 |
$1,443.20 $1,553.58 $1,670.50 $2,085.88 |
Toc - Plan #81 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Enhanced Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$414.74 $470.72 $530.03 $740.71 $1,125.58 |
$732.01 $787.99 $847.30 $1,057.98 |
$1,049.28 $1,105.26 $1,164.57 $1,375.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$829.48 $941.44 $1,060.06 $1,481.42 $2,251.16 |
$1,146.75 $1,258.71 $1,377.33 $1,798.69 |
$1,464.02 $1,575.98 $1,694.60 $2,115.96 |
Toc - Plan #82 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.61 $515.97 $580.98 $811.91 $1,233.78 |
$802.38 $863.74 $928.75 $1,159.68 |
$1,150.15 $1,211.51 $1,276.52 $1,507.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$909.22 $1,031.94 $1,161.96 $1,623.82 $2,467.56 |
$1,256.99 $1,379.71 $1,509.73 $1,971.59 |
$1,604.76 $1,727.48 $1,857.50 $2,319.36 |
Toc - Plan #83 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$328.24 $372.54 $419.48 $586.22 $890.82 |
$579.34 $623.64 $670.58 $837.32 |
$830.44 $874.74 $921.68 $1,088.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$656.48 $745.08 $838.96 $1,172.44 $1,781.64 |
$907.58 $996.18 $1,090.06 $1,423.54 |
$1,158.68 $1,247.28 $1,341.16 $1,674.64 |
Toc - Plan #84 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(EPO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.19 $426.96 $480.76 $671.86 $1,020.95 |
$663.97 $714.74 $768.54 $959.64 |
$951.75 $1,002.52 $1,056.32 $1,247.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$752.38 $853.92 $961.52 $1,343.72 $2,041.90 |
$1,040.16 $1,141.70 $1,249.30 $1,631.50 |
$1,327.94 $1,429.48 $1,537.08 $1,919.28 |
Toc - Plan #85 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(EPO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.31 $467.96 $526.92 $736.36 $1,118.98 |
$727.72 $783.37 $842.33 $1,051.77 |
$1,043.13 $1,098.78 $1,157.74 $1,367.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$824.62 $935.92 $1,053.84 $1,472.72 $2,237.96 |
$1,140.03 $1,251.33 $1,369.25 $1,788.13 |
$1,455.44 $1,566.74 $1,684.66 $2,103.54 |
Toc - Plan #86 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(EPO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.70 $443.44 $499.31 $697.78 $1,060.34 |
$689.58 $742.32 $798.19 $996.66 |
$988.46 $1,041.20 $1,097.07 $1,295.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.40 $886.88 $998.62 $1,395.56 $2,120.68 |
$1,080.28 $1,185.76 $1,297.50 $1,694.44 |
$1,379.16 $1,484.64 $1,596.38 $1,993.32 |
ADVERTISEMENT
Florida Blue HMO (a BlueCross BlueShield FL company)Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771 |
Toc - Plan #87 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Platinum
(HMO) BlueCare Platinum 2151 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$868.11 $985.30 $1,109.44 $1,550.44 $2,356.05 |
$1,532.21 $1,649.40 $1,773.54 $2,214.54 |
$2,196.31 $2,313.50 $2,437.64 $2,878.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,736.22 $1,970.60 $2,218.88 $3,100.88 $4,712.10 |
$2,400.32 $2,634.70 $2,882.98 $3,764.98 |
$3,064.42 $3,298.80 $3,547.08 $4,429.08 |
Toc - Plan #88 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Bronze 2153 ($0 Virtual Visits / 3 PCP Visits for $0 / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$510.36 $579.26 $652.24 $911.50 $1,385.12 |
$900.79 $969.69 $1,042.67 $1,301.93 |
$1,291.22 $1,360.12 $1,433.10 $1,692.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,020.72 $1,158.52 $1,304.48 $1,823.00 $2,770.24 |
$1,411.15 $1,548.95 $1,694.91 $2,213.43 |
$1,801.58 $1,939.38 $2,085.34 $2,603.86 |
Toc - Plan #89 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Bronze 2154 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$481.50 $546.50 $615.36 $859.96 $1,306.79 |
$849.85 $914.85 $983.71 $1,228.31 |
$1,218.20 $1,283.20 $1,352.06 $1,596.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$963.00 $1,093.00 $1,230.72 $1,719.92 $2,613.58 |
$1,331.35 $1,461.35 $1,599.07 $2,088.27 |
$1,699.70 $1,829.70 $1,967.42 $2,456.62 |
Toc - Plan #90 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Gold
(HMO) BlueCare Gold 2156 ($0 Virtual Visits / $20 PCP Visit / $15 Generic Meds / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$765.96 $869.36 $978.90 $1,368.00 $2,078.82 |
$1,351.92 $1,455.32 $1,564.86 $1,953.96 |
$1,937.88 $2,041.28 $2,150.82 $2,539.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,531.92 $1,738.72 $1,957.80 $2,736.00 $4,157.64 |
$2,117.88 $2,324.68 $2,543.76 $3,321.96 |
$2,703.84 $2,910.64 $3,129.72 $3,907.92 |
Toc - Plan #91 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) BlueCare Silver 2157 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$630.83 $715.99 $806.20 $1,126.66 $1,712.07 |
$1,113.41 $1,198.57 $1,288.78 $1,609.24 |
$1,595.99 $1,681.15 $1,771.36 $2,091.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,261.66 $1,431.98 $1,612.40 $2,253.32 $3,424.14 |
$1,744.24 $1,914.56 $2,094.98 $2,735.90 |
$2,226.82 $2,397.14 $2,577.56 $3,218.48 |
Toc - Plan #92 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Bronze 2159 ($0 Deductible / $0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$553.86 $628.63 $707.83 $989.19 $1,503.18 |
$977.56 $1,052.33 $1,131.53 $1,412.89 |
$1,401.26 $1,476.03 $1,555.23 $1,836.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,107.72 $1,257.26 $1,415.66 $1,978.38 $3,006.36 |
$1,531.42 $1,680.96 $1,839.36 $2,402.08 |
$1,955.12 $2,104.66 $2,263.06 $2,825.78 |
Toc - Plan #93 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Bronze
(HMO) BlueCare Bronze 2351S (Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.65 $516.03 $581.04 $812.00 $1,233.92 |
$802.46 $863.84 $928.85 $1,159.81 |
$1,150.27 $1,211.65 $1,276.66 $1,507.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$909.30 $1,032.06 $1,162.08 $1,624.00 $2,467.84 |
$1,257.11 $1,379.87 $1,509.89 $1,971.81 |
$1,604.92 $1,727.68 $1,857.70 $2,319.62 |
Toc - Plan #94 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Bronze 2352S (Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$500.90 $568.52 $640.15 $894.61 $1,359.44 |
$884.09 $951.71 $1,023.34 $1,277.80 |
$1,267.28 $1,334.90 $1,406.53 $1,660.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,001.80 $1,137.04 $1,280.30 $1,789.22 $2,718.88 |
$1,384.99 $1,520.23 $1,663.49 $2,172.41 |
$1,768.18 $1,903.42 $2,046.68 $2,555.60 |
Toc - Plan #95 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) BlueCare Silver 2353S ($40 PCP Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$673.40 $764.31 $860.61 $1,202.69 $1,827.61 |
$1,188.55 $1,279.46 $1,375.76 $1,717.84 |
$1,703.70 $1,794.61 $1,890.91 $2,232.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,346.80 $1,528.62 $1,721.22 $2,405.38 $3,655.22 |
$1,861.95 $2,043.77 $2,236.37 $2,920.53 |
$2,377.10 $2,558.92 $2,751.52 $3,435.68 |
Toc - Plan #96 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Gold
(HMO) BlueCare Gold 2354S ($30 PCP Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$694.24 $787.96 $887.24 $1,239.91 $1,884.17 |
$1,225.33 $1,319.05 $1,418.33 $1,771.00 |
$1,756.42 $1,850.14 $1,949.42 $2,302.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,388.48 $1,575.92 $1,774.48 $2,479.82 $3,768.34 |
$1,919.57 $2,107.01 $2,305.57 $3,010.91 |
$2,450.66 $2,638.10 $2,836.66 $3,542.00 |
Toc - Plan #97 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Platinum
(HMO) BlueCare Platinum 2355S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$865.73 $982.60 $1,106.40 $1,546.19 $2,349.59 |
$1,528.01 $1,644.88 $1,768.68 $2,208.47 |
$2,190.29 $2,307.16 $2,430.96 $2,870.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,731.46 $1,965.20 $2,212.80 $3,092.38 $4,699.18 |
$2,393.74 $2,627.48 $2,875.08 $3,754.66 |
$3,056.02 $3,289.76 $3,537.36 $4,416.94 |
Toc - Plan #98 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Bronze 2359 ($0 Deductible / $0 Virtual Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$535.60 $607.91 $684.50 $956.58 $1,453.62 |
$945.33 $1,017.64 $1,094.23 $1,366.31 |
$1,355.06 $1,427.37 $1,503.96 $1,776.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,071.20 $1,215.82 $1,369.00 $1,913.16 $2,907.24 |
$1,480.93 $1,625.55 $1,778.73 $2,322.89 |
$1,890.66 $2,035.28 $2,188.46 $2,732.62 |
Toc - Plan #99 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 1601 ($0 Virtual Visits / 3 PCP Visits for $0 / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.46 $403.45 $454.28 $634.85 $964.72 |
$627.39 $675.38 $726.21 $906.78 |
$899.32 $947.31 $998.14 $1,178.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.92 $806.90 $908.56 $1,269.70 $1,929.44 |
$982.85 $1,078.83 $1,180.49 $1,541.63 |
$1,254.78 $1,350.76 $1,452.42 $1,813.56 |
Toc - Plan #100 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 1602 ($0 Virtual Visits / $20 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.62 $379.79 $427.64 $597.63 $908.16 |
$590.60 $635.77 $683.62 $853.61 |
$846.58 $891.75 $939.60 $1,109.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$669.24 $759.58 $855.28 $1,195.26 $1,816.32 |
$925.22 $1,015.56 $1,111.26 $1,451.24 |
$1,181.20 $1,271.54 $1,367.24 $1,707.22 |
Toc - Plan #101 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 1603 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$437.76 $496.86 $559.46 $781.84 $1,188.08 |
$772.65 $831.75 $894.35 $1,116.73 |
$1,107.54 $1,166.64 $1,229.24 $1,451.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$875.52 $993.72 $1,118.92 $1,563.68 $2,376.16 |
$1,210.41 $1,328.61 $1,453.81 $1,898.57 |
$1,545.30 $1,663.50 $1,788.70 $2,233.46 |
Toc - Plan #102 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 1604 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.29 $473.62 $533.30 $745.28 $1,132.53 |
$736.52 $792.85 $852.53 $1,064.51 |
$1,055.75 $1,112.08 $1,171.76 $1,383.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$834.58 $947.24 $1,066.60 $1,490.56 $2,265.06 |
$1,153.81 $1,266.47 $1,385.83 $1,809.79 |
$1,473.04 $1,585.70 $1,705.06 $2,129.02 |
Toc - Plan #103 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Gold
(HMO) myBlue Gold 1605 ($0 Virtual Visits / $0 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$495.58 $562.48 $633.35 $885.11 $1,345.00 |
$874.70 $941.60 $1,012.47 $1,264.23 |
$1,253.82 $1,320.72 $1,391.59 $1,643.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$991.16 $1,124.96 $1,266.70 $1,770.22 $2,690.00 |
$1,370.28 $1,504.08 $1,645.82 $2,149.34 |
$1,749.40 $1,883.20 $2,024.94 $2,528.46 |
Toc - Plan #104 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 1710 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.75 $504.79 $568.39 $794.32 $1,207.05 |
$784.98 $845.02 $908.62 $1,134.55 |
$1,125.21 $1,185.25 $1,248.85 $1,474.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$889.50 $1,009.58 $1,136.78 $1,588.64 $2,414.10 |
$1,229.73 $1,349.81 $1,477.01 $1,928.87 |
$1,569.96 $1,690.04 $1,817.24 $2,269.10 |
Toc - Plan #105 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2017 ($0 Virtual Visits / $20 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.92 $469.80 $528.99 $739.26 $1,123.38 |
$730.57 $786.45 $845.64 $1,055.91 |
$1,047.22 $1,103.10 $1,162.29 $1,372.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.84 $939.60 $1,057.98 $1,478.52 $2,246.76 |
$1,144.49 $1,256.25 $1,374.63 $1,795.17 |
$1,461.14 $1,572.90 $1,691.28 $2,111.82 |
Toc - Plan #106 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2127 ($0 Virtual Visits / $25 Generic Meds / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.36 $468.03 $527.00 $736.47 $1,119.15 |
$727.82 $783.49 $842.46 $1,051.93 |
$1,043.28 $1,098.95 $1,157.92 $1,367.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$824.72 $936.06 $1,054.00 $1,472.94 $2,238.30 |
$1,140.18 $1,251.52 $1,369.46 $1,788.40 |
$1,455.64 $1,566.98 $1,684.92 $2,103.86 |
Toc - Plan #107 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 2129 ($0 Deductible / $0 Virtual Visits / $35 PCP Visit / $80 Specialist Visits / $25 Generic Meds / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$384.53 $436.44 $491.43 $686.77 $1,043.61 |
$678.70 $730.61 $785.60 $980.94 |
$972.87 $1,024.78 $1,079.77 $1,275.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.06 $872.88 $982.86 $1,373.54 $2,087.22 |
$1,063.23 $1,167.05 $1,277.03 $1,667.71 |
$1,357.40 $1,461.22 $1,571.20 $1,961.88 |
Toc - Plan #108 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 2126 ($0 Virtual Visits / 3 PCP Visits for $0 / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.87 $403.91 $454.80 $635.58 $965.83 |
$628.11 $676.15 $727.04 $907.82 |
$900.35 $948.39 $999.28 $1,180.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.74 $807.82 $909.60 $1,271.16 $1,931.66 |
$983.98 $1,080.06 $1,181.84 $1,543.40 |
$1,256.22 $1,352.30 $1,454.08 $1,815.64 |
Toc - Plan #109 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2237 ($0 Virtual Visits / $80 PCP Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.14 $459.83 $517.77 $723.58 $1,099.55 |
$715.07 $769.76 $827.70 $1,033.51 |
$1,025.00 $1,079.69 $1,137.63 $1,343.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$810.28 $919.66 $1,035.54 $1,447.16 $2,199.10 |
$1,120.21 $1,229.59 $1,345.47 $1,757.09 |
$1,430.14 $1,539.52 $1,655.40 $2,067.02 |
Toc - Plan #110 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 2219 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.82 $394.78 $444.51 $621.21 $943.98 |
$613.90 $660.86 $710.59 $887.29 |
$879.98 $926.94 $976.67 $1,153.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$695.64 $789.56 $889.02 $1,242.42 $1,887.96 |
$961.72 $1,055.64 $1,155.10 $1,508.50 |
$1,227.80 $1,321.72 $1,421.18 $1,774.58 |
Toc - Plan #111 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 2266 ($0 Virtual Visits / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.56 $395.62 $445.46 $622.53 $945.99 |
$615.21 $662.27 $712.11 $889.18 |
$881.86 $928.92 $978.76 $1,155.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.12 $791.24 $890.92 $1,245.06 $1,891.98 |
$963.77 $1,057.89 $1,157.57 $1,511.71 |
$1,230.42 $1,324.54 $1,424.22 $1,778.36 |
Toc - Plan #112 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Bronze
(HMO) myBlue Bronze 2311S (Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.68 $359.43 $404.72 $565.59 $859.47 |
$558.94 $601.69 $646.98 $807.85 |
$801.20 $843.95 $889.24 $1,050.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$633.36 $718.86 $809.44 $1,131.18 $1,718.94 |
$875.62 $961.12 $1,051.70 $1,373.44 |
$1,117.88 $1,203.38 $1,293.96 $1,615.70 |
Toc - Plan #113 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 2312S (Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$339.73 $385.59 $434.17 $606.76 $922.03 |
$599.62 $645.48 $694.06 $866.65 |
$859.51 $905.37 $953.95 $1,126.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$679.46 $771.18 $868.34 $1,213.52 $1,844.06 |
$939.35 $1,031.07 $1,128.23 $1,473.41 |
$1,199.24 $1,290.96 $1,388.12 $1,733.30 |
Toc - Plan #114 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Bronze 2329 ($0 Deductible / $0 Virtual Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.34 $422.61 $475.85 $665.00 $1,010.53 |
$657.18 $707.45 $760.69 $949.84 |
$942.02 $992.29 $1,045.53 $1,234.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$744.68 $845.22 $951.70 $1,330.00 $2,021.06 |
$1,029.52 $1,130.06 $1,236.54 $1,614.84 |
$1,314.36 $1,414.90 $1,521.38 $1,899.68 |
Toc - Plan #115 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Connected Care Silver 2230 ($0 Primary Care Virtual Visits / $0 Primary Care Visits with Select Providers / 24x7 Provider Access / Disponible en Español / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$401.52 $455.73 $513.14 $717.11 $1,089.73 |
$708.68 $762.89 $820.30 $1,024.27 |
$1,015.84 $1,070.05 $1,127.46 $1,331.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$803.04 $911.46 $1,026.28 $1,434.22 $2,179.46 |
$1,110.20 $1,218.62 $1,333.44 $1,741.38 |
$1,417.36 $1,525.78 $1,640.60 $2,048.54 |
Toc - Plan #116 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Expanded Bronze
(HMO) myBlue Connected Care Bronze 2231 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24x7 Provider Access / Disponible en Español / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329.36 $373.82 $420.92 $588.24 $893.88 |
$581.32 $625.78 $672.88 $840.20 |
$833.28 $877.74 $924.84 $1,092.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$658.72 $747.64 $841.84 $1,176.48 $1,787.76 |
$910.68 $999.60 $1,093.80 $1,428.44 |
$1,162.64 $1,251.56 $1,345.76 $1,680.40 |
Toc - Plan #117 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24x7 Provider Access / Disponible en Español / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.86 $441.36 $496.96 $694.50 $1,055.37 |
$686.34 $738.84 $794.44 $991.98 |
$983.82 $1,036.32 $1,091.92 $1,289.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$777.72 $882.72 $993.92 $1,389.00 $2,110.74 |
$1,075.20 $1,180.20 $1,291.40 $1,686.48 |
$1,372.68 $1,477.68 $1,588.88 $1,983.96 |
Toc - Plan #118 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2337 ($0 Virtual Visits / $20 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$392.17 $445.11 $501.19 $700.42 $1,064.35 |
$692.18 $745.12 $801.20 $1,000.43 |
$992.19 $1,045.13 $1,101.21 $1,300.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$784.34 $890.22 $1,002.38 $1,400.84 $2,128.70 |
$1,084.35 $1,190.23 $1,302.39 $1,700.85 |
$1,384.36 $1,490.24 $1,602.40 $2,000.86 |
Toc - Plan #119 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2313S ($40 PCP Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$407.80 $462.85 $521.17 $728.33 $1,106.77 |
$719.77 $774.82 $833.14 $1,040.30 |
$1,031.74 $1,086.79 $1,145.11 $1,352.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$815.60 $925.70 $1,042.34 $1,456.66 $2,213.54 |
$1,127.57 $1,237.67 $1,354.31 $1,768.63 |
$1,439.54 $1,549.64 $1,666.28 $2,080.60 |
Toc - Plan #120 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Gold
(HMO) myBlue Gold 2314S ($30 PCP Visits / Multilingual Available / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$469.09 $532.42 $599.50 $837.79 $1,273.11 |
$827.94 $891.27 $958.35 $1,196.64 |
$1,186.79 $1,250.12 $1,317.20 $1,555.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$938.18 $1,064.84 $1,199.00 $1,675.58 $2,546.22 |
$1,297.03 $1,423.69 $1,557.85 $2,034.43 |
$1,655.88 $1,782.54 $1,916.70 $2,393.28 |
Toc - Plan #121 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2237D ($0 Virtual Visits / $80 PCP Visits / Adult Dental / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.37 $469.17 $528.29 $738.28 $1,121.89 |
$729.60 $785.40 $844.52 $1,054.51 |
$1,045.83 $1,101.63 $1,160.75 $1,370.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$826.74 $938.34 $1,056.58 $1,476.56 $2,243.78 |
$1,142.97 $1,254.57 $1,372.81 $1,792.79 |
$1,459.20 $1,570.80 $1,689.04 $2,109.02 |
Toc - Plan #122 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Connected Care Silver 2332D ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / Adult Dental / 24x7 Provider Access / Disponible en Español / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.07 $450.67 $507.46 $709.17 $1,077.65 |
$700.83 $754.43 $811.22 $1,012.93 |
$1,004.59 $1,058.19 $1,114.98 $1,316.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$794.14 $901.34 $1,014.92 $1,418.34 $2,155.30 |
$1,097.90 $1,205.10 $1,318.68 $1,722.10 |
$1,401.66 $1,508.86 $1,622.44 $2,025.86 |
Toc - Plan #123 Florida Blue HMO (a BlueCross BlueShield FL company) | ||||||||||||||||||||
Silver
(HMO) myBlue Silver 2337D ($0 Virtual Visits / Adult Dental / $20 Labs / Rewards $$$) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-352-2583
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.37 $454.42 $511.67 $715.06 $1,086.60 |
$706.65 $760.70 $817.95 $1,021.34 |
$1,012.93 $1,066.98 $1,124.23 $1,327.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.74 $908.84 $1,023.34 $1,430.12 $2,173.20 |
$1,107.02 $1,215.12 $1,329.62 $1,736.40 |
$1,413.30 $1,521.40 $1,635.90 $2,042.68 |
ADVERTISEMENT
Oscar Insurance Company of FloridaLocal: 1-855-672-2755 | Toll Free: 1-855-672-2755 |
Toc - Plan #124 Oscar Insurance Company of Florida | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- 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 |
$311.19 $353.19 $397.69 $555.77 $844.55 |
$549.24 $591.24 $635.74 $793.82 |
$787.29 $829.29 $873.79 $1,031.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.38 $706.38 $795.38 $1,111.54 $1,689.10 |
$860.43 $944.43 $1,033.43 $1,349.59 |
$1,098.48 $1,182.48 $1,271.48 $1,587.64 |
Toc - Plan #125 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$301.84 $342.58 $385.74 $539.08 $819.18 |
$532.74 $573.48 $616.64 $769.98 |
$763.64 $804.38 $847.54 $1,000.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$603.68 $685.16 $771.48 $1,078.16 $1,638.36 |
$834.58 $916.06 $1,002.38 $1,309.06 |
$1,065.48 $1,146.96 $1,233.28 $1,539.96 |
Toc - Plan #126 Oscar Insurance Company of Florida | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- Deductible+PCP Saver Plus |
||||||||||||||||||||
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 |
$367.54 $417.15 $469.71 $656.42 $997.49 |
$648.70 $698.31 $750.87 $937.58 |
$929.86 $979.47 $1,032.03 $1,218.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.08 $834.30 $939.42 $1,312.84 $1,994.98 |
$1,016.24 $1,115.46 $1,220.58 $1,594.00 |
$1,297.40 $1,396.62 $1,501.74 $1,875.16 |
Toc - Plan #127 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$408.60 $463.75 $522.18 $729.75 $1,108.92 |
$721.17 $776.32 $834.75 $1,042.32 |
$1,033.74 $1,088.89 $1,147.32 $1,354.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.20 $927.50 $1,044.36 $1,459.50 $2,217.84 |
$1,129.77 $1,240.07 $1,356.93 $1,772.07 |
$1,442.34 $1,552.64 $1,669.50 $2,084.64 |
Toc - Plan #128 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$406.23 $461.06 $519.15 $725.51 $1,102.48 |
$716.99 $771.82 $829.91 $1,036.27 |
$1,027.75 $1,082.58 $1,140.67 $1,347.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$812.46 $922.12 $1,038.30 $1,451.02 $2,204.96 |
$1,123.22 $1,232.88 $1,349.06 $1,761.78 |
$1,433.98 $1,543.64 $1,659.82 $2,072.54 |
Toc - Plan #129 Oscar Insurance Company of Florida | ||||||||||||||||||||
Silver
(EPO) Silver Classic- 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 |
$409.20 $464.43 $522.94 $730.81 $1,110.53 |
$722.23 $777.46 $835.97 $1,043.84 |
$1,035.26 $1,090.49 $1,149.00 $1,356.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$818.40 $928.86 $1,045.88 $1,461.62 $2,221.06 |
$1,131.43 $1,241.89 $1,358.91 $1,774.65 |
$1,444.46 $1,554.92 $1,671.94 $2,087.68 |
Toc - Plan #130 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$233.03 $264.48 $297.80 $416.17 $632.42 |
$411.29 $442.74 $476.06 $594.43 |
$589.55 $621.00 $654.32 $772.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$466.06 $528.96 $595.60 $832.34 $1,264.84 |
$644.32 $707.22 $773.86 $1,010.60 |
$822.58 $885.48 $952.12 $1,188.86 |
Toc - Plan #131 Oscar Insurance Company of Florida | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- Deductible+Specialist Saver Plus |
||||||||||||||||||||
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 |
$366.59 $416.06 $468.49 $654.71 $994.89 |
$647.02 $696.49 $748.92 $935.14 |
$927.45 $976.92 $1,029.35 $1,215.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.18 $832.12 $936.98 $1,309.42 $1,989.78 |
$1,013.61 $1,112.55 $1,217.41 $1,589.85 |
$1,294.04 $1,392.98 $1,497.84 $1,870.28 |
Toc - Plan #132 Oscar Insurance Company of Florida | ||||||||||||||||||||
Gold
(EPO) Gold 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 |
$432.61 $491.00 $552.86 $772.62 $1,174.07 |
$763.55 $821.94 $883.80 $1,103.56 |
$1,094.49 $1,152.88 $1,214.74 $1,434.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$865.22 $982.00 $1,105.72 $1,545.24 $2,348.14 |
$1,196.16 $1,312.94 $1,436.66 $1,876.18 |
$1,527.10 $1,643.88 $1,767.60 $2,207.12 |
Toc - Plan #133 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$322.79 $366.35 $412.51 $576.48 $876.02 |
$569.72 $613.28 $659.44 $823.41 |
$816.65 $860.21 $906.37 $1,070.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$645.58 $732.70 $825.02 $1,152.96 $1,752.04 |
$892.51 $979.63 $1,071.95 $1,399.89 |
$1,139.44 $1,226.56 $1,318.88 $1,646.82 |
Toc - Plan #134 Oscar Insurance Company of Florida | ||||||||||||||||||||
Silver
(EPO) Silver Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.64 $460.39 $518.39 $724.45 $1,100.87 |
$715.94 $770.69 $828.69 $1,034.75 |
$1,026.24 $1,080.99 $1,138.99 $1,345.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.28 $920.78 $1,036.78 $1,448.90 $2,201.74 |
$1,121.58 $1,231.08 $1,347.08 $1,759.20 |
$1,431.88 $1,541.38 $1,657.38 $2,069.50 |
Toc - Plan #135 Oscar Insurance Company of Florida | ||||||||||||||||||||
Silver
(EPO) Silver Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.95 $469.82 $529.02 $739.30 $1,123.43 |
$730.61 $786.48 $845.68 $1,055.96 |
$1,047.27 $1,103.14 $1,162.34 $1,372.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.90 $939.64 $1,058.04 $1,478.60 $2,246.86 |
$1,144.56 $1,256.30 $1,374.70 $1,795.26 |
$1,461.22 $1,572.96 $1,691.36 $2,111.92 |
Toc - Plan #136 Oscar Insurance Company of Florida | ||||||||||||||||||||
Silver
(EPO) Silver Classic- Deductible 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 |
$416.92 $473.20 $532.82 $744.61 $1,131.51 |
$735.86 $792.14 $851.76 $1,063.55 |
$1,054.80 $1,111.08 $1,170.70 $1,382.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$833.84 $946.40 $1,065.64 $1,489.22 $2,263.02 |
$1,152.78 $1,265.34 $1,384.58 $1,808.16 |
$1,471.72 $1,584.28 $1,703.52 $2,127.10 |
Toc - Plan #137 Oscar Insurance Company of Florida | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- PCP Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.05 $364.38 $410.28 $573.37 $871.29 |
$566.64 $609.97 $655.87 $818.96 |
$812.23 $855.56 $901.46 $1,064.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$642.10 $728.76 $820.56 $1,146.74 $1,742.58 |
$887.69 $974.35 $1,066.15 $1,392.33 |
$1,133.28 $1,219.94 $1,311.74 $1,637.92 |
Toc - Plan #138 Oscar Insurance Company of Florida | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic- Deductible 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 |
$330.47 $375.07 $422.32 $590.20 $896.86 |
$583.27 $627.87 $675.12 $843.00 |
$836.07 $880.67 $927.92 $1,095.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$660.94 $750.14 $844.64 $1,180.40 $1,793.72 |
$913.74 $1,002.94 $1,097.44 $1,433.20 |
$1,166.54 $1,255.74 $1,350.24 $1,686.00 |
Toc - Plan #139 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$402.67 $457.02 $514.60 $719.16 $1,092.83 |
$710.71 $765.06 $822.64 $1,027.20 |
$1,018.75 $1,073.10 $1,130.68 $1,335.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.34 $914.04 $1,029.20 $1,438.32 $2,185.66 |
$1,113.38 $1,222.08 $1,337.24 $1,746.36 |
$1,421.42 $1,530.12 $1,645.28 $2,054.40 |
Toc - Plan #140 Oscar Insurance Company of Florida | ||||||||||||||||||||
Silver
(EPO) Silver Elite- PCP Saver Plus |
||||||||||||||||||||
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 |
$418.71 $475.22 $535.10 $747.80 $1,136.35 |
$739.02 $795.53 $855.41 $1,068.11 |
$1,059.33 $1,115.84 $1,175.72 $1,388.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$837.42 $950.44 $1,070.20 $1,495.60 $2,272.70 |
$1,157.73 $1,270.75 $1,390.51 $1,815.91 |
$1,478.04 $1,591.06 $1,710.82 $2,136.22 |
Toc - Plan #141 Oscar Insurance Company of Florida | ||||||||||||||||||||
Silver
(EPO) Silver Elite- Deductible Saver Plus |
||||||||||||||||||||
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 |
$408.60 $463.75 $522.18 $729.75 $1,108.92 |
$721.17 $776.32 $834.75 $1,042.32 |
$1,033.74 $1,088.89 $1,147.32 $1,354.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.20 $927.50 $1,044.36 $1,459.50 $2,217.84 |
$1,129.77 $1,240.07 $1,356.93 $1,772.07 |
$1,442.34 $1,552.64 $1,669.50 $2,084.64 |
Toc - Plan #142 Oscar Insurance Company of Florida | ||||||||||||||||||||
Gold
(EPO) Gold Elite- Deductible Saver Plus |
||||||||||||||||||||
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 |
$474.27 $538.28 $606.10 $847.02 $1,287.13 |
$837.08 $901.09 $968.91 $1,209.83 |
$1,199.89 $1,263.90 $1,331.72 $1,572.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$948.54 $1,076.56 $1,212.20 $1,694.04 $2,574.26 |
$1,311.35 $1,439.37 $1,575.01 $2,056.85 |
$1,674.16 $1,802.18 $1,937.82 $2,419.66 |
Toc - Plan #143 Oscar Insurance Company of Florida | ||||||||||||||||||||
Gold
(EPO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.06 $504.00 $567.50 $793.07 $1,205.15 |
$783.76 $843.70 $907.20 $1,132.77 |
$1,123.46 $1,183.40 $1,246.90 $1,472.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.12 $1,008.00 $1,135.00 $1,586.14 $2,410.30 |
$1,227.82 $1,347.70 $1,474.70 $1,925.84 |
$1,567.52 $1,687.40 $1,814.40 $2,265.54 |
Toc - Plan #144 Oscar Insurance Company of Florida | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite- Deductible Saver Plus |
||||||||||||||||||||
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 |
$357.99 $406.30 $457.49 $639.35 $971.55 |
$631.84 $680.15 $731.34 $913.20 |
$905.69 $954.00 $1,005.19 $1,187.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$715.98 $812.60 $914.98 $1,278.70 $1,943.10 |
$989.83 $1,086.45 $1,188.83 $1,552.55 |
$1,263.68 $1,360.30 $1,462.68 $1,826.40 |
Toc - Plan #145 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$407.42 $462.41 $520.67 $727.63 $1,105.70 |
$719.09 $774.08 $832.34 $1,039.30 |
$1,030.76 $1,085.75 $1,144.01 $1,350.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$814.84 $924.82 $1,041.34 $1,455.26 $2,211.40 |
$1,126.51 $1,236.49 $1,353.01 $1,766.93 |
$1,438.18 $1,548.16 $1,664.68 $2,078.60 |
Toc - Plan #146 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$327.17 $371.32 $418.11 $584.30 $887.90 |
$577.44 $621.59 $668.38 $834.57 |
$827.71 $871.86 $918.65 $1,084.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$654.34 $742.64 $836.22 $1,168.60 $1,775.80 |
$904.61 $992.91 $1,086.49 $1,418.87 |
$1,154.88 $1,243.18 $1,336.76 $1,669.14 |
Toc - Plan #147 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$287.89 $326.74 $367.91 $514.15 $781.30 |
$508.12 $546.97 $588.14 $734.38 |
$728.35 $767.20 $808.37 $954.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$575.78 $653.48 $735.82 $1,028.30 $1,562.60 |
$796.01 $873.71 $956.05 $1,248.53 |
$1,016.24 $1,093.94 $1,176.28 $1,468.76 |
Toc - Plan #148 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$403.27 $457.70 $515.36 $720.22 $1,094.44 |
$711.76 $766.19 $823.85 $1,028.71 |
$1,020.25 $1,074.68 $1,132.34 $1,337.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$806.54 $915.40 $1,030.72 $1,440.44 $2,188.88 |
$1,115.03 $1,223.89 $1,339.21 $1,748.93 |
$1,423.52 $1,532.38 $1,647.70 $2,057.42 |
Toc - Plan #149 Oscar Insurance Company of Florida | ||||||||||||||||||||
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 |
$412.53 $468.21 $527.20 $736.76 $1,119.58 |
$728.11 $783.79 $842.78 $1,052.34 |
$1,043.69 $1,099.37 $1,158.36 $1,367.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$825.06 $936.42 $1,054.40 $1,473.52 $2,239.16 |
$1,140.64 $1,252.00 $1,369.98 $1,789.10 |
$1,456.22 $1,567.58 $1,685.56 $2,104.68 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #150 Cigna Healthcare | ||||||||||||||||||||
Bronze
(EPO) Cigna Connect 8700 |
||||||||||||||||||||
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 |
$344.87 $391.43 $440.74 $615.93 $935.97 |
$608.69 $655.25 $704.56 $879.75 |
$872.51 $919.07 $968.38 $1,143.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$689.74 $782.86 $881.48 $1,231.86 $1,871.94 |
$953.56 $1,046.68 $1,145.30 $1,495.68 |
$1,217.38 $1,310.50 $1,409.12 $1,759.50 |
Toc - Plan #151 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 7300 |
||||||||||||||||||||
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 |
$358.19 $406.54 $457.77 $639.73 $972.12 |
$632.20 $680.55 $731.78 $913.74 |
$906.21 $954.56 $1,005.79 $1,187.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.38 $813.08 $915.54 $1,279.46 $1,944.24 |
$990.39 $1,087.09 $1,189.55 $1,553.47 |
$1,264.40 $1,361.10 $1,463.56 $1,827.48 |
Toc - Plan #152 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 8200 |
||||||||||||||||||||
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 |
$358.33 $406.71 $457.95 $639.98 $972.51 |
$632.45 $680.83 $732.07 $914.10 |
$906.57 $954.95 $1,006.19 $1,188.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.66 $813.42 $915.90 $1,279.96 $1,945.02 |
$990.78 $1,087.54 $1,190.02 $1,554.08 |
$1,264.90 $1,361.66 $1,464.14 $1,828.20 |
Toc - Plan #153 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 4400 |
||||||||||||||||||||
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 |
$411.71 $467.29 $526.16 $735.31 $1,117.38 |
$726.67 $782.25 $841.12 $1,050.27 |
$1,041.63 $1,097.21 $1,156.08 $1,365.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$823.42 $934.58 $1,052.32 $1,470.62 $2,234.76 |
$1,138.38 $1,249.54 $1,367.28 $1,785.58 |
$1,453.34 $1,564.50 $1,682.24 $2,100.54 |
Toc - Plan #154 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 4500 |
||||||||||||||||||||
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 |
$415.98 $472.13 $531.62 $742.93 $1,128.96 |
$734.20 $790.35 $849.84 $1,061.15 |
$1,052.42 $1,108.57 $1,168.06 $1,379.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.96 $944.26 $1,063.24 $1,485.86 $2,257.92 |
$1,150.18 $1,262.48 $1,381.46 $1,804.08 |
$1,468.40 $1,580.70 $1,699.68 $2,122.30 |
Toc - Plan #155 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 8900 |
||||||||||||||||||||
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 |
$419.25 $475.84 $535.80 $748.77 $1,137.83 |
$739.97 $796.56 $856.52 $1,069.49 |
$1,060.69 $1,117.28 $1,177.24 $1,390.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$838.50 $951.68 $1,071.60 $1,497.54 $2,275.66 |
$1,159.22 $1,272.40 $1,392.32 $1,818.26 |
$1,479.94 $1,593.12 $1,713.04 $2,138.98 |
Toc - Plan #156 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 3500 |
||||||||||||||||||||
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 |
$419.91 $476.60 $536.64 $749.96 $1,139.64 |
$741.14 $797.83 $857.87 $1,071.19 |
$1,062.37 $1,119.06 $1,179.10 $1,392.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.82 $953.20 $1,073.28 $1,499.92 $2,279.28 |
$1,161.05 $1,274.43 $1,394.51 $1,821.15 |
$1,482.28 $1,595.66 $1,715.74 $2,142.38 |
Toc - Plan #157 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 1950 |
||||||||||||||||||||
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 |
$499.79 $567.26 $638.73 $892.62 $1,356.42 |
$882.13 $949.60 $1,021.07 $1,274.96 |
$1,264.47 $1,331.94 $1,403.41 $1,657.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$999.58 $1,134.52 $1,277.46 $1,785.24 $2,712.84 |
$1,381.92 $1,516.86 $1,659.80 $2,167.58 |
$1,764.26 $1,899.20 $2,042.14 $2,549.92 |
Toc - Plan #158 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 8000 |
||||||||||||||||||||
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 |
$357.38 $405.63 $456.74 $638.29 $969.94 |
$630.78 $679.03 $730.14 $911.69 |
$904.18 $952.43 $1,003.54 $1,185.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.76 $811.26 $913.48 $1,276.58 $1,939.88 |
$988.16 $1,084.66 $1,186.88 $1,549.98 |
$1,261.56 $1,358.06 $1,460.28 $1,823.38 |
Toc - Plan #159 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 6800 Enhanced Diabetes Care |
||||||||||||||||||||
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 |
$357.15 $405.36 $456.43 $637.86 $969.29 |
$630.37 $678.58 $729.65 $911.08 |
$903.59 $951.80 $1,002.87 $1,184.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.30 $810.72 $912.86 $1,275.72 $1,938.58 |
$987.52 $1,083.94 $1,186.08 $1,548.94 |
$1,260.74 $1,357.16 $1,459.30 $1,822.16 |
Toc - Plan #160 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 3000 |
||||||||||||||||||||
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 |
$413.04 $468.80 $527.86 $737.68 $1,120.98 |
$729.01 $784.77 $843.83 $1,053.65 |
$1,044.98 $1,100.74 $1,159.80 $1,369.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$826.08 $937.60 $1,055.72 $1,475.36 $2,241.96 |
$1,142.05 $1,253.57 $1,371.69 $1,791.33 |
$1,458.02 $1,569.54 $1,687.66 $2,107.30 |
Toc - Plan #161 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 0B |
||||||||||||||||||||
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 |
$431.05 $489.24 $550.88 $769.85 $1,169.87 |
$760.80 $818.99 $880.63 $1,099.60 |
$1,090.55 $1,148.74 $1,210.38 $1,429.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$862.10 $978.48 $1,101.76 $1,539.70 $2,339.74 |
$1,191.85 $1,308.23 $1,431.51 $1,869.45 |
$1,521.60 $1,637.98 $1,761.26 $2,199.20 |
Toc - Plan #162 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 4200 Enhanced Asthma COPD Care |
||||||||||||||||||||
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 |
$416.69 $472.94 $532.53 $744.20 $1,130.89 |
$735.45 $791.70 $851.29 $1,062.96 |
$1,054.21 $1,110.46 $1,170.05 $1,381.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$833.38 $945.88 $1,065.06 $1,488.40 $2,261.78 |
$1,152.14 $1,264.64 $1,383.82 $1,807.16 |
$1,470.90 $1,583.40 $1,702.58 $2,125.92 |
Toc - Plan #163 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 900 |
||||||||||||||||||||
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 |
$519.51 $589.64 $663.93 $927.84 $1,409.94 |
$916.93 $987.06 $1,061.35 $1,325.26 |
$1,314.35 $1,384.48 $1,458.77 $1,722.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,039.02 $1,179.28 $1,327.86 $1,855.68 $2,819.88 |
$1,436.44 $1,576.70 $1,725.28 $2,253.10 |
$1,833.86 $1,974.12 $2,122.70 $2,650.52 |
Toc - Plan #164 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 1900 Enhanced Diabetes Care |
||||||||||||||||||||
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 |
$502.77 $570.65 $642.54 $897.95 $1,364.53 |
$887.39 $955.27 $1,027.16 $1,282.57 |
$1,272.01 $1,339.89 $1,411.78 $1,667.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,005.54 $1,141.30 $1,285.08 $1,795.90 $2,729.06 |
$1,390.16 $1,525.92 $1,669.70 $2,180.52 |
$1,774.78 $1,910.54 $2,054.32 $2,565.14 |
Toc - Plan #165 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 |
$500.45 $568.01 $639.58 $893.80 $1,358.22 |
$883.29 $950.85 $1,022.42 $1,276.64 |
$1,266.13 $1,333.69 $1,405.26 $1,659.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,000.90 $1,136.02 $1,279.16 $1,787.60 $2,716.44 |
$1,383.74 $1,518.86 $1,662.00 $2,170.44 |
$1,766.58 $1,901.70 $2,044.84 $2,553.28 |
Toc - Plan #166 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 |
$412.14 $467.77 $526.71 $736.07 $1,118.54 |
$727.42 $783.05 $841.99 $1,051.35 |
$1,042.70 $1,098.33 $1,157.27 $1,366.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$824.28 $935.54 $1,053.42 $1,472.14 $2,237.08 |
$1,139.56 $1,250.82 $1,368.70 $1,787.42 |
$1,454.84 $1,566.10 $1,683.98 $2,102.70 |
Toc - Plan #167 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 |
$341.55 $387.66 $436.50 $610.01 $926.97 |
$602.84 $648.95 $697.79 $871.30 |
$864.13 $910.24 $959.08 $1,132.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.10 $775.32 $873.00 $1,220.02 $1,853.94 |
$944.39 $1,036.61 $1,134.29 $1,481.31 |
$1,205.68 $1,297.90 $1,395.58 $1,742.60 |
Toc - Plan #168 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Simple Choice 7500 |
||||||||||||||||||||
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 |
$355.91 $403.96 $454.86 $635.66 $965.95 |
$628.18 $676.23 $727.13 $907.93 |
$900.45 $948.50 $999.40 $1,180.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.82 $807.92 $909.72 $1,271.32 $1,931.90 |
$984.09 $1,080.19 $1,181.99 $1,543.59 |
$1,256.36 $1,352.46 $1,454.26 $1,815.86 |
Toc - Plan #169 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 0A |
||||||||||||||||||||
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 |
$383.50 $435.28 $490.12 $684.94 $1,040.83 |
$676.88 $728.66 $783.50 $978.32 |
$970.26 $1,022.04 $1,076.88 $1,271.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.00 $870.56 $980.24 $1,369.88 $2,081.66 |
$1,060.38 $1,163.94 $1,273.62 $1,663.26 |
$1,353.76 $1,457.32 $1,567.00 $1,956.64 |
Toc - Plan #170 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 7600 Enhanced Asthma COPD Care |
||||||||||||||||||||
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 |
$357.05 $405.25 $456.31 $637.69 $969.04 |
$630.19 $678.39 $729.45 $910.83 |
$903.33 $951.53 $1,002.59 $1,183.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.10 $810.50 $912.62 $1,275.38 $1,938.08 |
$987.24 $1,083.64 $1,185.76 $1,548.52 |
$1,260.38 $1,356.78 $1,458.90 $1,821.66 |
Toc - Plan #171 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 2100 Enhanced Asthma COPD Care |
||||||||||||||||||||
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 |
$499.83 $567.31 $638.79 $892.70 $1,356.55 |
$882.20 $949.68 $1,021.16 $1,275.07 |
$1,264.57 $1,332.05 $1,403.53 $1,657.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$999.66 $1,134.62 $1,277.58 $1,785.40 $2,713.10 |
$1,382.03 $1,516.99 $1,659.95 $2,167.77 |
$1,764.40 $1,899.36 $2,042.32 $2,550.14 |
Toc - Plan #172 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 5400 |
||||||||||||||||||||
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 |
$363.83 $412.95 $464.97 $649.80 $987.43 |
$642.16 $691.28 $743.30 $928.13 |
$920.49 $969.61 $1,021.63 $1,206.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$727.66 $825.90 $929.94 $1,299.60 $1,974.86 |
$1,005.99 $1,104.23 $1,208.27 $1,577.93 |
$1,284.32 $1,382.56 $1,486.60 $1,856.26 |
Toc - Plan #173 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 3800 Enhanced Diabetes Care |
||||||||||||||||||||
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 |
$416.16 $472.35 $531.86 $743.27 $1,129.47 |
$734.53 $790.72 $850.23 $1,061.64 |
$1,052.90 $1,109.09 $1,168.60 $1,380.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.32 $944.70 $1,063.72 $1,486.54 $2,258.94 |
$1,150.69 $1,263.07 $1,382.09 $1,804.91 |
$1,469.06 $1,581.44 $1,700.46 $2,123.28 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-560-5716 | Toll Free: 1-888-560-5716 | TTY: 1-800-955-8771 |
Toc - Plan #174 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$453.50 $514.72 $579.57 $809.94 $1,230.79 |
$800.42 $861.64 $926.49 $1,156.86 |
$1,147.34 $1,208.56 $1,273.41 $1,503.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$907.00 $1,029.44 $1,159.14 $1,619.88 $2,461.58 |
$1,253.92 $1,376.36 $1,506.06 $1,966.80 |
$1,600.84 $1,723.28 $1,852.98 $2,313.72 |
Toc - Plan #175 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.30 $447.53 $503.92 $704.23 $1,070.14 |
$695.94 $749.17 $805.56 $1,005.87 |
$997.58 $1,050.81 $1,107.20 $1,307.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.60 $895.06 $1,007.84 $1,408.46 $2,140.28 |
$1,090.24 $1,196.70 $1,309.48 $1,710.10 |
$1,391.88 $1,498.34 $1,611.12 $2,011.74 |
Toc - Plan #176 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 4 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$361.96 $410.82 $462.58 $646.46 $982.35 |
$638.86 $687.72 $739.48 $923.36 |
$915.76 $964.62 $1,016.38 $1,200.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$723.92 $821.64 $925.16 $1,292.92 $1,964.70 |
$1,000.82 $1,098.54 $1,202.06 $1,569.82 |
$1,277.72 $1,375.44 $1,478.96 $1,846.72 |
Toc - Plan #177 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.94 $525.43 $591.63 $826.80 $1,256.41 |
$817.09 $879.58 $945.78 $1,180.95 |
$1,171.24 $1,233.73 $1,299.93 $1,535.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$925.88 $1,050.86 $1,183.26 $1,653.60 $2,512.82 |
$1,280.03 $1,405.01 $1,537.41 $2,007.75 |
$1,634.18 $1,759.16 $1,891.56 $2,361.90 |
Toc - Plan #178 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$401.77 $456.00 $513.46 $717.55 $1,090.39 |
$709.12 $763.35 $820.81 $1,024.90 |
$1,016.47 $1,070.70 $1,128.16 $1,332.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$803.54 $912.00 $1,026.92 $1,435.10 $2,180.78 |
$1,110.89 $1,219.35 $1,334.27 $1,742.45 |
$1,418.24 $1,526.70 $1,641.62 $2,049.80 |
Toc - Plan #179 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$313.13 $355.40 $400.17 $559.24 $849.82 |
$552.67 $594.94 $639.71 $798.78 |
$792.21 $834.48 $879.25 $1,038.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$626.26 $710.80 $800.34 $1,118.48 $1,699.64 |
$865.80 $950.34 $1,039.88 $1,358.02 |
$1,105.34 $1,189.88 $1,279.42 $1,597.56 |
Toc - Plan #180 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$457.75 $519.55 $585.01 $817.55 $1,242.34 |
$807.93 $869.73 $935.19 $1,167.73 |
$1,158.11 $1,219.91 $1,285.37 $1,517.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$915.50 $1,039.10 $1,170.02 $1,635.10 $2,484.68 |
$1,265.68 $1,389.28 $1,520.20 $1,985.28 |
$1,615.86 $1,739.46 $1,870.38 $2,335.46 |
Toc - Plan #181 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-5716
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.57 $452.37 $509.37 $711.84 $1,081.71 |
$703.47 $757.27 $814.27 $1,016.74 |
$1,008.37 $1,062.17 $1,119.17 $1,321.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797.14 $904.74 $1,018.74 $1,423.68 $2,163.42 |
$1,102.04 $1,209.64 $1,323.64 $1,728.58 |
$1,406.94 $1,514.54 $1,628.54 $2,033.48 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-888-200-0405 | Toll Free: 1-888-200-0405 | TTY: 1-888-200-0405 |
Toc - Plan #182 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value $2,150 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$469.23 $532.58 $599.68 $838.04 $1,273.49 |
$828.19 $891.54 $958.64 $1,197.00 |
$1,187.15 $1,250.50 $1,317.60 $1,555.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$938.46 $1,065.16 $1,199.36 $1,676.08 $2,546.98 |
$1,297.42 $1,424.12 $1,558.32 $2,035.04 |
$1,656.38 $1,783.08 $1,917.28 $2,394.00 |
Toc - Plan #183 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value $2,200 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$468.10 $531.30 $598.24 $836.03 $1,270.43 |
$826.20 $889.40 $956.34 $1,194.13 |
$1,184.30 $1,247.50 $1,314.44 $1,552.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$936.20 $1,062.60 $1,196.48 $1,672.06 $2,540.86 |
$1,294.30 $1,420.70 $1,554.58 $2,030.16 |
$1,652.40 $1,778.80 $1,912.68 $2,388.26 |
Toc - Plan #184 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value $4,000 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.91 $475.47 $535.37 $748.18 $1,136.93 |
$739.38 $795.94 $855.84 $1,068.65 |
$1,059.85 $1,116.41 $1,176.31 $1,389.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$837.82 $950.94 $1,070.74 $1,496.36 $2,273.86 |
$1,158.29 $1,271.41 $1,391.21 $1,816.83 |
$1,478.76 $1,591.88 $1,711.68 $2,137.30 |
Toc - Plan #185 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First $3,800 Indiv Ded ($0 App-based Care, $3 Generic Rx Pref Pharm) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.56 $461.45 $519.59 $726.12 $1,103.42 |
$717.58 $772.47 $830.61 $1,037.14 |
$1,028.60 $1,083.49 $1,141.63 $1,348.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.12 $922.90 $1,039.18 $1,452.24 $2,206.84 |
$1,124.14 $1,233.92 $1,350.20 $1,763.26 |
$1,435.16 $1,544.94 $1,661.22 $2,074.28 |
Toc - Plan #186 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value $3,400 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.75 $474.14 $533.88 $746.10 $1,133.77 |
$737.33 $793.72 $853.46 $1,065.68 |
$1,056.91 $1,113.30 $1,173.04 $1,385.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.50 $948.28 $1,067.76 $1,492.20 $2,267.54 |
$1,155.08 $1,267.86 $1,387.34 $1,811.78 |
$1,474.66 $1,587.44 $1,706.92 $2,131.36 |
Toc - Plan #187 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value $3,000 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.56 $473.93 $533.64 $745.76 $1,133.25 |
$736.99 $793.36 $853.07 $1,065.19 |
$1,056.42 $1,112.79 $1,172.50 $1,384.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.12 $947.86 $1,067.28 $1,491.52 $2,266.50 |
$1,154.55 $1,267.29 $1,386.71 $1,810.95 |
$1,473.98 $1,586.72 $1,706.14 $2,130.38 |
Toc - Plan #188 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First $3,400 Indiv Ded ($0 App-based Care, $3 Generic Rx Pref Pharm) (Disponible en español) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$407.12 $462.08 $520.30 $727.11 $1,104.92 |
$718.56 $773.52 $831.74 $1,038.55 |
$1,030.00 $1,084.96 $1,143.18 $1,349.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$814.24 $924.16 $1,040.60 $1,454.22 $2,209.84 |
$1,125.68 $1,235.60 $1,352.04 $1,765.66 |
$1,437.12 $1,547.04 $1,663.48 $2,077.10 |
Toc - Plan #189 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Essential $9,100 Indiv Ded ($3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.06 $370.08 $416.70 $582.34 $884.92 |
$575.49 $619.51 $666.13 $831.77 |
$824.92 $868.94 $915.56 $1,081.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.12 $740.16 $833.40 $1,164.68 $1,769.84 |
$901.55 $989.59 $1,082.83 $1,414.11 |
$1,150.98 $1,239.02 $1,332.26 $1,663.54 |
Toc - Plan #190 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.39 $379.53 $427.34 $597.21 $907.52 |
$590.19 $635.33 $683.14 $853.01 |
$845.99 $891.13 $938.94 $1,108.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$668.78 $759.06 $854.68 $1,194.42 $1,815.04 |
$924.58 $1,014.86 $1,110.48 $1,450.22 |
$1,180.38 $1,270.66 $1,366.28 $1,706.02 |
Toc - Plan #191 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First ($0 App-based Care, $3 Generic Rx Pref Pharm) (Disponible en español) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325.38 $369.31 $415.84 $581.14 $883.09 |
$574.30 $618.23 $664.76 $830.06 |
$823.22 $867.15 $913.68 $1,078.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$650.76 $738.62 $831.68 $1,162.28 $1,766.18 |
$899.68 $987.54 $1,080.60 $1,411.20 |
$1,148.60 $1,236.46 $1,329.52 $1,660.12 |
Toc - Plan #192 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage $0 Medical Ded ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$498.83 $566.17 $637.50 $890.91 $1,353.82 |
$880.43 $947.77 $1,019.10 $1,272.51 |
$1,262.03 $1,329.37 $1,400.70 $1,654.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$997.66 $1,132.34 $1,275.00 $1,781.82 $2,707.64 |
$1,379.26 $1,513.94 $1,656.60 $2,163.42 |
$1,760.86 $1,895.54 $2,038.20 $2,545.02 |
Toc - Plan #193 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$499.14 $566.52 $637.90 $891.46 $1,354.66 |
$880.98 $948.36 $1,019.74 $1,273.30 |
$1,262.82 $1,330.20 $1,401.58 $1,655.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$998.28 $1,133.04 $1,275.80 $1,782.92 $2,709.32 |
$1,380.12 $1,514.88 $1,657.64 $2,164.76 |
$1,761.96 $1,896.72 $2,039.48 $2,546.60 |
Toc - Plan #194 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$476.97 $541.36 $609.57 $851.87 $1,294.51 |
$841.85 $906.24 $974.45 $1,216.75 |
$1,206.73 $1,271.12 $1,339.33 $1,581.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$953.94 $1,082.72 $1,219.14 $1,703.74 $2,589.02 |
$1,318.82 $1,447.60 $1,584.02 $2,068.62 |
$1,683.70 $1,812.48 $1,948.90 $2,433.50 |
Toc - Plan #195 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.30 $475.90 $535.86 $748.86 $1,137.97 |
$740.06 $796.66 $856.62 $1,069.62 |
$1,060.82 $1,117.42 $1,177.38 $1,390.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$838.60 $951.80 $1,071.72 $1,497.72 $2,275.94 |
$1,159.36 $1,272.56 $1,392.48 $1,818.48 |
$1,480.12 $1,593.32 $1,713.24 $2,139.24 |
Toc - Plan #196 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage $0 Medical Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$437.89 $497.01 $559.63 $782.07 $1,188.44 |
$772.88 $832.00 $894.62 $1,117.06 |
$1,107.87 $1,166.99 $1,229.61 $1,452.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$875.78 $994.02 $1,119.26 $1,564.14 $2,376.88 |
$1,210.77 $1,329.01 $1,454.25 $1,899.13 |
$1,545.76 $1,664.00 $1,789.24 $2,234.12 |
Toc - Plan #197 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.96 $499.36 $562.27 $785.77 $1,194.06 |
$776.53 $835.93 $898.84 $1,122.34 |
$1,113.10 $1,172.50 $1,235.41 $1,458.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$879.92 $998.72 $1,124.54 $1,571.54 $2,388.12 |
$1,216.49 $1,335.29 $1,461.11 $1,908.11 |
$1,553.06 $1,671.86 $1,797.68 $2,244.68 |
Toc - Plan #198 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.65 $476.30 $536.31 $749.49 $1,138.93 |
$740.68 $797.33 $857.34 $1,070.52 |
$1,061.71 $1,118.36 $1,178.37 $1,391.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.30 $952.60 $1,072.62 $1,498.98 $2,277.86 |
$1,160.33 $1,273.63 $1,393.65 $1,820.01 |
$1,481.36 $1,594.66 $1,714.68 $2,141.04 |
Toc - Plan #199 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Essential $6,350 Indiv Ded ($3 Generic Rx Pref Pharm) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.58 $368.40 $414.81 $579.70 $880.91 |
$572.88 $616.70 $663.11 $828.00 |
$821.18 $865.00 $911.41 $1,076.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$649.16 $736.80 $829.62 $1,159.40 $1,761.82 |
$897.46 $985.10 $1,077.92 $1,407.70 |
$1,145.76 $1,233.40 $1,326.22 $1,656.00 |
Toc - Plan #200 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Standard $7,500 Indiv Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.37 $381.78 $429.88 $600.75 $912.90 |
$593.69 $639.10 $687.20 $858.07 |
$851.01 $896.42 $944.52 $1,115.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.74 $763.56 $859.76 $1,201.50 $1,825.80 |
$930.06 $1,020.88 $1,117.08 $1,458.82 |
$1,187.38 $1,278.20 $1,374.40 $1,716.14 |
Toc - Plan #201 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Standard $9,100 Indiv Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0405
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317.94 $360.86 $406.33 $567.84 $862.89 |
$561.17 $604.09 $649.56 $811.07 |
$804.40 $847.32 $892.79 $1,054.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$635.88 $721.72 $812.66 $1,135.68 $1,725.78 |
$879.11 $964.95 $1,055.89 $1,378.91 |
$1,122.34 $1,208.18 $1,299.12 $1,622.14 |
ADVERTISEMENT
Ambetter from Sunshine HealthLocal: 1-877-687-1169 | Toll Free: 1-877-687-1169 | TTY: 1-800-955-8770 |
Toc - Plan #202 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite VALUE Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.39 $399.95 $450.34 $629.35 $956.35 |
$621.96 $669.52 $719.91 $898.92 |
$891.53 $939.09 $989.48 $1,168.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.78 $799.90 $900.68 $1,258.70 $1,912.70 |
$974.35 $1,069.47 $1,170.25 $1,528.27 |
$1,243.92 $1,339.04 $1,439.82 $1,797.84 |
Toc - Plan #203 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(HMO) Complete VALUE Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$392.07 $444.98 $501.05 $700.21 $1,064.04 |
$691.99 $744.90 $800.97 $1,000.13 |
$991.91 $1,044.82 $1,100.89 $1,300.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$784.14 $889.96 $1,002.10 $1,400.42 $2,128.08 |
$1,084.06 $1,189.88 $1,302.02 $1,700.34 |
$1,383.98 $1,489.80 $1,601.94 $2,000.26 |
Toc - Plan #204 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(HMO) Clear VALUE Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.98 $434.67 $489.43 $683.98 $1,039.37 |
$675.95 $727.64 $782.40 $976.95 |
$968.92 $1,020.61 $1,075.37 $1,269.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.96 $869.34 $978.86 $1,367.96 $2,078.74 |
$1,058.93 $1,162.31 $1,271.83 $1,660.93 |
$1,351.90 $1,455.28 $1,564.80 $1,953.90 |
Toc - Plan #205 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(HMO) Focused VALUE Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$386.25 $438.38 $493.61 $689.82 $1,048.25 |
$681.72 $733.85 $789.08 $985.29 |
$977.19 $1,029.32 $1,084.55 $1,280.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$772.50 $876.76 $987.22 $1,379.64 $2,096.50 |
$1,067.97 $1,172.23 $1,282.69 $1,675.11 |
$1,363.44 $1,467.70 $1,578.16 $1,970.58 |
Toc - Plan #206 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(HMO) Complete VALUE Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.54 $435.31 $490.15 $684.99 $1,040.90 |
$676.94 $728.71 $783.55 $978.39 |
$970.34 $1,022.11 $1,076.95 $1,271.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.08 $870.62 $980.30 $1,369.98 $2,081.80 |
$1,060.48 $1,164.02 $1,273.70 $1,663.38 |
$1,353.88 $1,457.42 $1,567.10 $1,956.78 |
Toc - Plan #207 Ambetter from Sunshine Health | ||||||||||||||||||||
Expanded Bronze
(HMO) CMS Standard Expanded Bronze VALUE |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$301.76 $342.49 $385.64 $538.93 $818.95 |
$532.60 $573.33 $616.48 $769.77 |
$763.44 $804.17 $847.32 $1,000.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$603.52 $684.98 $771.28 $1,077.86 $1,637.90 |
$834.36 $915.82 $1,002.12 $1,308.70 |
$1,065.20 $1,146.66 $1,232.96 $1,539.54 |
Toc - Plan #208 Ambetter from Sunshine Health | ||||||||||||||||||||
Silver
(HMO) CMS Standard Silver VALUE |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.77 $434.44 $489.17 $683.62 $1,038.82 |
$675.58 $727.25 $781.98 $976.43 |
$968.39 $1,020.06 $1,074.79 $1,269.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.54 $868.88 $978.34 $1,367.24 $2,077.64 |
$1,058.35 $1,161.69 $1,271.15 $1,660.05 |
$1,351.16 $1,454.50 $1,563.96 $1,952.86 |
Toc - Plan #209 Ambetter from Sunshine Health | ||||||||||||||||||||
Gold
(HMO) CMS Standard Gold VALUE |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1169
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.45 $406.83 $458.09 $640.17 $972.80 |
$632.66 $681.04 $732.30 $914.38 |
$906.87 $955.25 $1,006.51 $1,188.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.90 $813.66 $916.18 $1,280.34 $1,945.60 |
$991.11 $1,087.87 $1,190.39 $1,554.55 |
$1,265.32 $1,362.08 $1,464.60 $1,828.76 |
‡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 Orange County here.
Orange County is in “Rating Area 48” of Florida.
Currently, there are 209 plans offered in Rating Area 48.