Obamacare 2023 Rates for Ben Hill County
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Obamacare > Rates > Georgia > Ben Hill County
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CareSourceLocal: 1-833-230-2099 | Toll Free: 1-833-230-2099 | TTY: 1-800-255-0056 |
Toc - Plan #1 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$236.39 $268.30 $302.10 $422.18 $641.54 |
$417.22 $449.13 $482.93 $603.01 |
$598.05 $629.96 $663.76 $783.84 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$472.78 $536.60 $604.20 $844.36 $1,283.08 |
$653.61 $717.43 $785.03 $1,025.19 |
$834.44 $898.26 $965.86 $1,206.02 |
Toc - Plan #2 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$321.82 $365.26 $411.28 $574.76 $873.40 |
$568.01 $611.45 $657.47 $820.95 |
$814.20 $857.64 $903.66 $1,067.14 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$643.64 $730.52 $822.56 $1,149.52 $1,746.80 |
$889.83 $976.71 $1,068.75 $1,395.71 |
$1,136.02 $1,222.90 $1,314.94 $1,641.90 |
Toc - Plan #3 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$321.56 $364.97 $410.95 $574.31 $872.71 |
$567.55 $610.96 $656.94 $820.30 |
$813.54 $856.95 $902.93 $1,066.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$643.12 $729.94 $821.90 $1,148.62 $1,745.42 |
$889.11 $975.93 $1,067.89 $1,394.61 |
$1,135.10 $1,221.92 $1,313.88 $1,640.60 |
Toc - Plan #4 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$329.11 $373.54 $420.60 $587.79 $893.20 |
$580.88 $625.31 $672.37 $839.56 |
$832.65 $877.08 $924.14 $1,091.33 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$658.22 $747.08 $841.20 $1,175.58 $1,786.40 |
$909.99 $998.85 $1,092.97 $1,427.35 |
$1,161.76 $1,250.62 $1,344.74 $1,679.12 |
Toc - Plan #5 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace HSA Eligible Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$260.63 $295.81 $333.08 $465.47 $707.33 |
$460.01 $495.19 $532.46 $664.85 |
$659.39 $694.57 $731.84 $864.23 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$521.26 $591.62 $666.16 $930.94 $1,414.66 |
$720.64 $791.00 $865.54 $1,130.32 |
$920.02 $990.38 $1,064.92 $1,329.70 |
Toc - Plan #6 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$223.37 $253.52 $285.46 $398.93 $606.22 |
$394.25 $424.40 $456.34 $569.81 |
$565.13 $595.28 $627.22 $740.69 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$446.74 $507.04 $570.92 $797.86 $1,212.44 |
$617.62 $677.92 $741.80 $968.74 |
$788.50 $848.80 $912.68 $1,139.62 |
Toc - Plan #7 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Essential Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$350.64 $397.97 $448.11 $626.23 $951.62 |
$618.87 $666.20 $716.34 $894.46 |
$887.10 $934.43 $984.57 $1,162.69 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$701.28 $795.94 $896.22 $1,252.46 $1,903.24 |
$969.51 $1,064.17 $1,164.45 $1,520.69 |
$1,237.74 $1,332.40 $1,432.68 $1,788.92 |
Toc - Plan #8 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Federal Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$328.80 $373.18 $420.20 $587.22 $892.34 |
$580.33 $624.71 $671.73 $838.75 |
$831.86 $876.24 $923.26 $1,090.28 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$657.60 $746.36 $840.40 $1,174.44 $1,784.68 |
$909.13 $997.89 $1,091.93 $1,425.97 |
$1,160.66 $1,249.42 $1,343.46 $1,677.50 |
Toc - Plan #9 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Federal Standard Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$328.03 $372.31 $419.22 $585.86 $890.27 |
$578.97 $623.25 $670.16 $836.80 |
$829.91 $874.19 $921.10 $1,087.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$656.06 $744.62 $838.44 $1,171.72 $1,780.54 |
$907.00 $995.56 $1,089.38 $1,422.66 |
$1,157.94 $1,246.50 $1,340.32 $1,673.60 |
Toc - Plan #10 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$244.16 $277.12 $312.04 $436.07 $662.65 |
$430.94 $463.90 $498.82 $622.85 |
$617.72 $650.68 $685.60 $809.63 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$488.32 $554.24 $624.08 $872.14 $1,325.30 |
$675.10 $741.02 $810.86 $1,058.92 |
$861.88 $927.80 $997.64 $1,245.70 |
Toc - Plan #11 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$329.87 $374.40 $421.58 $589.15 $895.27 |
$582.22 $626.75 $673.93 $841.50 |
$834.57 $879.10 $926.28 $1,093.85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$659.74 $748.80 $843.16 $1,178.30 $1,790.54 |
$912.09 $1,001.15 $1,095.51 $1,430.65 |
$1,164.44 $1,253.50 $1,347.86 $1,683.00 |
Toc - Plan #12 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$329.24 $373.68 $420.76 $588.01 $893.54 |
$581.10 $625.54 $672.62 $839.87 |
$832.96 $877.40 $924.48 $1,091.73 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$658.48 $747.36 $841.52 $1,176.02 $1,787.08 |
$910.34 $999.22 $1,093.38 $1,427.88 |
$1,162.20 $1,251.08 $1,345.24 $1,679.74 |
Toc - Plan #13 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$336.78 $382.25 $430.41 $601.49 $914.02 |
$594.42 $639.89 $688.05 $859.13 |
$852.06 $897.53 $945.69 $1,116.77 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$673.56 $764.50 $860.82 $1,202.98 $1,828.04 |
$931.20 $1,022.14 $1,118.46 $1,460.62 |
$1,188.84 $1,279.78 $1,376.10 $1,718.26 |
Toc - Plan #14 CareSource | ||||||||||||||||||||
Bronze
(HMO) CareSource Marketplace Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$230.52 $261.63 $294.59 $411.69 $625.61 |
$406.86 $437.97 $470.93 $588.03 |
$583.20 $614.31 $647.27 $764.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$461.04 $523.26 $589.18 $823.38 $1,251.22 |
$637.38 $699.60 $765.52 $999.72 |
$813.72 $875.94 $941.86 $1,176.06 |
Toc - Plan #15 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Essential Silver Dental, Vision, & Fitness |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
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 |
$357.93 $406.25 $457.43 $639.26 $971.42 |
$631.74 $680.06 $731.24 $913.07 |
$905.55 $953.87 $1,005.05 $1,186.88 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$715.86 $812.50 $914.86 $1,278.52 $1,942.84 |
$989.67 $1,086.31 $1,188.67 $1,552.33 |
$1,263.48 $1,360.12 $1,462.48 $1,826.14 |
Toc - Plan #16 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Federal Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$336.47 $381.89 $430.00 $600.93 $913.17 |
$593.87 $639.29 $687.40 $858.33 |
$851.27 $896.69 $944.80 $1,115.73 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$672.94 $763.78 $860.00 $1,201.86 $1,826.34 |
$930.34 $1,021.18 $1,117.40 $1,459.26 |
$1,187.74 $1,278.58 $1,374.80 $1,716.66 |
Toc - Plan #17 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Federal Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$336.09 $381.46 $429.52 $600.25 $912.14 |
$593.20 $638.57 $686.63 $857.36 |
$850.31 $895.68 $943.74 $1,114.47 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$672.18 $762.92 $859.04 $1,200.50 $1,824.28 |
$929.29 $1,020.03 $1,116.15 $1,457.61 |
$1,186.40 $1,277.14 $1,373.26 $1,714.72 |
ADVERTISEMENT
Ambetter from Peach State Health PlanLocal: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231 |
Toc - Plan #18 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
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 |
$243.62 $276.50 $311.34 $435.10 $661.17 |
$429.99 $462.87 $497.71 $621.47 |
$616.36 $649.24 $684.08 $807.84 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$487.24 $553.00 $622.68 $870.20 $1,322.34 |
$673.61 $739.37 $809.05 $1,056.57 |
$859.98 $925.74 $995.42 $1,242.94 |
Toc - Plan #19 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
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 |
$292.57 $332.06 $373.89 $522.51 $794.01 |
$516.38 $555.87 $597.70 $746.32 |
$740.19 $779.68 $821.51 $970.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$585.14 $664.12 $747.78 $1,045.02 $1,588.02 |
$808.95 $887.93 $971.59 $1,268.83 |
$1,032.76 $1,111.74 $1,195.40 $1,492.64 |
Toc - Plan #20 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
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 |
$289.32 $328.37 $369.74 $516.71 $785.19 |
$510.64 $549.69 $591.06 $738.03 |
$731.96 $771.01 $812.38 $959.35 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578.64 $656.74 $739.48 $1,033.42 $1,570.38 |
$799.96 $878.06 $960.80 $1,254.74 |
$1,021.28 $1,099.38 $1,182.12 $1,476.06 |
Toc - Plan #21 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
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 |
$306.12 $347.43 $391.20 $546.70 $830.77 |
$540.29 $581.60 $625.37 $780.87 |
$774.46 $815.77 $859.54 $1,015.04 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$612.24 $694.86 $782.40 $1,093.40 $1,661.54 |
$846.41 $929.03 $1,016.57 $1,327.57 |
$1,080.58 $1,163.20 $1,250.74 $1,561.74 |
Toc - Plan #22 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Everyday Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
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 |
$286.31 $324.95 $365.89 $511.33 $777.02 |
$505.33 $543.97 $584.91 $730.35 |
$724.35 $762.99 $803.93 $949.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$572.62 $649.90 $731.78 $1,022.66 $1,554.04 |
$791.64 $868.92 $950.80 $1,241.68 |
$1,010.66 $1,087.94 $1,169.82 $1,460.70 |
Toc - Plan #23 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
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 |
$267.70 $303.83 $342.11 $478.10 $726.52 |
$472.48 $508.61 $546.89 $682.88 |
$677.26 $713.39 $751.67 $887.66 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$535.40 $607.66 $684.22 $956.20 $1,453.04 |
$740.18 $812.44 $889.00 $1,160.98 |
$944.96 $1,017.22 $1,093.78 $1,365.76 |
Toc - Plan #24 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$262.11 $297.49 $334.97 $468.12 $711.35 |
$462.62 $498.00 $535.48 $668.63 |
$663.13 $698.51 $735.99 $869.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$524.22 $594.98 $669.94 $936.24 $1,422.70 |
$724.73 $795.49 $870.45 $1,136.75 |
$925.24 $996.00 $1,070.96 $1,337.26 |
Toc - Plan #25 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.58 $336.60 $379.01 $529.67 $804.88 |
$523.45 $563.47 $605.88 $756.54 |
$750.32 $790.34 $832.75 $983.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$593.16 $673.20 $758.02 $1,059.34 $1,609.76 |
$820.03 $900.07 $984.89 $1,286.21 |
$1,046.90 $1,126.94 $1,211.76 $1,513.08 |
Toc - Plan #26 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.04 $320.10 $360.43 $503.70 $765.42 |
$497.79 $535.85 $576.18 $719.45 |
$713.54 $751.60 $791.93 $935.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$564.08 $640.20 $720.86 $1,007.40 $1,530.84 |
$779.83 $855.95 $936.61 $1,223.15 |
$995.58 $1,071.70 $1,152.36 $1,438.90 |
Toc - Plan #27 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$285.23 $323.72 $364.51 $509.40 $774.08 |
$503.42 $541.91 $582.70 $727.59 |
$721.61 $760.10 $800.89 $945.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$570.46 $647.44 $729.02 $1,018.80 $1,548.16 |
$788.65 $865.63 $947.21 $1,236.99 |
$1,006.84 $1,083.82 $1,165.40 $1,455.18 |
Toc - Plan #28 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.60 $332.09 $373.93 $522.56 $794.09 |
$516.43 $555.92 $597.76 $746.39 |
$740.26 $779.75 $821.59 $970.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$585.20 $664.18 $747.86 $1,045.12 $1,588.18 |
$809.03 $888.01 $971.69 $1,268.95 |
$1,032.86 $1,111.84 $1,195.52 $1,492.78 |
Toc - Plan #29 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.21 $328.24 $369.59 $516.50 $784.88 |
$510.44 $549.47 $590.82 $737.73 |
$731.67 $770.70 $812.05 $958.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578.42 $656.48 $739.18 $1,033.00 $1,569.76 |
$799.65 $877.71 $960.41 $1,254.23 |
$1,020.88 $1,098.94 $1,181.64 $1,475.46 |
Toc - Plan #30 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.71 $383.29 $431.58 $603.14 $916.52 |
$596.05 $641.63 $689.92 $861.48 |
$854.39 $899.97 $948.26 $1,119.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$675.42 $766.58 $863.16 $1,206.28 $1,833.04 |
$933.76 $1,024.92 $1,121.50 $1,464.62 |
$1,192.10 $1,283.26 $1,379.84 $1,722.96 |
Toc - Plan #31 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) CMS Standard Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$231.92 $263.22 $296.38 $414.19 $629.41 |
$409.33 $440.63 $473.79 $591.60 |
$586.74 $618.04 $651.20 $769.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$463.84 $526.44 $592.76 $828.38 $1,258.82 |
$641.25 $703.85 $770.17 $1,005.79 |
$818.66 $881.26 $947.58 $1,183.20 |
Toc - Plan #32 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) CMS Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$256.61 $291.25 $327.94 $458.29 $696.42 |
$452.91 $487.55 $524.24 $654.59 |
$649.21 $683.85 $720.54 $850.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$513.22 $582.50 $655.88 $916.58 $1,392.84 |
$709.52 $778.80 $852.18 $1,112.88 |
$905.82 $975.10 $1,048.48 $1,309.18 |
Toc - Plan #33 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) CMS Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.65 $320.80 $361.22 $504.80 $767.09 |
$498.87 $537.02 $577.44 $721.02 |
$715.09 $753.24 $793.66 $937.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$565.30 $641.60 $722.44 $1,009.60 $1,534.18 |
$781.52 $857.82 $938.66 $1,225.82 |
$997.74 $1,074.04 $1,154.88 $1,442.04 |
Toc - Plan #34 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) CMS Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.85 $328.97 $370.41 $517.65 $786.62 |
$511.58 $550.70 $592.14 $739.38 |
$733.31 $772.43 $813.87 $961.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$579.70 $657.94 $740.82 $1,035.30 $1,573.24 |
$801.43 $879.67 $962.55 $1,257.03 |
$1,023.16 $1,101.40 $1,184.28 $1,478.76 |
Toc - Plan #35 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Everyday Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.65 $337.82 $380.38 $531.58 $807.79 |
$525.34 $565.51 $608.07 $759.27 |
$753.03 $793.20 $835.76 $986.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$595.30 $675.64 $760.76 $1,063.16 $1,615.58 |
$822.99 $903.33 $988.45 $1,290.85 |
$1,050.68 $1,131.02 $1,216.14 $1,518.54 |
Toc - Plan #36 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.16 $345.21 $388.70 $543.21 $825.46 |
$536.83 $577.88 $621.37 $775.88 |
$769.50 $810.55 $854.04 $1,008.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608.32 $690.42 $777.40 $1,086.42 $1,650.92 |
$840.99 $923.09 $1,010.07 $1,319.09 |
$1,073.66 $1,155.76 $1,242.74 $1,551.76 |
Toc - Plan #37 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.78 $341.38 $384.39 $537.18 $816.29 |
$530.87 $571.47 $614.48 $767.27 |
$760.96 $801.56 $844.57 $997.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$601.56 $682.76 $768.78 $1,074.36 $1,632.58 |
$831.65 $912.85 $998.87 $1,304.45 |
$1,061.74 $1,142.94 $1,228.96 $1,534.54 |
Toc - Plan #38 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$253.27 $287.45 $323.67 $452.33 $687.36 |
$447.02 $481.20 $517.42 $646.08 |
$640.77 $674.95 $711.17 $839.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$506.54 $574.90 $647.34 $904.66 $1,374.72 |
$700.29 $768.65 $841.09 $1,098.41 |
$894.04 $962.40 $1,034.84 $1,292.16 |
Toc - Plan #39 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.24 $361.19 $406.70 $568.36 $863.68 |
$561.69 $604.64 $650.15 $811.81 |
$805.14 $848.09 $893.60 $1,055.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.48 $722.38 $813.40 $1,136.72 $1,727.36 |
$879.93 $965.83 $1,056.85 $1,380.17 |
$1,123.38 $1,209.28 $1,300.30 $1,623.62 |
Toc - Plan #40 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278.31 $315.87 $355.66 $497.04 $755.29 |
$491.21 $528.77 $568.56 $709.94 |
$704.11 $741.67 $781.46 $922.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$556.62 $631.74 $711.32 $994.08 $1,510.58 |
$769.52 $844.64 $924.22 $1,206.98 |
$982.42 $1,057.54 $1,137.12 $1,419.88 |
Toc - Plan #41 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$272.50 $309.27 $348.24 $486.66 $739.53 |
$480.95 $517.72 $556.69 $695.11 |
$689.40 $726.17 $765.14 $903.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$545.00 $618.54 $696.48 $973.32 $1,479.06 |
$753.45 $826.99 $904.93 $1,181.77 |
$961.90 $1,035.44 $1,113.38 $1,390.22 |
Toc - Plan #42 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.32 $349.94 $394.03 $550.65 $836.77 |
$544.18 $585.80 $629.89 $786.51 |
$780.04 $821.66 $865.75 $1,022.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$616.64 $699.88 $788.06 $1,101.30 $1,673.54 |
$852.50 $935.74 $1,023.92 $1,337.16 |
$1,088.36 $1,171.60 $1,259.78 $1,573.02 |
Toc - Plan #43 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.52 $336.54 $378.94 $529.57 $804.74 |
$523.35 $563.37 $605.77 $756.40 |
$750.18 $790.20 $832.60 $983.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$593.04 $673.08 $757.88 $1,059.14 $1,609.48 |
$819.87 $899.91 $984.71 $1,285.97 |
$1,046.70 $1,126.74 $1,211.54 $1,512.80 |
Toc - Plan #44 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.19 $345.24 $388.74 $543.26 $825.54 |
$536.89 $577.94 $621.44 $775.96 |
$769.59 $810.64 $854.14 $1,008.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608.38 $690.48 $777.48 $1,086.52 $1,651.08 |
$841.08 $923.18 $1,010.18 $1,319.22 |
$1,073.78 $1,155.88 $1,242.88 $1,551.92 |
Toc - Plan #45 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.21 $332.78 $374.71 $523.65 $795.74 |
$517.51 $557.08 $599.01 $747.95 |
$741.81 $781.38 $823.31 $972.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586.42 $665.56 $749.42 $1,047.30 $1,591.48 |
$810.72 $889.86 $973.72 $1,271.60 |
$1,035.02 $1,114.16 $1,198.02 $1,495.90 |
Toc - Plan #46 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.66 $341.24 $384.23 $536.96 $815.96 |
$530.66 $571.24 $614.23 $766.96 |
$760.66 $801.24 $844.23 $996.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$601.32 $682.48 $768.46 $1,073.92 $1,631.92 |
$831.32 $912.48 $998.46 $1,303.92 |
$1,061.32 $1,142.48 $1,228.46 $1,533.92 |
Toc - Plan #47 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.09 $398.47 $448.68 $627.02 $952.82 |
$619.66 $667.04 $717.25 $895.59 |
$888.23 $935.61 $985.82 $1,164.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.18 $796.94 $897.36 $1,254.04 $1,905.64 |
$970.75 $1,065.51 $1,165.93 $1,522.61 |
$1,239.32 $1,334.08 $1,434.50 $1,791.18 |
Toc - Plan #48 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Ambetter Virtual Access Bronze - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$255.06 $289.49 $325.96 $455.53 $692.22 |
$450.18 $484.61 $521.08 $650.65 |
$645.30 $679.73 $716.20 $845.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$510.12 $578.98 $651.92 $911.06 $1,384.44 |
$705.24 $774.10 $847.04 $1,106.18 |
$900.36 $969.22 $1,042.16 $1,301.30 |
Toc - Plan #49 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Ambetter Virtual Access Silver - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$279.08 $316.75 $356.65 $498.42 $757.40 |
$492.57 $530.24 $570.14 $711.91 |
$706.06 $743.73 $783.63 $925.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$558.16 $633.50 $713.30 $996.84 $1,514.80 |
$771.65 $846.99 $926.79 $1,210.33 |
$985.14 $1,060.48 $1,140.28 $1,423.82 |
Toc - Plan #50 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Ambetter Virtual Access Gold - Virtual PCP selection required |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.37 $337.50 $380.02 $531.08 $807.03 |
$524.85 $564.98 $607.50 $758.56 |
$752.33 $792.46 $834.98 $986.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$594.74 $675.00 $760.04 $1,062.16 $1,614.06 |
$822.22 $902.48 $987.52 $1,289.64 |
$1,049.70 $1,129.96 $1,215.00 $1,517.12 |
ADVERTISEMENT
Alliant Health PlansLocal: 1-800-811-4793 | Toll Free: 1-800-811-4793 |
Toc - Plan #51 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare Gold PPO (3 Free PCP Visits) 40002 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.27 $328.31 $369.68 $516.62 $785.05 |
$510.55 $549.59 $590.96 $737.90 |
$731.83 $770.87 $812.24 $959.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578.54 $656.62 $739.36 $1,033.24 $1,570.10 |
$799.82 $877.90 $960.64 $1,254.52 |
$1,021.10 $1,099.18 $1,181.92 $1,475.80 |
Toc - Plan #52 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40017 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.72 $323.15 $363.87 $508.50 $772.72 |
$502.53 $540.96 $581.68 $726.31 |
$720.34 $758.77 $799.49 $944.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$569.44 $646.30 $727.74 $1,017.00 $1,545.44 |
$787.25 $864.11 $945.55 $1,234.81 |
$1,005.06 $1,081.92 $1,163.36 $1,452.62 |
Toc - Plan #53 Alliant Health Plans | ||||||||||||||||||||
Platinum
(PPO) SoloCare Platinum PPO Copay Plan (3 Free PCP Visits) 40184 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.62 $429.72 $483.87 $676.20 $1,027.55 |
$668.26 $719.36 $773.51 $965.84 |
$957.90 $1,009.00 $1,063.15 $1,255.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$757.24 $859.44 $967.74 $1,352.40 $2,055.10 |
$1,046.88 $1,149.08 $1,257.38 $1,642.04 |
$1,336.52 $1,438.72 $1,547.02 $1,931.68 |
Toc - Plan #54 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare Gold PPO (3 Free PCP Visits) 40330 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$300.63 $341.20 $384.19 $536.91 $815.89 |
$530.60 $571.17 $614.16 $766.88 |
$760.57 $801.14 $844.13 $996.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$601.26 $682.40 $768.38 $1,073.82 $1,631.78 |
$831.23 $912.37 $998.35 $1,303.79 |
$1,061.20 $1,142.34 $1,228.32 $1,533.76 |
Toc - Plan #55 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40331 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$283.21 $321.43 $361.93 $505.80 $768.61 |
$499.86 $538.08 $578.58 $722.45 |
$716.51 $754.73 $795.23 $939.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$566.42 $642.86 $723.86 $1,011.60 $1,537.22 |
$783.07 $859.51 $940.51 $1,228.25 |
$999.72 $1,076.16 $1,157.16 $1,444.90 |
Toc - Plan #56 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40336 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.54 $330.89 $372.57 $520.67 $791.21 |
$514.56 $553.91 $595.59 $743.69 |
$737.58 $776.93 $818.61 $966.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$583.08 $661.78 $745.14 $1,041.34 $1,582.42 |
$806.10 $884.80 $968.16 $1,264.36 |
$1,029.12 $1,107.82 $1,191.18 $1,487.38 |
Toc - Plan #57 Alliant Health Plans | ||||||||||||||||||||
Platinum
(PPO) SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Dental) 40348 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.76 $446.91 $503.22 $703.24 $1,068.64 |
$694.98 $748.13 $804.44 $1,004.46 |
$996.20 $1,049.35 $1,105.66 $1,305.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$787.52 $893.82 $1,006.44 $1,406.48 $2,137.28 |
$1,088.74 $1,195.04 $1,307.66 $1,707.70 |
$1,389.96 $1,496.26 $1,608.88 $2,008.92 |
Toc - Plan #58 Alliant Health Plans | ||||||||||||||||||||
Platinum
(PPO) SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Chiro + Dental) 40349 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.55 $451.21 $508.06 $710.01 $1,078.93 |
$701.67 $755.33 $812.18 $1,014.13 |
$1,005.79 $1,059.45 $1,116.30 $1,318.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$795.10 $902.42 $1,016.12 $1,420.02 $2,157.86 |
$1,099.22 $1,206.54 $1,320.24 $1,724.14 |
$1,403.34 $1,510.66 $1,624.36 $2,028.26 |
Toc - Plan #59 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare Gold PPO (3 Free PCP Visits + Dental) 40354 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$301.00 $341.63 $384.67 $537.58 $816.90 |
$531.26 $571.89 $614.93 $767.84 |
$761.52 $802.15 $845.19 $998.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$602.00 $683.26 $769.34 $1,075.16 $1,633.80 |
$832.26 $913.52 $999.60 $1,305.42 |
$1,062.52 $1,143.78 $1,229.86 $1,535.68 |
Toc - Plan #60 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40355 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.04 $345.07 $388.55 $542.99 $825.13 |
$536.62 $577.65 $621.13 $775.57 |
$769.20 $810.23 $853.71 $1,008.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608.08 $690.14 $777.10 $1,085.98 $1,650.26 |
$840.66 $922.72 $1,009.68 $1,318.56 |
$1,073.24 $1,155.30 $1,242.26 $1,551.14 |
Toc - Plan #61 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare Gold PPO (3 Free PCP Visits + Dental) 40357 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$312.36 $354.52 $399.19 $557.87 $847.73 |
$551.31 $593.47 $638.14 $796.82 |
$790.26 $832.42 $877.09 $1,035.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$624.72 $709.04 $798.38 $1,115.74 $1,695.46 |
$863.67 $947.99 $1,037.33 $1,354.69 |
$1,102.62 $1,186.94 $1,276.28 $1,593.64 |
Toc - Plan #62 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40358 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.77 $358.39 $403.54 $563.95 $856.98 |
$557.33 $599.95 $645.10 $805.51 |
$798.89 $841.51 $886.66 $1,047.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$631.54 $716.78 $807.08 $1,127.90 $1,713.96 |
$873.10 $958.34 $1,048.64 $1,369.46 |
$1,114.66 $1,199.90 $1,290.20 $1,611.02 |
Toc - Plan #63 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits +$225 Specialty Drug Copay + Dental) 40368 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$296.09 $336.05 $378.38 $528.79 $803.55 |
$522.59 $562.55 $604.88 $755.29 |
$749.09 $789.05 $831.38 $981.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$592.18 $672.10 $756.76 $1,057.58 $1,607.10 |
$818.68 $898.60 $983.26 $1,284.08 |
$1,045.18 $1,125.10 $1,209.76 $1,510.58 |
Toc - Plan #64 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay + Dental) 40369 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.35 $338.62 $381.28 $532.84 $809.70 |
$526.58 $566.85 $609.51 $761.07 |
$754.81 $795.08 $837.74 $989.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$596.70 $677.24 $762.56 $1,065.68 $1,619.40 |
$824.93 $905.47 $990.79 $1,293.91 |
$1,053.16 $1,133.70 $1,219.02 $1,522.14 |
Toc - Plan #65 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40372 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$294.57 $334.33 $376.45 $526.09 $799.44 |
$519.91 $559.67 $601.79 $751.43 |
$745.25 $785.01 $827.13 $976.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$589.14 $668.66 $752.90 $1,052.18 $1,598.88 |
$814.48 $894.00 $978.24 $1,277.52 |
$1,039.82 $1,119.34 $1,203.58 $1,502.86 |
Toc - Plan #66 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay + Dental) 40373 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.22 $337.34 $379.84 $530.82 $806.64 |
$524.59 $564.71 $607.21 $758.19 |
$751.96 $792.08 $834.58 $985.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$594.44 $674.68 $759.68 $1,061.64 $1,613.28 |
$821.81 $902.05 $987.05 $1,289.01 |
$1,049.18 $1,129.42 $1,214.42 $1,516.38 |
Toc - Plan #67 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40375 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$303.28 $344.21 $387.58 $541.64 $823.08 |
$535.28 $576.21 $619.58 $773.64 |
$767.28 $808.21 $851.58 $1,005.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$606.56 $688.42 $775.16 $1,083.28 $1,646.16 |
$838.56 $920.42 $1,007.16 $1,315.28 |
$1,070.56 $1,152.42 $1,239.16 $1,547.28 |
Toc - Plan #68 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay + Dental) 40376 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.55 $346.79 $390.48 $545.69 $829.24 |
$539.29 $580.53 $624.22 $779.43 |
$773.03 $814.27 $857.96 $1,013.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$611.10 $693.58 $780.96 $1,091.38 $1,658.48 |
$844.84 $927.32 $1,014.70 $1,325.12 |
$1,078.58 $1,161.06 $1,248.44 $1,558.86 |
Toc - Plan #69 Alliant Health Plans | ||||||||||||||||||||
Platinum
(PPO) SoloCare PPO Platinum Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$391.11 $443.90 $499.83 $698.51 $1,061.45 |
$690.30 $743.09 $799.02 $997.70 |
$989.49 $1,042.28 $1,098.21 $1,296.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$782.22 $887.80 $999.66 $1,397.02 $2,122.90 |
$1,081.41 $1,186.99 $1,298.85 $1,696.21 |
$1,380.60 $1,486.18 $1,598.04 $1,995.40 |
Toc - Plan #70 Alliant Health Plans | ||||||||||||||||||||
Gold
(PPO) SoloCare PPO Gold Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$283.21 $321.43 $361.93 $505.80 $768.61 |
$499.86 $538.08 $578.58 $722.45 |
$716.51 $754.73 $795.23 $939.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$566.42 $642.86 $723.86 $1,011.60 $1,537.22 |
$783.07 $859.51 $940.51 $1,228.25 |
$999.72 $1,076.16 $1,157.16 $1,444.90 |
Toc - Plan #71 Alliant Health Plans | ||||||||||||||||||||
Silver
(PPO) SoloCare PPO Silver Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$268.83 $305.11 $343.55 $480.11 $729.57 |
$474.48 $510.76 $549.20 $685.76 |
$680.13 $716.41 $754.85 $891.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$537.66 $610.22 $687.10 $960.22 $1,459.14 |
$743.31 $815.87 $892.75 $1,165.87 |
$948.96 $1,021.52 $1,098.40 $1,371.52 |
Toc - Plan #72 Alliant Health Plans | ||||||||||||||||||||
Gold
(HMO) SoloCare Gold No Referral HMO (3 Free PCP Visits) 110003 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$287.76 $326.59 $367.74 $513.92 $780.95 |
$507.89 $546.72 $587.87 $734.05 |
$728.02 $766.85 $808.00 $954.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$575.52 $653.18 $735.48 $1,027.84 $1,561.90 |
$795.65 $873.31 $955.61 $1,247.97 |
$1,015.78 $1,093.44 $1,175.74 $1,468.10 |
Toc - Plan #73 Alliant Health Plans | ||||||||||||||||||||
Gold
(HMO) SoloCare Gold No Referral HMO (3 Free PCP Visits) 110004 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.49 $339.91 $382.74 $534.88 $812.79 |
$528.59 $569.01 $611.84 $763.98 |
$757.69 $798.11 $840.94 $993.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598.98 $679.82 $765.48 $1,069.76 $1,625.58 |
$828.08 $908.92 $994.58 $1,298.86 |
$1,057.18 $1,138.02 $1,223.68 $1,527.96 |
Toc - Plan #74 Alliant Health Plans | ||||||||||||||||||||
Silver
(HMO) SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110008 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$280.94 $318.86 $359.03 $501.75 $762.46 |
$495.85 $533.77 $573.94 $716.66 |
$710.76 $748.68 $788.85 $931.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$561.88 $637.72 $718.06 $1,003.50 $1,524.92 |
$776.79 $852.63 $932.97 $1,218.41 |
$991.70 $1,067.54 $1,147.88 $1,433.32 |
Toc - Plan #75 Alliant Health Plans | ||||||||||||||||||||
Silver
(HMO) SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110009 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$279.42 $317.13 $357.09 $499.03 $758.33 |
$493.17 $530.88 $570.84 $712.78 |
$706.92 $744.63 $784.59 $926.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$558.84 $634.26 $714.18 $998.06 $1,516.66 |
$772.59 $848.01 $927.93 $1,211.81 |
$986.34 $1,061.76 $1,141.68 $1,425.56 |
Toc - Plan #76 Alliant Health Plans | ||||||||||||||||||||
Silver
(HMO) SoloCare Silver HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110010 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$287.76 $326.59 $367.74 $513.92 $780.95 |
$507.89 $546.72 $587.87 $734.05 |
$728.02 $766.85 $808.00 $954.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$575.52 $653.18 $735.48 $1,027.84 $1,561.90 |
$795.65 $873.31 $955.61 $1,247.97 |
$1,015.78 $1,093.44 $1,175.74 $1,468.10 |
Toc - Plan #77 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay) 110011 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$218.09 $247.53 $278.71 $389.50 $591.88 |
$384.92 $414.36 $445.54 $556.33 |
$551.75 $581.19 $612.37 $723.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$436.18 $495.06 $557.42 $779.00 $1,183.76 |
$603.01 $661.89 $724.25 $945.83 |
$769.84 $828.72 $891.08 $1,112.66 |
Toc - Plan #78 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay + Dental) 110013 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$226.79 $257.40 $289.83 $405.04 $615.49 |
$400.28 $430.89 $463.32 $578.53 |
$573.77 $604.38 $636.81 $752.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$453.58 $514.80 $579.66 $810.08 $1,230.98 |
$627.07 $688.29 $753.15 $983.57 |
$800.56 $861.78 $926.64 $1,157.06 |
Toc - Plan #79 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare Bronze No Referral HMO 110015 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$217.71 $247.09 $278.22 $388.82 $590.84 |
$384.25 $413.63 $444.76 $555.36 |
$550.79 $580.17 $611.30 $721.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$435.42 $494.18 $556.44 $777.64 $1,181.68 |
$601.96 $660.72 $722.98 $944.18 |
$768.50 $827.26 $889.52 $1,110.72 |
Toc - Plan #80 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare Bronze No Referral HMO (+ Dental) 110017 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$226.42 $256.98 $289.35 $404.37 $614.48 |
$399.62 $430.18 $462.55 $577.57 |
$572.82 $603.38 $635.75 $750.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$452.84 $513.96 $578.70 $808.74 $1,228.96 |
$626.04 $687.16 $751.90 $981.94 |
$799.24 $860.36 $925.10 $1,155.14 |
Toc - Plan #81 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare Bronze No Referral HMO HDHP 110019 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$223.39 $253.53 $285.48 $398.95 $606.25 |
$394.27 $424.41 $456.36 $569.83 |
$565.15 $595.29 $627.24 $740.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$446.78 $507.06 $570.96 $797.90 $1,212.50 |
$617.66 $677.94 $741.84 $968.78 |
$788.54 $848.82 $912.72 $1,139.66 |
Toc - Plan #82 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare Bronze No Referral HMO HDHP (+ Dental) 110021 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$232.10 $263.42 $296.61 $414.51 $629.88 |
$409.65 $440.97 $474.16 $592.06 |
$587.20 $618.52 $651.71 $769.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$464.20 $526.84 $593.22 $829.02 $1,259.76 |
$641.75 $704.39 $770.77 $1,006.57 |
$819.30 $881.94 $948.32 $1,184.12 |
Toc - Plan #83 Alliant Health Plans | ||||||||||||||||||||
Catastrophic
(HMO) SoloCare Catastropic No Referral HMO 110023 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$162.81 $184.78 $208.06 $290.77 $441.85 |
$287.36 $309.33 $332.61 $415.32 |
$411.91 $433.88 $457.16 $539.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$325.62 $369.56 $416.12 $581.54 $883.70 |
$450.17 $494.11 $540.67 $706.09 |
$574.72 $618.66 $665.22 $830.64 |
Toc - Plan #84 Alliant Health Plans | ||||||||||||||||||||
Gold
(HMO) SoloCare HMO Gold Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.70 $319.72 $360.00 $503.10 $764.51 |
$497.19 $535.21 $575.49 $718.59 |
$712.68 $750.70 $790.98 $934.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$563.40 $639.44 $720.00 $1,006.20 $1,529.02 |
$778.89 $854.93 $935.49 $1,221.69 |
$994.38 $1,070.42 $1,150.98 $1,437.18 |
Toc - Plan #85 Alliant Health Plans | ||||||||||||||||||||
Silver
(HMO) SoloCare HMO Silver Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$265.79 $301.67 $339.67 $474.69 $721.34 |
$469.11 $504.99 $542.99 $678.01 |
$672.43 $708.31 $746.31 $881.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$531.58 $603.34 $679.34 $949.38 $1,442.68 |
$734.90 $806.66 $882.66 $1,152.70 |
$938.22 $1,009.98 $1,085.98 $1,356.02 |
Toc - Plan #86 Alliant Health Plans | ||||||||||||||||||||
Bronze
(HMO) SoloCare HMO Bronze Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$201.43 $228.61 $257.42 $359.74 $546.66 |
$355.52 $382.70 $411.51 $513.83 |
$509.61 $536.79 $565.60 $667.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$402.86 $457.22 $514.84 $719.48 $1,093.32 |
$556.95 $611.31 $668.93 $873.57 |
$711.04 $765.40 $823.02 $1,027.66 |
Toc - Plan #87 Alliant Health Plans | ||||||||||||||||||||
Expanded Bronze
(HMO) SoloCare HMO Expanded Bronze Standardized |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-811-4793
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$202.57 $229.91 $258.87 $361.77 $549.75 |
$357.53 $384.87 $413.83 $516.73 |
$512.49 $539.83 $568.79 $671.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$405.14 $459.82 $517.74 $723.54 $1,099.50 |
$560.10 $614.78 $672.70 $878.50 |
$715.06 $769.74 $827.66 $1,033.46 |
‡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 Ben Hill County here.
Ben Hill County is in “Rating Area 15” of Georgia.
Currently, there are 87 plans offered in Rating Area 15.