Obamacare 2023 Rates for Charlton County
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Obamacare > Rates > Georgia > Charlton County
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Blue Cross Blue Shield Healthcare Plan of Georgia, IncLocal: 1-855-738-6652 | Toll Free: 1-855-738-6652 |
Toc - Plan #1 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Catastrophic
(HMO) Anthem Catastrophic Pathway X HMO 9100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$212.65 $241.36 $271.77 $379.79 $577.13 |
$375.33 $404.04 $434.45 $542.47 |
$538.01 $566.72 $597.13 $705.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$425.30 $482.72 $543.54 $759.58 $1,154.26 |
$587.98 $645.40 $706.22 $922.26 |
$750.66 $808.08 $868.90 $1,084.94 |
Toc - Plan #2 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 0% for HSA |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$309.12 $350.85 $395.06 $552.09 $838.95 |
$545.60 $587.33 $631.54 $788.57 |
$782.08 $823.81 $868.02 $1,025.05 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$618.24 $701.70 $790.12 $1,104.18 $1,677.90 |
$854.72 $938.18 $1,026.60 $1,340.66 |
$1,091.20 $1,174.66 $1,263.08 $1,577.14 |
Toc - Plan #3 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 5600($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$299.40 $339.82 $382.63 $534.73 $812.57 |
$528.44 $568.86 $611.67 $763.77 |
$757.48 $797.90 $840.71 $992.81 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$598.80 $679.64 $765.26 $1,069.46 $1,625.14 |
$827.84 $908.68 $994.30 $1,298.50 |
$1,056.88 $1,137.72 $1,223.34 $1,527.54 |
Toc - Plan #4 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 6000($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$294.29 $334.02 $376.10 $525.60 $798.70 |
$519.42 $559.15 $601.23 $750.73 |
$744.55 $784.28 $826.36 $975.86 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$588.58 $668.04 $752.20 $1,051.20 $1,597.40 |
$813.71 $893.17 $977.33 $1,276.33 |
$1,038.84 $1,118.30 $1,202.46 $1,501.46 |
Toc - Plan #5 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 3000($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$369.39 $419.26 $472.08 $659.73 $1,002.52 |
$651.97 $701.84 $754.66 $942.31 |
$934.55 $984.42 $1,037.24 $1,224.89 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$738.78 $838.52 $944.16 $1,319.46 $2,005.04 |
$1,021.36 $1,121.10 $1,226.74 $1,602.04 |
$1,303.94 $1,403.68 $1,509.32 $1,884.62 |
Toc - Plan #6 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 5500($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$372.18 $422.42 $475.65 $664.71 $1,010.10 |
$656.90 $707.14 $760.37 $949.43 |
$941.62 $991.86 $1,045.09 $1,234.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$744.36 $844.84 $951.30 $1,329.42 $2,020.20 |
$1,029.08 $1,129.56 $1,236.02 $1,614.14 |
$1,313.80 $1,414.28 $1,520.74 $1,898.86 |
Toc - Plan #7 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Pathway X HMO 8000($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$282.64 $320.80 $361.21 $504.80 $767.08 |
$498.86 $537.02 $577.43 $721.02 |
$715.08 $753.24 $793.65 $937.24 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$565.28 $641.60 $722.42 $1,009.60 $1,534.16 |
$781.50 $857.82 $938.64 $1,225.82 |
$997.72 $1,074.04 $1,154.86 $1,442.04 |
Toc - Plan #8 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 4950($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$374.49 $425.05 $478.60 $668.84 $1,016.37 |
$660.97 $711.53 $765.08 $955.32 |
$947.45 $998.01 $1,051.56 $1,241.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$748.98 $850.10 $957.20 $1,337.68 $2,032.74 |
$1,035.46 $1,136.58 $1,243.68 $1,624.16 |
$1,321.94 $1,423.06 $1,530.16 $1,910.64 |
Toc - Plan #9 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 6500($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$367.80 $417.45 $470.05 $656.89 $998.21 |
$649.17 $698.82 $751.42 $938.26 |
$930.54 $980.19 $1,032.79 $1,219.63 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$735.60 $834.90 $940.10 $1,313.78 $1,996.42 |
$1,016.97 $1,116.27 $1,221.47 $1,595.15 |
$1,298.34 $1,397.64 $1,502.84 $1,876.52 |
Toc - Plan #10 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway X HMO 1600($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$411.01 $466.50 $525.27 $734.06 $1,115.48 |
$725.43 $780.92 $839.69 $1,048.48 |
$1,039.85 $1,095.34 $1,154.11 $1,362.90 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$822.02 $933.00 $1,050.54 $1,468.12 $2,230.96 |
$1,136.44 $1,247.42 $1,364.96 $1,782.54 |
$1,450.86 $1,561.84 $1,679.38 $2,096.96 |
Toc - Plan #11 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 5000($0 Virtual PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$312.08 $354.21 $398.84 $557.37 $846.99 |
$550.82 $592.95 $637.58 $796.11 |
$789.56 $831.69 $876.32 $1,034.85 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$624.16 $708.42 $797.68 $1,114.74 $1,693.98 |
$862.90 $947.16 $1,036.42 $1,353.48 |
$1,101.64 $1,185.90 $1,275.16 $1,592.22 |
Toc - Plan #12 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 2600($0 PCP+$0 Select Drugs) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$392.34 $445.31 $501.41 $700.72 $1,064.81 |
$692.48 $745.45 $801.55 $1,000.86 |
$992.62 $1,045.59 $1,101.69 $1,301.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$784.68 $890.62 $1,002.82 $1,401.44 $2,129.62 |
$1,084.82 $1,190.76 $1,302.96 $1,701.58 |
$1,384.96 $1,490.90 $1,603.10 $2,001.72 |
Toc - Plan #13 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Pathway X HMO 9100/0% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$291.09 $330.39 $372.01 $519.89 $790.02 |
$513.77 $553.07 $594.69 $742.57 |
$736.45 $775.75 $817.37 $965.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$582.18 $660.78 $744.02 $1,039.78 $1,580.04 |
$804.86 $883.46 $966.70 $1,262.46 |
$1,027.54 $1,106.14 $1,189.38 $1,485.14 |
Toc - Plan #14 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X HMO 7500/50% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$318.42 $361.41 $406.94 $568.70 $864.19 |
$562.01 $605.00 $650.53 $812.29 |
$805.60 $848.59 $894.12 $1,055.88 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$636.84 $722.82 $813.88 $1,137.40 $1,728.38 |
$880.43 $966.41 $1,057.47 $1,380.99 |
$1,124.02 $1,210.00 $1,301.06 $1,624.58 |
Toc - Plan #15 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway X HMO 5800/40% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$373.53 $423.96 $477.37 $667.12 $1,013.76 |
$659.28 $709.71 $763.12 $952.87 |
$945.03 $995.46 $1,048.87 $1,238.62 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$747.06 $847.92 $954.74 $1,334.24 $2,027.52 |
$1,032.81 $1,133.67 $1,240.49 $1,619.99 |
$1,318.56 $1,419.42 $1,526.24 $1,905.74 |
Toc - Plan #16 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway X HMO 2000/25% Standard |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
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 |
$422.37 $479.39 $539.79 $754.35 $1,146.31 |
$745.48 $802.50 $862.90 $1,077.46 |
$1,068.59 $1,125.61 $1,186.01 $1,400.57 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$844.74 $958.78 $1,079.58 $1,508.70 $2,292.62 |
$1,167.85 $1,281.89 $1,402.69 $1,831.81 |
$1,490.96 $1,605.00 $1,725.80 $2,154.92 |
ADVERTISEMENT
CareSourceLocal: 1-833-230-2099 | Toll Free: 1-833-230-2099 | TTY: 1-800-255-0056 |
Toc - Plan #17 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 |
$210.26 $238.64 $268.70 $375.51 $570.62 |
$371.10 $399.48 $429.54 $536.35 |
$531.94 $560.32 $590.38 $697.19 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$420.52 $477.28 $537.40 $751.02 $1,141.24 |
$581.36 $638.12 $698.24 $911.86 |
$742.20 $798.96 $859.08 $1,072.70 |
Toc - Plan #18 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 |
$286.24 $324.88 $365.81 $511.22 $776.85 |
$505.21 $543.85 $584.78 $730.19 |
$724.18 $762.82 $803.75 $949.16 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$572.48 $649.76 $731.62 $1,022.44 $1,553.70 |
$791.45 $868.73 $950.59 $1,241.41 |
$1,010.42 $1,087.70 $1,169.56 $1,460.38 |
Toc - Plan #19 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 |
$286.02 $324.62 $365.52 $510.82 $776.24 |
$504.82 $543.42 $584.32 $729.62 |
$723.62 $762.22 $803.12 $948.42 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$572.04 $649.24 $731.04 $1,021.64 $1,552.48 |
$790.84 $868.04 $949.84 $1,240.44 |
$1,009.64 $1,086.84 $1,168.64 $1,459.24 |
Toc - Plan #20 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 |
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21 30 40 50 60 |
$292.73 $332.24 $374.10 $522.81 $794.46 |
$516.67 $556.18 $598.04 $746.75 |
$740.61 $780.12 $821.98 $970.69 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$585.46 $664.48 $748.20 $1,045.62 $1,588.92 |
$809.40 $888.42 $972.14 $1,269.56 |
$1,033.34 $1,112.36 $1,196.08 $1,493.50 |
Toc - Plan #21 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 |
$231.82 $263.11 $296.26 $414.02 $629.14 |
$409.16 $440.45 $473.60 $591.36 |
$586.50 $617.79 $650.94 $768.70 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$463.64 $526.22 $592.52 $828.04 $1,258.28 |
$640.98 $703.56 $769.86 $1,005.38 |
$818.32 $880.90 $947.20 $1,182.72 |
Toc - Plan #22 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 |
$198.68 $225.49 $253.91 $354.83 $539.20 |
$350.67 $377.48 $405.90 $506.82 |
$502.66 $529.47 $557.89 $658.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$397.36 $450.98 $507.82 $709.66 $1,078.40 |
$549.35 $602.97 $659.81 $861.65 |
$701.34 $754.96 $811.80 $1,013.64 |
Toc - Plan #23 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Essential Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.87 $353.97 $398.57 $557.00 $846.42 |
$550.45 $592.55 $637.15 $795.58 |
$789.03 $831.13 $875.73 $1,034.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.74 $707.94 $797.14 $1,114.00 $1,692.84 |
$862.32 $946.52 $1,035.72 $1,352.58 |
$1,100.90 $1,185.10 $1,274.30 $1,591.16 |
Toc - Plan #24 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Federal Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.45 $331.93 $373.75 $522.31 $793.70 |
$516.17 $555.65 $597.47 $746.03 |
$739.89 $779.37 $821.19 $969.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$584.90 $663.86 $747.50 $1,044.62 $1,587.40 |
$808.62 $887.58 $971.22 $1,268.34 |
$1,032.34 $1,111.30 $1,194.94 $1,492.06 |
Toc - Plan #25 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]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.77 $331.16 $372.88 $521.10 $791.86 |
$514.97 $554.36 $596.08 $744.30 |
$738.17 $777.56 $819.28 $967.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$583.54 $662.32 $745.76 $1,042.20 $1,583.72 |
$806.74 $885.52 $968.96 $1,265.40 |
$1,029.94 $1,108.72 $1,192.16 $1,488.60 |
Toc - Plan #26 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$217.17 $246.49 $277.54 $387.86 $589.39 |
$383.30 $412.62 $443.67 $553.99 |
$549.43 $578.75 $609.80 $720.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$434.34 $492.98 $555.08 $775.72 $1,178.78 |
$600.47 $659.11 $721.21 $941.85 |
$766.60 $825.24 $887.34 $1,107.98 |
Toc - Plan #27 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.41 $333.01 $374.97 $524.02 $796.30 |
$517.86 $557.46 $599.42 $748.47 |
$742.31 $781.91 $823.87 $972.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586.82 $666.02 $749.94 $1,048.04 $1,592.60 |
$811.27 $890.47 $974.39 $1,272.49 |
$1,035.72 $1,114.92 $1,198.84 $1,496.94 |
Toc - Plan #28 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.84 $332.37 $374.25 $523.01 $794.76 |
$516.86 $556.39 $598.27 $747.03 |
$740.88 $780.41 $822.29 $971.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$585.68 $664.74 $748.50 $1,046.02 $1,589.52 |
$809.70 $888.76 $972.52 $1,270.04 |
$1,033.72 $1,112.78 $1,196.54 $1,494.06 |
Toc - Plan #29 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]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.55 $339.99 $382.83 $535.00 $812.98 |
$528.71 $569.15 $611.99 $764.16 |
$757.87 $798.31 $841.15 $993.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$599.10 $679.98 $765.66 $1,070.00 $1,625.96 |
$828.26 $909.14 $994.82 $1,299.16 |
$1,057.42 $1,138.30 $1,223.98 $1,528.32 |
Toc - Plan #30 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]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$205.03 $232.71 $262.03 $366.18 $556.45 |
$361.88 $389.56 $418.88 $523.03 |
$518.73 $546.41 $575.73 $679.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$410.06 $465.42 $524.06 $732.36 $1,112.90 |
$566.91 $622.27 $680.91 $889.21 |
$723.76 $779.12 $837.76 $1,046.06 |
Toc - Plan #31 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Essential Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.36 $361.34 $406.86 $568.59 $864.03 |
$561.91 $604.89 $650.41 $812.14 |
$805.46 $848.44 $893.96 $1,055.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.72 $722.68 $813.72 $1,137.18 $1,728.06 |
$880.27 $966.23 $1,057.27 $1,380.73 |
$1,123.82 $1,209.78 $1,300.82 $1,624.28 |
Toc - Plan #32 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Federal Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.27 $339.67 $382.47 $534.50 $812.22 |
$528.21 $568.61 $611.41 $763.44 |
$757.15 $797.55 $840.35 $992.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598.54 $679.34 $764.94 $1,069.00 $1,624.44 |
$827.48 $908.28 $993.88 $1,297.94 |
$1,056.42 $1,137.22 $1,222.82 $1,526.88 |
Toc - Plan #33 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]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.94 $339.29 $382.04 $533.90 $811.31 |
$527.63 $567.98 $610.73 $762.59 |
$756.32 $796.67 $839.42 $991.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$597.88 $678.58 $764.08 $1,067.80 $1,622.62 |
$826.57 $907.27 $992.77 $1,296.49 |
$1,055.26 $1,135.96 $1,221.46 $1,525.18 |
ADVERTISEMENT
Ambetter from Peach State Health PlanLocal: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231 |
Toc - Plan #34 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear 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 |
$254.92 $289.32 $325.77 $455.27 $691.82 |
$449.93 $484.33 $520.78 $650.28 |
$644.94 $679.34 $715.79 $845.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$509.84 $578.64 $651.54 $910.54 $1,383.64 |
$704.85 $773.65 $846.55 $1,105.55 |
$899.86 $968.66 $1,041.56 $1,300.56 |
Toc - Plan #35 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier 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 |
$306.13 $347.45 $391.23 $546.74 $830.82 |
$540.31 $581.63 $625.41 $780.92 |
$774.49 $815.81 $859.59 $1,015.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612.26 $694.90 $782.46 $1,093.48 $1,661.64 |
$846.44 $929.08 $1,016.64 $1,327.66 |
$1,080.62 $1,163.26 $1,250.82 $1,561.84 |
Toc - Plan #36 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]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$302.74 $343.59 $386.88 $540.67 $821.60 |
$534.33 $575.18 $618.47 $772.26 |
$765.92 $806.77 $850.06 $1,003.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$605.48 $687.18 $773.76 $1,081.34 $1,643.20 |
$837.07 $918.77 $1,005.35 $1,312.93 |
$1,068.66 $1,150.36 $1,236.94 $1,544.52 |
Toc - Plan #37 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete 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 |
$320.31 $363.54 $409.34 $572.05 $869.29 |
$565.34 $608.57 $654.37 $817.08 |
$810.37 $853.60 $899.40 $1,062.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640.62 $727.08 $818.68 $1,144.10 $1,738.58 |
$885.65 $972.11 $1,063.71 $1,389.13 |
$1,130.68 $1,217.14 $1,308.74 $1,634.16 |
Toc - Plan #38 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Everyday 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 |
$299.58 $340.02 $382.85 $535.04 $813.04 |
$528.75 $569.19 $612.02 $764.21 |
$757.92 $798.36 $841.19 $993.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$599.16 $680.04 $765.70 $1,070.08 $1,626.08 |
$828.33 $909.21 $994.87 $1,299.25 |
$1,057.50 $1,138.38 $1,224.04 $1,528.42 |
Toc - Plan #39 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA |
||||||||||||||||||||
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 |
$280.11 $317.92 $357.97 $500.26 $760.20 |
$494.39 $532.20 $572.25 $714.54 |
$708.67 $746.48 $786.53 $928.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$560.22 $635.84 $715.94 $1,000.52 $1,520.40 |
$774.50 $850.12 $930.22 $1,214.80 |
$988.78 $1,064.40 $1,144.50 $1,429.08 |
Toc - Plan #40 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 |
$274.27 $311.28 $350.50 $489.82 $744.33 |
$484.08 $521.09 $560.31 $699.63 |
$693.89 $730.90 $770.12 $909.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$548.54 $622.56 $701.00 $979.64 $1,488.66 |
$758.35 $832.37 $910.81 $1,189.45 |
$968.16 $1,042.18 $1,120.62 $1,399.26 |
Toc - Plan #41 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 |
$310.33 $352.21 $396.59 $554.23 $842.20 |
$547.72 $589.60 $633.98 $791.62 |
$785.11 $826.99 $871.37 $1,029.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620.66 $704.42 $793.18 $1,108.46 $1,684.40 |
$858.05 $941.81 $1,030.57 $1,345.85 |
$1,095.44 $1,179.20 $1,267.96 $1,583.24 |
Toc - Plan #42 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 |
$295.11 $334.94 $377.14 $527.05 $800.91 |
$520.86 $560.69 $602.89 $752.80 |
$746.61 $786.44 $828.64 $978.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$590.22 $669.88 $754.28 $1,054.10 $1,601.82 |
$815.97 $895.63 $980.03 $1,279.85 |
$1,041.72 $1,121.38 $1,205.78 $1,505.60 |
Toc - Plan #43 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 |
$298.45 $338.73 $381.41 $533.01 $809.97 |
$526.76 $567.04 $609.72 $761.32 |
$755.07 $795.35 $838.03 $989.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$596.90 $677.46 $762.82 $1,066.02 $1,619.94 |
$825.21 $905.77 $991.13 $1,294.33 |
$1,053.52 $1,134.08 $1,219.44 $1,522.64 |
Toc - Plan #44 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 |
$306.16 $347.49 $391.27 $546.79 $830.90 |
$540.37 $581.70 $625.48 $781.00 |
$774.58 $815.91 $859.69 $1,015.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612.32 $694.98 $782.54 $1,093.58 $1,661.80 |
$846.53 $929.19 $1,016.75 $1,327.79 |
$1,080.74 $1,163.40 $1,250.96 $1,562.00 |
Toc - Plan #45 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 |
$302.61 $343.45 $386.73 $540.45 $821.27 |
$534.10 $574.94 $618.22 $771.94 |
$765.59 $806.43 $849.71 $1,003.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$605.22 $686.90 $773.46 $1,080.90 $1,642.54 |
$836.71 $918.39 $1,004.95 $1,312.39 |
$1,068.20 $1,149.88 $1,236.44 $1,543.88 |
Toc - Plan #46 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 |
$353.37 $401.06 $451.59 $631.10 $959.02 |
$623.69 $671.38 $721.91 $901.42 |
$894.01 $941.70 $992.23 $1,171.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.74 $802.12 $903.18 $1,262.20 $1,918.04 |
$977.06 $1,072.44 $1,173.50 $1,532.52 |
$1,247.38 $1,342.76 $1,443.82 $1,802.84 |
Toc - Plan #47 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 |
$242.67 $275.42 $310.12 $433.40 $658.59 |
$428.31 $461.06 $495.76 $619.04 |
$613.95 $646.70 $681.40 $804.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$485.34 $550.84 $620.24 $866.80 $1,317.18 |
$670.98 $736.48 $805.88 $1,052.44 |
$856.62 $922.12 $991.52 $1,238.08 |
Toc - Plan #48 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 |
$268.51 $304.75 $343.14 $479.54 $728.71 |
$473.91 $510.15 $548.54 $684.94 |
$679.31 $715.55 $753.94 $890.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$537.02 $609.50 $686.28 $959.08 $1,457.42 |
$742.42 $814.90 $891.68 $1,164.48 |
$947.82 $1,020.30 $1,097.08 $1,369.88 |
Toc - Plan #49 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 |
$295.76 $335.67 $377.96 $528.20 $802.66 |
$522.01 $561.92 $604.21 $754.45 |
$748.26 $788.17 $830.46 $980.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$591.52 $671.34 $755.92 $1,056.40 $1,605.32 |
$817.77 $897.59 $982.17 $1,282.65 |
$1,044.02 $1,123.84 $1,208.42 $1,508.90 |
Toc - Plan #50 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 |
$303.29 $344.22 $387.59 $541.65 $823.09 |
$535.30 $576.23 $619.60 $773.66 |
$767.31 $808.24 $851.61 $1,005.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$606.58 $688.44 $775.18 $1,083.30 $1,646.18 |
$838.59 $920.45 $1,007.19 $1,315.31 |
$1,070.60 $1,152.46 $1,239.20 $1,547.32 |
Toc - Plan #51 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 |
$311.45 $353.48 $398.02 $556.23 $845.24 |
$549.70 $591.73 $636.27 $794.48 |
$787.95 $829.98 $874.52 $1,032.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.90 $706.96 $796.04 $1,112.46 $1,690.48 |
$861.15 $945.21 $1,034.29 $1,350.71 |
$1,099.40 $1,183.46 $1,272.54 $1,588.96 |
Toc - Plan #52 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 |
$318.26 $361.21 $406.72 $568.39 $863.73 |
$561.72 $604.67 $650.18 $811.85 |
$805.18 $848.13 $893.64 $1,055.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.52 $722.42 $813.44 $1,136.78 $1,727.46 |
$879.98 $965.88 $1,056.90 $1,380.24 |
$1,123.44 $1,209.34 $1,300.36 $1,623.70 |
Toc - Plan #53 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 |
$314.73 $357.20 $402.21 $562.08 $854.14 |
$555.49 $597.96 $642.97 $802.84 |
$796.25 $838.72 $883.73 $1,043.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$629.46 $714.40 $804.42 $1,124.16 $1,708.28 |
$870.22 $955.16 $1,045.18 $1,364.92 |
$1,110.98 $1,195.92 $1,285.94 $1,605.68 |
Toc - Plan #54 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 |
$265.02 $300.78 $338.68 $473.30 $719.23 |
$467.75 $503.51 $541.41 $676.03 |
$670.48 $706.24 $744.14 $878.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$530.04 $601.56 $677.36 $946.60 $1,438.46 |
$732.77 $804.29 $880.09 $1,149.33 |
$935.50 $1,007.02 $1,082.82 $1,352.06 |
Toc - Plan #55 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 |
$332.99 $377.94 $425.55 $594.71 $903.72 |
$587.72 $632.67 $680.28 $849.44 |
$842.45 $887.40 $935.01 $1,104.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$665.98 $755.88 $851.10 $1,189.42 $1,807.44 |
$920.71 $1,010.61 $1,105.83 $1,444.15 |
$1,175.44 $1,265.34 $1,360.56 $1,698.88 |
Toc - Plan #56 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 |
$291.21 $330.51 $372.15 $520.08 $790.31 |
$513.98 $553.28 $594.92 $742.85 |
$736.75 $776.05 $817.69 $965.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$582.42 $661.02 $744.30 $1,040.16 $1,580.62 |
$805.19 $883.79 $967.07 $1,262.93 |
$1,027.96 $1,106.56 $1,189.84 $1,485.70 |
Toc - Plan #57 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 |
$285.13 $323.61 $364.38 $509.22 $773.81 |
$503.25 $541.73 $582.50 $727.34 |
$721.37 $759.85 $800.62 $945.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$570.26 $647.22 $728.76 $1,018.44 $1,547.62 |
$788.38 $865.34 $946.88 $1,236.56 |
$1,006.50 $1,083.46 $1,165.00 $1,454.68 |
Toc - Plan #58 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 |
$322.62 $366.16 $412.29 $576.18 $875.56 |
$569.42 $612.96 $659.09 $822.98 |
$816.22 $859.76 $905.89 $1,069.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$645.24 $732.32 $824.58 $1,152.36 $1,751.12 |
$892.04 $979.12 $1,071.38 $1,399.16 |
$1,138.84 $1,225.92 $1,318.18 $1,645.96 |
Toc - Plan #59 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 |
$310.27 $352.15 $396.51 $554.13 $842.05 |
$547.62 $589.50 $633.86 $791.48 |
$784.97 $826.85 $871.21 $1,028.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620.54 $704.30 $793.02 $1,108.26 $1,684.10 |
$857.89 $941.65 $1,030.37 $1,345.61 |
$1,095.24 $1,179.00 $1,267.72 $1,582.96 |
Toc - Plan #60 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 |
$318.29 $361.25 $406.76 $568.45 $863.81 |
$561.77 $604.73 $650.24 $811.93 |
$805.25 $848.21 $893.72 $1,055.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.58 $722.50 $813.52 $1,136.90 $1,727.62 |
$880.06 $965.98 $1,057.00 $1,380.38 |
$1,123.54 $1,209.46 $1,300.48 $1,623.86 |
Toc - Plan #61 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 |
$306.80 $348.21 $392.08 $547.93 $832.63 |
$541.50 $582.91 $626.78 $782.63 |
$776.20 $817.61 $861.48 $1,017.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$613.60 $696.42 $784.16 $1,095.86 $1,665.26 |
$848.30 $931.12 $1,018.86 $1,330.56 |
$1,083.00 $1,165.82 $1,253.56 $1,565.26 |
Toc - Plan #62 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 |
$314.60 $357.06 $402.05 $561.86 $853.80 |
$555.26 $597.72 $642.71 $802.52 |
$795.92 $838.38 $883.37 $1,043.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$629.20 $714.12 $804.10 $1,123.72 $1,707.60 |
$869.86 $954.78 $1,044.76 $1,364.38 |
$1,110.52 $1,195.44 $1,285.42 $1,605.04 |
Toc - Plan #63 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 |
$367.36 $416.95 $469.48 $656.10 $997.00 |
$648.39 $697.98 $750.51 $937.13 |
$929.42 $979.01 $1,031.54 $1,218.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.72 $833.90 $938.96 $1,312.20 $1,994.00 |
$1,015.75 $1,114.93 $1,219.99 $1,593.23 |
$1,296.78 $1,395.96 $1,501.02 $1,874.26 |
Toc - Plan #64 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 |
$266.89 $302.91 $341.07 $476.65 $724.31 |
$471.05 $507.07 $545.23 $680.81 |
$675.21 $711.23 $749.39 $884.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$533.78 $605.82 $682.14 $953.30 $1,448.62 |
$737.94 $809.98 $886.30 $1,157.46 |
$942.10 $1,014.14 $1,090.46 $1,361.62 |
Toc - Plan #65 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 |
$292.02 $331.43 $373.19 $521.53 $792.52 |
$515.41 $554.82 $596.58 $744.92 |
$738.80 $778.21 $819.97 $968.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$584.04 $662.86 $746.38 $1,043.06 $1,585.04 |
$807.43 $886.25 $969.77 $1,266.45 |
$1,030.82 $1,109.64 $1,193.16 $1,489.84 |
Toc - Plan #66 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 |
$311.15 $353.15 $397.64 $555.70 $844.45 |
$549.18 $591.18 $635.67 $793.73 |
$787.21 $829.21 $873.70 $1,031.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.30 $706.30 $795.28 $1,111.40 $1,688.90 |
$860.33 $944.33 $1,033.31 $1,349.43 |
$1,098.36 $1,182.36 $1,271.34 $1,587.46 |
‡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 Charlton County here.
Charlton County is in “Rating Area 6” of Georgia.
Currently, there are 66 plans offered in Rating Area 6.