Obamacare 2023 Rates for Spalding County
Obamacare > Rates > Georgia > Spalding County
ADVERTISEMENT
Obamacare > Rates > Georgia > Spalding County
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
Cigna HealthCare of Georgia, IncLocal: | Toll Free: |
Toc - Plan #1 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Bronze
(HMO) Cigna Connect 9100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$275.95 $313.20 $352.66 $492.84 $748.92 |
$487.05 $524.30 $563.76 $703.94 |
$698.15 $735.40 $774.86 $915.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$551.90 $626.40 $705.32 $985.68 $1,497.84 |
$763.00 $837.50 $916.42 $1,196.78 |
$974.10 $1,048.60 $1,127.52 $1,407.88 |
Toc - Plan #2 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 7800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$285.68 $324.25 $365.10 $510.23 $775.35 |
$504.23 $542.80 $583.65 $728.78 |
$722.78 $761.35 $802.20 $947.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$571.36 $648.50 $730.20 $1,020.46 $1,550.70 |
$789.91 $867.05 $948.75 $1,239.01 |
$1,008.46 $1,085.60 $1,167.30 $1,457.56 |
Toc - Plan #3 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 6500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$286.65 $325.35 $366.34 $511.96 $777.97 |
$505.94 $544.64 $585.63 $731.25 |
$725.23 $763.93 $804.92 $950.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$573.30 $650.70 $732.68 $1,023.92 $1,555.94 |
$792.59 $869.99 $951.97 $1,243.21 |
$1,011.88 $1,089.28 $1,171.26 $1,462.50 |
Toc - Plan #4 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect HSA 7050 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.74 $328.86 $370.29 $517.48 $786.36 |
$511.39 $550.51 $591.94 $739.13 |
$733.04 $772.16 $813.59 $960.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$579.48 $657.72 $740.58 $1,034.96 $1,572.72 |
$801.13 $879.37 $962.23 $1,256.61 |
$1,022.78 $1,101.02 $1,183.88 $1,478.26 |
Toc - Plan #5 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 6800 Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.47 $328.55 $369.94 $516.99 $785.62 |
$510.92 $550.00 $591.39 $738.44 |
$732.37 $771.45 $812.84 $959.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578.94 $657.10 $739.88 $1,033.98 $1,571.24 |
$800.39 $878.55 $961.33 $1,255.43 |
$1,021.84 $1,100.00 $1,182.78 $1,476.88 |
Toc - Plan #6 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 3700 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.53 $379.69 $427.53 $597.47 $907.91 |
$590.44 $635.60 $683.44 $853.38 |
$846.35 $891.51 $939.35 $1,109.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$669.06 $759.38 $855.06 $1,194.94 $1,815.82 |
$924.97 $1,015.29 $1,110.97 $1,450.85 |
$1,180.88 $1,271.20 $1,366.88 $1,706.76 |
Toc - Plan #7 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 5000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.57 $379.73 $427.58 $597.54 $908.01 |
$590.51 $635.67 $683.52 $853.48 |
$846.45 $891.61 $939.46 $1,109.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$669.14 $759.46 $855.16 $1,195.08 $1,816.02 |
$925.08 $1,015.40 $1,111.10 $1,451.02 |
$1,181.02 $1,271.34 $1,367.04 $1,706.96 |
Toc - Plan #8 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 6000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.07 $380.30 $428.22 $598.43 $909.38 |
$591.40 $636.63 $684.55 $854.76 |
$847.73 $892.96 $940.88 $1,111.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670.14 $760.60 $856.44 $1,196.86 $1,818.76 |
$926.47 $1,016.93 $1,112.77 $1,453.19 |
$1,182.80 $1,273.26 $1,369.10 $1,709.52 |
Toc - Plan #9 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 7200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$339.44 $385.26 $433.80 $606.23 $921.23 |
$599.11 $644.93 $693.47 $865.90 |
$858.78 $904.60 $953.14 $1,125.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$678.88 $770.52 $867.60 $1,212.46 $1,842.46 |
$938.55 $1,030.19 $1,127.27 $1,472.13 |
$1,198.22 $1,289.86 $1,386.94 $1,731.80 |
Toc - Plan #10 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 3800 Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.81 $383.42 $431.72 $603.33 $916.82 |
$596.24 $641.85 $690.15 $861.76 |
$854.67 $900.28 $948.58 $1,120.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$675.62 $766.84 $863.44 $1,206.66 $1,833.64 |
$934.05 $1,025.27 $1,121.87 $1,465.09 |
$1,192.48 $1,283.70 $1,380.30 $1,723.52 |
Toc - Plan #11 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Connect 4200 Enhanced Asthma COPD Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.23 $381.62 $429.70 $600.50 $912.52 |
$593.44 $638.83 $686.91 $857.71 |
$850.65 $896.04 $944.12 $1,114.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.46 $763.24 $859.40 $1,201.00 $1,825.04 |
$929.67 $1,020.45 $1,116.61 $1,458.21 |
$1,186.88 $1,277.66 $1,373.82 $1,715.42 |
Toc - Plan #12 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Cigna Connect 1600 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.75 $480.96 $541.56 $756.82 $1,150.07 |
$747.92 $805.13 $865.73 $1,080.99 |
$1,072.09 $1,129.30 $1,189.90 $1,405.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.50 $961.92 $1,083.12 $1,513.64 $2,300.14 |
$1,171.67 $1,286.09 $1,407.29 $1,837.81 |
$1,495.84 $1,610.26 $1,731.46 $2,161.98 |
Toc - Plan #13 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Cigna Connect 1900 Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.46 $484.03 $545.01 $761.65 $1,157.41 |
$752.70 $810.27 $871.25 $1,087.89 |
$1,078.94 $1,136.51 $1,197.49 $1,414.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$852.92 $968.06 $1,090.02 $1,523.30 $2,314.82 |
$1,179.16 $1,294.30 $1,416.26 $1,849.54 |
$1,505.40 $1,620.54 $1,742.50 $2,175.78 |
Toc - Plan #14 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 7600 Enhanced Asthma COPD Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$290.20 $329.38 $370.88 $518.31 $787.62 |
$512.21 $551.39 $592.89 $740.32 |
$734.22 $773.40 $814.90 $962.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$580.40 $658.76 $741.76 $1,036.62 $1,575.24 |
$802.41 $880.77 $963.77 $1,258.63 |
$1,024.42 $1,102.78 $1,185.78 $1,480.64 |
Toc - Plan #15 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Bronze
(HMO) Cigna Simple Choice 9100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$275.95 $313.20 $352.66 $492.84 $748.92 |
$487.05 $524.30 $563.76 $703.94 |
$698.15 $735.40 $774.86 $915.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$551.90 $626.40 $705.32 $985.68 $1,497.84 |
$763.00 $837.50 $916.42 $1,196.78 |
$974.10 $1,048.60 $1,127.52 $1,407.88 |
Toc - Plan #16 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Simple Choice 7500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$287.54 $326.36 $367.47 $513.54 $780.38 |
$507.51 $546.33 $587.44 $733.51 |
$727.48 $766.30 $807.41 $953.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$575.08 $652.72 $734.94 $1,027.08 $1,560.76 |
$795.05 $872.69 $954.91 $1,247.05 |
$1,015.02 $1,092.66 $1,174.88 $1,467.02 |
Toc - Plan #17 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Cigna Connect 0 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.95 $350.65 $394.83 $551.78 $838.48 |
$545.29 $586.99 $631.17 $788.12 |
$781.63 $823.33 $867.51 $1,024.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$617.90 $701.30 $789.66 $1,103.56 $1,676.96 |
$854.24 $937.64 $1,026.00 $1,339.90 |
$1,090.58 $1,173.98 $1,262.34 $1,576.24 |
Toc - Plan #18 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Cigna Simple Choice 2000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.78 $478.72 $539.04 $753.30 $1,144.72 |
$744.44 $801.38 $861.70 $1,075.96 |
$1,067.10 $1,124.04 $1,184.36 $1,398.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$843.56 $957.44 $1,078.08 $1,506.60 $2,289.44 |
$1,166.22 $1,280.10 $1,400.74 $1,829.26 |
$1,488.88 $1,602.76 $1,723.40 $2,151.92 |
Toc - Plan #19 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Cigna Simple Choice 5800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.07 $380.30 $428.22 $598.43 $909.38 |
$591.40 $636.63 $684.55 $854.76 |
$847.73 $892.96 $940.88 $1,111.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670.14 $760.60 $856.44 $1,196.86 $1,818.76 |
$926.47 $1,016.93 $1,112.77 $1,453.19 |
$1,182.80 $1,273.26 $1,369.10 $1,709.52 |
ADVERTISEMENT
Oscar Health Plan of GeorgiaLocal: 1-855-672-2755 | Toll Free: |
Toc - Plan #20 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278.71 $316.32 $356.18 $497.76 $756.39 |
$491.92 $529.53 $569.39 $710.97 |
$705.13 $742.74 $782.60 $924.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$557.42 $632.64 $712.36 $995.52 $1,512.78 |
$770.63 $845.85 $925.57 $1,208.73 |
$983.84 $1,059.06 $1,138.78 $1,421.94 |
Toc - Plan #21 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.45 $310.35 $349.46 $488.36 $742.12 |
$482.63 $519.53 $558.64 $697.54 |
$691.81 $728.71 $767.82 $906.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$546.90 $620.70 $698.92 $976.72 $1,484.24 |
$756.08 $829.88 $908.10 $1,185.90 |
$965.26 $1,039.06 $1,117.28 $1,395.08 |
Toc - Plan #22 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Elite- $0 Ded+PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.55 $370.62 $417.31 $583.20 $886.22 |
$576.35 $620.42 $667.11 $833.00 |
$826.15 $870.22 $916.91 $1,082.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$653.10 $741.24 $834.62 $1,166.40 $1,772.44 |
$902.90 $991.04 $1,084.42 $1,416.20 |
$1,152.70 $1,240.84 $1,334.22 $1,666.00 |
Toc - Plan #23 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$352.36 $399.91 $450.30 $629.29 $956.27 |
$621.91 $669.46 $719.85 $898.84 |
$891.46 $939.01 $989.40 $1,168.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$704.72 $799.82 $900.60 $1,258.58 $1,912.54 |
$974.27 $1,069.37 $1,170.15 $1,528.13 |
$1,243.82 $1,338.92 $1,439.70 $1,797.68 |
Toc - Plan #24 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple- Specialist Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.08 $395.06 $444.83 $621.65 $944.66 |
$614.35 $661.33 $711.10 $887.92 |
$880.62 $927.60 $977.37 $1,154.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.16 $790.12 $889.66 $1,243.30 $1,889.32 |
$962.43 $1,056.39 $1,155.93 $1,509.57 |
$1,228.70 $1,322.66 $1,422.20 $1,775.84 |
Toc - Plan #25 Oscar Health Plan of Georgia | ||||||||||||||||||||
Catastrophic
(HMO) Secure |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$236.62 $268.55 $302.39 $422.59 $642.16 |
$417.63 $449.56 $483.40 $603.60 |
$598.64 $630.57 $664.41 $784.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$473.24 $537.10 $604.78 $845.18 $1,284.32 |
$654.25 $718.11 $785.79 $1,026.19 |
$835.26 $899.12 $966.80 $1,207.20 |
Toc - Plan #26 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Elite- $0 Ded+Specialist Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.30 $370.34 $417.00 $582.75 $885.55 |
$575.91 $619.95 $666.61 $832.36 |
$825.52 $869.56 $916.22 $1,081.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.60 $740.68 $834.00 $1,165.50 $1,771.10 |
$902.21 $990.29 $1,083.61 $1,415.11 |
$1,151.82 $1,239.90 $1,333.22 $1,664.72 |
Toc - Plan #27 Oscar Health Plan of Georgia | ||||||||||||||||||||
Gold
(HMO) Gold Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.93 $422.13 $475.31 $664.25 $1,009.38 |
$656.45 $706.65 $759.83 $948.77 |
$940.97 $991.17 $1,044.35 $1,233.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$743.86 $844.26 $950.62 $1,328.50 $2,018.76 |
$1,028.38 $1,128.78 $1,235.14 $1,613.02 |
$1,312.90 $1,413.30 $1,519.66 $1,897.54 |
Toc - Plan #28 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289.49 $328.56 $369.95 $517.01 $785.64 |
$510.94 $550.01 $591.40 $738.46 |
$732.39 $771.46 $812.85 $959.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578.98 $657.12 $739.90 $1,034.02 $1,571.28 |
$800.43 $878.57 $961.35 $1,255.47 |
$1,021.88 $1,100.02 $1,182.80 $1,476.92 |
Toc - Plan #29 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.26 $395.26 $445.06 $621.97 $945.14 |
$614.67 $661.67 $711.47 $888.38 |
$881.08 $928.08 $977.88 $1,154.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.52 $790.52 $890.12 $1,243.94 $1,890.28 |
$962.93 $1,056.93 $1,156.53 $1,510.35 |
$1,229.34 $1,323.34 $1,422.94 $1,776.76 |
Toc - Plan #30 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Classic- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.97 $414.23 $466.42 $651.83 $990.51 |
$644.17 $693.43 $745.62 $931.03 |
$923.37 $972.63 $1,024.82 $1,210.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.94 $828.46 $932.84 $1,303.66 $1,981.02 |
$1,009.14 $1,107.66 $1,212.04 $1,582.86 |
$1,288.34 $1,386.86 $1,491.24 $1,862.06 |
Toc - Plan #31 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- $0 PCP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.15 $327.04 $368.24 $514.62 $782.01 |
$508.58 $547.47 $588.67 $735.05 |
$729.01 $767.90 $809.10 $955.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$576.30 $654.08 $736.48 $1,029.24 $1,564.02 |
$796.73 $874.51 $956.91 $1,249.67 |
$1,017.16 $1,094.94 $1,177.34 $1,470.10 |
Toc - Plan #32 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- $3000 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.15 $361.09 $406.58 $568.20 $863.43 |
$561.53 $604.47 $649.96 $811.58 |
$804.91 $847.85 $893.34 $1,054.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.30 $722.18 $813.16 $1,136.40 $1,726.86 |
$879.68 $965.56 $1,056.54 $1,379.78 |
$1,123.06 $1,208.94 $1,299.92 $1,623.16 |
Toc - Plan #33 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- $4700 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.13 $332.69 $374.61 $523.52 $795.53 |
$517.37 $556.93 $598.85 $747.76 |
$741.61 $781.17 $823.09 $972.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$586.26 $665.38 $749.22 $1,047.04 $1,591.06 |
$810.50 $889.62 $973.46 $1,271.28 |
$1,034.74 $1,113.86 $1,197.70 $1,495.52 |
Toc - Plan #34 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple- PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.07 $387.11 $435.88 $609.14 $925.64 |
$601.98 $648.02 $696.79 $870.05 |
$862.89 $908.93 $957.70 $1,130.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.14 $774.22 $871.76 $1,218.28 $1,851.28 |
$943.05 $1,035.13 $1,132.67 $1,479.19 |
$1,203.96 $1,296.04 $1,393.58 $1,740.10 |
Toc - Plan #35 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Elite- $0 PCP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.54 $409.20 $460.76 $643.90 $978.47 |
$636.34 $685.00 $736.56 $919.70 |
$912.14 $960.80 $1,012.36 $1,195.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$721.08 $818.40 $921.52 $1,287.80 $1,956.94 |
$996.88 $1,094.20 $1,197.32 $1,563.60 |
$1,272.68 $1,370.00 $1,473.12 $1,839.40 |
Toc - Plan #36 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple- HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.90 $401.66 $452.27 $632.04 $960.45 |
$624.62 $672.38 $722.99 $902.76 |
$895.34 $943.10 $993.71 $1,173.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.80 $803.32 $904.54 $1,264.08 $1,920.90 |
$978.52 $1,074.04 $1,175.26 $1,534.80 |
$1,249.24 $1,344.76 $1,445.98 $1,805.52 |
Toc - Plan #37 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.03 $402.94 $453.71 $634.06 $963.51 |
$626.62 $674.53 $725.30 $905.65 |
$898.21 $946.12 $996.89 $1,177.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.06 $805.88 $907.42 $1,268.12 $1,927.02 |
$981.65 $1,077.47 $1,179.01 $1,539.71 |
$1,253.24 $1,349.06 $1,450.60 $1,811.30 |
Toc - Plan #38 Oscar Health Plan of Georgia | ||||||||||||||||||||
Gold
(HMO) Gold Elite- $0 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$404.89 $459.54 $517.44 $723.12 $1,098.86 |
$714.63 $769.28 $827.18 $1,032.86 |
$1,024.37 $1,079.02 $1,136.92 $1,342.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$809.78 $919.08 $1,034.88 $1,446.24 $2,197.72 |
$1,119.52 $1,228.82 $1,344.62 $1,755.98 |
$1,429.26 $1,538.56 $1,654.36 $2,065.72 |
Toc - Plan #39 Oscar Health Plan of Georgia | ||||||||||||||||||||
Gold
(HMO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.01 $434.70 $489.47 $684.03 $1,039.45 |
$676.00 $727.69 $782.46 $977.02 |
$968.99 $1,020.68 $1,075.45 $1,270.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766.02 $869.40 $978.94 $1,368.06 $2,078.90 |
$1,059.01 $1,162.39 $1,271.93 $1,661.05 |
$1,352.00 $1,455.38 $1,564.92 $1,954.04 |
Toc - Plan #40 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Elite- $1000 Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.63 $367.31 $413.59 $577.99 $878.31 |
$571.20 $614.88 $661.16 $825.56 |
$818.77 $862.45 $908.73 $1,073.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$647.26 $734.62 $827.18 $1,155.98 $1,756.62 |
$894.83 $982.19 $1,074.75 $1,403.55 |
$1,142.40 $1,229.76 $1,322.32 $1,651.12 |
Toc - Plan #41 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple- For Diabetes |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.09 $396.20 $446.12 $623.45 $947.40 |
$616.14 $663.25 $713.17 $890.50 |
$883.19 $930.30 $980.22 $1,157.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.18 $792.40 $892.24 $1,246.90 $1,894.80 |
$965.23 $1,059.45 $1,159.29 $1,513.95 |
$1,232.28 $1,326.50 $1,426.34 $1,781.00 |
Toc - Plan #42 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$287.08 $325.82 $366.88 $512.71 $779.11 |
$506.69 $545.43 $586.49 $732.32 |
$726.30 $765.04 $806.10 $951.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$574.16 $651.64 $733.76 $1,025.42 $1,558.22 |
$793.77 $871.25 $953.37 $1,245.03 |
$1,013.38 $1,090.86 $1,172.98 $1,464.64 |
Toc - Plan #43 Oscar Health Plan of Georgia | ||||||||||||||||||||
Bronze
(HMO) Bronze Simple- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$261.55 $296.85 $334.25 $467.11 $709.82 |
$461.63 $496.93 $534.33 $667.19 |
$661.71 $697.01 $734.41 $867.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$523.10 $593.70 $668.50 $934.22 $1,419.64 |
$723.18 $793.78 $868.58 $1,134.30 |
$923.26 $993.86 $1,068.66 $1,334.38 |
Toc - Plan #44 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$343.69 $390.08 $439.23 $613.82 $932.76 |
$606.61 $653.00 $702.15 $876.74 |
$869.53 $915.92 $965.07 $1,139.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$687.38 $780.16 $878.46 $1,227.64 $1,865.52 |
$950.30 $1,043.08 $1,141.38 $1,490.56 |
$1,213.22 $1,306.00 $1,404.30 $1,753.48 |
Toc - Plan #45 Oscar Health Plan of Georgia | ||||||||||||||||||||
Gold
(HMO) Gold Classic- Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.26 $400.94 $451.46 $630.91 $958.73 |
$623.50 $671.18 $721.70 $901.15 |
$893.74 $941.42 $991.94 $1,171.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.52 $801.88 $902.92 $1,261.82 $1,917.46 |
$976.76 $1,072.12 $1,173.16 $1,532.06 |
$1,247.00 $1,342.36 $1,443.40 $1,802.30 |
ADVERTISEMENT
CareSourceLocal: 1-833-230-2099 | Toll Free: 1-833-230-2099 | TTY: 1-800-255-0056 |
Toc - Plan #46 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 |
$312.08 $354.20 $398.83 $557.36 $846.97 |
$550.82 $592.94 $637.57 $796.10 |
$789.56 $831.68 $876.31 $1,034.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$624.16 $708.40 $797.66 $1,114.72 $1,693.94 |
$862.90 $947.14 $1,036.40 $1,353.46 |
$1,101.64 $1,185.88 $1,275.14 $1,592.20 |
Toc - Plan #47 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 |
$424.86 $482.21 $542.97 $758.80 $1,153.06 |
$749.88 $807.23 $867.99 $1,083.82 |
$1,074.90 $1,132.25 $1,193.01 $1,408.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$849.72 $964.42 $1,085.94 $1,517.60 $2,306.12 |
$1,174.74 $1,289.44 $1,410.96 $1,842.62 |
$1,499.76 $1,614.46 $1,735.98 $2,167.64 |
Toc - Plan #48 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 |
$424.53 $481.84 $542.54 $758.20 $1,152.16 |
$749.29 $806.60 $867.30 $1,082.96 |
$1,074.05 $1,131.36 $1,192.06 $1,407.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$849.06 $963.68 $1,085.08 $1,516.40 $2,304.32 |
$1,173.82 $1,288.44 $1,409.84 $1,841.16 |
$1,498.58 $1,613.20 $1,734.60 $2,165.92 |
Toc - Plan #49 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 |
$434.49 $493.15 $555.28 $776.00 $1,179.20 |
$766.87 $825.53 $887.66 $1,108.38 |
$1,099.25 $1,157.91 $1,220.04 $1,440.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$868.98 $986.30 $1,110.56 $1,552.00 $2,358.40 |
$1,201.36 $1,318.68 $1,442.94 $1,884.38 |
$1,533.74 $1,651.06 $1,775.32 $2,216.76 |
Toc - Plan #50 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace HSA Eligible 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 |
$344.08 $390.53 $439.73 $614.52 $933.82 |
$607.30 $653.75 $702.95 $877.74 |
$870.52 $916.97 $966.17 $1,140.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.16 $781.06 $879.46 $1,229.04 $1,867.64 |
$951.38 $1,044.28 $1,142.68 $1,492.26 |
$1,214.60 $1,307.50 $1,405.90 $1,755.48 |
Toc - Plan #51 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 |
$294.89 $334.70 $376.87 $526.67 $800.33 |
$520.48 $560.29 $602.46 $752.26 |
$746.07 $785.88 $828.05 $977.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$589.78 $669.40 $753.74 $1,053.34 $1,600.66 |
$815.37 $894.99 $979.33 $1,278.93 |
$1,040.96 $1,120.58 $1,204.92 $1,504.52 |
Toc - Plan #52 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 |
$462.91 $525.40 $591.59 $826.75 $1,256.33 |
$817.03 $879.52 $945.71 $1,180.87 |
$1,171.15 $1,233.64 $1,299.83 $1,534.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$925.82 $1,050.80 $1,183.18 $1,653.50 $2,512.66 |
$1,279.94 $1,404.92 $1,537.30 $2,007.62 |
$1,634.06 $1,759.04 $1,891.42 $2,361.74 |
Toc - Plan #53 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 |
$434.08 $492.67 $554.75 $775.26 $1,178.08 |
$766.15 $824.74 $886.82 $1,107.33 |
$1,098.22 $1,156.81 $1,218.89 $1,439.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$868.16 $985.34 $1,109.50 $1,550.52 $2,356.16 |
$1,200.23 $1,317.41 $1,441.57 $1,882.59 |
$1,532.30 $1,649.48 $1,773.64 $2,214.66 |
Toc - Plan #54 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 |
$433.07 $491.53 $553.46 $773.46 $1,175.34 |
$764.37 $822.83 $884.76 $1,104.76 |
$1,095.67 $1,154.13 $1,216.06 $1,436.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.14 $983.06 $1,106.92 $1,546.92 $2,350.68 |
$1,197.44 $1,314.36 $1,438.22 $1,878.22 |
$1,528.74 $1,645.66 $1,769.52 $2,209.52 |
Toc - Plan #55 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 |
$322.34 $365.86 $411.95 $575.70 $874.83 |
$568.93 $612.45 $658.54 $822.29 |
$815.52 $859.04 $905.13 $1,068.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$644.68 $731.72 $823.90 $1,151.40 $1,749.66 |
$891.27 $978.31 $1,070.49 $1,397.99 |
$1,137.86 $1,224.90 $1,317.08 $1,644.58 |
Toc - Plan #56 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 |
$435.50 $494.29 $556.56 $777.80 $1,181.94 |
$768.66 $827.45 $889.72 $1,110.96 |
$1,101.82 $1,160.61 $1,222.88 $1,444.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$871.00 $988.58 $1,113.12 $1,555.60 $2,363.88 |
$1,204.16 $1,321.74 $1,446.28 $1,888.76 |
$1,537.32 $1,654.90 $1,779.44 $2,221.92 |
Toc - Plan #57 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 |
$434.66 $493.33 $555.49 $776.29 $1,179.65 |
$767.17 $825.84 $888.00 $1,108.80 |
$1,099.68 $1,158.35 $1,220.51 $1,441.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$869.32 $986.66 $1,110.98 $1,552.58 $2,359.30 |
$1,201.83 $1,319.17 $1,443.49 $1,885.09 |
$1,534.34 $1,651.68 $1,776.00 $2,217.60 |
Toc - Plan #58 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 |
$444.62 $504.64 $568.22 $794.09 $1,206.70 |
$784.75 $844.77 $908.35 $1,134.22 |
$1,124.88 $1,184.90 $1,248.48 $1,474.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$889.24 $1,009.28 $1,136.44 $1,588.18 $2,413.40 |
$1,229.37 $1,349.41 $1,476.57 $1,928.31 |
$1,569.50 $1,689.54 $1,816.70 $2,268.44 |
Toc - Plan #59 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 |
$304.33 $345.41 $388.92 $543.52 $825.93 |
$537.14 $578.22 $621.73 $776.33 |
$769.95 $811.03 $854.54 $1,009.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$608.66 $690.82 $777.84 $1,087.04 $1,651.86 |
$841.47 $923.63 $1,010.65 $1,319.85 |
$1,074.28 $1,156.44 $1,243.46 $1,552.66 |
Toc - Plan #60 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 |
$472.54 $536.33 $603.90 $843.95 $1,282.47 |
$834.03 $897.82 $965.39 $1,205.44 |
$1,195.52 $1,259.31 $1,326.88 $1,566.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$945.08 $1,072.66 $1,207.80 $1,687.90 $2,564.94 |
$1,306.57 $1,434.15 $1,569.29 $2,049.39 |
$1,668.06 $1,795.64 $1,930.78 $2,410.88 |
Toc - Plan #61 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 |
$444.21 $504.17 $567.69 $793.35 $1,205.57 |
$784.03 $843.99 $907.51 $1,133.17 |
$1,123.85 $1,183.81 $1,247.33 $1,472.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.42 $1,008.34 $1,135.38 $1,586.70 $2,411.14 |
$1,228.24 $1,348.16 $1,475.20 $1,926.52 |
$1,568.06 $1,687.98 $1,815.02 $2,266.34 |
Toc - Plan #62 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 |
$443.71 $503.61 $567.05 $792.46 $1,204.22 |
$783.14 $843.04 $906.48 $1,131.89 |
$1,122.57 $1,182.47 $1,245.91 $1,471.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$887.42 $1,007.22 $1,134.10 $1,584.92 $2,408.44 |
$1,226.85 $1,346.65 $1,473.53 $1,924.35 |
$1,566.28 $1,686.08 $1,812.96 $2,263.78 |
ADVERTISEMENT
Ambetter from Peach State Health PlanLocal: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231 |
Toc - Plan #63 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 |
$328.58 $372.93 $419.92 $586.83 $891.75 |
$579.94 $624.29 $671.28 $838.19 |
$831.30 $875.65 $922.64 $1,089.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$657.16 $745.86 $839.84 $1,173.66 $1,783.50 |
$908.52 $997.22 $1,091.20 $1,425.02 |
$1,159.88 $1,248.58 $1,342.56 $1,676.38 |
Toc - Plan #64 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 |
$394.60 $447.86 $504.28 $704.74 $1,070.91 |
$696.46 $749.72 $806.14 $1,006.60 |
$998.32 $1,051.58 $1,108.00 $1,308.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.20 $895.72 $1,008.56 $1,409.48 $2,141.82 |
$1,091.06 $1,197.58 $1,310.42 $1,711.34 |
$1,392.92 $1,499.44 $1,612.28 $2,013.20 |
Toc - Plan #65 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 |
$390.22 $442.89 $498.69 $696.91 $1,059.03 |
$688.73 $741.40 $797.20 $995.42 |
$987.24 $1,039.91 $1,095.71 $1,293.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$780.44 $885.78 $997.38 $1,393.82 $2,118.06 |
$1,078.95 $1,184.29 $1,295.89 $1,692.33 |
$1,377.46 $1,482.80 $1,594.40 $1,990.84 |
Toc - Plan #66 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 |
$412.87 $468.59 $527.63 $737.36 $1,120.50 |
$728.71 $784.43 $843.47 $1,053.20 |
$1,044.55 $1,100.27 $1,159.31 $1,369.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$825.74 $937.18 $1,055.26 $1,474.72 $2,241.00 |
$1,141.58 $1,253.02 $1,371.10 $1,790.56 |
$1,457.42 $1,568.86 $1,686.94 $2,106.40 |
Toc - Plan #67 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 |
$386.15 $438.27 $493.49 $689.65 $1,048.00 |
$681.55 $733.67 $788.89 $985.05 |
$976.95 $1,029.07 $1,084.29 $1,280.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$772.30 $876.54 $986.98 $1,379.30 $2,096.00 |
$1,067.70 $1,171.94 $1,282.38 $1,674.70 |
$1,363.10 $1,467.34 $1,577.78 $1,970.10 |
Toc - Plan #68 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 |
$361.06 $409.79 $461.42 $644.83 $979.89 |
$637.26 $685.99 $737.62 $921.03 |
$913.46 $962.19 $1,013.82 $1,197.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$722.12 $819.58 $922.84 $1,289.66 $1,959.78 |
$998.32 $1,095.78 $1,199.04 $1,565.86 |
$1,274.52 $1,371.98 $1,475.24 $1,842.06 |
Toc - Plan #69 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 |
$353.52 $401.24 $451.79 $631.37 $959.43 |
$623.96 $671.68 $722.23 $901.81 |
$894.40 $942.12 $992.67 $1,172.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.04 $802.48 $903.58 $1,262.74 $1,918.86 |
$977.48 $1,072.92 $1,174.02 $1,533.18 |
$1,247.92 $1,343.36 $1,444.46 $1,803.62 |
Toc - Plan #70 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 |
$400.00 $453.99 $511.19 $714.39 $1,085.58 |
$706.00 $759.99 $817.19 $1,020.39 |
$1,012.00 $1,065.99 $1,123.19 $1,326.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.00 $907.98 $1,022.38 $1,428.78 $2,171.16 |
$1,106.00 $1,213.98 $1,328.38 $1,734.78 |
$1,412.00 $1,519.98 $1,634.38 $2,040.78 |
Toc - Plan #71 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 |
$380.39 $431.74 $486.13 $679.36 $1,032.36 |
$671.38 $722.73 $777.12 $970.35 |
$962.37 $1,013.72 $1,068.11 $1,261.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$760.78 $863.48 $972.26 $1,358.72 $2,064.72 |
$1,051.77 $1,154.47 $1,263.25 $1,649.71 |
$1,342.76 $1,445.46 $1,554.24 $1,940.70 |
Toc - Plan #72 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 |
$384.69 $436.62 $491.63 $687.05 $1,044.03 |
$678.97 $730.90 $785.91 $981.33 |
$973.25 $1,025.18 $1,080.19 $1,275.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.38 $873.24 $983.26 $1,374.10 $2,088.06 |
$1,063.66 $1,167.52 $1,277.54 $1,668.38 |
$1,357.94 $1,461.80 $1,571.82 $1,962.66 |
Toc - Plan #73 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 |
$394.64 $447.90 $504.33 $704.81 $1,071.02 |
$696.53 $749.79 $806.22 $1,006.70 |
$998.42 $1,051.68 $1,108.11 $1,308.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.28 $895.80 $1,008.66 $1,409.62 $2,142.04 |
$1,091.17 $1,197.69 $1,310.55 $1,711.51 |
$1,393.06 $1,499.58 $1,612.44 $2,013.40 |
Toc - Plan #74 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 |
$390.06 $442.71 $498.48 $696.63 $1,058.60 |
$688.45 $741.10 $796.87 $995.02 |
$986.84 $1,039.49 $1,095.26 $1,293.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$780.12 $885.42 $996.96 $1,393.26 $2,117.20 |
$1,078.51 $1,183.81 $1,295.35 $1,691.65 |
$1,376.90 $1,482.20 $1,593.74 $1,990.04 |
Toc - Plan #75 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 |
$455.48 $516.96 $582.10 $813.48 $1,236.16 |
$803.92 $865.40 $930.54 $1,161.92 |
$1,152.36 $1,213.84 $1,278.98 $1,510.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$910.96 $1,033.92 $1,164.20 $1,626.96 $2,472.32 |
$1,259.40 $1,382.36 $1,512.64 $1,975.40 |
$1,607.84 $1,730.80 $1,861.08 $2,323.84 |
Toc - Plan #76 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 |
$312.80 $355.02 $399.75 $558.64 $848.91 |
$552.08 $594.30 $639.03 $797.92 |
$791.36 $833.58 $878.31 $1,037.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$625.60 $710.04 $799.50 $1,117.28 $1,697.82 |
$864.88 $949.32 $1,038.78 $1,356.56 |
$1,104.16 $1,188.60 $1,278.06 $1,595.84 |
Toc - Plan #77 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 |
$346.10 $392.82 $442.31 $618.12 $939.30 |
$610.86 $657.58 $707.07 $882.88 |
$875.62 $922.34 $971.83 $1,147.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$692.20 $785.64 $884.62 $1,236.24 $1,878.60 |
$956.96 $1,050.40 $1,149.38 $1,501.00 |
$1,221.72 $1,315.16 $1,414.14 $1,765.76 |
Toc - Plan #78 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 |
$381.22 $432.68 $487.19 $680.84 $1,034.61 |
$672.85 $724.31 $778.82 $972.47 |
$964.48 $1,015.94 $1,070.45 $1,264.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.44 $865.36 $974.38 $1,361.68 $2,069.22 |
$1,054.07 $1,156.99 $1,266.01 $1,653.31 |
$1,345.70 $1,448.62 $1,557.64 $1,944.94 |
Toc - Plan #79 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 |
$390.93 $443.69 $499.59 $698.18 $1,060.95 |
$689.98 $742.74 $798.64 $997.23 |
$989.03 $1,041.79 $1,097.69 $1,296.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.86 $887.38 $999.18 $1,396.36 $2,121.90 |
$1,080.91 $1,186.43 $1,298.23 $1,695.41 |
$1,379.96 $1,485.48 $1,597.28 $1,994.46 |
Toc - Plan #80 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 |
$401.45 $455.63 $513.04 $716.97 $1,089.51 |
$708.55 $762.73 $820.14 $1,024.07 |
$1,015.65 $1,069.83 $1,127.24 $1,331.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$802.90 $911.26 $1,026.08 $1,433.94 $2,179.02 |
$1,110.00 $1,218.36 $1,333.18 $1,741.04 |
$1,417.10 $1,525.46 $1,640.28 $2,048.14 |
Toc - Plan #81 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 |
$410.23 $465.60 $524.26 $732.65 $1,113.33 |
$724.05 $779.42 $838.08 $1,046.47 |
$1,037.87 $1,093.24 $1,151.90 $1,360.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$820.46 $931.20 $1,048.52 $1,465.30 $2,226.66 |
$1,134.28 $1,245.02 $1,362.34 $1,779.12 |
$1,448.10 $1,558.84 $1,676.16 $2,092.94 |
Toc - Plan #82 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 |
$405.67 $460.43 $518.44 $724.52 $1,100.97 |
$716.00 $770.76 $828.77 $1,034.85 |
$1,026.33 $1,081.09 $1,139.10 $1,345.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.34 $920.86 $1,036.88 $1,449.04 $2,201.94 |
$1,121.67 $1,231.19 $1,347.21 $1,759.37 |
$1,432.00 $1,541.52 $1,657.54 $2,069.70 |
Toc - Plan #83 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 |
$341.60 $387.70 $436.55 $610.08 $927.07 |
$602.92 $649.02 $697.87 $871.40 |
$864.24 $910.34 $959.19 $1,132.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.20 $775.40 $873.10 $1,220.16 $1,854.14 |
$944.52 $1,036.72 $1,134.42 $1,481.48 |
$1,205.84 $1,298.04 $1,395.74 $1,742.80 |
Toc - Plan #84 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 |
$429.22 $487.15 $548.53 $766.57 $1,164.88 |
$757.57 $815.50 $876.88 $1,094.92 |
$1,085.92 $1,143.85 $1,205.23 $1,423.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.44 $974.30 $1,097.06 $1,533.14 $2,329.76 |
$1,186.79 $1,302.65 $1,425.41 $1,861.49 |
$1,515.14 $1,631.00 $1,753.76 $2,189.84 |
Toc - Plan #85 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 |
$375.36 $426.02 $479.70 $670.37 $1,018.70 |
$662.50 $713.16 $766.84 $957.51 |
$949.64 $1,000.30 $1,053.98 $1,244.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$750.72 $852.04 $959.40 $1,340.74 $2,037.40 |
$1,037.86 $1,139.18 $1,246.54 $1,627.88 |
$1,325.00 $1,426.32 $1,533.68 $1,915.02 |
Toc - Plan #86 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 |
$367.52 $417.13 $469.68 $656.38 $997.43 |
$648.67 $698.28 $750.83 $937.53 |
$929.82 $979.43 $1,031.98 $1,218.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.04 $834.26 $939.36 $1,312.76 $1,994.86 |
$1,016.19 $1,115.41 $1,220.51 $1,593.91 |
$1,297.34 $1,396.56 $1,501.66 $1,875.06 |
Toc - Plan #87 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 |
$415.85 $471.98 $531.44 $742.69 $1,128.58 |
$733.97 $790.10 $849.56 $1,060.81 |
$1,052.09 $1,108.22 $1,167.68 $1,378.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.70 $943.96 $1,062.88 $1,485.38 $2,257.16 |
$1,149.82 $1,262.08 $1,381.00 $1,803.50 |
$1,467.94 $1,580.20 $1,699.12 $2,121.62 |
Toc - Plan #88 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 |
$399.93 $453.91 $511.10 $714.26 $1,085.39 |
$705.87 $759.85 $817.04 $1,020.20 |
$1,011.81 $1,065.79 $1,122.98 $1,326.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$799.86 $907.82 $1,022.20 $1,428.52 $2,170.78 |
$1,105.80 $1,213.76 $1,328.14 $1,734.46 |
$1,411.74 $1,519.70 $1,634.08 $2,040.40 |
Toc - Plan #89 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 |
$410.27 $465.64 $524.31 $732.72 $1,113.44 |
$724.12 $779.49 $838.16 $1,046.57 |
$1,037.97 $1,093.34 $1,152.01 $1,360.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$820.54 $931.28 $1,048.62 $1,465.44 $2,226.88 |
$1,134.39 $1,245.13 $1,362.47 $1,779.29 |
$1,448.24 $1,558.98 $1,676.32 $2,093.14 |
Toc - Plan #90 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 |
$395.46 $448.84 $505.39 $706.27 $1,073.25 |
$697.98 $751.36 $807.91 $1,008.79 |
$1,000.50 $1,053.88 $1,110.43 $1,311.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.92 $897.68 $1,010.78 $1,412.54 $2,146.50 |
$1,093.44 $1,200.20 $1,313.30 $1,715.06 |
$1,395.96 $1,502.72 $1,615.82 $2,017.58 |
Toc - Plan #91 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 |
$405.51 $460.24 $518.23 $724.22 $1,100.53 |
$715.72 $770.45 $828.44 $1,034.43 |
$1,025.93 $1,080.66 $1,138.65 $1,344.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.02 $920.48 $1,036.46 $1,448.44 $2,201.06 |
$1,121.23 $1,230.69 $1,346.67 $1,758.65 |
$1,431.44 $1,540.90 $1,656.88 $2,068.86 |
Toc - Plan #92 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 |
$473.52 $537.44 $605.15 $845.70 $1,285.12 |
$835.76 $899.68 $967.39 $1,207.94 |
$1,198.00 $1,261.92 $1,329.63 $1,570.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$947.04 $1,074.88 $1,210.30 $1,691.40 $2,570.24 |
$1,309.28 $1,437.12 $1,572.54 $2,053.64 |
$1,671.52 $1,799.36 $1,934.78 $2,415.88 |
Toc - Plan #93 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 |
$344.01 $390.44 $439.63 $614.39 $933.62 |
$607.17 $653.60 $702.79 $877.55 |
$870.33 $916.76 $965.95 $1,140.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.02 $780.88 $879.26 $1,228.78 $1,867.24 |
$951.18 $1,044.04 $1,142.42 $1,491.94 |
$1,214.34 $1,307.20 $1,405.58 $1,755.10 |
Toc - Plan #94 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 |
$376.41 $427.21 $481.04 $672.25 $1,021.54 |
$664.35 $715.15 $768.98 $960.19 |
$952.29 $1,003.09 $1,056.92 $1,248.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$752.82 $854.42 $962.08 $1,344.50 $2,043.08 |
$1,040.76 $1,142.36 $1,250.02 $1,632.44 |
$1,328.70 $1,430.30 $1,537.96 $1,920.38 |
Toc - Plan #95 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 |
$401.07 $455.20 $512.55 $716.29 $1,088.48 |
$707.88 $762.01 $819.36 $1,023.10 |
$1,014.69 $1,068.82 $1,126.17 $1,329.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$802.14 $910.40 $1,025.10 $1,432.58 $2,176.96 |
$1,108.95 $1,217.21 $1,331.91 $1,739.39 |
$1,415.76 $1,524.02 $1,638.72 $2,046.20 |
ADVERTISEMENT
Kaiser PermanenteLocal: 1-800-494-5314 | Toll Free: 1-800-494-5314 |
Toc - Plan #96 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Gold 500/20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409.39 $464.66 $523.20 $731.17 $1,111.09 |
$722.57 $777.84 $836.38 $1,044.35 |
$1,035.75 $1,091.02 $1,149.56 $1,357.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$818.78 $929.32 $1,046.40 $1,462.34 $2,222.18 |
$1,131.96 $1,242.50 $1,359.58 $1,775.52 |
$1,445.14 $1,555.68 $1,672.76 $2,088.70 |
Toc - Plan #97 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver 3400/30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.58 $466.01 $524.73 $733.30 $1,114.33 |
$724.68 $780.11 $838.83 $1,047.40 |
$1,038.78 $1,094.21 $1,152.93 $1,361.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.16 $932.02 $1,049.46 $1,466.60 $2,228.66 |
$1,135.26 $1,246.12 $1,363.56 $1,780.70 |
$1,449.36 $1,560.22 $1,677.66 $2,094.80 |
Toc - Plan #98 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver 3500/20%/HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$399.61 $453.56 $510.70 $713.70 $1,084.54 |
$705.31 $759.26 $816.40 $1,019.40 |
$1,011.01 $1,064.96 $1,122.10 $1,325.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$799.22 $907.12 $1,021.40 $1,427.40 $2,169.08 |
$1,104.92 $1,212.82 $1,327.10 $1,733.10 |
$1,410.62 $1,518.52 $1,632.80 $2,038.80 |
Toc - Plan #99 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Bronze Virtual Complete 5500/60 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.55 $337.72 $380.27 $531.42 $807.54 |
$525.17 $565.34 $607.89 $759.04 |
$752.79 $792.96 $835.51 $986.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$595.10 $675.44 $760.54 $1,062.84 $1,615.08 |
$822.72 $903.06 $988.16 $1,290.46 |
$1,050.34 $1,130.68 $1,215.78 $1,518.08 |
Toc - Plan #100 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Bronze 6500/40%/HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298.81 $339.15 $381.88 $533.68 $810.98 |
$527.40 $567.74 $610.47 $762.27 |
$755.99 $796.33 $839.06 $990.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$597.62 $678.30 $763.76 $1,067.36 $1,621.96 |
$826.21 $906.89 $992.35 $1,295.95 |
$1,054.80 $1,135.48 $1,220.94 $1,524.54 |
Toc - Plan #101 Kaiser Permanente | ||||||||||||||||||||
Catastrophic
(HMO) KP GA Catastrophic 9100/0 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$258.76 $293.70 $330.70 $462.15 $702.28 |
$456.71 $491.65 $528.65 $660.10 |
$654.66 $689.60 $726.60 $858.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$517.52 $587.40 $661.40 $924.30 $1,404.56 |
$715.47 $785.35 $859.35 $1,122.25 |
$913.42 $983.30 $1,057.30 $1,320.20 |
Toc - Plan #102 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Gold 1500/20 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.35 $446.46 $502.71 $702.53 $1,067.56 |
$694.27 $747.38 $803.63 $1,003.45 |
$995.19 $1,048.30 $1,104.55 $1,304.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$786.70 $892.92 $1,005.42 $1,405.06 $2,135.12 |
$1,087.62 $1,193.84 $1,306.34 $1,705.98 |
$1,388.54 $1,494.76 $1,607.26 $2,006.90 |
Toc - Plan #103 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver 4500/35 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.11 $451.86 $508.79 $711.03 $1,080.48 |
$702.67 $756.42 $813.35 $1,015.59 |
$1,007.23 $1,060.98 $1,117.91 $1,320.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$796.22 $903.72 $1,017.58 $1,422.06 $2,160.96 |
$1,100.78 $1,208.28 $1,322.14 $1,726.62 |
$1,405.34 $1,512.84 $1,626.70 $2,031.18 |
Toc - Plan #104 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Gold 1800/25 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.63 $426.34 $480.05 $670.87 $1,019.45 |
$662.99 $713.70 $767.41 $958.23 |
$950.35 $1,001.06 $1,054.77 $1,245.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.26 $852.68 $960.10 $1,341.74 $2,038.90 |
$1,038.62 $1,140.04 $1,247.46 $1,629.10 |
$1,325.98 $1,427.40 $1,534.82 $1,916.46 |
Toc - Plan #105 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Silver Virtual Complete 4800/40 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.66 $427.51 $481.37 $672.71 $1,022.26 |
$664.80 $715.65 $769.51 $960.85 |
$952.94 $1,003.79 $1,057.65 $1,248.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.32 $855.02 $962.74 $1,345.42 $2,044.52 |
$1,041.46 $1,143.16 $1,250.88 $1,633.56 |
$1,329.60 $1,431.30 $1,539.02 $1,921.70 |
Toc - Plan #106 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Standard Gold 2000/30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$386.18 $438.31 $493.54 $689.72 $1,048.09 |
$681.61 $733.74 $788.97 $985.15 |
$977.04 $1,029.17 $1,084.40 $1,280.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$772.36 $876.62 $987.08 $1,379.44 $2,096.18 |
$1,067.79 $1,172.05 $1,282.51 $1,674.87 |
$1,363.22 $1,467.48 $1,577.94 $1,970.30 |
Toc - Plan #107 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Standard Silver 5800/40 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.64 $435.44 $490.30 $685.19 $1,041.21 |
$677.13 $728.93 $783.79 $978.68 |
$970.62 $1,022.42 $1,077.28 $1,272.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.28 $870.88 $980.60 $1,370.38 $2,082.42 |
$1,060.77 $1,164.37 $1,274.09 $1,663.87 |
$1,354.26 $1,457.86 $1,567.58 $1,957.36 |
Toc - Plan #108 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Standard Bronze 7500/50 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.90 $354.00 $398.61 $557.05 $846.49 |
$550.50 $592.60 $637.21 $795.65 |
$789.10 $831.20 $875.81 $1,034.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.80 $708.00 $797.22 $1,114.10 $1,692.98 |
$862.40 $946.60 $1,035.82 $1,352.70 |
$1,101.00 $1,185.20 $1,274.42 $1,591.30 |
‡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 Spalding County here.
Spalding County is in “Rating Area 3” of Georgia.
Currently, there are 108 plans offered in Rating Area 3.