Obamacare 2023 Rates for Holt County

Obamacare > Rates > Missouri > Holt County

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Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Holt County, MO.

The health insurance rates listed below are for calendar year 2023.

For information on subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 34 Plans and 2023 Rates for Holt County, Missouri

Below, you’ll find a summary of the 34 plans for Holt County, Missouri and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Holt County Resources

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Blue Cross and Blue Shield of Kansas City

Local: 1-816-395-3558 | Toll Free: 1-888-800-4478

Toc - Plan #1 Blue Cross and Blue Shield of Kansas City
Expanded Bronze

(EPO) Blue KC Saver Bronze 6500 with broad Preferred-Care Blue EPO

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$506.25
$574.60
$646.99
$904.17
$1,373.97 		$893.53
$961.88
$1,034.27
$1,291.45 		$1,280.81
$1,349.16
$1,421.55
$1,678.73 		$1,668.09
$1,736.44
$1,808.83
$2,066.01 		$387.28
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,012.50
$1,149.20
$1,293.98
$1,808.34
$2,747.94 		$1,399.78
$1,536.48
$1,681.26
$2,195.62 		$1,787.06
$1,923.76
$2,068.54
$2,582.90 		$2,174.34
$2,311.04
$2,455.82
$2,970.18 		$387.28
Toc - Plan #2 Blue Cross and Blue Shield of Kansas City
Silver

(EPO) Blue KC Community Silver 6000 with broad Preferred-Care Blue EPO

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,250 $16,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$671.61
$762.28
$858.32
$1,199.49
$1,822.75 		$1,185.39
$1,276.06
$1,372.10
$1,713.27 		$1,699.17
$1,789.84
$1,885.88
$2,227.05 		$2,212.95
$2,303.62
$2,399.66
$2,740.83 		$513.78
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,343.22
$1,524.56
$1,716.64
$2,398.98
$3,645.50 		$1,857.00
$2,038.34
$2,230.42
$2,912.76 		$2,370.78
$2,552.12
$2,744.20
$3,426.54 		$2,884.56
$3,065.90
$3,257.98
$3,940.32 		$513.78
Toc - Plan #3 Blue Cross and Blue Shield of Kansas City
Expanded Bronze

(EPO) Blue KC First Bronze 7000 with broad Preferred-Care Blue EPO

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$527.60
$598.82
$674.27
$942.29
$1,431.90 		$931.21
$1,002.43
$1,077.88
$1,345.90 		$1,334.82
$1,406.04
$1,481.49
$1,749.51 		$1,738.43
$1,809.65
$1,885.10
$2,153.12 		$403.61
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,055.20
$1,197.64
$1,348.54
$1,884.58
$2,863.80 		$1,458.81
$1,601.25
$1,752.15
$2,288.19 		$1,862.42
$2,004.86
$2,155.76
$2,691.80 		$2,266.03
$2,408.47
$2,559.37
$3,095.41 		$403.61
Toc - Plan #4 Blue Cross and Blue Shield of Kansas City
Gold

(EPO) Blue KC Standard Gold 2000 with broad Preferred-Care Blue EPO

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$735.19
$834.44
$939.57
$1,313.05
$1,995.31 		$1,297.61
$1,396.86
$1,501.99
$1,875.47 		$1,860.03
$1,959.28
$2,064.41
$2,437.89 		$2,422.45
$2,521.70
$2,626.83
$3,000.31 		$562.42
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,470.38
$1,668.88
$1,879.14
$2,626.10
$3,990.62 		$2,032.80
$2,231.30
$2,441.56
$3,188.52 		$2,595.22
$2,793.72
$3,003.98
$3,750.94 		$3,157.64
$3,356.14
$3,566.40
$4,313.36 		$562.42
Toc - Plan #5 Blue Cross and Blue Shield of Kansas City
Silver

(EPO) Blue KC Standard Silver 5800 with broad Preferred-Care Blue EPO

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$8,900 $17,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$647.05
$734.40
$826.92
$1,155.62
$1,756.08 		$1,142.04
$1,229.39
$1,321.91
$1,650.61 		$1,637.03
$1,724.38
$1,816.90
$2,145.60 		$2,132.02
$2,219.37
$2,311.89
$2,640.59 		$494.99
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,294.10
$1,468.80
$1,653.84
$2,311.24
$3,512.16 		$1,789.09
$1,963.79
$2,148.83
$2,806.23 		$2,284.08
$2,458.78
$2,643.82
$3,301.22 		$2,779.07
$2,953.77
$3,138.81
$3,796.21 		$494.99
Toc - Plan #6 Blue Cross and Blue Shield of Kansas City
Expanded Bronze

(EPO) Blue KC Standard Bronze 7500 with broad Preferred-Care Blue EPO

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$463.12
$525.64
$591.86
$827.13
$1,256.90 		$817.40
$879.92
$946.14
$1,181.41 		$1,171.68
$1,234.20
$1,300.42
$1,535.69 		$1,525.96
$1,588.48
$1,654.70
$1,889.97 		$354.28
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$926.24
$1,051.28
$1,183.72
$1,654.26
$2,513.80 		$1,280.52
$1,405.56
$1,538.00
$2,008.54 		$1,634.80
$1,759.84
$1,892.28
$2,362.82 		$1,989.08
$2,114.12
$2,246.56
$2,717.10 		$354.28

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Ambetter from Home State Health

Local: 1-855-650-3789 | Toll Free: 1-855-650-3789 | TTY: 1-855-650-3789
Toc - Plan #7 Ambetter from Home State Health
Bronze

(EPO) Clear Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$8,600 $17,200 Annual Deductible
$8,600 $17,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$387.32
$439.59
$494.98
$691.73
$1,051.15 		$683.61
$735.88
$791.27
$988.02 		$979.90
$1,032.17
$1,087.56
$1,284.31 		$1,276.19
$1,328.46
$1,383.85
$1,580.60 		$296.29
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$774.64
$879.18
$989.96
$1,383.46
$2,102.30 		$1,070.93
$1,175.47
$1,286.25
$1,679.75 		$1,367.22
$1,471.76
$1,582.54
$1,976.04 		$1,663.51
$1,768.05
$1,878.83
$2,272.33 		$296.29
Toc - Plan #8 Ambetter from Home State Health
Silver

(EPO) Premier Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$7,750 $15,500 Annual Deductible
$7,750 $15,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$448.59
$509.14
$573.29
$801.17
$1,217.46 		$791.76
$852.31
$916.46
$1,144.34 		$1,134.93
$1,195.48
$1,259.63
$1,487.51 		$1,478.10
$1,538.65
$1,602.80
$1,830.68 		$343.17
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$897.18
$1,018.28
$1,146.58
$1,602.34
$2,434.92 		$1,240.35
$1,361.45
$1,489.75
$1,945.51 		$1,583.52
$1,704.62
$1,832.92
$2,288.68 		$1,926.69
$2,047.79
$2,176.09
$2,631.85 		$343.17
Toc - Plan #9 Ambetter from Home State Health
Silver

(EPO) Complete Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$446.94
$507.26
$571.17
$798.21
$1,212.95 		$788.84
$849.16
$913.07
$1,140.11 		$1,130.74
$1,191.06
$1,254.97
$1,482.01 		$1,472.64
$1,532.96
$1,596.87
$1,823.91 		$341.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$893.88
$1,014.52
$1,142.34
$1,596.42
$2,425.90 		$1,235.78
$1,356.42
$1,484.24
$1,938.32 		$1,577.68
$1,698.32
$1,826.14
$2,280.22 		$1,919.58
$2,040.22
$2,168.04
$2,622.12 		$341.90
Toc - Plan #10 Ambetter from Home State Health
Gold

(EPO) Complete Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$7,700 $15,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$555.72
$630.73
$710.19
$992.49
$1,508.19 		$980.84
$1,055.85
$1,135.31
$1,417.61 		$1,405.96
$1,480.97
$1,560.43
$1,842.73 		$1,831.08
$1,906.09
$1,985.55
$2,267.85 		$425.12
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,111.44
$1,261.46
$1,420.38
$1,984.98
$3,016.38 		$1,536.56
$1,686.58
$1,845.50
$2,410.10 		$1,961.68
$2,111.70
$2,270.62
$2,835.22 		$2,386.80
$2,536.82
$2,695.74
$3,260.34 		$425.12
Toc - Plan #11 Ambetter from Home State Health
Expanded Bronze

(EPO) Everyday Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$8,300 $16,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$419.39
$476.00
$535.97
$749.02
$1,138.20 		$740.22
$796.83
$856.80
$1,069.85 		$1,061.05
$1,117.66
$1,177.63
$1,390.68 		$1,381.88
$1,438.49
$1,498.46
$1,711.51 		$320.83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$838.78
$952.00
$1,071.94
$1,498.04
$2,276.40 		$1,159.61
$1,272.83
$1,392.77
$1,818.87 		$1,480.44
$1,593.66
$1,713.60
$2,139.70 		$1,801.27
$1,914.49
$2,034.43
$2,460.53 		$320.83
Toc - Plan #12 Ambetter from Home State Health
Expanded Bronze

(EPO) Choice Bronze HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$425.72
$483.18
$544.05
$760.31
$1,155.37 		$751.39
$808.85
$869.72
$1,085.98 		$1,077.06
$1,134.52
$1,195.39
$1,411.65 		$1,402.73
$1,460.19
$1,521.06
$1,737.32 		$325.67
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$851.44
$966.36
$1,088.10
$1,520.62
$2,310.74 		$1,177.11
$1,292.03
$1,413.77
$1,846.29 		$1,502.78
$1,617.70
$1,739.44
$2,171.96 		$1,828.45
$1,943.37
$2,065.11
$2,497.63 		$325.67
Toc - Plan #13 Ambetter from Home State Health
Expanded Bronze

(EPO) Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$469.72
$533.12
$600.29
$838.91
$1,274.80 		$829.05
$892.45
$959.62
$1,198.24 		$1,188.38
$1,251.78
$1,318.95
$1,557.57 		$1,547.71
$1,611.11
$1,678.28
$1,916.90 		$359.33
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$939.44
$1,066.24
$1,200.58
$1,677.82
$2,549.60 		$1,298.77
$1,425.57
$1,559.91
$2,037.15 		$1,658.10
$1,784.90
$1,919.24
$2,396.48 		$2,017.43
$2,144.23
$2,278.57
$2,755.81 		$359.33
Toc - Plan #14 Ambetter from Home State Health
Silver

(EPO) Clear Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$5,400 $10,800 Annual Deductible
$5,400 $10,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$432.49
$490.87
$552.71
$772.41
$1,173.75 		$763.34
$821.72
$883.56
$1,103.26 		$1,094.19
$1,152.57
$1,214.41
$1,434.11 		$1,425.04
$1,483.42
$1,545.26
$1,764.96 		$330.85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$864.98
$981.74
$1,105.42
$1,544.82
$2,347.50 		$1,195.83
$1,312.59
$1,436.27
$1,875.67 		$1,526.68
$1,643.44
$1,767.12
$2,206.52 		$1,857.53
$1,974.29
$2,097.97
$2,537.37 		$330.85
Toc - Plan #15 Ambetter from Home State Health
Silver

(EPO) Focused Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$6,100 $12,200 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$440.61
$500.08
$563.09
$786.91
$1,195.79 		$777.67
$837.14
$900.15
$1,123.97 		$1,114.73
$1,174.20
$1,237.21
$1,461.03 		$1,451.79
$1,511.26
$1,574.27
$1,798.09 		$337.06
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$881.22
$1,000.16
$1,126.18
$1,573.82
$2,391.58 		$1,218.28
$1,337.22
$1,463.24
$1,910.88 		$1,555.34
$1,674.28
$1,800.30
$2,247.94 		$1,892.40
$2,011.34
$2,137.36
$2,585.00 		$337.06
Toc - Plan #16 Ambetter from Home State Health
Gold

(EPO) Everyday Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$532.26
$604.10
$680.21
$950.59
$1,444.52 		$939.43
$1,011.27
$1,087.38
$1,357.76 		$1,346.60
$1,418.44
$1,494.55
$1,764.93 		$1,753.77
$1,825.61
$1,901.72
$2,172.10 		$407.17
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,064.52
$1,208.20
$1,360.42
$1,901.18
$2,889.04 		$1,471.69
$1,615.37
$1,767.59
$2,308.35 		$1,878.86
$2,022.54
$2,174.76
$2,715.52 		$2,286.03
$2,429.71
$2,581.93
$3,122.69 		$407.17
Toc - Plan #17 Ambetter from Home State Health
Gold

(EPO) Clear Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$900 $1,800 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$524.36
$595.14
$670.12
$936.49
$1,423.09 		$925.49
$996.27
$1,071.25
$1,337.62 		$1,326.62
$1,397.40
$1,472.38
$1,738.75 		$1,727.75
$1,798.53
$1,873.51
$2,139.88 		$401.13
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,048.72
$1,190.28
$1,340.24
$1,872.98
$2,846.18 		$1,449.85
$1,591.41
$1,741.37
$2,274.11 		$1,850.98
$1,992.54
$2,142.50
$2,675.24 		$2,252.11
$2,393.67
$2,543.63
$3,076.37 		$401.13
Toc - Plan #18 Ambetter from Home State Health
Gold

(EPO) Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$5,300 $10,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$608.25
$690.35
$777.33
$1,086.31
$1,650.75 		$1,073.55
$1,155.65
$1,242.63
$1,551.61 		$1,538.85
$1,620.95
$1,707.93
$2,016.91 		$2,004.15
$2,086.25
$2,173.23
$2,482.21 		$465.30
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,216.50
$1,380.70
$1,554.66
$2,172.62
$3,301.50 		$1,681.80
$1,846.00
$2,019.96
$2,637.92 		$2,147.10
$2,311.30
$2,485.26
$3,103.22 		$2,612.40
$2,776.60
$2,950.56
$3,568.52 		$465.30
Toc - Plan #19 Ambetter from Home State Health
Bronze

(EPO) CMS Standard Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$9,100 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$369.24
$419.08
$471.88
$659.45
$1,002.09 		$651.70
$701.54
$754.34
$941.91 		$934.16
$984.00
$1,036.80
$1,224.37 		$1,216.62
$1,266.46
$1,319.26
$1,506.83 		$282.46
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$738.48
$838.16
$943.76
$1,318.90
$2,004.18 		$1,020.94
$1,120.62
$1,226.22
$1,601.36 		$1,303.40
$1,403.08
$1,508.68
$1,883.82 		$1,585.86
$1,685.54
$1,791.14
$2,166.28 		$282.46
Toc - Plan #20 Ambetter from Home State Health
Expanded Bronze

(EPO) CMS Standard Expanded Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$406.20
$461.03
$519.12
$725.46
$1,102.41 		$716.94
$771.77
$829.86
$1,036.20 		$1,027.68
$1,082.51
$1,140.60
$1,346.94 		$1,338.42
$1,393.25
$1,451.34
$1,657.68 		$310.74
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$812.40
$922.06
$1,038.24
$1,450.92
$2,204.82 		$1,123.14
$1,232.80
$1,348.98
$1,761.66 		$1,433.88
$1,543.54
$1,659.72
$2,072.40 		$1,744.62
$1,854.28
$1,970.46
$2,383.14 		$310.74
Toc - Plan #21 Ambetter from Home State Health
Silver

(EPO) CMS Standard Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$8,900 $17,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$431.68
$489.95
$551.68
$770.97
$1,171.56 		$761.91
$820.18
$881.91
$1,101.20 		$1,092.14
$1,150.41
$1,212.14
$1,431.43 		$1,422.37
$1,480.64
$1,542.37
$1,761.66 		$330.23
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$863.36
$979.90
$1,103.36
$1,541.94
$2,343.12 		$1,193.59
$1,310.13
$1,433.59
$1,872.17 		$1,523.82
$1,640.36
$1,763.82
$2,202.40 		$1,854.05
$1,970.59
$2,094.05
$2,532.63 		$330.23
Toc - Plan #22 Ambetter from Home State Health
Gold

(EPO) CMS Standard Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$524.72
$595.55
$670.58
$937.13
$1,424.06 		$926.12
$996.95
$1,071.98
$1,338.53 		$1,327.52
$1,398.35
$1,473.38
$1,739.93 		$1,728.92
$1,799.75
$1,874.78
$2,141.33 		$401.40
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,049.44
$1,191.10
$1,341.16
$1,874.26
$2,848.12 		$1,450.84
$1,592.50
$1,742.56
$2,275.66 		$1,852.24
$1,993.90
$2,143.96
$2,677.06 		$2,253.64
$2,395.30
$2,545.36
$3,078.46 		$401.40
Toc - Plan #23 Ambetter from Home State Health
Expanded Bronze

(EPO) Clear Bronze + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$8,600 $17,200 Annual Deductible
$8,600 $17,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$399.93
$453.91
$511.09
$714.25
$1,085.38 		$705.87
$759.85
$817.03
$1,020.19 		$1,011.81
$1,065.79
$1,122.97
$1,326.13 		$1,317.75
$1,371.73
$1,428.91
$1,632.07 		$305.94
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$799.86
$907.82
$1,022.18
$1,428.50
$2,170.76 		$1,105.80
$1,213.76
$1,328.12
$1,734.44 		$1,411.74
$1,519.70
$1,634.06
$2,040.38 		$1,717.68
$1,825.64
$1,940.00
$2,346.32 		$305.94
Toc - Plan #24 Ambetter from Home State Health
Expanded Bronze

(EPO) Everyday Bronze + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$8,300 $16,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$433.05
$491.50
$553.42
$773.40
$1,175.26 		$764.32
$822.77
$884.69
$1,104.67 		$1,095.59
$1,154.04
$1,215.96
$1,435.94 		$1,426.86
$1,485.31
$1,547.23
$1,767.21 		$331.27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$866.10
$983.00
$1,106.84
$1,546.80
$2,350.52 		$1,197.37
$1,314.27
$1,438.11
$1,878.07 		$1,528.64
$1,645.54
$1,769.38
$2,209.34 		$1,859.91
$1,976.81
$2,100.65
$2,540.61 		$331.27
Toc - Plan #25 Ambetter from Home State Health
Gold

(EPO) Complete Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$7,700 $15,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$573.81
$651.26
$733.31
$1,024.80
$1,557.29 		$1,012.77
$1,090.22
$1,172.27
$1,463.76 		$1,451.73
$1,529.18
$1,611.23
$1,902.72 		$1,890.69
$1,968.14
$2,050.19
$2,341.68 		$438.96
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,147.62
$1,302.52
$1,466.62
$2,049.60
$3,114.58 		$1,586.58
$1,741.48
$1,905.58
$2,488.56 		$2,025.54
$2,180.44
$2,344.54
$2,927.52 		$2,464.50
$2,619.40
$2,783.50
$3,366.48 		$438.96
Toc - Plan #26 Ambetter from Home State Health
Silver

(EPO) Complete Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$461.49
$523.77
$589.77
$824.19
$1,252.44 		$814.52
$876.80
$942.80
$1,177.22 		$1,167.55
$1,229.83
$1,295.83
$1,530.25 		$1,520.58
$1,582.86
$1,648.86
$1,883.28 		$353.03
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$922.98
$1,047.54
$1,179.54
$1,648.38
$2,504.88 		$1,276.01
$1,400.57
$1,532.57
$2,001.41 		$1,629.04
$1,753.60
$1,885.60
$2,354.44 		$1,982.07
$2,106.63
$2,238.63
$2,707.47 		$353.03
Toc - Plan #27 Ambetter from Home State Health
Silver

(EPO) Premier Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$7,750 $15,500 Annual Deductible
$7,750 $15,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$463.20
$525.72
$591.96
$827.26
$1,257.10 		$817.54
$880.06
$946.30
$1,181.60 		$1,171.88
$1,234.40
$1,300.64
$1,535.94 		$1,526.22
$1,588.74
$1,654.98
$1,890.28 		$354.34
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$926.40
$1,051.44
$1,183.92
$1,654.52
$2,514.20 		$1,280.74
$1,405.78
$1,538.26
$2,008.86 		$1,635.08
$1,760.12
$1,892.60
$2,363.20 		$1,989.42
$2,114.46
$2,246.94
$2,717.54 		$354.34
Toc - Plan #28 Ambetter from Home State Health
Expanded Bronze

(EPO) Choice Bronze HSA + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$439.58
$498.91
$561.77
$785.07
$1,192.98 		$775.85
$835.18
$898.04
$1,121.34 		$1,112.12
$1,171.45
$1,234.31
$1,457.61 		$1,448.39
$1,507.72
$1,570.58
$1,793.88 		$336.27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$879.16
$997.82
$1,123.54
$1,570.14
$2,385.96 		$1,215.43
$1,334.09
$1,459.81
$1,906.41 		$1,551.70
$1,670.36
$1,796.08
$2,242.68 		$1,887.97
$2,006.63
$2,132.35
$2,578.95 		$336.27
Toc - Plan #29 Ambetter from Home State Health
Expanded Bronze

(EPO) Elite Bronze + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$485.02
$550.48
$619.84
$866.22
$1,316.30 		$856.05
$921.51
$990.87
$1,237.25 		$1,227.08
$1,292.54
$1,361.90
$1,608.28 		$1,598.11
$1,663.57
$1,732.93
$1,979.31 		$371.03
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$970.04
$1,100.96
$1,239.68
$1,732.44
$2,632.60 		$1,341.07
$1,471.99
$1,610.71
$2,103.47 		$1,712.10
$1,843.02
$1,981.74
$2,474.50 		$2,083.13
$2,214.05
$2,352.77
$2,845.53 		$371.03
Toc - Plan #30 Ambetter from Home State Health
Silver

(EPO) Focused Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$6,100 $12,200 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$454.95
$516.36
$581.42
$812.53
$1,234.72 		$802.98
$864.39
$929.45
$1,160.56 		$1,151.01
$1,212.42
$1,277.48
$1,508.59 		$1,499.04
$1,560.45
$1,625.51
$1,856.62 		$348.03
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$909.90
$1,032.72
$1,162.84
$1,625.06
$2,469.44 		$1,257.93
$1,380.75
$1,510.87
$1,973.09 		$1,605.96
$1,728.78
$1,858.90
$2,321.12 		$1,953.99
$2,076.81
$2,206.93
$2,669.15 		$348.03
Toc - Plan #31 Ambetter from Home State Health
Gold

(EPO) Everyday Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$549.58
$623.77
$702.36
$981.54
$1,491.54 		$970.00
$1,044.19
$1,122.78
$1,401.96 		$1,390.42
$1,464.61
$1,543.20
$1,822.38 		$1,810.84
$1,885.03
$1,963.62
$2,242.80 		$420.42
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,099.16
$1,247.54
$1,404.72
$1,963.08
$2,983.08 		$1,519.58
$1,667.96
$1,825.14
$2,383.50 		$1,940.00
$2,088.38
$2,245.56
$2,803.92 		$2,360.42
$2,508.80
$2,665.98
$3,224.34 		$420.42
Toc - Plan #32 Ambetter from Home State Health
Silver

(EPO) Clear Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$5,400 $10,800 Annual Deductible
$5,400 $10,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$446.57
$506.85
$570.70
$797.56
$1,211.97 		$788.19
$848.47
$912.32
$1,139.18 		$1,129.81
$1,190.09
$1,253.94
$1,480.80 		$1,471.43
$1,531.71
$1,595.56
$1,822.42 		$341.62
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$893.14
$1,013.70
$1,141.40
$1,595.12
$2,423.94 		$1,234.76
$1,355.32
$1,483.02
$1,936.74 		$1,576.38
$1,696.94
$1,824.64
$2,278.36 		$1,918.00
$2,038.56
$2,166.26
$2,619.98 		$341.62
Toc - Plan #33 Ambetter from Home State Health
Gold

(EPO) Clear Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$900 $1,800 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$541.43
$614.51
$691.94
$966.98
$1,469.42 		$955.62
$1,028.70
$1,106.13
$1,381.17 		$1,369.81
$1,442.89
$1,520.32
$1,795.36 		$1,784.00
$1,857.08
$1,934.51
$2,209.55 		$414.19
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,082.86
$1,229.02
$1,383.88
$1,933.96
$2,938.84 		$1,497.05
$1,643.21
$1,798.07
$2,348.15 		$1,911.24
$2,057.40
$2,212.26
$2,762.34 		$2,325.43
$2,471.59
$2,626.45
$3,176.53 		$414.19
Toc - Plan #34 Ambetter from Home State Health
Gold

(EPO) Elite Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-650-3789

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$5,300 $10,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$628.05
$712.82
$802.63
$1,121.68
$1,704.50 		$1,108.50
$1,193.27
$1,283.08
$1,602.13 		$1,588.95
$1,673.72
$1,763.53
$2,082.58 		$2,069.40
$2,154.17
$2,243.98
$2,563.03 		$480.45
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,256.10
$1,425.64
$1,605.26
$2,243.36
$3,409.00 		$1,736.55
$1,906.09
$2,085.71
$2,723.81 		$2,217.00
$2,386.54
$2,566.16
$3,204.26 		$2,697.45
$2,866.99
$3,046.61
$3,684.71 		$480.45

‡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 Holt County here.

Holt County is in “Rating Area 1” of Missouri.

Currently, there are 34 plans offered in Rating Area 1.

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2023 Obamacare Plans for Holt County, MO

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