Obamacare 2023 Rates for Sanders County
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Obamacare > Rates > Montana > Sanders County
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PacificSource Health PlansLocal: 1-406-442-6589 | Toll Free: 1-877-590-1596 |
Toc - Plan #1 PacificSource Health Plans | ||||||||||||||||||||
Expanded Bronze
(PPO) Navigator Bronze HSA 7050 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$346.00 $393.00 $442.00 $618.00 $939.00 |
$611.00 $658.00 $707.00 $883.00 |
$876.00 $923.00 $972.00 $1,148.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$692.00 $786.00 $884.00 $1,236.00 $1,878.00 |
$957.00 $1,051.00 $1,149.00 $1,501.00 |
$1,222.00 $1,316.00 $1,414.00 $1,766.00 |
Toc - Plan #2 PacificSource Health Plans | ||||||||||||||||||||
Expanded Bronze
(PPO) Navigator Bronze HSA 7050 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$346.00 $393.00 $442.00 $618.00 $939.00 |
$611.00 $658.00 $707.00 $883.00 |
$876.00 $923.00 $972.00 $1,148.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$692.00 $786.00 $884.00 $1,236.00 $1,878.00 |
$957.00 $1,051.00 $1,149.00 $1,501.00 |
$1,222.00 $1,316.00 $1,414.00 $1,766.00 |
Toc - Plan #3 PacificSource Health Plans | ||||||||||||||||||||
Silver
(PPO) Navigator Silver HSA 3500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$464.00 $527.00 $593.00 $829.00 $1,260.00 |
$819.00 $882.00 $948.00 $1,184.00 |
$1,174.00 $1,237.00 $1,303.00 $1,539.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$928.00 $1,054.00 $1,186.00 $1,658.00 $2,520.00 |
$1,283.00 $1,409.00 $1,541.00 $2,013.00 |
$1,638.00 $1,764.00 $1,896.00 $2,368.00 |
Toc - Plan #4 PacificSource Health Plans | ||||||||||||||||||||
Silver
(PPO) Navigator Silver HSA 3500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$464.00 $527.00 $593.00 $829.00 $1,260.00 |
$819.00 $882.00 $948.00 $1,184.00 |
$1,174.00 $1,237.00 $1,303.00 $1,539.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$928.00 $1,054.00 $1,186.00 $1,658.00 $2,520.00 |
$1,283.00 $1,409.00 $1,541.00 $2,013.00 |
$1,638.00 $1,764.00 $1,896.00 $2,368.00 |
Toc - Plan #5 PacificSource Health Plans | ||||||||||||||||||||
Gold
(PPO) Navigator Gold 1500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$508.00 $577.00 $650.00 $908.00 $1,380.00 |
$897.00 $966.00 $1,039.00 $1,297.00 |
$1,286.00 $1,355.00 $1,428.00 $1,686.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,016.00 $1,154.00 $1,300.00 $1,816.00 $2,760.00 |
$1,405.00 $1,543.00 $1,689.00 $2,205.00 |
$1,794.00 $1,932.00 $2,078.00 $2,594.00 |
Toc - Plan #6 PacificSource Health Plans | ||||||||||||||||||||
Gold
(PPO) Navigator Gold 1500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$508.00 $577.00 $650.00 $908.00 $1,380.00 |
$897.00 $966.00 $1,039.00 $1,297.00 |
$1,286.00 $1,355.00 $1,428.00 $1,686.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,016.00 $1,154.00 $1,300.00 $1,816.00 $2,760.00 |
$1,405.00 $1,543.00 $1,689.00 $2,205.00 |
$1,794.00 $1,932.00 $2,078.00 $2,594.00 |
Toc - Plan #7 PacificSource Health Plans | ||||||||||||||||||||
Expanded Bronze
(PPO) Navigator Bronze 7000 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$356.00 $404.00 $455.00 $636.00 $967.00 |
$629.00 $677.00 $728.00 $909.00 |
$902.00 $950.00 $1,001.00 $1,182.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$712.00 $808.00 $910.00 $1,272.00 $1,934.00 |
$985.00 $1,081.00 $1,183.00 $1,545.00 |
$1,258.00 $1,354.00 $1,456.00 $1,818.00 |
Toc - Plan #8 PacificSource Health Plans | ||||||||||||||||||||
Expanded Bronze
(PPO) Navigator Bronze 7000 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$356.00 $404.00 $455.00 $636.00 $967.00 |
$629.00 $677.00 $728.00 $909.00 |
$902.00 $950.00 $1,001.00 $1,182.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$712.00 $808.00 $910.00 $1,272.00 $1,934.00 |
$985.00 $1,081.00 $1,183.00 $1,545.00 |
$1,258.00 $1,354.00 $1,456.00 $1,818.00 |
Toc - Plan #9 PacificSource Health Plans | ||||||||||||||||||||
Silver
(PPO) Navigator Silver 5000 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$453.00 $514.00 $579.00 $809.00 $1,230.00 |
$800.00 $861.00 $926.00 $1,156.00 |
$1,147.00 $1,208.00 $1,273.00 $1,503.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$906.00 $1,028.00 $1,158.00 $1,618.00 $2,460.00 |
$1,253.00 $1,375.00 $1,505.00 $1,965.00 |
$1,600.00 $1,722.00 $1,852.00 $2,312.00 |
Toc - Plan #10 PacificSource Health Plans | ||||||||||||||||||||
Silver
(PPO) Navigator Silver 5000 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$453.00 $514.00 $579.00 $809.00 $1,230.00 |
$800.00 $861.00 $926.00 $1,156.00 |
$1,147.00 $1,208.00 $1,273.00 $1,503.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$906.00 $1,028.00 $1,158.00 $1,618.00 $2,460.00 |
$1,253.00 $1,375.00 $1,505.00 $1,965.00 |
$1,600.00 $1,722.00 $1,852.00 $2,312.00 |
Toc - Plan #11 PacificSource Health Plans | ||||||||||||||||||||
Bronze
(PPO) Navigator Bronze 9100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$320.00 $364.00 $409.00 $572.00 $869.00 |
$565.00 $609.00 $654.00 $817.00 |
$810.00 $854.00 $899.00 $1,062.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$640.00 $728.00 $818.00 $1,144.00 $1,738.00 |
$885.00 $973.00 $1,063.00 $1,389.00 |
$1,130.00 $1,218.00 $1,308.00 $1,634.00 |
Toc - Plan #12 PacificSource Health Plans | ||||||||||||||||||||
Bronze
(PPO) Navigator Bronze 9100 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$320.00 $364.00 $409.00 $572.00 $869.00 |
$565.00 $609.00 $654.00 $817.00 |
$810.00 $854.00 $899.00 $1,062.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640.00 $728.00 $818.00 $1,144.00 $1,738.00 |
$885.00 $973.00 $1,063.00 $1,389.00 |
$1,130.00 $1,218.00 $1,308.00 $1,634.00 |
Toc - Plan #13 PacificSource Health Plans | ||||||||||||||||||||
Expanded Bronze
(PPO) Navigator Standard Expanded Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$351.00 $398.00 $448.00 $626.00 $952.00 |
$619.00 $666.00 $716.00 $894.00 |
$887.00 $934.00 $984.00 $1,162.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$702.00 $796.00 $896.00 $1,252.00 $1,904.00 |
$970.00 $1,064.00 $1,164.00 $1,520.00 |
$1,238.00 $1,332.00 $1,432.00 $1,788.00 |
Toc - Plan #14 PacificSource Health Plans | ||||||||||||||||||||
Expanded Bronze
(PPO) Navigator Standard Expanded Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$351.00 $398.00 $448.00 $626.00 $952.00 |
$619.00 $666.00 $716.00 $894.00 |
$887.00 $934.00 $984.00 $1,162.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$702.00 $796.00 $896.00 $1,252.00 $1,904.00 |
$970.00 $1,064.00 $1,164.00 $1,520.00 |
$1,238.00 $1,332.00 $1,432.00 $1,788.00 |
Toc - Plan #15 PacificSource Health Plans | ||||||||||||||||||||
Silver
(PPO) Navigator Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$447.00 $507.00 $571.00 $799.00 $1,213.00 |
$789.00 $849.00 $913.00 $1,141.00 |
$1,131.00 $1,191.00 $1,255.00 $1,483.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$894.00 $1,014.00 $1,142.00 $1,598.00 $2,426.00 |
$1,236.00 $1,356.00 $1,484.00 $1,940.00 |
$1,578.00 $1,698.00 $1,826.00 $2,282.00 |
Toc - Plan #16 PacificSource Health Plans | ||||||||||||||||||||
Silver
(PPO) Navigator Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$447.00 $507.00 $571.00 $799.00 $1,213.00 |
$789.00 $849.00 $913.00 $1,141.00 |
$1,131.00 $1,191.00 $1,255.00 $1,483.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$894.00 $1,014.00 $1,142.00 $1,598.00 $2,426.00 |
$1,236.00 $1,356.00 $1,484.00 $1,940.00 |
$1,578.00 $1,698.00 $1,826.00 $2,282.00 |
Toc - Plan #17 PacificSource Health Plans | ||||||||||||||||||||
Gold
(PPO) Navigator Standard Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$474.00 $538.00 $606.00 $847.00 $1,286.00 |
$837.00 $901.00 $969.00 $1,210.00 |
$1,200.00 $1,264.00 $1,332.00 $1,573.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$948.00 $1,076.00 $1,212.00 $1,694.00 $2,572.00 |
$1,311.00 $1,439.00 $1,575.00 $2,057.00 |
$1,674.00 $1,802.00 $1,938.00 $2,420.00 |
Toc - Plan #18 PacificSource Health Plans | ||||||||||||||||||||
Gold
(PPO) Navigator Standard Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-590-1596
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$474.00 $538.00 $606.00 $847.00 $1,286.00 |
$837.00 $901.00 $969.00 $1,210.00 |
$1,200.00 $1,264.00 $1,332.00 $1,573.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$948.00 $1,076.00 $1,212.00 $1,694.00 $2,572.00 |
$1,311.00 $1,439.00 $1,575.00 $2,057.00 |
$1,674.00 $1,802.00 $1,938.00 $2,420.00 |
ADVERTISEMENT
Blue Cross and Blue Shield of MontanaLocal: 1-855-258-8471 | Toll Free: 1-855-258-8471 | TTY: 1-406-444-4212 |
Toc - Plan #19 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Gold
(PPO) Blue Preferred Gold PPO? 204 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$483.30 $548.54 $617.66 $863.17 $1,311.67 |
$853.02 $918.26 $987.38 $1,232.89 |
$1,222.74 $1,287.98 $1,357.10 $1,602.61 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$966.60 $1,097.08 $1,235.32 $1,726.34 $2,623.34 |
$1,336.32 $1,466.80 $1,605.04 $2,096.06 |
$1,706.04 $1,836.52 $1,974.76 $2,465.78 |
Toc - Plan #20 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Silver
(PPO) Blue Preferred Silver PPO? 203 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$453.80 $515.06 $579.95 $810.48 $1,231.61 |
$800.96 $862.22 $927.11 $1,157.64 |
$1,148.12 $1,209.38 $1,274.27 $1,504.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$907.60 $1,030.12 $1,159.90 $1,620.96 $2,463.22 |
$1,254.76 $1,377.28 $1,507.06 $1,968.12 |
$1,601.92 $1,724.44 $1,854.22 $2,315.28 |
Toc - Plan #21 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Preferred Bronze PPO? 201 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$347.42 $394.32 $444.00 $620.49 $942.89 |
$613.19 $660.09 $709.77 $886.26 |
$878.96 $925.86 $975.54 $1,152.03 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$694.84 $788.64 $888.00 $1,240.98 $1,885.78 |
$960.61 $1,054.41 $1,153.77 $1,506.75 |
$1,226.38 $1,320.18 $1,419.54 $1,772.52 |
Toc - Plan #22 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Preferred Bronze PPO? 202 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$369.67 $419.57 $472.44 $660.23 $1,003.28 |
$652.47 $702.37 $755.24 $943.03 |
$935.27 $985.17 $1,038.04 $1,225.83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$739.34 $839.14 $944.88 $1,320.46 $2,006.56 |
$1,022.14 $1,121.94 $1,227.68 $1,603.26 |
$1,304.94 $1,404.74 $1,510.48 $1,886.06 |
Toc - Plan #23 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Catastrophic
(PPO) Blue Preferred Security PPO? 200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.92 $333.60 $375.63 $524.94 $797.69 |
$518.77 $558.45 $600.48 $749.79 |
$743.62 $783.30 $825.33 $974.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$587.84 $667.20 $751.26 $1,049.88 $1,595.38 |
$812.69 $892.05 $976.11 $1,274.73 |
$1,037.54 $1,116.90 $1,200.96 $1,499.58 |
Toc - Plan #24 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Silver
(PPO) Blue Preferred Silver PPO? 308 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$435.16 $493.91 $556.13 $777.19 $1,181.02 |
$768.06 $826.81 $889.03 $1,110.09 |
$1,100.96 $1,159.71 $1,221.93 $1,442.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$870.32 $987.82 $1,112.26 $1,554.38 $2,362.04 |
$1,203.22 $1,320.72 $1,445.16 $1,887.28 |
$1,536.12 $1,653.62 $1,778.06 $2,220.18 |
Toc - Plan #25 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Bronze
(PPO) Blue Preferred Bronze PPO? 301 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.21 $381.60 $429.68 $600.47 $912.47 |
$593.41 $638.80 $686.88 $857.67 |
$850.61 $896.00 $944.08 $1,114.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.42 $763.20 $859.36 $1,200.94 $1,824.94 |
$929.62 $1,020.40 $1,116.56 $1,458.14 |
$1,186.82 $1,277.60 $1,373.76 $1,715.34 |
Toc - Plan #26 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Preferred Bronze PPO? 705 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.75 $416.26 $468.71 $655.02 $995.36 |
$647.32 $696.83 $749.28 $935.59 |
$927.89 $977.40 $1,029.85 $1,216.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$733.50 $832.52 $937.42 $1,310.04 $1,990.72 |
$1,014.07 $1,113.09 $1,217.99 $1,590.61 |
$1,294.64 $1,393.66 $1,498.56 $1,871.18 |
Toc - Plan #27 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Gold
(PPO) Blue Preferred Gold PPO? 704 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$479.41 $544.13 $612.69 $856.23 $1,301.12 |
$846.16 $910.88 $979.44 $1,222.98 |
$1,212.91 $1,277.63 $1,346.19 $1,589.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$958.82 $1,088.26 $1,225.38 $1,712.46 $2,602.24 |
$1,325.57 $1,455.01 $1,592.13 $2,079.21 |
$1,692.32 $1,821.76 $1,958.88 $2,445.96 |
Toc - Plan #28 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Silver
(PPO) Blue Preferred Silver PPO? 703 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.02 $502.82 $566.17 $791.23 $1,202.35 |
$781.93 $841.73 $905.08 $1,130.14 |
$1,120.84 $1,180.64 $1,243.99 $1,469.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$886.04 $1,005.64 $1,132.34 $1,582.46 $2,404.70 |
$1,224.95 $1,344.55 $1,471.25 $1,921.37 |
$1,563.86 $1,683.46 $1,810.16 $2,260.28 |
Toc - Plan #29 Blue Cross and Blue Shield of Montana | ||||||||||||||||||||
Bronze
(PPO) Blue Preferred Bronze PPO? 701 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-258-8471
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$328.99 $373.41 $420.45 $587.58 $892.88 |
$580.67 $625.09 $672.13 $839.26 |
$832.35 $876.77 $923.81 $1,090.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$657.98 $746.82 $840.90 $1,175.16 $1,785.76 |
$909.66 $998.50 $1,092.58 $1,426.84 |
$1,161.34 $1,250.18 $1,344.26 $1,678.52 |
ADVERTISEMENT
Mountain Health CO-OPLocal: 1-406-447-9510 | Toll Free: 1-855-447-2900 | TTY: 1-855-447-2900 |
Toc - Plan #30 Mountain Health CO-OP | ||||||||||||||||||||
Gold
(PPO) Plus Ind Gold MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.13 $479.12 $539.48 $753.93 $1,145.67 |
$745.06 $802.05 $862.41 $1,076.86 |
$1,067.99 $1,124.98 $1,185.34 $1,399.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$844.26 $958.24 $1,078.96 $1,507.86 $2,291.34 |
$1,167.19 $1,281.17 $1,401.89 $1,830.79 |
$1,490.12 $1,604.10 $1,724.82 $2,153.72 |
Toc - Plan #31 Mountain Health CO-OP | ||||||||||||||||||||
Silver
(PPO) Plus Ind Silver MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$380.13 $431.45 $485.81 $678.92 $1,031.69 |
$670.93 $722.25 $776.61 $969.72 |
$961.73 $1,013.05 $1,067.41 $1,260.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$760.26 $862.90 $971.62 $1,357.84 $2,063.38 |
$1,051.06 $1,153.70 $1,262.42 $1,648.64 |
$1,341.86 $1,444.50 $1,553.22 $1,939.44 |
Toc - Plan #32 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Plus Ind Bronze MT Expanded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$285.74 $324.32 $365.18 $510.34 $775.51 |
$504.33 $542.91 $583.77 $728.93 |
$722.92 $761.50 $802.36 $947.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$571.48 $648.64 $730.36 $1,020.68 $1,551.02 |
$790.07 $867.23 $948.95 $1,239.27 |
$1,008.66 $1,085.82 $1,167.54 $1,457.86 |
Toc - Plan #33 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Plus Ind Bronze MT HD |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.92 $333.60 $375.63 $524.94 $797.69 |
$518.77 $558.45 $600.48 $749.79 |
$743.62 $783.30 $825.33 $974.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$587.84 $667.20 $751.26 $1,049.88 $1,595.38 |
$812.69 $892.05 $976.11 $1,274.73 |
$1,037.54 $1,116.90 $1,200.96 $1,499.58 |
Toc - Plan #34 Mountain Health CO-OP | ||||||||||||||||||||
Gold
(PPO) Plus Ind Gold Standard MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.34 $475.95 $535.91 $748.94 $1,138.08 |
$740.13 $796.74 $856.70 $1,069.73 |
$1,060.92 $1,117.53 $1,177.49 $1,390.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$838.68 $951.90 $1,071.82 $1,497.88 $2,276.16 |
$1,159.47 $1,272.69 $1,392.61 $1,818.67 |
$1,480.26 $1,593.48 $1,713.40 $2,139.46 |
Toc - Plan #35 Mountain Health CO-OP | ||||||||||||||||||||
Silver
(PPO) Plus Ind Silver Standard MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.13 $440.53 $496.03 $693.20 $1,053.38 |
$685.05 $737.45 $792.95 $990.12 |
$981.97 $1,034.37 $1,089.87 $1,287.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.26 $881.06 $992.06 $1,386.40 $2,106.76 |
$1,073.18 $1,177.98 $1,288.98 $1,683.32 |
$1,370.10 $1,474.90 $1,585.90 $1,980.24 |
Toc - Plan #36 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Plus Ind Bronze Standard MT Expanded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$290.36 $329.56 $371.08 $518.58 $788.03 |
$512.48 $551.68 $593.20 $740.70 |
$734.60 $773.80 $815.32 $962.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$580.72 $659.12 $742.16 $1,037.16 $1,576.06 |
$802.84 $881.24 $964.28 $1,259.28 |
$1,024.96 $1,103.36 $1,186.40 $1,481.40 |
Toc - Plan #37 Mountain Health CO-OP | ||||||||||||||||||||
Gold
(PPO) Connect Ind Gold MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$463.25 $525.79 $592.03 $827.36 $1,257.26 |
$817.64 $880.18 $946.42 $1,181.75 |
$1,172.03 $1,234.57 $1,300.81 $1,536.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$926.50 $1,051.58 $1,184.06 $1,654.72 $2,514.52 |
$1,280.89 $1,405.97 $1,538.45 $2,009.11 |
$1,635.28 $1,760.36 $1,892.84 $2,363.50 |
Toc - Plan #38 Mountain Health CO-OP | ||||||||||||||||||||
Silver
(PPO) Connect Ind Silver MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.36 $479.38 $539.77 $754.33 $1,146.28 |
$745.46 $802.48 $862.87 $1,077.43 |
$1,068.56 $1,125.58 $1,185.97 $1,400.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$844.72 $958.76 $1,079.54 $1,508.66 $2,292.56 |
$1,167.82 $1,281.86 $1,402.64 $1,831.76 |
$1,490.92 $1,604.96 $1,725.74 $2,154.86 |
Toc - Plan #39 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Connect Ind Bronze MT Expanded 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306.37 $347.73 $391.54 $547.18 $831.50 |
$540.75 $582.11 $625.92 $781.56 |
$775.13 $816.49 $860.30 $1,015.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612.74 $695.46 $783.08 $1,094.36 $1,663.00 |
$847.12 $929.84 $1,017.46 $1,328.74 |
$1,081.50 $1,164.22 $1,251.84 $1,563.12 |
Toc - Plan #40 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Connect Ind Bronze MT HD |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.68 $365.11 $411.11 $574.52 $873.05 |
$567.77 $611.20 $657.20 $820.61 |
$813.86 $857.29 $903.29 $1,066.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$643.36 $730.22 $822.22 $1,149.04 $1,746.10 |
$889.45 $976.31 $1,068.31 $1,395.13 |
$1,135.54 $1,222.40 $1,314.40 $1,641.22 |
Toc - Plan #41 Mountain Health CO-OP | ||||||||||||||||||||
Silver
(PPO) Connect Ind Silver MT Option 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.12 $466.63 $525.42 $734.27 $1,115.79 |
$725.63 $781.14 $839.93 $1,048.78 |
$1,040.14 $1,095.65 $1,154.44 $1,363.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.24 $933.26 $1,050.84 $1,468.54 $2,231.58 |
$1,136.75 $1,247.77 $1,365.35 $1,783.05 |
$1,451.26 $1,562.28 $1,679.86 $2,097.56 |
Toc - Plan #42 Mountain Health CO-OP | ||||||||||||||||||||
Catastrophic
(PPO) Connect Ind Catastrophic MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$209.44 $237.71 $267.66 $374.06 $568.42 |
$369.66 $397.93 $427.88 $534.28 |
$529.88 $558.15 $588.10 $694.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$418.88 $475.42 $535.32 $748.12 $1,136.84 |
$579.10 $635.64 $695.54 $908.34 |
$739.32 $795.86 $855.76 $1,068.56 |
Toc - Plan #43 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Connect Ind Bronze MT Expanded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$319.51 $362.64 $408.33 $570.64 $867.14 |
$563.93 $607.06 $652.75 $815.06 |
$808.35 $851.48 $897.17 $1,059.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$639.02 $725.28 $816.66 $1,141.28 $1,734.28 |
$883.44 $969.70 $1,061.08 $1,385.70 |
$1,127.86 $1,214.12 $1,305.50 $1,630.12 |
Toc - Plan #44 Mountain Health CO-OP | ||||||||||||||||||||
Gold
(PPO) Connect Ind Gold Standard MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$456.26 $517.85 $583.10 $814.88 $1,238.29 |
$805.30 $866.89 $932.14 $1,163.92 |
$1,154.34 $1,215.93 $1,281.18 $1,512.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$912.52 $1,035.70 $1,166.20 $1,629.76 $2,476.58 |
$1,261.56 $1,384.74 $1,515.24 $1,978.80 |
$1,610.60 $1,733.78 $1,864.28 $2,327.84 |
Toc - Plan #45 Mountain Health CO-OP | ||||||||||||||||||||
Silver
(PPO) Connect Ind Silver Standard MT |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.63 $480.82 $541.40 $756.60 $1,149.72 |
$747.70 $804.89 $865.47 $1,080.67 |
$1,071.77 $1,128.96 $1,189.54 $1,404.74 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.26 $961.64 $1,082.80 $1,513.20 $2,299.44 |
$1,171.33 $1,285.71 $1,406.87 $1,837.27 |
$1,495.40 $1,609.78 $1,730.94 $2,161.34 |
Toc - Plan #46 Mountain Health CO-OP | ||||||||||||||||||||
Expanded Bronze
(PPO) Connect Ind Bronze Expanded Standard MT |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-447-2900
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.47 $359.19 $404.45 $565.21 $858.90 |
$558.57 $601.29 $646.55 $807.31 |
$800.67 $843.39 $888.65 $1,049.41 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$632.94 $718.38 $808.90 $1,130.42 $1,717.80 |
$875.04 $960.48 $1,051.00 $1,372.52 |
$1,117.14 $1,202.58 $1,293.10 $1,614.62 |
‡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 Sanders County here.
Sanders County is in “Rating Area 4” of Montana.
Currently, there are 46 plans offered in Rating Area 4.