Obamacare 2023 Rates for Pender County

Obamacare > Rates > North Carolina > Pender 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 Pender County, NC.

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, 52 Plans and 2023 Rates for Pender County, North Carolina

Below, you’ll find a summary of the 52 plans for Pender County, North Carolina 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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Blue Cross and Blue Shield of NC

Local: 1-800-324-4973 | Toll Free: 1-800-324-4973

Toc - Plan #1 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Simple | $0 Deductible | 3 Free PCP | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$557.22
$632.44
$712.13
$995.19
$1,512.30
$983.49
$1,058.71
$1,138.40
$1,421.46
$1,409.76
$1,484.98
$1,564.67
$1,847.73
$1,836.03
$1,911.25
$1,990.94
$2,274.00
$426.27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,114.44
$1,264.88
$1,424.26
$1,990.38
$3,024.60
$1,540.71
$1,691.15
$1,850.53
$2,416.65
$1,966.98
$2,117.42
$2,276.80
$2,842.92
$2,393.25
$2,543.69
$2,703.07
$3,269.19
$426.27
Toc - Plan #2 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Preferred 3100 | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$3,100 $6,200 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
$515.92
$585.57
$659.35
$921.43
$1,400.21
$910.60
$980.25
$1,054.03
$1,316.11
$1,305.28
$1,374.93
$1,448.71
$1,710.79
$1,699.96
$1,769.61
$1,843.39
$2,105.47
$394.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,031.84
$1,171.14
$1,318.70
$1,842.86
$2,800.42
$1,426.52
$1,565.82
$1,713.38
$2,237.54
$1,821.20
$1,960.50
$2,108.06
$2,632.22
$2,215.88
$2,355.18
$2,502.74
$3,026.90
$394.68
Toc - Plan #3 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Secure 1900 | $15 PCP | $15 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,900 $3,800 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
$536.46
$608.88
$685.60
$958.12
$1,455.95
$946.85
$1,019.27
$1,095.99
$1,368.51
$1,357.24
$1,429.66
$1,506.38
$1,778.90
$1,767.63
$1,840.05
$1,916.77
$2,189.29
$410.39
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,072.92
$1,217.76
$1,371.20
$1,916.24
$2,911.90
$1,483.31
$1,628.15
$1,781.59
$2,326.63
$1,893.70
$2,038.54
$2,191.98
$2,737.02
$2,304.09
$2,448.93
$2,602.37
$3,147.41
$410.39
Toc - Plan #4 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze 7000 | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$376.60
$427.44
$481.29
$672.61
$1,022.09
$664.70
$715.54
$769.39
$960.71
$952.80
$1,003.64
$1,057.49
$1,248.81
$1,240.90
$1,291.74
$1,345.59
$1,536.91
$288.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$753.20
$854.88
$962.58
$1,345.22
$2,044.18
$1,041.30
$1,142.98
$1,250.68
$1,633.32
$1,329.40
$1,431.08
$1,538.78
$1,921.42
$1,617.50
$1,719.18
$1,826.88
$2,209.52
$288.10
Toc - Plan #5 Blue Cross and Blue Shield of NC
Gold

(PPO) Blue Advantage Gold 1800 | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,800 $3,600 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
$530.04
$601.60
$677.39
$946.65
$1,438.53
$935.52
$1,007.08
$1,082.87
$1,352.13
$1,341.00
$1,412.56
$1,488.35
$1,757.61
$1,746.48
$1,818.04
$1,893.83
$2,163.09
$405.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,060.08
$1,203.20
$1,354.78
$1,893.30
$2,877.06
$1,465.56
$1,608.68
$1,760.26
$2,298.78
$1,871.04
$2,014.16
$2,165.74
$2,704.26
$2,276.52
$2,419.64
$2,571.22
$3,109.74
$405.48
Toc - Plan #6 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Total 3500 | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 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
$544.83
$618.38
$696.29
$973.07
$1,478.67
$961.62
$1,035.17
$1,113.08
$1,389.86
$1,378.41
$1,451.96
$1,529.87
$1,806.65
$1,795.20
$1,868.75
$1,946.66
$2,223.44
$416.79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,089.66
$1,236.76
$1,392.58
$1,946.14
$2,957.34
$1,506.45
$1,653.55
$1,809.37
$2,362.93
$1,923.24
$2,070.34
$2,226.16
$2,779.72
$2,340.03
$2,487.13
$2,642.95
$3,196.51
$416.79
Toc - Plan #7 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze 7500 | HSA Eligible | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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
$395.19
$448.54
$505.05
$705.81
$1,072.55
$697.51
$750.86
$807.37
$1,008.13
$999.83
$1,053.18
$1,109.69
$1,310.45
$1,302.15
$1,355.50
$1,412.01
$1,612.77
$302.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$790.38
$897.08
$1,010.10
$1,411.62
$2,145.10
$1,092.70
$1,199.40
$1,312.42
$1,713.94
$1,395.02
$1,501.72
$1,614.74
$2,016.26
$1,697.34
$1,804.04
$1,917.06
$2,318.58
$302.32
Toc - Plan #8 Blue Cross and Blue Shield of NC
Catastrophic

(PPO) Blue Advantage Catastrophic 9100 | 3 PCP $35 | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$276.72
$314.08
$353.65
$494.22
$751.02
$488.41
$525.77
$565.34
$705.91
$700.10
$737.46
$777.03
$917.60
$911.79
$949.15
$988.72
$1,129.29
$211.69
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$553.44
$628.16
$707.30
$988.44
$1,502.04
$765.13
$839.85
$918.99
$1,200.13
$976.82
$1,051.54
$1,130.68
$1,411.82
$1,188.51
$1,263.23
$1,342.37
$1,623.51
$211.69
Toc - Plan #9 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Choice 4000 | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 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
$538.63
$611.35
$688.37
$961.99
$1,461.84
$950.68
$1,023.40
$1,100.42
$1,374.04
$1,362.73
$1,435.45
$1,512.47
$1,786.09
$1,774.78
$1,847.50
$1,924.52
$2,198.14
$412.05
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,077.26
$1,222.70
$1,376.74
$1,923.98
$2,923.68
$1,489.31
$1,634.75
$1,788.79
$2,336.03
$1,901.36
$2,046.80
$2,200.84
$2,748.08
$2,313.41
$2,458.85
$2,612.89
$3,160.13
$412.05
Toc - Plan #10 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze 5500 | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 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
$397.97
$451.70
$508.61
$710.77
$1,080.09
$702.42
$756.15
$813.06
$1,015.22
$1,006.87
$1,060.60
$1,117.51
$1,319.67
$1,311.32
$1,365.05
$1,421.96
$1,624.12
$304.45
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$795.94
$903.40
$1,017.22
$1,421.54
$2,160.18
$1,100.39
$1,207.85
$1,321.67
$1,725.99
$1,404.84
$1,512.30
$1,626.12
$2,030.44
$1,709.29
$1,816.75
$1,930.57
$2,334.89
$304.45
Toc - Plan #11 Blue Cross and Blue Shield of NC
Bronze

(PPO) Blue Advantage Bronze 9100 | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$377.32
$428.26
$482.21
$673.89
$1,024.05
$665.97
$716.91
$770.86
$962.54
$954.62
$1,005.56
$1,059.51
$1,251.19
$1,243.27
$1,294.21
$1,348.16
$1,539.84
$288.65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$754.64
$856.52
$964.42
$1,347.78
$2,048.10
$1,043.29
$1,145.17
$1,253.07
$1,636.43
$1,331.94
$1,433.82
$1,541.72
$1,925.08
$1,620.59
$1,722.47
$1,830.37
$2,213.73
$288.65
Toc - Plan #12 Blue Cross and Blue Shield of NC
Gold

(PPO) Blue Advantage Gold Standard 2000 | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$528.09
$599.38
$674.90
$943.17
$1,433.24
$932.08
$1,003.37
$1,078.89
$1,347.16
$1,336.07
$1,407.36
$1,482.88
$1,751.15
$1,740.06
$1,811.35
$1,886.87
$2,155.14
$403.99
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,056.18
$1,198.76
$1,349.80
$1,886.34
$2,866.48
$1,460.17
$1,602.75
$1,753.79
$2,290.33
$1,864.16
$2,006.74
$2,157.78
$2,694.32
$2,268.15
$2,410.73
$2,561.77
$3,098.31
$403.99
Toc - Plan #13 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Standard 5800 | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$534.22
$606.34
$682.73
$954.12
$1,449.87
$942.90
$1,015.02
$1,091.41
$1,362.80
$1,351.58
$1,423.70
$1,500.09
$1,771.48
$1,760.26
$1,832.38
$1,908.77
$2,180.16
$408.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,068.44
$1,212.68
$1,365.46
$1,908.24
$2,899.74
$1,477.12
$1,621.36
$1,774.14
$2,316.92
$1,885.80
$2,030.04
$2,182.82
$2,725.60
$2,294.48
$2,438.72
$2,591.50
$3,134.28
$408.68
Toc - Plan #14 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze Standard 7500 | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$377.04
$427.94
$481.86
$673.39
$1,023.29
$665.48
$716.38
$770.30
$961.83
$953.92
$1,004.82
$1,058.74
$1,250.27
$1,242.36
$1,293.26
$1,347.18
$1,538.71
$288.44
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$754.08
$855.88
$963.72
$1,346.78
$2,046.58
$1,042.52
$1,144.32
$1,252.16
$1,635.22
$1,330.96
$1,432.76
$1,540.60
$1,923.66
$1,619.40
$1,721.20
$1,829.04
$2,212.10
$288.44
Toc - Plan #15 Blue Cross and Blue Shield of NC
Bronze

(POS) Blue Value Bronze 9100 | Integrated | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$331.61
$376.38
$423.80
$592.26
$899.99
$585.29
$630.06
$677.48
$845.94
$838.97
$883.74
$931.16
$1,099.62
$1,092.65
$1,137.42
$1,184.84
$1,353.30
$253.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$663.22
$752.76
$847.60
$1,184.52
$1,799.98
$916.90
$1,006.44
$1,101.28
$1,438.20
$1,170.58
$1,260.12
$1,354.96
$1,691.88
$1,424.26
$1,513.80
$1,608.64
$1,945.56
$253.68
Toc - Plan #16 Blue Cross and Blue Shield of NC
Gold

(POS) Blue Value Gold 1800 | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,800 $3,600 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
$465.80
$528.68
$595.29
$831.92
$1,264.18
$822.14
$885.02
$951.63
$1,188.26
$1,178.48
$1,241.36
$1,307.97
$1,544.60
$1,534.82
$1,597.70
$1,664.31
$1,900.94
$356.34
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$931.60
$1,057.36
$1,190.58
$1,663.84
$2,528.36
$1,287.94
$1,413.70
$1,546.92
$2,020.18
$1,644.28
$1,770.04
$1,903.26
$2,376.52
$2,000.62
$2,126.38
$2,259.60
$2,732.86
$356.34
Toc - Plan #17 Blue Cross and Blue Shield of NC
Expanded Bronze

(POS) Blue Value Bronze 7500 | HSA Eligible | Integrated | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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
$347.29
$394.17
$443.84
$620.26
$942.55
$612.97
$659.85
$709.52
$885.94
$878.65
$925.53
$975.20
$1,151.62
$1,144.33
$1,191.21
$1,240.88
$1,417.30
$265.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$694.58
$788.34
$887.68
$1,240.52
$1,885.10
$960.26
$1,054.02
$1,153.36
$1,506.20
$1,225.94
$1,319.70
$1,419.04
$1,771.88
$1,491.62
$1,585.38
$1,684.72
$2,037.56
$265.68
Toc - Plan #18 Blue Cross and Blue Shield of NC
Catastrophic

(POS) Blue Value Catastrophic 9100 | 3 PCP $35 | Integrated | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$243.21
$276.04
$310.82
$434.37
$660.07
$429.27
$462.10
$496.88
$620.43
$615.33
$648.16
$682.94
$806.49
$801.39
$834.22
$869.00
$992.55
$186.06
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$486.42
$552.08
$621.64
$868.74
$1,320.14
$672.48
$738.14
$807.70
$1,054.80
$858.54
$924.20
$993.76
$1,240.86
$1,044.60
$1,110.26
$1,179.82
$1,426.92
$186.06
Toc - Plan #19 Blue Cross and Blue Shield of NC
Silver

(POS) Blue Value Silver Choice 4000 | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 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
$473.34
$537.24
$604.93
$845.39
$1,284.64
$835.45
$899.35
$967.04
$1,207.50
$1,197.56
$1,261.46
$1,329.15
$1,569.61
$1,559.67
$1,623.57
$1,691.26
$1,931.72
$362.11
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$946.68
$1,074.48
$1,209.86
$1,690.78
$2,569.28
$1,308.79
$1,436.59
$1,571.97
$2,052.89
$1,670.90
$1,798.70
$1,934.08
$2,415.00
$2,033.01
$2,160.81
$2,296.19
$2,777.11
$362.11
Toc - Plan #20 Blue Cross and Blue Shield of NC
Expanded Bronze

(POS) Blue Value Bronze 5500 | $60 PCP | $20 Tier 1 Rx | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 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
$349.75
$396.97
$446.98
$624.65
$949.22
$617.31
$664.53
$714.54
$892.21
$884.87
$932.09
$982.10
$1,159.77
$1,152.43
$1,199.65
$1,249.66
$1,427.33
$267.56
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$699.50
$793.94
$893.96
$1,249.30
$1,898.44
$967.06
$1,061.50
$1,161.52
$1,516.86
$1,234.62
$1,329.06
$1,429.08
$1,784.42
$1,502.18
$1,596.62
$1,696.64
$2,051.98
$267.56
Toc - Plan #21 Blue Cross and Blue Shield of NC
Silver

(POS) Blue Value Silver Total 3500 | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 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
$478.83
$543.47
$611.94
$855.19
$1,299.54
$845.13
$909.77
$978.24
$1,221.49
$1,211.43
$1,276.07
$1,344.54
$1,587.79
$1,577.73
$1,642.37
$1,710.84
$1,954.09
$366.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$957.66
$1,086.94
$1,223.88
$1,710.38
$2,599.08
$1,323.96
$1,453.24
$1,590.18
$2,076.68
$1,690.26
$1,819.54
$1,956.48
$2,442.98
$2,056.56
$2,185.84
$2,322.78
$2,809.28
$366.30
Toc - Plan #22 Blue Cross and Blue Shield of NC
Silver

(POS) Blue Value Silver Simple | $0 Deductible | 3 Free PCP | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$489.72
$555.83
$625.86
$874.64
$1,329.10
$864.36
$930.47
$1,000.50
$1,249.28
$1,239.00
$1,305.11
$1,375.14
$1,623.92
$1,613.64
$1,679.75
$1,749.78
$1,998.56
$374.64
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$979.44
$1,111.66
$1,251.72
$1,749.28
$2,658.20
$1,354.08
$1,486.30
$1,626.36
$2,123.92
$1,728.72
$1,860.94
$2,001.00
$2,498.56
$2,103.36
$2,235.58
$2,375.64
$2,873.20
$374.64
Toc - Plan #23 Blue Cross and Blue Shield of NC
Silver

(POS) Blue Value Silver Preferred 3100 | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$3,100 $6,200 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
$453.45
$514.67
$579.51
$809.86
$1,230.66
$800.34
$861.56
$926.40
$1,156.75
$1,147.23
$1,208.45
$1,273.29
$1,503.64
$1,494.12
$1,555.34
$1,620.18
$1,850.53
$346.89
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$906.90
$1,029.34
$1,159.02
$1,619.72
$2,461.32
$1,253.79
$1,376.23
$1,505.91
$1,966.61
$1,600.68
$1,723.12
$1,852.80
$2,313.50
$1,947.57
$2,070.01
$2,199.69
$2,660.39
$346.89
Toc - Plan #24 Blue Cross and Blue Shield of NC
Silver

(POS) Blue Value Silver Secure 1900 | $15 PCP | $15 Tier 1 Rx | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,900 $3,800 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
$471.44
$535.08
$602.50
$841.99
$1,279.49
$832.09
$895.73
$963.15
$1,202.64
$1,192.74
$1,256.38
$1,323.80
$1,563.29
$1,553.39
$1,617.03
$1,684.45
$1,923.94
$360.65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$942.88
$1,070.16
$1,205.00
$1,683.98
$2,558.98
$1,303.53
$1,430.81
$1,565.65
$2,044.63
$1,664.18
$1,791.46
$1,926.30
$2,405.28
$2,024.83
$2,152.11
$2,286.95
$2,765.93
$360.65
Toc - Plan #25 Blue Cross and Blue Shield of NC
Expanded Bronze

(POS) Blue Value Bronze 7000 | 3 Free PCP | $20 Tier 1 Rx | Integrated | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$330.96
$375.64
$422.97
$591.09
$898.23
$584.14
$628.82
$676.15
$844.27
$837.32
$882.00
$929.33
$1,097.45
$1,090.50
$1,135.18
$1,182.51
$1,350.63
$253.18
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$661.92
$751.28
$845.94
$1,182.18
$1,796.46
$915.10
$1,004.46
$1,099.12
$1,435.36
$1,168.28
$1,257.64
$1,352.30
$1,688.54
$1,421.46
$1,510.82
$1,605.48
$1,941.72
$253.18
Toc - Plan #26 Blue Cross and Blue Shield of NC
Gold

(POS) Blue Value Gold Standard 2000 | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$464.04
$526.69
$593.04
$828.78
$1,259.40
$819.03
$881.68
$948.03
$1,183.77
$1,174.02
$1,236.67
$1,303.02
$1,538.76
$1,529.01
$1,591.66
$1,658.01
$1,893.75
$354.99
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$928.08
$1,053.38
$1,186.08
$1,657.56
$2,518.80
$1,283.07
$1,408.37
$1,541.07
$2,012.55
$1,638.06
$1,763.36
$1,896.06
$2,367.54
$1,993.05
$2,118.35
$2,251.05
$2,722.53
$354.99
Toc - Plan #27 Blue Cross and Blue Shield of NC
Silver

(POS) Blue Value Silver Standard 5800 | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$469.49
$532.87
$600.01
$838.51
$1,274.20
$828.65
$892.03
$959.17
$1,197.67
$1,187.81
$1,251.19
$1,318.33
$1,556.83
$1,546.97
$1,610.35
$1,677.49
$1,915.99
$359.16
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$938.98
$1,065.74
$1,200.02
$1,677.02
$2,548.40
$1,298.14
$1,424.90
$1,559.18
$2,036.18
$1,657.30
$1,784.06
$1,918.34
$2,395.34
$2,016.46
$2,143.22
$2,277.50
$2,754.50
$359.16
Toc - Plan #28 Blue Cross and Blue Shield of NC
Expanded Bronze

(POS) Blue Value Bronze Standard 7500 | Statewide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

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
$331.36
$376.09
$423.48
$591.81
$899.31
$584.85
$629.58
$676.97
$845.30
$838.34
$883.07
$930.46
$1,098.79
$1,091.83
$1,136.56
$1,183.95
$1,352.28
$253.49
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$662.72
$752.18
$846.96
$1,183.62
$1,798.62
$916.21
$1,005.67
$1,100.45
$1,437.11
$1,169.70
$1,259.16
$1,353.94
$1,690.60
$1,423.19
$1,512.65
$1,607.43
$1,944.09
$253.49

ADVERTISEMENT

WellCare of North Carolina

Local: 1-833-705-2175 | Toll Free: 1-833-705-2175

Toc - Plan #29 WellCare of North Carolina
Expanded Bronze

(PPO) WellCare Secure Health Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-705-2175

Annual Out of Pocket Expenses:

Individual Family
$7,100 $14,200 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
$630.29
$715.37
$805.50
$1,125.69
$1,710.59
$1,112.46
$1,197.54
$1,287.67
$1,607.86
$1,594.63
$1,679.71
$1,769.84
$2,090.03
$2,076.80
$2,161.88
$2,252.01
$2,572.20
$482.17
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,260.58
$1,430.74
$1,611.00
$2,251.38
$3,421.18
$1,742.75
$1,912.91
$2,093.17
$2,733.55
$2,224.92
$2,395.08
$2,575.34
$3,215.72
$2,707.09
$2,877.25
$3,057.51
$3,697.89
$482.17
Toc - Plan #30 WellCare of North Carolina
Silver

(PPO) WellCare Secure Health Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-705-2175

Annual Out of Pocket Expenses:

Individual Family
$8,100 $16,200 Annual Deductible
$8,100 $16,200 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
$808.58
$917.73
$1,033.36
$1,444.11
$2,194.47
$1,427.14
$1,536.29
$1,651.92
$2,062.67
$2,045.70
$2,154.85
$2,270.48
$2,681.23
$2,664.26
$2,773.41
$2,889.04
$3,299.79
$618.56
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,617.16
$1,835.46
$2,066.72
$2,888.22
$4,388.94
$2,235.72
$2,454.02
$2,685.28
$3,506.78
$2,854.28
$3,072.58
$3,303.84
$4,125.34
$3,472.84
$3,691.14
$3,922.40
$4,743.90
$618.56
Toc - Plan #31 WellCare of North Carolina
Gold

(PPO) WellCare Secure Health Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-705-2175

Annual Out of Pocket Expenses:

Individual Family
$1,850 $3,700 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
$836.64
$949.58
$1,069.22
$1,494.23
$2,270.62
$1,476.66
$1,589.60
$1,709.24
$2,134.25
$2,116.68
$2,229.62
$2,349.26
$2,774.27
$2,756.70
$2,869.64
$2,989.28
$3,414.29
$640.02
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,673.28
$1,899.16
$2,138.44
$2,988.46
$4,541.24
$2,313.30
$2,539.18
$2,778.46
$3,628.48
$2,953.32
$3,179.20
$3,418.48
$4,268.50
$3,593.34
$3,819.22
$4,058.50
$4,908.52
$640.02
Toc - Plan #32 WellCare of North Carolina
Expanded Bronze

(PPO) CMS Standard Expanded Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-705-2175

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
$631.35
$716.57
$806.85
$1,127.56
$1,713.44
$1,114.32
$1,199.54
$1,289.82
$1,610.53
$1,597.29
$1,682.51
$1,772.79
$2,093.50
$2,080.26
$2,165.48
$2,255.76
$2,576.47
$482.97
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,262.70
$1,433.14
$1,613.70
$2,255.12
$3,426.88
$1,745.67
$1,916.11
$2,096.67
$2,738.09
$2,228.64
$2,399.08
$2,579.64
$3,221.06
$2,711.61
$2,882.05
$3,062.61
$3,704.03
$482.97
Toc - Plan #33 WellCare of North Carolina
Silver

(PPO) CMS Standard Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-705-2175

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
$798.80
$906.63
$1,020.86
$1,426.64
$2,167.92
$1,409.88
$1,517.71
$1,631.94
$2,037.72
$2,020.96
$2,128.79
$2,243.02
$2,648.80
$2,632.04
$2,739.87
$2,854.10
$3,259.88
$611.08
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,597.60
$1,813.26
$2,041.72
$2,853.28
$4,335.84
$2,208.68
$2,424.34
$2,652.80
$3,464.36
$2,819.76
$3,035.42
$3,263.88
$4,075.44
$3,430.84
$3,646.50
$3,874.96
$4,686.52
$611.08
Toc - Plan #34 WellCare of North Carolina
Gold

(PPO) CMS Standard Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-705-2175

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
$813.52
$923.33
$1,039.66
$1,452.92
$2,207.86
$1,435.85
$1,545.66
$1,661.99
$2,075.25
$2,058.18
$2,167.99
$2,284.32
$2,697.58
$2,680.51
$2,790.32
$2,906.65
$3,319.91
$622.33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,627.04
$1,846.66
$2,079.32
$2,905.84
$4,415.72
$2,249.37
$2,468.99
$2,701.65
$3,528.17
$2,871.70
$3,091.32
$3,323.98
$4,150.50
$3,494.03
$3,713.65
$3,946.31
$4,772.83
$622.33

ADVERTISEMENT

UnitedHealthcare

Local: 1-800-980-5357 | Toll Free: 1-800-980-5357 | TTY: 1-800-980-5357

Toc - Plan #35 UnitedHealthcare
Gold

(HMO) UHC Gold Value ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$1,900 $3,800 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
$530.60
$602.24
$678.11
$947.66
$1,440.06
$936.51
$1,008.15
$1,084.02
$1,353.57
$1,342.42
$1,414.06
$1,489.93
$1,759.48
$1,748.33
$1,819.97
$1,895.84
$2,165.39
$405.91
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,061.20
$1,204.48
$1,356.22
$1,895.32
$2,880.12
$1,467.11
$1,610.39
$1,762.13
$2,301.23
$1,873.02
$2,016.30
$2,168.04
$2,707.14
$2,278.93
$2,422.21
$2,573.95
$3,113.05
$405.91
Toc - Plan #36 UnitedHealthcare
Silver

(HMO) UHC Silver Value $3,000 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 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
$523.84
$594.56
$669.47
$935.58
$1,421.70
$924.58
$995.30
$1,070.21
$1,336.32
$1,325.32
$1,396.04
$1,470.95
$1,737.06
$1,726.06
$1,796.78
$1,871.69
$2,137.80
$400.74
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,047.68
$1,189.12
$1,338.94
$1,871.16
$2,843.40
$1,448.42
$1,589.86
$1,739.68
$2,271.90
$1,849.16
$1,990.60
$2,140.42
$2,672.64
$2,249.90
$2,391.34
$2,541.16
$3,073.38
$400.74
Toc - Plan #37 UnitedHealthcare
Silver

(HMO) UHC Silver Value $3,350 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$3,350 $6,700 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
$523.00
$593.60
$668.39
$934.07
$1,419.41
$923.09
$993.69
$1,068.48
$1,334.16
$1,323.18
$1,393.78
$1,468.57
$1,734.25
$1,723.27
$1,793.87
$1,868.66
$2,134.34
$400.09
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,046.00
$1,187.20
$1,336.78
$1,868.14
$2,838.82
$1,446.09
$1,587.29
$1,736.87
$2,268.23
$1,846.18
$1,987.38
$2,136.96
$2,668.32
$2,246.27
$2,387.47
$2,537.05
$3,068.41
$400.09
Toc - Plan #38 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value $7,500 Indiv Ded Saver ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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
$369.52
$419.41
$472.25
$659.97
$1,002.89
$652.21
$702.10
$754.94
$942.66
$934.90
$984.79
$1,037.63
$1,225.35
$1,217.59
$1,267.48
$1,320.32
$1,508.04
$282.69
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$739.04
$838.82
$944.50
$1,319.94
$2,005.78
$1,021.73
$1,121.51
$1,227.19
$1,602.63
$1,304.42
$1,404.20
$1,509.88
$1,885.32
$1,587.11
$1,686.89
$1,792.57
$2,168.01
$282.69
Toc - Plan #39 UnitedHealthcare
Gold

(HMO) UHC Gold Advantage ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$1,200 $2,400 Annual Deductible
$7,000 $14,000 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
$551.13
$625.53
$704.34
$984.32
$1,495.77
$972.74
$1,047.14
$1,125.95
$1,405.93
$1,394.35
$1,468.75
$1,547.56
$1,827.54
$1,815.96
$1,890.36
$1,969.17
$2,249.15
$421.61
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,102.26
$1,251.06
$1,408.68
$1,968.64
$2,991.54
$1,523.87
$1,672.67
$1,830.29
$2,390.25
$1,945.48
$2,094.28
$2,251.90
$2,811.86
$2,367.09
$2,515.89
$2,673.51
$3,233.47
$421.61
Toc - Plan #40 UnitedHealthcare
Gold

(HMO) UHC Gold Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $1 Generic Rx Pref Pharm, Dental + Vision, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$1,200 $2,400 Annual Deductible
$7,000 $14,000 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
$571.63
$648.79
$730.54
$1,020.92
$1,551.39
$1,008.92
$1,086.08
$1,167.83
$1,458.21
$1,446.21
$1,523.37
$1,605.12
$1,895.50
$1,883.50
$1,960.66
$2,042.41
$2,332.79
$437.29
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,143.26
$1,297.58
$1,461.08
$2,041.84
$3,102.78
$1,580.55
$1,734.87
$1,898.37
$2,479.13
$2,017.84
$2,172.16
$2,335.66
$2,916.42
$2,455.13
$2,609.45
$2,772.95
$3,353.71
$437.29
Toc - Plan #41 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value HSA (No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$6,700 $13,400 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
$393.00
$446.06
$502.26
$701.90
$1,066.60
$693.65
$746.71
$802.91
$1,002.55
$994.30
$1,047.36
$1,103.56
$1,303.20
$1,294.95
$1,348.01
$1,404.21
$1,603.85
$300.65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$786.00
$892.12
$1,004.52
$1,403.80
$2,133.20
$1,086.65
$1,192.77
$1,305.17
$1,704.45
$1,387.30
$1,493.42
$1,605.82
$2,005.10
$1,687.95
$1,794.07
$1,906.47
$2,305.75
$300.65
Toc - Plan #42 UnitedHealthcare
Silver

(HMO) UHC Silver Value $4,000 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 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
$523.33
$593.98
$668.81
$934.67
$1,420.32
$923.68
$994.33
$1,069.16
$1,335.02
$1,324.03
$1,394.68
$1,469.51
$1,735.37
$1,724.38
$1,795.03
$1,869.86
$2,135.72
$400.35
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,046.66
$1,187.96
$1,337.62
$1,869.34
$2,840.64
$1,447.01
$1,588.31
$1,737.97
$2,269.69
$1,847.36
$1,988.66
$2,138.32
$2,670.04
$2,247.71
$2,389.01
$2,538.67
$3,070.39
$400.35
Toc - Plan #43 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value $7,500 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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
$374.05
$424.55
$478.04
$668.06
$1,015.18
$660.20
$710.70
$764.19
$954.21
$946.35
$996.85
$1,050.34
$1,240.36
$1,232.50
$1,283.00
$1,336.49
$1,526.51
$286.15
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$748.10
$849.10
$956.08
$1,336.12
$2,030.36
$1,034.25
$1,135.25
$1,242.23
$1,622.27
$1,320.40
$1,421.40
$1,528.38
$1,908.42
$1,606.55
$1,707.55
$1,814.53
$2,194.57
$286.15
Toc - Plan #44 UnitedHealthcare
Gold

(HMO) UHC Gold Standard (No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

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
$540.08
$612.99
$690.23
$964.59
$1,465.78
$953.24
$1,026.15
$1,103.39
$1,377.75
$1,366.40
$1,439.31
$1,516.55
$1,790.91
$1,779.56
$1,852.47
$1,929.71
$2,204.07
$413.16
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,080.16
$1,225.98
$1,380.46
$1,929.18
$2,931.56
$1,493.32
$1,639.14
$1,793.62
$2,342.34
$1,906.48
$2,052.30
$2,206.78
$2,755.50
$2,319.64
$2,465.46
$2,619.94
$3,168.66
$413.16
Toc - Plan #45 UnitedHealthcare
Silver

(HMO) UHC Silver Advantage $0 Medical Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$531.17
$602.87
$678.83
$948.66
$1,441.58
$937.51
$1,009.21
$1,085.17
$1,355.00
$1,343.85
$1,415.55
$1,491.51
$1,761.34
$1,750.19
$1,821.89
$1,897.85
$2,167.68
$406.34
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,062.34
$1,205.74
$1,357.66
$1,897.32
$2,883.16
$1,468.68
$1,612.08
$1,764.00
$2,303.66
$1,875.02
$2,018.42
$2,170.34
$2,710.00
$2,281.36
$2,424.76
$2,576.68
$3,116.34
$406.34
Toc - Plan #46 UnitedHealthcare
Silver

(HMO) UHC Silver Advantage $2,000 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 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
$518.63
$588.65
$662.81
$926.28
$1,407.57
$915.38
$985.40
$1,059.56
$1,323.03
$1,312.13
$1,382.15
$1,456.31
$1,719.78
$1,708.88
$1,778.90
$1,853.06
$2,116.53
$396.75
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,037.26
$1,177.30
$1,325.62
$1,852.56
$2,815.14
$1,434.01
$1,574.05
$1,722.37
$2,249.31
$1,830.76
$1,970.80
$2,119.12
$2,646.06
$2,227.51
$2,367.55
$2,515.87
$3,042.81
$396.75
Toc - Plan #47 UnitedHealthcare
Silver

(HMO) UHC Silver Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $3 Generic Rx Pref Pharm, Dental + Vision, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 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
$546.82
$620.64
$698.83
$976.62
$1,484.06
$965.14
$1,038.96
$1,117.15
$1,394.94
$1,383.46
$1,457.28
$1,535.47
$1,813.26
$1,801.78
$1,875.60
$1,953.79
$2,231.58
$418.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,093.64
$1,241.28
$1,397.66
$1,953.24
$2,968.12
$1,511.96
$1,659.60
$1,815.98
$2,371.56
$1,930.28
$2,077.92
$2,234.30
$2,789.88
$2,348.60
$2,496.24
$2,652.62
$3,208.20
$418.32
Toc - Plan #48 UnitedHealthcare
Silver

(HMO) UHC Silver Standard (No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

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
$521.54
$591.95
$666.53
$931.47
$1,415.46
$920.52
$990.93
$1,065.51
$1,330.45
$1,319.50
$1,389.91
$1,464.49
$1,729.43
$1,718.48
$1,788.89
$1,863.47
$2,128.41
$398.98
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,043.08
$1,183.90
$1,333.06
$1,862.94
$2,830.92
$1,442.06
$1,582.88
$1,732.04
$2,261.92
$1,841.04
$1,981.86
$2,131.02
$2,660.90
$2,240.02
$2,380.84
$2,530.00
$3,059.88
$398.98
Toc - Plan #49 UnitedHealthcare
Bronze

(HMO) UHC Bronze Essential $9,100 Indiv Ded ($3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

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
$357.43
$405.68
$456.79
$638.36
$970.05
$630.86
$679.11
$730.22
$911.79
$904.29
$952.54
$1,003.65
$1,185.22
$1,177.72
$1,225.97
$1,277.08
$1,458.65
$273.43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$714.86
$811.36
$913.58
$1,276.72
$1,940.10
$988.29
$1,084.79
$1,187.01
$1,550.15
$1,261.72
$1,358.22
$1,460.44
$1,823.58
$1,535.15
$1,631.65
$1,733.87
$2,097.01
$273.43
Toc - Plan #50 UnitedHealthcare
Bronze

(HMO) UHC Bronze Standard $9,100 Indiv Ded (No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

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
$356.19
$404.27
$455.21
$636.15
$966.70
$628.67
$676.75
$727.69
$908.63
$901.15
$949.23
$1,000.17
$1,181.11
$1,173.63
$1,221.71
$1,272.65
$1,453.59
$272.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$712.38
$808.54
$910.42
$1,272.30
$1,933.40
$984.86
$1,081.02
$1,182.90
$1,544.78
$1,257.34
$1,353.50
$1,455.38
$1,817.26
$1,529.82
$1,625.98
$1,727.86
$2,089.74
$272.48
Toc - Plan #51 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Standard $7,500 Indiv Ded (No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

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
$374.67
$425.25
$478.83
$669.16
$1,016.85
$661.29
$711.87
$765.45
$955.78
$947.91
$998.49
$1,052.07
$1,242.40
$1,234.53
$1,285.11
$1,338.69
$1,529.02
$286.62
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$749.34
$850.50
$957.66
$1,338.32
$2,033.70
$1,035.96
$1,137.12
$1,244.28
$1,624.94
$1,322.58
$1,423.74
$1,530.90
$1,911.56
$1,609.20
$1,710.36
$1,817.52
$2,198.18
$286.62
Toc - Plan #52 UnitedHealthcare
Bronze

(HMO) UHC Bronze Essential $6,350 Indiv Ded ($3 Generic Rx Pref Pharm, No Referrals)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$6,350 $12,700 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
$364.84
$414.09
$466.26
$651.60
$990.16
$643.94
$693.19
$745.36
$930.70
$923.04
$972.29
$1,024.46
$1,209.80
$1,202.14
$1,251.39
$1,303.56
$1,488.90
$279.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$729.68
$828.18
$932.52
$1,303.20
$1,980.32
$1,008.78
$1,107.28
$1,211.62
$1,582.30
$1,287.88
$1,386.38
$1,490.72
$1,861.40
$1,566.98
$1,665.48
$1,769.82
$2,140.50
$279.10

‡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 Pender County here.

Pender County is in “Rating Area 15” of North Carolina.

Currently, there are 52 plans offered in Rating Area 15.

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2023 Obamacare Plans for Pender County, NC

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