Obamacare 2023 Rates for Pottawatomie County
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Obamacare > Rates > Oklahoma > Pottawatomie County
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MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-676-3777 |
Toc - Plan #1 Medica | ||||||||||||||||||||
Expanded Bronze
(PPO) Harmony by Medica Bronze HSA ($0 Virtual Care after Deductible with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$455.31 $516.76 $581.87 $813.16 $1,235.67 |
$803.61 $865.06 $930.17 $1,161.46 |
$1,151.91 $1,213.36 $1,278.47 $1,509.76 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$910.62 $1,033.52 $1,163.74 $1,626.32 $2,471.34 |
$1,258.92 $1,381.82 $1,512.04 $1,974.62 |
$1,607.22 $1,730.12 $1,860.34 $2,322.92 |
Toc - Plan #2 Medica | ||||||||||||||||||||
Catastrophic
(PPO) Harmony by Medica Catastrophic ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
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Customer Service Phone: 1-888-592-8211
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 |
$263.99 $299.62 $337.37 $471.47 $716.45 |
$465.94 $501.57 $539.32 $673.42 |
$667.89 $703.52 $741.27 $875.37 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$527.98 $599.24 $674.74 $942.94 $1,432.90 |
$729.93 $801.19 $876.69 $1,144.89 |
$931.88 $1,003.14 $1,078.64 $1,346.84 |
Toc - Plan #3 Medica | ||||||||||||||||||||
Expanded Bronze
(PPO) Harmony by Medica Bronze Share Plus ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$385.34 $437.35 $492.45 $688.20 $1,045.78 |
$680.12 $732.13 $787.23 $982.98 |
$974.90 $1,026.91 $1,082.01 $1,277.76 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$770.68 $874.70 $984.90 $1,376.40 $2,091.56 |
$1,065.46 $1,169.48 $1,279.68 $1,671.18 |
$1,360.24 $1,464.26 $1,574.46 $1,965.96 |
Toc - Plan #4 Medica | ||||||||||||||||||||
Expanded Bronze
(PPO) Harmony by Medica Bronze Copay $0 PCP ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$372.43 $422.70 $475.95 $665.14 $1,010.75 |
$657.33 $707.60 $760.85 $950.04 |
$942.23 $992.50 $1,045.75 $1,234.94 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$744.86 $845.40 $951.90 $1,330.28 $2,021.50 |
$1,029.76 $1,130.30 $1,236.80 $1,615.18 |
$1,314.66 $1,415.20 $1,521.70 $1,900.08 |
Toc - Plan #5 Medica | ||||||||||||||||||||
Gold
(PPO) Harmony by Medica Gold Copay $0 PCP ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$476.50 $540.81 $608.94 $851.00 $1,293.17 |
$841.01 $905.32 $973.45 $1,215.51 |
$1,205.52 $1,269.83 $1,337.96 $1,580.02 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$953.00 $1,081.62 $1,217.88 $1,702.00 $2,586.34 |
$1,317.51 $1,446.13 $1,582.39 $2,066.51 |
$1,682.02 $1,810.64 $1,946.90 $2,431.02 |
Toc - Plan #6 Medica | ||||||||||||||||||||
Expanded Bronze
(PPO) Harmony by Medica Bronze Premier ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$376.18 $426.95 $480.74 $671.84 $1,020.92 |
$663.95 $714.72 $768.51 $959.61 |
$951.72 $1,002.49 $1,056.28 $1,247.38 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$752.36 $853.90 $961.48 $1,343.68 $2,041.84 |
$1,040.13 $1,141.67 $1,249.25 $1,631.45 |
$1,327.90 $1,429.44 $1,537.02 $1,919.22 |
Toc - Plan #7 Medica | ||||||||||||||||||||
Gold
(PPO) Harmony by Medica Gold Standard ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$454.16 $515.46 $580.40 $811.11 $1,232.56 |
$801.58 $862.88 $927.82 $1,158.53 |
$1,149.00 $1,210.30 $1,275.24 $1,505.95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$908.32 $1,030.92 $1,160.80 $1,622.22 $2,465.12 |
$1,255.74 $1,378.34 $1,508.22 $1,969.64 |
$1,603.16 $1,725.76 $1,855.64 $2,317.06 |
Toc - Plan #8 Medica | ||||||||||||||||||||
Silver
(PPO) Harmony by Medica Silver Standard ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$453.02 $514.16 $578.94 $809.07 $1,229.45 |
$799.57 $860.71 $925.49 $1,155.62 |
$1,146.12 $1,207.26 $1,272.04 $1,502.17 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$906.04 $1,028.32 $1,157.88 $1,618.14 $2,458.90 |
$1,252.59 $1,374.87 $1,504.43 $1,964.69 |
$1,599.14 $1,721.42 $1,850.98 $2,311.24 |
Toc - Plan #9 Medica | ||||||||||||||||||||
Bronze
(PPO) Harmony by Medica Bronze Standard ($0 Virtual Care with Designated Providers) |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
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 |
$355.98 $404.03 $454.93 $635.76 $966.10 |
$628.30 $676.35 $727.25 $908.08 |
$900.62 $948.67 $999.57 $1,180.40 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$711.96 $808.06 $909.86 $1,271.52 $1,932.20 |
$984.28 $1,080.38 $1,182.18 $1,543.84 |
$1,256.60 $1,352.70 $1,454.50 $1,816.16 |
ADVERTISEMENT
Ambetter of OklahomaLocal: 1-833-492-0679 | Toll Free: 1-833-492-0679 |
Toc - Plan #10 Ambetter of Oklahoma | ||||||||||||||||||||
Bronze
(PPO) Clear Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$280.61 $318.49 $358.61 $501.16 $761.56 |
$495.27 $533.15 $573.27 $715.82 |
$709.93 $747.81 $787.93 $930.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$561.22 $636.98 $717.22 $1,002.32 $1,523.12 |
$775.88 $851.64 $931.88 $1,216.98 |
$990.54 $1,066.30 $1,146.54 $1,431.64 |
Toc - Plan #11 Ambetter of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) Everyday Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$302.74 $343.60 $386.89 $540.68 $821.61 |
$534.33 $575.19 $618.48 $772.27 |
$765.92 $806.78 $850.07 $1,003.86 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$605.48 $687.20 $773.78 $1,081.36 $1,643.22 |
$837.07 $918.79 $1,005.37 $1,312.95 |
$1,068.66 $1,150.38 $1,236.96 $1,544.54 |
Toc - Plan #12 Ambetter of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) Elite Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$342.30 $388.50 $437.44 $611.32 $928.97 |
$604.15 $650.35 $699.29 $873.17 |
$866.00 $912.20 $961.14 $1,135.02 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$684.60 $777.00 $874.88 $1,222.64 $1,857.94 |
$946.45 $1,038.85 $1,136.73 $1,484.49 |
$1,208.30 $1,300.70 $1,398.58 $1,746.34 |
Toc - Plan #13 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Complete Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$352.88 $400.51 $450.97 $630.23 $957.70 |
$622.83 $670.46 $720.92 $900.18 |
$892.78 $940.41 $990.87 $1,170.13 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$705.76 $801.02 $901.94 $1,260.46 $1,915.40 |
$975.71 $1,070.97 $1,171.89 $1,530.41 |
$1,245.66 $1,340.92 $1,441.84 $1,800.36 |
Toc - Plan #14 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Clear Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$342.61 $388.86 $437.85 $611.89 $929.83 |
$604.70 $650.95 $699.94 $873.98 |
$866.79 $913.04 $962.03 $1,136.07 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$685.22 $777.72 $875.70 $1,223.78 $1,859.66 |
$947.31 $1,039.81 $1,137.79 $1,485.87 |
$1,209.40 $1,301.90 $1,399.88 $1,747.96 |
Toc - Plan #15 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Focused Silver |
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Benefits & Coverage
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Customer Service Phone: 1-833-492-0679
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 |
$347.59 $394.50 $444.21 $620.78 $943.33 |
$613.49 $660.40 $710.11 $886.68 |
$879.39 $926.30 $976.01 $1,152.58 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$695.18 $789.00 $888.42 $1,241.56 $1,886.66 |
$961.08 $1,054.90 $1,154.32 $1,507.46 |
$1,226.98 $1,320.80 $1,420.22 $1,773.36 |
Toc - Plan #16 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Everyday Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$388.74 $441.20 $496.79 $694.26 $1,055.00 |
$686.11 $738.57 $794.16 $991.63 |
$983.48 $1,035.94 $1,091.53 $1,289.00 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$777.48 $882.40 $993.58 $1,388.52 $2,110.00 |
$1,074.85 $1,179.77 $1,290.95 $1,685.89 |
$1,372.22 $1,477.14 $1,588.32 $1,983.26 |
Toc - Plan #17 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Elite Gold |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-833-492-0679
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 |
$449.61 $510.29 $574.58 $802.98 $1,220.20 |
$793.55 $854.23 $918.52 $1,146.92 |
$1,137.49 $1,198.17 $1,262.46 $1,490.86 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$899.22 $1,020.58 $1,149.16 $1,605.96 $2,440.40 |
$1,243.16 $1,364.52 $1,493.10 $1,949.90 |
$1,587.10 $1,708.46 $1,837.04 $2,293.84 |
Toc - Plan #18 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Clear Gold |
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Benefits & Coverage
Plan Brochure
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Customer Service Phone: 1-833-492-0679
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 |
$384.32 $436.20 $491.15 $686.39 $1,043.03 |
$678.32 $730.20 $785.15 $980.39 |
$972.32 $1,024.20 $1,079.15 $1,274.39 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$768.64 $872.40 $982.30 $1,372.78 $2,086.06 |
$1,062.64 $1,166.40 $1,276.30 $1,666.78 |
$1,356.64 $1,460.40 $1,570.30 $1,960.78 |
Toc - Plan #19 Ambetter of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) CMS Standard Expanded Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$295.96 $335.91 $378.23 $528.58 $803.22 |
$522.37 $562.32 $604.64 $754.99 |
$748.78 $788.73 $831.05 $981.40 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$591.92 $671.82 $756.46 $1,057.16 $1,606.44 |
$818.33 $898.23 $982.87 $1,283.57 |
$1,044.74 $1,124.64 $1,209.28 $1,509.98 |
Toc - Plan #20 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) CMS Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$343.85 $390.26 $439.43 $614.10 $933.18 |
$606.89 $653.30 $702.47 $877.14 |
$869.93 $916.34 $965.51 $1,140.18 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$687.70 $780.52 $878.86 $1,228.20 $1,866.36 |
$950.74 $1,043.56 $1,141.90 $1,491.24 |
$1,213.78 $1,306.60 $1,404.94 $1,754.28 |
Toc - Plan #21 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) CMS Standard Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$383.23 $434.96 $489.76 $684.43 $1,040.06 |
$676.39 $728.12 $782.92 $977.59 |
$969.55 $1,021.28 $1,076.08 $1,270.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$766.46 $869.92 $979.52 $1,368.86 $2,080.12 |
$1,059.62 $1,163.08 $1,272.68 $1,662.02 |
$1,352.78 $1,456.24 $1,565.84 $1,955.18 |
Toc - Plan #22 Ambetter of Oklahoma | ||||||||||||||||||||
Bronze
(PPO) Clear Bronze + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
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 |
$294.46 $334.21 $376.31 $525.90 $799.15 |
$519.72 $559.47 $601.57 $751.16 |
$744.98 $784.73 $826.83 $976.42 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$588.92 $668.42 $752.62 $1,051.80 $1,598.30 |
$814.18 $893.68 $977.88 $1,277.06 |
$1,039.44 $1,118.94 $1,203.14 $1,502.32 |
Toc - Plan #23 Ambetter of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317.68 $360.56 $405.99 $567.36 $862.16 |
$560.70 $603.58 $649.01 $810.38 |
$803.72 $846.60 $892.03 $1,053.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$635.36 $721.12 $811.98 $1,134.72 $1,724.32 |
$878.38 $964.14 $1,055.00 $1,377.74 |
$1,121.40 $1,207.16 $1,298.02 $1,620.76 |
Toc - Plan #24 Ambetter of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.19 $407.67 $459.03 $641.50 $974.82 |
$633.96 $682.44 $733.80 $916.27 |
$908.73 $957.21 $1,008.57 $1,191.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$718.38 $815.34 $918.06 $1,283.00 $1,949.64 |
$993.15 $1,090.11 $1,192.83 $1,557.77 |
$1,267.92 $1,364.88 $1,467.60 $1,832.54 |
Toc - Plan #25 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.30 $420.28 $473.23 $661.34 $1,004.97 |
$653.57 $703.55 $756.50 $944.61 |
$936.84 $986.82 $1,039.77 $1,227.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$740.60 $840.56 $946.46 $1,322.68 $2,009.94 |
$1,023.87 $1,123.83 $1,229.73 $1,605.95 |
$1,307.14 $1,407.10 $1,513.00 $1,889.22 |
Toc - Plan #26 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.75 $413.98 $466.13 $651.42 $989.89 |
$643.77 $693.00 $745.15 $930.44 |
$922.79 $972.02 $1,024.17 $1,209.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.50 $827.96 $932.26 $1,302.84 $1,979.78 |
$1,008.52 $1,106.98 $1,211.28 $1,581.86 |
$1,287.54 $1,386.00 $1,490.30 $1,860.88 |
Toc - Plan #27 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$407.92 $462.98 $521.31 $728.53 $1,107.07 |
$719.97 $775.03 $833.36 $1,040.58 |
$1,032.02 $1,087.08 $1,145.41 $1,352.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$815.84 $925.96 $1,042.62 $1,457.06 $2,214.14 |
$1,127.89 $1,238.01 $1,354.67 $1,769.11 |
$1,439.94 $1,550.06 $1,666.72 $2,081.16 |
Toc - Plan #28 Ambetter of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.53 $408.05 $459.46 $642.09 $975.72 |
$634.56 $683.08 $734.49 $917.12 |
$909.59 $958.11 $1,009.52 $1,192.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.06 $816.10 $918.92 $1,284.18 $1,951.44 |
$994.09 $1,091.13 $1,193.95 $1,559.21 |
$1,269.12 $1,366.16 $1,468.98 $1,834.24 |
Toc - Plan #29 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$471.80 $535.48 $602.94 $842.61 $1,280.43 |
$832.72 $896.40 $963.86 $1,203.53 |
$1,193.64 $1,257.32 $1,324.78 $1,564.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$943.60 $1,070.96 $1,205.88 $1,685.22 $2,560.86 |
$1,304.52 $1,431.88 $1,566.80 $2,046.14 |
$1,665.44 $1,792.80 $1,927.72 $2,407.06 |
Toc - Plan #30 Ambetter of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-492-0679
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403.29 $457.73 $515.40 $720.26 $1,094.51 |
$711.80 $766.24 $823.91 $1,028.77 |
$1,020.31 $1,074.75 $1,132.42 $1,337.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$806.58 $915.46 $1,030.80 $1,440.52 $2,189.02 |
$1,115.09 $1,223.97 $1,339.31 $1,749.03 |
$1,423.60 $1,532.48 $1,647.82 $2,057.54 |
ADVERTISEMENT
Blue Cross and Blue Shield of OklahomaLocal: 1-866-520-2507 | Toll Free: 1-866-520-2507 | TTY: 1-800-722-0353 |
Toc - Plan #31 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Blue Preferred Silver PPO? 201 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$558.10 $633.44 $713.25 $996.77 $1,514.68 |
$985.05 $1,060.39 $1,140.20 $1,423.72 |
$1,412.00 $1,487.34 $1,567.15 $1,850.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,116.20 $1,266.88 $1,426.50 $1,993.54 $3,029.36 |
$1,543.15 $1,693.83 $1,853.45 $2,420.49 |
$1,970.10 $2,120.78 $2,280.40 $2,847.44 |
Toc - Plan #32 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Catastrophic
(PPO) Blue Preferred Security PPO? 200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.26 $391.87 $441.25 $616.64 $937.04 |
$609.39 $656.00 $705.38 $880.77 |
$873.52 $920.13 $969.51 $1,144.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.52 $783.74 $882.50 $1,233.28 $1,874.08 |
$954.65 $1,047.87 $1,146.63 $1,497.41 |
$1,218.78 $1,312.00 $1,410.76 $1,761.54 |
Toc - Plan #33 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Blue Preferred Gold PPO? 205 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$515.12 $584.66 $658.33 $920.01 $1,398.04 |
$909.19 $978.73 $1,052.40 $1,314.08 |
$1,303.26 $1,372.80 $1,446.47 $1,708.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,030.24 $1,169.32 $1,316.66 $1,840.02 $2,796.08 |
$1,424.31 $1,563.39 $1,710.73 $2,234.09 |
$1,818.38 $1,957.46 $2,104.80 $2,628.16 |
Toc - Plan #34 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Bronze
(PPO) Blue Preferred Bronze PPO? 206 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.89 $457.28 $514.90 $719.57 $1,093.45 |
$711.10 $765.49 $823.11 $1,027.78 |
$1,019.31 $1,073.70 $1,131.32 $1,335.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.78 $914.56 $1,029.80 $1,439.14 $2,186.90 |
$1,113.99 $1,222.77 $1,338.01 $1,747.35 |
$1,422.20 $1,530.98 $1,646.22 $2,055.56 |
Toc - Plan #35 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Bronze
(PPO) Blue Preferred Bronze PPO? 603 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.22 $440.63 $496.15 $693.36 $1,053.63 |
$685.21 $737.62 $793.14 $990.35 |
$982.20 $1,034.61 $1,090.13 $1,287.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.44 $881.26 $992.30 $1,386.72 $2,107.26 |
$1,073.43 $1,178.25 $1,289.29 $1,683.71 |
$1,370.42 $1,475.24 $1,586.28 $1,980.70 |
Toc - Plan #36 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Blue Preferred Gold PPO? 705 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$527.94 $599.21 $674.71 $942.91 $1,432.84 |
$931.82 $1,003.09 $1,078.59 $1,346.79 |
$1,335.70 $1,406.97 $1,482.47 $1,750.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,055.88 $1,198.42 $1,349.42 $1,885.82 $2,865.68 |
$1,459.76 $1,602.30 $1,753.30 $2,289.70 |
$1,863.64 $2,006.18 $2,157.18 $2,693.58 |
Toc - Plan #37 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Blue Preferred Silver PPO? 701 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$540.81 $613.82 $691.16 $965.89 $1,467.76 |
$954.53 $1,027.54 $1,104.88 $1,379.61 |
$1,368.25 $1,441.26 $1,518.60 $1,793.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,081.62 $1,227.64 $1,382.32 $1,931.78 $2,935.52 |
$1,495.34 $1,641.36 $1,796.04 $2,345.50 |
$1,909.06 $2,055.08 $2,209.76 $2,759.22 |
Toc - Plan #38 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Bronze
(PPO) Blue Preferred Bronze PPO? 706 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.35 $468.02 $526.98 $736.46 $1,119.12 |
$727.80 $783.47 $842.43 $1,051.91 |
$1,043.25 $1,098.92 $1,157.88 $1,367.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$824.70 $936.04 $1,053.96 $1,472.92 $2,238.24 |
$1,140.15 $1,251.49 $1,369.41 $1,788.37 |
$1,455.60 $1,566.94 $1,684.86 $2,103.82 |
Toc - Plan #39 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Preferred Bronze PPO? 707 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$452.40 $513.47 $578.17 $807.99 $1,227.82 |
$798.49 $859.56 $924.26 $1,154.08 |
$1,144.58 $1,205.65 $1,270.35 $1,500.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$904.80 $1,026.94 $1,156.34 $1,615.98 $2,455.64 |
$1,250.89 $1,373.03 $1,502.43 $1,962.07 |
$1,596.98 $1,719.12 $1,848.52 $2,308.16 |
Toc - Plan #40 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Advantage Bronze PPO? 203 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.23 $429.29 $483.38 $675.52 $1,026.52 |
$667.58 $718.64 $772.73 $964.87 |
$956.93 $1,007.99 $1,062.08 $1,254.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.46 $858.58 $966.76 $1,351.04 $2,053.04 |
$1,045.81 $1,147.93 $1,256.11 $1,640.39 |
$1,335.16 $1,437.28 $1,545.46 $1,929.74 |
Toc - Plan #41 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Blue Advantage Silver PPO? 204 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.47 $515.83 $580.82 $811.69 $1,233.44 |
$802.14 $863.50 $928.49 $1,159.36 |
$1,149.81 $1,211.17 $1,276.16 $1,507.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$908.94 $1,031.66 $1,161.64 $1,623.38 $2,466.88 |
$1,256.61 $1,379.33 $1,509.31 $1,971.05 |
$1,604.28 $1,727.00 $1,856.98 $2,318.72 |
Toc - Plan #42 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Bronze
(PPO) Blue Advantage Bronze PPO? 202 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.48 $370.56 $417.24 $583.09 $886.07 |
$576.24 $620.32 $667.00 $832.85 |
$826.00 $870.08 $916.76 $1,082.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.96 $741.12 $834.48 $1,166.18 $1,772.14 |
$902.72 $990.88 $1,084.24 $1,415.94 |
$1,152.48 $1,240.64 $1,334.00 $1,665.70 |
Toc - Plan #43 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Blue Advantage Gold PPO? 309 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.88 $490.19 $551.94 $771.34 $1,172.13 |
$762.27 $820.58 $882.33 $1,101.73 |
$1,092.66 $1,150.97 $1,212.72 $1,432.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$863.76 $980.38 $1,103.88 $1,542.68 $2,344.26 |
$1,194.15 $1,310.77 $1,434.27 $1,873.07 |
$1,524.54 $1,641.16 $1,764.66 $2,203.46 |
Toc - Plan #44 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Silver
(PPO) Blue Advantage Silver PPO? 605 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473.11 $536.98 $604.64 $844.98 $1,284.02 |
$835.04 $898.91 $966.57 $1,206.91 |
$1,196.97 $1,260.84 $1,328.50 $1,568.84 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$946.22 $1,073.96 $1,209.28 $1,689.96 $2,568.04 |
$1,308.15 $1,435.89 $1,571.21 $2,051.89 |
$1,670.08 $1,797.82 $1,933.14 $2,413.82 |
Toc - Plan #45 Blue Cross and Blue Shield of Oklahoma | ||||||||||||||||||||
Gold
(PPO) Blue Advantage Gold PPO? 604 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-520-2507
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 |
$421.97 $478.93 $539.27 $753.63 $1,145.22 |
$744.78 $801.74 $862.08 $1,076.44 |
$1,067.59 $1,124.55 $1,184.89 $1,399.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$843.94 $957.86 $1,078.54 $1,507.26 $2,290.44 |
$1,166.75 $1,280.67 $1,401.35 $1,830.07 |
$1,489.56 $1,603.48 $1,724.16 $2,152.88 |
‡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 Pottawatomie County here.
Pottawatomie County is in “Rating Area 5” of Oklahoma.
Currently, there are 45 plans offered in Rating Area 5.