Georgia Obamacare 2024 Rates
ADVERTISEMENT
Counties in Georgia
- Fulton County (Atlanta)
- Gwinnett County (Lawrenceville)
- Cobb County (Marietta)
- DeKalb County (Decatur)
- Clayton County (Jonesboro)
- Chatham County (Savannah)
- Cherokee County (Canton)
- Forsyth County (Cumming)
- Henry County (McDonough)
- Muscogee County (Columbus)
- Richmond County (Augusta)
- Hall County (Gainesville)
- Paulding County (Dallas)
- Houston County (Perry)
- Bibb County (Macon)
- Columbia County (Appling)
- Coweta County (Newnan)
- Douglas County (Douglasville)
- Clarke County (Athens)
- Fayette County (Fayetteville)
- Carroll County (Carrollton)
- Lowndes County (Valdosta)
- Newton County (Covington)
- Bartow County (Cartersville)
- Whitfield County (Dalton)
- Floyd County (Rome)
- Walton County (Monroe)
- Rockdale County (Conyers)
- Dougherty County (Albany)
- Glynn County (Brunswick)
- Barrow County (Winder)
- Bulloch County (Statesboro)
- Jackson County (Jefferson)
- Troup County (Lagrange)
- Catoosa County (Ringgold)
- Walker County (Lafayette)
- Spalding County (Griffin)
- Liberty County (Hinesville)
- Effingham County (Springfield)
- Gordon County (Calhoun)
- Camden County (Woodbine)
- Laurens County (Dublin)
- Habersham County (Clarkesville)
- Colquitt County (Moultrie)
- Thomas County (Thomasville)
- Bryan County (Pembroke)
- Baldwin County (Milledgeville)
- Coffee County (Douglas)
- Polk County (Cedartown)
- Oconee County (Watkinsville)
- Tift County (Tifton)
- Murray County (Chatsworth)
- Ware County (Waycross)
- Harris County (Hamilton)
- Lumpkin County (Dahlonega)
- Pickens County (Jasper)
- Lee County (Leesburg)
- Gilmer County (Ellijay)
- Wayne County (Jesup)
- Madison County (Danielsville)
- Haralson County (Buchanan)
- Sumter County (Americus)
- Decatur County (Bainbridge)
- Jones County (Gray)
- White County (Cleveland)
- Peach County (Fort Valley)
- Monroe County (Forsyth)
- Upson County (Thomaston)
- Toombs County (Lyons)
- Dawson County (Dawsonville)
- Stephens County (Toccoa)
- Grady County (Cairo)
- Hart County (Hartwell)
- Butts County (Jackson)
- Fannin County (Blue Ridge)
- Chattooga County (Summerville)
- Union County (Blairsville)
- Burke County (Waynesboro)
- Franklin County (Carnesville)
- Tattnall County (Reidsville)
- Emanuel County (Swainsboro)
- Putnam County (Eatonton)
- Mitchell County (Camilla)
- McDuffie County (Thomson)
- Worth County (Sylvester)
- Meriwether County (Greenville)
- Crisp County (Cordele)
- Morgan County (Madison)
- Washington County (Sandersville)
- Dodge County (Eastman)
- Pierce County (Blackshear)
- Elbert County (Elberton)
- Greene County (Greensboro)
- Pike County (Zebulon)
- Lamar County (Barnesville)
- Appling County (Baxley)
- Berrien County (Nashville)
- Banks County (Homer)
- Brantley County (Nahunta)
- Cook County (Adel)
- Ben Hill County (Fitzgerald)
- Rabun County (Clayton)
- Brooks County (Quitman)
- Dade County (Trenton)
- Long County (Ludowici)
- Jefferson County (Louisville)
- Oglethorpe County (Lexington)
- Jeff Davis County (Hazlehurst)
- Jasper County (Monticello)
- Screven County (Sylvania)
- Bleckley County (Cochran)
- Charlton County (Folkston)
- Towns County (Hiawassee)
- Telfair County (McRae)
- Crawford County (Knoxville)
- Macon County (Oglethorpe)
- Heard County (Franklin)
- Dooly County (Vienna)
- Bacon County (Alma)
- Candler County (Metter)
- McIntosh County (Darien)
- Early County (Blakely)
- Evans County (Claxton)
- Lanier County (Lakeland)
- Pulaski County (Hawkinsville)
- Irwin County (Ocilla)
- Chattahoochee County (Cusseta)
- Wilkes County (Washington)
- Johnson County (Wrightsville)
- Terrell County (Dawson)
- Seminole County (Donalsonville)
- Turner County (Ashburn)
- Wilkinson County (Irwinton)
- Wilcox County (Abbeville)
- Hancock County (Sparta)
- Jenkins County (Millen)
- Montgomery County (Mount Vernon)
- Atkinson County (Pearson)
- Twiggs County (Jeffersonville)
- Taylor County (Butler)
- Lincoln County (Lincolnton)
- Marion County (Buena Vista)
- Wheeler County (Alamo)
- Clinch County (Homerville)
- Randolph County (Cuthbert)
- Treutlen County (Soperton)
- Miller County (Colquitt)
- Talbot County (Talbotton)
- Calhoun County (Morgan)
- Stewart County (Lumpkin)
- Warren County (Warrenton)
- Schley County (Ellaville)
- Echols County (Statenville)
- Glascock County (Gibson)
- Baker County (Newton)
- Clay County (Fort Gaines)
- Webster County (Preston)
- Quitman County (Georgetown)
- Taliaferro County (Crawfordville)
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
ADVERTISEMENT
Cigna HealthCare of Georgia, IncLocal: | Toll Free: |
Toc - Plan #1 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 8500 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$387.06 $439.31 $494.66 $691.28 $1,050.47 |
$683.16 $735.41 $790.76 $987.38 |
$979.26 $1,031.51 $1,086.86 $1,283.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774.12 $878.62 $989.32 $1,382.56 $2,100.94 |
$1,070.22 $1,174.72 $1,285.42 $1,678.66 |
$1,366.32 $1,470.82 $1,581.52 $1,974.76 |
Toc - Plan #2 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 6500 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$391.81 $444.71 $500.74 $699.78 $1,063.38 |
$691.55 $744.45 $800.48 $999.52 |
$991.29 $1,044.19 $1,100.22 $1,299.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$783.62 $889.42 $1,001.48 $1,399.56 $2,126.76 |
$1,083.36 $1,189.16 $1,301.22 $1,699.30 |
$1,383.10 $1,488.90 $1,600.96 $1,999.04 |
Toc - Plan #3 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 4500 Indiv Med Deductible Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$396.23 $449.72 $506.39 $707.67 $1,075.38 |
$699.35 $752.84 $809.51 $1,010.79 |
$1,002.47 $1,055.96 $1,112.63 $1,313.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$792.46 $899.44 $1,012.78 $1,415.34 $2,150.76 |
$1,095.58 $1,202.56 $1,315.90 $1,718.46 |
$1,398.70 $1,505.68 $1,619.02 $2,021.58 |
Toc - Plan #4 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Connect Silver 3700 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$471.94 $535.65 $603.14 $842.89 $1,280.85 |
$832.98 $896.69 $964.18 $1,203.93 |
$1,194.02 $1,257.73 $1,325.22 $1,564.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$943.88 $1,071.30 $1,206.28 $1,685.78 $2,561.70 |
$1,304.92 $1,432.34 $1,567.32 $2,046.82 |
$1,665.96 $1,793.38 $1,928.36 $2,407.86 |
Toc - Plan #5 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Connect Silver 5000 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473.06 $536.93 $604.57 $844.89 $1,283.89 |
$834.95 $898.82 $966.46 $1,206.78 |
$1,196.84 $1,260.71 $1,328.35 $1,568.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$946.12 $1,073.86 $1,209.14 $1,689.78 $2,567.78 |
$1,308.01 $1,435.75 $1,571.03 $2,051.67 |
$1,669.90 $1,797.64 $1,932.92 $2,413.56 |
Toc - Plan #6 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Connect Silver 7000 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$472.39 $536.16 $603.71 $843.69 $1,282.07 |
$833.77 $897.54 $965.09 $1,205.07 |
$1,195.15 $1,258.92 $1,326.47 $1,566.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$944.78 $1,072.32 $1,207.42 $1,687.38 $2,564.14 |
$1,306.16 $1,433.70 $1,568.80 $2,048.76 |
$1,667.54 $1,795.08 $1,930.18 $2,410.14 |
Toc - Plan #7 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Connect Silver 2700 Indiv Med Deductible Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$478.66 $543.28 $611.72 $854.88 $1,299.08 |
$844.83 $909.45 $977.89 $1,221.05 |
$1,211.00 $1,275.62 $1,344.06 $1,587.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$957.32 $1,086.56 $1,223.44 $1,709.76 $2,598.16 |
$1,323.49 $1,452.73 $1,589.61 $2,075.93 |
$1,689.66 $1,818.90 $1,955.78 $2,442.10 |
Toc - Plan #8 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Connect Gold 500 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$612.17 $694.81 $782.35 $1,093.34 $1,661.43 |
$1,080.48 $1,163.12 $1,250.66 $1,561.65 |
$1,548.79 $1,631.43 $1,718.97 $2,029.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,224.34 $1,389.62 $1,564.70 $2,186.68 $3,322.86 |
$1,692.65 $1,857.93 $2,033.01 $2,654.99 |
$2,160.96 $2,326.24 $2,501.32 $3,123.30 |
Toc - Plan #9 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.97 $442.61 $498.38 $696.48 $1,058.37 |
$688.29 $740.93 $796.70 $994.80 |
$986.61 $1,039.25 $1,095.02 $1,293.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.94 $885.22 $996.76 $1,392.96 $2,116.74 |
$1,078.26 $1,183.54 $1,295.08 $1,691.28 |
$1,376.58 $1,481.86 $1,593.40 $1,989.60 |
Toc - Plan #10 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 0 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.95 $483.45 $544.36 $760.74 $1,156.02 |
$751.80 $809.30 $870.21 $1,086.59 |
$1,077.65 $1,135.15 $1,196.06 $1,412.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$851.90 $966.90 $1,088.72 $1,521.48 $2,312.04 |
$1,177.75 $1,292.75 $1,414.57 $1,847.33 |
$1,503.60 $1,618.60 $1,740.42 $2,173.18 |
Toc - Plan #11 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Gold
(HMO) Connect Gold CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$609.65 $691.96 $779.14 $1,088.84 $1,654.60 |
$1,076.03 $1,158.34 $1,245.52 $1,555.22 |
$1,542.41 $1,624.72 $1,711.90 $2,021.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,219.30 $1,383.92 $1,558.28 $2,177.68 $3,309.20 |
$1,685.68 $1,850.30 $2,024.66 $2,644.06 |
$2,152.06 $2,316.68 $2,491.04 $3,110.44 |
Toc - Plan #12 Cigna HealthCare of Georgia, Inc | ||||||||||||||||||||
Silver
(HMO) Connect Silver CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473.34 $537.24 $604.93 $845.39 $1,284.65 |
$835.45 $899.35 $967.04 $1,207.50 |
$1,197.56 $1,261.46 $1,329.15 $1,569.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$946.68 $1,074.48 $1,209.86 $1,690.78 $2,569.30 |
$1,308.79 $1,436.59 $1,571.97 $2,052.89 |
$1,670.90 $1,798.70 $1,934.08 $2,415.00 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-800-609-9754 | Toll Free: 1-800-609-9754 | TTY: 1-800-609-9754 |
Toc - Plan #13 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$516.97 $586.77 $660.69 $923.32 $1,403.07 |
$912.45 $982.25 $1,056.17 $1,318.80 |
$1,307.93 $1,377.73 $1,451.65 $1,714.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,033.94 $1,173.54 $1,321.38 $1,846.64 $2,806.14 |
$1,429.42 $1,569.02 $1,716.86 $2,242.12 |
$1,824.90 $1,964.50 $2,112.34 $2,637.60 |
Toc - Plan #14 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$453.76 $515.02 $579.90 $810.41 $1,231.50 |
$800.89 $862.15 $927.03 $1,157.54 |
$1,148.02 $1,209.28 $1,274.16 $1,504.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$907.52 $1,030.04 $1,159.80 $1,620.82 $2,463.00 |
$1,254.65 $1,377.17 $1,506.93 $1,967.95 |
$1,601.78 $1,724.30 $1,854.06 $2,315.08 |
Toc - Plan #15 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$572.89 $650.24 $732.16 $1,023.19 $1,554.84 |
$1,011.15 $1,088.50 $1,170.42 $1,461.45 |
$1,449.41 $1,526.76 $1,608.68 $1,899.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,145.78 $1,300.48 $1,464.32 $2,046.38 $3,109.68 |
$1,584.04 $1,738.74 $1,902.58 $2,484.64 |
$2,022.30 $2,177.00 $2,340.84 $2,922.90 |
Toc - Plan #16 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$525.19 $596.09 $671.19 $937.99 $1,425.36 |
$926.96 $997.86 $1,072.96 $1,339.76 |
$1,328.73 $1,399.63 $1,474.73 $1,741.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,050.38 $1,192.18 $1,342.38 $1,875.98 $2,850.72 |
$1,452.15 $1,593.95 $1,744.15 $2,277.75 |
$1,853.92 $1,995.72 $2,145.92 $2,679.52 |
Toc - Plan #17 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$518.04 $587.98 $662.06 $925.22 $1,405.97 |
$914.34 $984.28 $1,058.36 $1,321.52 |
$1,310.64 $1,380.58 $1,454.66 $1,717.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,036.08 $1,175.96 $1,324.12 $1,850.44 $2,811.94 |
$1,432.38 $1,572.26 $1,720.42 $2,246.74 |
$1,828.68 $1,968.56 $2,116.72 $2,643.04 |
Toc - Plan #18 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$523.68 $594.37 $669.26 $935.28 $1,421.25 |
$924.29 $994.98 $1,069.87 $1,335.89 |
$1,324.90 $1,395.59 $1,470.48 $1,736.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,047.36 $1,188.74 $1,338.52 $1,870.56 $2,842.50 |
$1,447.97 $1,589.35 $1,739.13 $2,271.17 |
$1,848.58 $1,989.96 $2,139.74 $2,671.78 |
Toc - Plan #19 UnitedHealthcare | ||||||||||||||||||||
Bronze
(HMO) UHC Bronze Essential ($0 Virtual Urgent Care, $3 Tier 2 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$451.60 $512.56 $577.14 $806.56 $1,225.64 |
$797.07 $858.03 $922.61 $1,152.03 |
$1,142.54 $1,203.50 $1,268.08 $1,497.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$903.20 $1,025.12 $1,154.28 $1,613.12 $2,451.28 |
$1,248.67 $1,370.59 $1,499.75 $1,958.59 |
$1,594.14 $1,716.06 $1,845.22 $2,304.06 |
Toc - Plan #20 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$468.18 $531.38 $598.33 $836.17 $1,270.64 |
$826.34 $889.54 $956.49 $1,194.33 |
$1,184.50 $1,247.70 $1,314.65 $1,552.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$936.36 $1,062.76 $1,196.66 $1,672.34 $2,541.28 |
$1,294.52 $1,420.92 $1,554.82 $2,030.50 |
$1,652.68 $1,779.08 $1,912.98 $2,388.66 |
Toc - Plan #21 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$460.45 $522.61 $588.45 $822.36 $1,249.66 |
$812.69 $874.85 $940.69 $1,174.60 |
$1,164.93 $1,227.09 $1,292.93 $1,526.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$920.90 $1,045.22 $1,176.90 $1,644.72 $2,499.32 |
$1,273.14 $1,397.46 $1,529.14 $1,996.96 |
$1,625.38 $1,749.70 $1,881.38 $2,349.20 |
Toc - Plan #22 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$477.92 $542.44 $610.78 $853.56 $1,297.07 |
$843.53 $908.05 $976.39 $1,219.17 |
$1,209.14 $1,273.66 $1,342.00 $1,584.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$955.84 $1,084.88 $1,221.56 $1,707.12 $2,594.14 |
$1,321.45 $1,450.49 $1,587.17 $2,072.73 |
$1,687.06 $1,816.10 $1,952.78 $2,438.34 |
Toc - Plan #23 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$519.98 $590.18 $664.54 $928.69 $1,411.23 |
$917.77 $987.97 $1,062.33 $1,326.48 |
$1,315.56 $1,385.76 $1,460.12 $1,724.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,039.96 $1,180.36 $1,329.08 $1,857.38 $2,822.46 |
$1,437.75 $1,578.15 $1,726.87 $2,255.17 |
$1,835.54 $1,975.94 $2,124.66 $2,652.96 |
Toc - Plan #24 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value ($0 Virtual Urgent Care + $0 PCP Visits, $1 Tier 2 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$546.66 $620.46 $698.63 $976.33 $1,483.63 |
$964.85 $1,038.65 $1,116.82 $1,394.52 |
$1,383.04 $1,456.84 $1,535.01 $1,812.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,093.32 $1,240.92 $1,397.26 $1,952.66 $2,967.26 |
$1,511.51 $1,659.11 $1,815.45 $2,370.85 |
$1,929.70 $2,077.30 $2,233.64 $2,789.04 |
Toc - Plan #25 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$549.65 $623.85 $702.45 $981.67 $1,491.74 |
$970.13 $1,044.33 $1,122.93 $1,402.15 |
$1,390.61 $1,464.81 $1,543.41 $1,822.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,099.30 $1,247.70 $1,404.90 $1,963.34 $2,983.48 |
$1,519.78 $1,668.18 $1,825.38 $2,383.82 |
$1,940.26 $2,088.66 $2,245.86 $2,804.30 |
Toc - Plan #26 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$574.99 $652.61 $734.84 $1,026.93 $1,560.52 |
$1,014.86 $1,092.48 $1,174.71 $1,466.80 |
$1,454.73 $1,532.35 $1,614.58 $1,906.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,149.98 $1,305.22 $1,469.68 $2,053.86 $3,121.04 |
$1,589.85 $1,745.09 $1,909.55 $2,493.73 |
$2,029.72 $2,184.96 $2,349.42 $2,933.60 |
Toc - Plan #27 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$542.56 $615.81 $693.39 $969.02 $1,472.51 |
$957.62 $1,030.87 $1,108.45 $1,384.08 |
$1,372.68 $1,445.93 $1,523.51 $1,799.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,085.12 $1,231.62 $1,386.78 $1,938.04 $2,945.02 |
$1,500.18 $1,646.68 $1,801.84 $2,353.10 |
$1,915.24 $2,061.74 $2,216.90 $2,768.16 |
Toc - Plan #28 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-609-9754
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$586.71 $665.92 $749.82 $1,047.86 $1,592.33 |
$1,035.54 $1,114.75 $1,198.65 $1,496.69 |
$1,484.37 $1,563.58 $1,647.48 $1,945.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,173.42 $1,331.84 $1,499.64 $2,095.72 $3,184.66 |
$1,622.25 $1,780.67 $1,948.47 $2,544.55 |
$2,071.08 $2,229.50 $2,397.30 $2,993.38 |
ADVERTISEMENT
Anthem Blue Cross and Blue ShieldLocal: 1-855-738-6652 | Toll Free: 1-855-738-6652 |
Toc - Plan #29 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway Guided Access HMO 0% for HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.68 $447.96 $504.40 $704.90 $1,071.16 |
$696.61 $749.89 $806.33 $1,006.83 |
$998.54 $1,051.82 $1,108.26 $1,308.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$789.36 $895.92 $1,008.80 $1,409.80 $2,142.32 |
$1,091.29 $1,197.85 $1,310.73 $1,711.73 |
$1,393.22 $1,499.78 $1,612.66 $2,013.66 |
Toc - Plan #30 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway Guided Access HMO 3000($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$486.25 $551.89 $621.43 $868.44 $1,319.68 |
$858.23 $923.87 $993.41 $1,240.42 |
$1,230.21 $1,295.85 $1,365.39 $1,612.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$972.50 $1,103.78 $1,242.86 $1,736.88 $2,639.36 |
$1,344.48 $1,475.76 $1,614.84 $2,108.86 |
$1,716.46 $1,847.74 $1,986.82 $2,480.84 |
Toc - Plan #31 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway Guided Access HMO 5500($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.26 $524.67 $590.77 $825.60 $1,254.57 |
$815.89 $878.30 $944.40 $1,179.23 |
$1,169.52 $1,231.93 $1,298.03 $1,532.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$924.52 $1,049.34 $1,181.54 $1,651.20 $2,509.14 |
$1,278.15 $1,402.97 $1,535.17 $2,004.83 |
$1,631.78 $1,756.60 $1,888.80 $2,358.46 |
Toc - Plan #32 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Catastrophic
(HMO) Anthem Catastrophic Pathway X Guided Access HMO 9450 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278.48 $316.07 $355.90 $497.37 $755.79 |
$491.52 $529.11 $568.94 $710.41 |
$704.56 $742.15 $781.98 $923.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$556.96 $632.14 $711.80 $994.74 $1,511.58 |
$770.00 $845.18 $924.84 $1,207.78 |
$983.04 $1,058.22 $1,137.88 $1,420.82 |
Toc - Plan #33 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Pathway Guided Access HMO 8000($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$363.52 $412.60 $464.58 $649.25 $986.59 |
$641.61 $690.69 $742.67 $927.34 |
$919.70 $968.78 $1,020.76 $1,205.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$727.04 $825.20 $929.16 $1,298.50 $1,973.18 |
$1,005.13 $1,103.29 $1,207.25 $1,576.59 |
$1,283.22 $1,381.38 $1,485.34 $1,854.68 |
Toc - Plan #34 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway Guided Access HMO 1350($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$527.02 $598.17 $673.53 $941.26 $1,430.33 |
$930.19 $1,001.34 $1,076.70 $1,344.43 |
$1,333.36 $1,404.51 $1,479.87 $1,747.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,054.04 $1,196.34 $1,347.06 $1,882.52 $2,860.66 |
$1,457.21 $1,599.51 $1,750.23 $2,285.69 |
$1,860.38 $2,002.68 $2,153.40 $2,688.86 |
Toc - Plan #35 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway Guided Access HMO 5000($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.48 $442.06 $497.76 $695.61 $1,057.05 |
$687.43 $740.01 $795.71 $993.56 |
$985.38 $1,037.96 $1,093.66 $1,291.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$778.96 $884.12 $995.52 $1,391.22 $2,114.10 |
$1,076.91 $1,182.07 $1,293.47 $1,689.17 |
$1,374.86 $1,480.02 $1,591.42 $1,987.12 |
Toc - Plan #36 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway Guided Access HMO 6450($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$456.18 $517.76 $583.00 $814.74 $1,238.07 |
$805.16 $866.74 $931.98 $1,163.72 |
$1,154.14 $1,215.72 $1,280.96 $1,512.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$912.36 $1,035.52 $1,166.00 $1,629.48 $2,476.14 |
$1,261.34 $1,384.50 $1,514.98 $1,978.46 |
$1,610.32 $1,733.48 $1,863.96 $2,327.44 |
Toc - Plan #37 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway X Guided Access HMO 7500/50% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.12 $433.71 $488.35 $682.47 $1,037.07 |
$674.44 $726.03 $780.67 $974.79 |
$966.76 $1,018.35 $1,072.99 $1,267.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.24 $867.42 $976.70 $1,364.94 $2,074.14 |
$1,056.56 $1,159.74 $1,269.02 $1,657.26 |
$1,348.88 $1,452.06 $1,561.34 $1,949.58 |
Toc - Plan #38 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway Guided Access HMO 5900/40% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$465.92 $528.82 $595.45 $832.13 $1,264.51 |
$822.35 $885.25 $951.88 $1,188.56 |
$1,178.78 $1,241.68 $1,308.31 $1,544.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$931.84 $1,057.64 $1,190.90 $1,664.26 $2,529.02 |
$1,288.27 $1,414.07 $1,547.33 $2,020.69 |
$1,644.70 $1,770.50 $1,903.76 $2,377.12 |
Toc - Plan #39 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway Guided Access HMO 1500/25% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$548.01 $621.99 $700.36 $978.75 $1,487.30 |
$967.24 $1,041.22 $1,119.59 $1,397.98 |
$1,386.47 $1,460.45 $1,538.82 $1,817.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,096.02 $1,243.98 $1,400.72 $1,957.50 $2,974.60 |
$1,515.25 $1,663.21 $1,819.95 $2,376.73 |
$1,934.48 $2,082.44 $2,239.18 $2,795.96 |
Toc - Plan #40 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Pathway PCP Copay Choice X 6000($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.28 $407.78 $459.16 $641.67 $975.09 |
$634.13 $682.63 $734.01 $916.52 |
$908.98 $957.48 $1,008.86 $1,191.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$718.56 $815.56 $918.32 $1,283.34 $1,950.18 |
$993.41 $1,090.41 $1,193.17 $1,558.19 |
$1,268.26 $1,365.26 $1,468.02 $1,833.04 |
Toc - Plan #41 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Pathway PCP Copay Choice X 5000($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.85 $504.90 $568.52 $794.50 $1,207.32 |
$785.16 $845.21 $908.83 $1,134.81 |
$1,125.47 $1,185.52 $1,249.14 $1,475.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$889.70 $1,009.80 $1,137.04 $1,589.00 $2,414.64 |
$1,230.01 $1,350.11 $1,477.35 $1,929.31 |
$1,570.32 $1,690.42 $1,817.66 $2,269.62 |
Toc - Plan #42 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Pathway PCP Copay Choice X 1200($0 Virtual PCP+$0 Select Drugs) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-738-6652
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$496.65 $563.70 $634.72 $887.02 $1,347.91 |
$876.59 $943.64 $1,014.66 $1,266.96 |
$1,256.53 $1,323.58 $1,394.60 $1,646.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$993.30 $1,127.40 $1,269.44 $1,774.04 $2,695.82 |
$1,373.24 $1,507.34 $1,649.38 $2,153.98 |
$1,753.18 $1,887.28 $2,029.32 $2,533.92 |
ADVERTISEMENT
Oscar Health Plan of GeorgiaLocal: 1-855-672-2755 | Toll Free: |
Toc - Plan #43 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Elite + PCP Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.78 $395.85 $445.72 $622.90 $946.55 |
$615.59 $662.66 $712.53 $889.71 |
$882.40 $929.47 $979.34 $1,156.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.56 $791.70 $891.44 $1,245.80 $1,893.10 |
$964.37 $1,058.51 $1,158.25 $1,512.61 |
$1,231.18 $1,325.32 $1,425.06 $1,779.42 |
Toc - Plan #44 Oscar Health Plan of Georgia | ||||||||||||||||||||
Catastrophic
(HMO) Secure |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$254.82 $289.21 $325.65 $455.10 $691.57 |
$449.75 $484.14 $520.58 $650.03 |
$644.68 $679.07 $715.51 $844.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$509.64 $578.42 $651.30 $910.20 $1,383.14 |
$704.57 $773.35 $846.23 $1,105.13 |
$899.50 $968.28 $1,041.16 $1,300.06 |
Toc - Plan #45 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.80 $428.80 $482.82 $674.74 $1,025.33 |
$666.81 $717.81 $771.83 $963.75 |
$955.82 $1,006.82 $1,060.84 $1,252.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.60 $857.60 $965.64 $1,349.48 $2,050.66 |
$1,044.61 $1,146.61 $1,254.65 $1,638.49 |
$1,333.62 $1,435.62 $1,543.66 $1,927.50 |
Toc - Plan #46 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic PCP Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.08 $357.60 $402.65 $562.71 $855.09 |
$556.11 $598.63 $643.68 $803.74 |
$797.14 $839.66 $884.71 $1,044.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$630.16 $715.20 $805.30 $1,125.42 $1,710.18 |
$871.19 $956.23 $1,046.33 $1,366.45 |
$1,112.22 $1,197.26 $1,287.36 $1,607.48 |
Toc - Plan #47 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic 4700 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.16 $361.10 $406.59 $568.21 $863.46 |
$561.54 $604.48 $649.97 $811.59 |
$804.92 $847.86 $893.35 $1,054.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.32 $722.20 $813.18 $1,136.42 $1,726.92 |
$879.70 $965.58 $1,056.56 $1,379.80 |
$1,123.08 $1,208.96 $1,299.94 $1,623.18 |
Toc - Plan #48 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.29 $422.54 $475.78 $664.90 $1,010.37 |
$657.09 $707.34 $760.58 $949.70 |
$941.89 $992.14 $1,045.38 $1,234.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$744.58 $845.08 $951.56 $1,329.80 $2,020.74 |
$1,029.38 $1,129.88 $1,236.36 $1,614.60 |
$1,314.18 $1,414.68 $1,521.16 $1,899.40 |
Toc - Plan #49 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Elite Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$385.99 $438.08 $493.28 $689.36 $1,047.54 |
$681.26 $733.35 $788.55 $984.63 |
$976.53 $1,028.62 $1,083.82 $1,279.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$771.98 $876.16 $986.56 $1,378.72 $2,095.08 |
$1,067.25 $1,171.43 $1,281.83 $1,673.99 |
$1,362.52 $1,466.70 $1,577.10 $1,969.26 |
Toc - Plan #50 Oscar Health Plan of Georgia | ||||||||||||||||||||
Gold
(HMO) Gold Elite Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$445.90 $506.09 $569.85 $796.37 $1,210.15 |
$787.01 $847.20 $910.96 $1,137.48 |
$1,128.12 $1,188.31 $1,252.07 $1,478.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$891.80 $1,012.18 $1,139.70 $1,592.74 $2,420.30 |
$1,232.91 $1,353.29 $1,480.81 $1,933.85 |
$1,574.02 $1,694.40 $1,821.92 $2,274.96 |
Toc - Plan #51 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Simple Diabetes |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.70 $429.81 $483.97 $676.34 $1,027.76 |
$668.40 $719.51 $773.67 $966.04 |
$958.10 $1,009.21 $1,063.37 $1,255.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$757.40 $859.62 $967.94 $1,352.68 $2,055.52 |
$1,047.10 $1,149.32 $1,257.64 $1,642.38 |
$1,336.80 $1,439.02 $1,547.34 $1,932.08 |
Toc - Plan #52 Oscar Health Plan of Georgia | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Classic Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$312.19 $354.32 $398.96 $557.55 $847.24 |
$551.00 $593.13 $637.77 $796.36 |
$789.81 $831.94 $876.58 $1,035.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$624.38 $708.64 $797.92 $1,115.10 $1,694.48 |
$863.19 $947.45 $1,036.73 $1,353.91 |
$1,102.00 $1,186.26 $1,275.54 $1,592.72 |
Toc - Plan #53 Oscar Health Plan of Georgia | ||||||||||||||||||||
Bronze
(HMO) Bronze Simple 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$279.83 $317.59 $357.61 $499.75 $759.43 |
$493.89 $531.65 $571.67 $713.81 |
$707.95 $745.71 $785.73 $927.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$559.66 $635.18 $715.22 $999.50 $1,518.86 |
$773.72 $849.24 $929.28 $1,213.56 |
$987.78 $1,063.30 $1,143.34 $1,427.62 |
Toc - Plan #54 Oscar Health Plan of Georgia | ||||||||||||||||||||
Silver
(HMO) Silver Classic Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372.72 $423.02 $476.32 $665.65 $1,011.52 |
$657.84 $708.14 $761.44 $950.77 |
$942.96 $993.26 $1,046.56 $1,235.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745.44 $846.04 $952.64 $1,331.30 $2,023.04 |
$1,030.56 $1,131.16 $1,237.76 $1,616.42 |
$1,315.68 $1,416.28 $1,522.88 $1,901.54 |
Toc - Plan #55 Oscar Health Plan of Georgia | ||||||||||||||||||||
Gold
(HMO) Gold Classic Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.72 $442.32 $498.04 $696.01 $1,057.66 |
$687.84 $740.44 $796.16 $994.13 |
$985.96 $1,038.56 $1,094.28 $1,292.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.44 $884.64 $996.08 $1,392.02 $2,115.32 |
$1,077.56 $1,182.76 $1,294.20 $1,690.14 |
$1,375.68 $1,480.88 $1,592.32 $1,988.26 |
ADVERTISEMENT
CareSourceLocal: 1-833-230-2099 | Toll Free: 1-833-230-2099 | TTY: 1-800-255-0056 |
Toc - Plan #56 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.03 $382.52 $430.72 $601.93 $914.69 |
$594.86 $640.35 $688.55 $859.76 |
$852.69 $898.18 $946.38 $1,117.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$674.06 $765.04 $861.44 $1,203.86 $1,829.38 |
$931.89 $1,022.87 $1,119.27 $1,461.69 |
$1,189.72 $1,280.70 $1,377.10 $1,719.52 |
Toc - Plan #57 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Core Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$533.59 $605.62 $681.93 $952.99 $1,448.16 |
$941.79 $1,013.82 $1,090.13 $1,361.19 |
$1,349.99 $1,422.02 $1,498.33 $1,769.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,067.18 $1,211.24 $1,363.86 $1,905.98 $2,896.32 |
$1,475.38 $1,619.44 $1,772.06 $2,314.18 |
$1,883.58 $2,027.64 $2,180.26 $2,722.38 |
Toc - Plan #58 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.72 $503.61 $567.06 $792.47 $1,204.24 |
$783.16 $843.05 $906.50 $1,131.91 |
$1,122.60 $1,182.49 $1,245.94 $1,471.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$887.44 $1,007.22 $1,134.12 $1,584.94 $2,408.48 |
$1,226.88 $1,346.66 $1,473.56 $1,924.38 |
$1,566.32 $1,686.10 $1,813.00 $2,263.82 |
Toc - Plan #59 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace HSA Eligible Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.74 $420.79 $473.81 $662.14 $1,006.19 |
$654.36 $704.41 $757.43 $945.76 |
$937.98 $988.03 $1,041.05 $1,229.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.48 $841.58 $947.62 $1,324.28 $2,012.38 |
$1,025.10 $1,125.20 $1,231.24 $1,607.90 |
$1,308.72 $1,408.82 $1,514.86 $1,891.52 |
Toc - Plan #60 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$441.15 $500.70 $563.78 $787.89 $1,197.27 |
$778.63 $838.18 $901.26 $1,125.37 |
$1,116.11 $1,175.66 $1,238.74 $1,462.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$882.30 $1,001.40 $1,127.56 $1,575.78 $2,394.54 |
$1,219.78 $1,338.88 $1,465.04 $1,913.26 |
$1,557.26 $1,676.36 $1,802.52 $2,250.74 |
Toc - Plan #61 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$556.48 $631.60 $711.18 $993.87 $1,510.28 |
$982.19 $1,057.31 $1,136.89 $1,419.58 |
$1,407.90 $1,483.02 $1,562.60 $1,845.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,112.96 $1,263.20 $1,422.36 $1,987.74 $3,020.56 |
$1,538.67 $1,688.91 $1,848.07 $2,413.45 |
$1,964.38 $2,114.62 $2,273.78 $2,839.16 |
Toc - Plan #62 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Diabetes Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$571.48 $648.62 $730.34 $1,020.65 $1,550.98 |
$1,008.66 $1,085.80 $1,167.52 $1,457.83 |
$1,445.84 $1,522.98 $1,604.70 $1,895.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,142.96 $1,297.24 $1,460.68 $2,041.30 $3,101.96 |
$1,580.14 $1,734.42 $1,897.86 $2,478.48 |
$2,017.32 $2,171.60 $2,335.04 $2,915.66 |
Toc - Plan #63 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Diabetes Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$458.39 $520.27 $585.82 $818.68 $1,244.06 |
$809.05 $870.93 $936.48 $1,169.34 |
$1,159.71 $1,221.59 $1,287.14 $1,520.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$916.78 $1,040.54 $1,171.64 $1,637.36 $2,488.12 |
$1,267.44 $1,391.20 $1,522.30 $1,988.02 |
$1,618.10 $1,741.86 $1,872.96 $2,338.68 |
Toc - Plan #64 CareSource | ||||||||||||||||||||
Expanded Bronze
(HMO) CareSource Marketplace Bronze First Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.78 $391.33 $440.63 $615.78 $935.74 |
$608.54 $655.09 $704.39 $879.54 |
$872.30 $918.85 $968.15 $1,143.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$689.56 $782.66 $881.26 $1,231.56 $1,871.48 |
$953.32 $1,046.42 $1,145.02 $1,495.32 |
$1,217.08 $1,310.18 $1,408.78 $1,759.08 |
Toc - Plan #65 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Core Gold Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$543.19 $616.52 $694.20 $970.14 $1,474.21 |
$958.73 $1,032.06 $1,109.74 $1,385.68 |
$1,374.27 $1,447.60 $1,525.28 $1,801.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,086.38 $1,233.04 $1,388.40 $1,940.28 $2,948.42 |
$1,501.92 $1,648.58 $1,803.94 $2,355.82 |
$1,917.46 $2,064.12 $2,219.48 $2,771.36 |
Toc - Plan #66 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$451.52 $512.48 $577.04 $806.42 $1,225.43 |
$796.93 $857.89 $922.45 $1,151.83 |
$1,142.34 $1,203.30 $1,267.86 $1,497.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$903.04 $1,024.96 $1,154.08 $1,612.84 $2,450.86 |
$1,248.45 $1,370.37 $1,499.49 $1,958.25 |
$1,593.86 $1,715.78 $1,844.90 $2,303.66 |
Toc - Plan #67 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$448.96 $509.56 $573.76 $801.83 $1,218.46 |
$792.41 $853.01 $917.21 $1,145.28 |
$1,135.86 $1,196.46 $1,260.66 $1,488.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$897.92 $1,019.12 $1,147.52 $1,603.66 $2,436.92 |
$1,241.37 $1,362.57 $1,490.97 $1,947.11 |
$1,584.82 $1,706.02 $1,834.42 $2,290.56 |
Toc - Plan #68 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Gold Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$566.08 $642.50 $723.45 $1,011.01 $1,536.33 |
$999.13 $1,075.55 $1,156.50 $1,444.06 |
$1,432.18 $1,508.60 $1,589.55 $1,877.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,132.16 $1,285.00 $1,446.90 $2,022.02 $3,072.66 |
$1,565.21 $1,718.05 $1,879.95 $2,455.07 |
$1,998.26 $2,151.10 $2,313.00 $2,888.12 |
Toc - Plan #69 CareSource | ||||||||||||||||||||
Gold
(HMO) CareSource Marketplace Diabetes Gold Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$581.07 $659.51 $742.60 $1,037.78 $1,577.01 |
$1,025.58 $1,104.02 $1,187.11 $1,482.29 |
$1,470.09 $1,548.53 $1,631.62 $1,926.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,162.14 $1,319.02 $1,485.20 $2,075.56 $3,154.02 |
$1,606.65 $1,763.53 $1,929.71 $2,520.07 |
$2,051.16 $2,208.04 $2,374.22 $2,964.58 |
Toc - Plan #70 CareSource | ||||||||||||||||||||
Silver
(HMO) CareSource Marketplace Diabetes Silver Dental, Vision, & Fitness |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-230-2099
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$466.20 $529.13 $595.79 $832.62 $1,265.25 |
$822.84 $885.77 $952.43 $1,189.26 |
$1,179.48 $1,242.41 $1,309.07 $1,545.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$932.40 $1,058.26 $1,191.58 $1,665.24 $2,530.50 |
$1,289.04 $1,414.90 $1,548.22 $2,021.88 |
$1,645.68 $1,771.54 $1,904.86 $2,378.52 |
ADVERTISEMENT
Ambetter from Peach State Health PlanLocal: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231 |
Toc - Plan #71 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.77 $402.65 $453.38 $633.60 $962.82 |
$626.16 $674.04 $724.77 $904.99 |
$897.55 $945.43 $996.16 $1,176.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$709.54 $805.30 $906.76 $1,267.20 $1,925.64 |
$980.93 $1,076.69 $1,178.15 $1,538.59 |
$1,252.32 $1,348.08 $1,449.54 $1,809.98 |
Toc - Plan #72 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.14 $477.99 $538.21 $752.15 $1,142.96 |
$743.31 $800.16 $860.38 $1,074.32 |
$1,065.48 $1,122.33 $1,182.55 $1,396.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$842.28 $955.98 $1,076.42 $1,504.30 $2,285.92 |
$1,164.45 $1,278.15 $1,398.59 $1,826.47 |
$1,486.62 $1,600.32 $1,720.76 $2,148.64 |
Toc - Plan #73 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.80 $503.70 $567.16 $792.60 $1,204.44 |
$783.30 $843.20 $906.66 $1,132.10 |
$1,122.80 $1,182.70 $1,246.16 $1,471.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$887.60 $1,007.40 $1,134.32 $1,585.20 $2,408.88 |
$1,227.10 $1,346.90 $1,473.82 $1,924.70 |
$1,566.60 $1,686.40 $1,813.32 $2,264.20 |
Toc - Plan #74 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$391.78 $444.66 $500.68 $699.70 $1,063.26 |
$691.48 $744.36 $800.38 $999.40 |
$991.18 $1,044.06 $1,100.08 $1,299.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$783.56 $889.32 $1,001.36 $1,399.40 $2,126.52 |
$1,083.26 $1,189.02 $1,301.06 $1,699.10 |
$1,382.96 $1,488.72 $1,600.76 $1,998.80 |
Toc - Plan #75 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.85 $435.66 $490.55 $685.54 $1,041.74 |
$677.49 $729.30 $784.19 $979.18 |
$971.13 $1,022.94 $1,077.83 $1,272.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.70 $871.32 $981.10 $1,371.08 $2,083.48 |
$1,061.34 $1,164.96 $1,274.74 $1,664.72 |
$1,354.98 $1,458.60 $1,568.38 $1,958.36 |
Toc - Plan #76 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.54 $463.68 $522.10 $729.63 $1,108.74 |
$721.06 $776.20 $834.62 $1,042.15 |
$1,033.58 $1,088.72 $1,147.14 $1,354.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.08 $927.36 $1,044.20 $1,459.26 $2,217.48 |
$1,129.60 $1,239.88 $1,356.72 $1,771.78 |
$1,442.12 $1,552.40 $1,669.24 $2,084.30 |
Toc - Plan #77 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$414.64 $470.60 $529.89 $740.52 $1,125.30 |
$731.83 $787.79 $847.08 $1,057.71 |
$1,049.02 $1,104.98 $1,164.27 $1,374.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$829.28 $941.20 $1,059.78 $1,481.04 $2,250.60 |
$1,146.47 $1,258.39 $1,376.97 $1,798.23 |
$1,463.66 $1,575.58 $1,694.16 $2,115.42 |
Toc - Plan #78 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.93 $482.28 $543.04 $758.90 $1,153.22 |
$749.99 $807.34 $868.10 $1,083.96 |
$1,075.05 $1,132.40 $1,193.16 $1,409.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$849.86 $964.56 $1,086.08 $1,517.80 $2,306.44 |
$1,174.92 $1,289.62 $1,411.14 $1,842.86 |
$1,499.98 $1,614.68 $1,736.20 $2,167.92 |
Toc - Plan #79 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.91 $475.45 $535.35 $748.15 $1,136.89 |
$739.37 $795.91 $855.81 $1,068.61 |
$1,059.83 $1,116.37 $1,176.27 $1,389.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$837.82 $950.90 $1,070.70 $1,496.30 $2,273.78 |
$1,158.28 $1,271.36 $1,391.16 $1,816.76 |
$1,478.74 $1,591.82 $1,711.62 $2,137.22 |
Toc - Plan #80 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$484.87 $550.32 $619.66 $865.97 $1,315.92 |
$855.79 $921.24 $990.58 $1,236.89 |
$1,226.71 $1,292.16 $1,361.50 $1,607.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$969.74 $1,100.64 $1,239.32 $1,731.94 $2,631.84 |
$1,340.66 $1,471.56 $1,610.24 $2,102.86 |
$1,711.58 $1,842.48 $1,981.16 $2,473.78 |
Toc - Plan #81 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.38 $428.32 $482.28 $673.99 $1,024.19 |
$666.07 $717.01 $770.97 $962.68 |
$954.76 $1,005.70 $1,059.66 $1,251.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$754.76 $856.64 $964.56 $1,347.98 $2,048.38 |
$1,043.45 $1,145.33 $1,253.25 $1,636.67 |
$1,332.14 $1,434.02 $1,541.94 $1,925.36 |
Toc - Plan #82 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.71 $461.60 $519.76 $726.36 $1,103.77 |
$717.83 $772.72 $830.88 $1,037.48 |
$1,028.95 $1,083.84 $1,142.00 $1,348.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.42 $923.20 $1,039.52 $1,452.72 $2,207.54 |
$1,124.54 $1,234.32 $1,350.64 $1,763.84 |
$1,435.66 $1,545.44 $1,661.76 $2,074.96 |
Toc - Plan #83 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.67 $484.26 $545.28 $762.02 $1,157.97 |
$753.07 $810.66 $871.68 $1,088.42 |
$1,079.47 $1,137.06 $1,198.08 $1,414.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$853.34 $968.52 $1,090.56 $1,524.04 $2,315.94 |
$1,179.74 $1,294.92 $1,416.96 $1,850.44 |
$1,506.14 $1,621.32 $1,743.36 $2,176.84 |
Toc - Plan #84 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$436.21 $495.09 $557.47 $779.06 $1,183.85 |
$769.91 $828.79 $891.17 $1,112.76 |
$1,103.61 $1,162.49 $1,224.87 $1,446.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$872.42 $990.18 $1,114.94 $1,558.12 $2,367.70 |
$1,206.12 $1,323.88 $1,448.64 $1,891.82 |
$1,539.82 $1,657.58 $1,782.34 $2,225.52 |
Toc - Plan #85 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Bronze
(HMO) Clear Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.47 $417.06 $469.61 $656.27 $997.27 |
$648.57 $698.16 $750.71 $937.37 |
$929.67 $979.26 $1,031.81 $1,218.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$734.94 $834.12 $939.22 $1,312.54 $1,994.54 |
$1,016.04 $1,115.22 $1,220.32 $1,593.64 |
$1,297.14 $1,396.32 $1,501.42 $1,874.74 |
Toc - Plan #86 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$459.68 $521.72 $587.45 $820.96 $1,247.53 |
$811.32 $873.36 $939.09 $1,172.60 |
$1,162.96 $1,225.00 $1,290.73 $1,524.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$919.36 $1,043.44 $1,174.90 $1,641.92 $2,495.06 |
$1,271.00 $1,395.08 $1,526.54 $1,993.56 |
$1,622.64 $1,746.72 $1,878.18 $2,345.20 |
Toc - Plan #87 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.80 $460.57 $518.60 $724.74 $1,101.31 |
$716.23 $771.00 $829.03 $1,035.17 |
$1,026.66 $1,081.43 $1,139.46 $1,345.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.60 $921.14 $1,037.20 $1,449.48 $2,202.62 |
$1,122.03 $1,231.57 $1,347.63 $1,759.91 |
$1,432.46 $1,542.00 $1,658.06 $2,070.34 |
Toc - Plan #88 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.58 $451.25 $508.10 $710.07 $1,079.02 |
$701.72 $755.39 $812.24 $1,014.21 |
$1,005.86 $1,059.53 $1,116.38 $1,318.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$795.16 $902.50 $1,016.20 $1,420.14 $2,158.04 |
$1,099.30 $1,206.64 $1,320.34 $1,724.28 |
$1,403.44 $1,510.78 $1,624.48 $2,028.42 |
Toc - Plan #89 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.47 $487.44 $548.85 $767.02 $1,165.56 |
$758.01 $815.98 $877.39 $1,095.56 |
$1,086.55 $1,144.52 $1,205.93 $1,424.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.94 $974.88 $1,097.70 $1,534.04 $2,331.12 |
$1,187.48 $1,303.42 $1,426.24 $1,862.58 |
$1,516.02 $1,631.96 $1,754.78 $2,191.12 |
Toc - Plan #90 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.13 $499.54 $562.47 $786.06 $1,194.49 |
$776.82 $836.23 $899.16 $1,122.75 |
$1,113.51 $1,172.92 $1,235.85 $1,459.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$880.26 $999.08 $1,124.94 $1,572.12 $2,388.98 |
$1,216.95 $1,335.77 $1,461.63 $1,908.81 |
$1,553.64 $1,672.46 $1,798.32 $2,245.50 |
Toc - Plan #91 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.15 $480.27 $540.78 $755.74 $1,148.41 |
$746.86 $803.98 $864.49 $1,079.45 |
$1,070.57 $1,127.69 $1,188.20 $1,403.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$846.30 $960.54 $1,081.56 $1,511.48 $2,296.82 |
$1,170.01 $1,284.25 $1,405.27 $1,835.19 |
$1,493.72 $1,607.96 $1,728.98 $2,158.90 |
Toc - Plan #92 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.90 $492.46 $554.51 $774.92 $1,177.57 |
$765.82 $824.38 $886.43 $1,106.84 |
$1,097.74 $1,156.30 $1,218.35 $1,438.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$867.80 $984.92 $1,109.02 $1,549.84 $2,355.14 |
$1,199.72 $1,316.84 $1,440.94 $1,881.76 |
$1,531.64 $1,648.76 $1,772.86 $2,213.68 |
Toc - Plan #93 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$502.22 $570.01 $641.83 $896.95 $1,363.00 |
$886.41 $954.20 $1,026.02 $1,281.14 |
$1,270.60 $1,338.39 $1,410.21 $1,665.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,004.44 $1,140.02 $1,283.66 $1,793.90 $2,726.00 |
$1,388.63 $1,524.21 $1,667.85 $2,178.09 |
$1,772.82 $1,908.40 $2,052.04 $2,562.28 |
Toc - Plan #94 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Standard Expanded Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.89 $443.64 $499.54 $698.11 $1,060.84 |
$689.91 $742.66 $798.56 $997.13 |
$988.93 $1,041.68 $1,097.58 $1,296.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$781.78 $887.28 $999.08 $1,396.22 $2,121.68 |
$1,080.80 $1,186.30 $1,298.10 $1,695.24 |
$1,379.82 $1,485.32 $1,597.12 $1,994.26 |
Toc - Plan #95 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Standard Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.26 $478.12 $538.36 $752.35 $1,143.27 |
$743.52 $800.38 $860.62 $1,074.61 |
$1,065.78 $1,122.64 $1,182.88 $1,396.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$842.52 $956.24 $1,076.72 $1,504.70 $2,286.54 |
$1,164.78 $1,278.50 $1,398.98 $1,826.96 |
$1,487.04 $1,600.76 $1,721.24 $2,149.22 |
Toc - Plan #96 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Standard Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$441.94 $501.59 $564.79 $789.29 $1,199.40 |
$780.02 $839.67 $902.87 $1,127.37 |
$1,118.10 $1,177.75 $1,240.95 $1,465.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$883.88 $1,003.18 $1,129.58 $1,578.58 $2,398.80 |
$1,221.96 $1,341.26 $1,467.66 $1,916.66 |
$1,560.04 $1,679.34 $1,805.74 $2,254.74 |
Toc - Plan #97 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Standard Silver SELECT Wellstar |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.61 $427.44 $481.30 $672.61 $1,022.09 |
$664.71 $715.54 $769.40 $960.71 |
$952.81 $1,003.64 $1,057.50 $1,248.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.22 $854.88 $962.60 $1,345.22 $2,044.18 |
$1,041.32 $1,142.98 $1,250.70 $1,633.32 |
$1,329.42 $1,431.08 $1,538.80 $1,921.42 |
Toc - Plan #98 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Standard Gold SELECT Wellstar |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$395.12 $448.44 $504.94 $705.66 $1,072.32 |
$697.38 $750.70 $807.20 $1,007.92 |
$999.64 $1,052.96 $1,109.46 $1,310.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$790.24 $896.88 $1,009.88 $1,411.32 $2,144.64 |
$1,092.50 $1,199.14 $1,312.14 $1,713.58 |
$1,394.76 $1,501.40 $1,614.40 $2,015.84 |
Toc - Plan #99 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Silver
(HMO) Standard Silver SELECT Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.73 $433.26 $487.84 $681.76 $1,036.00 |
$673.75 $725.28 $779.86 $973.78 |
$965.77 $1,017.30 $1,071.88 $1,265.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$763.46 $866.52 $975.68 $1,363.52 $2,072.00 |
$1,055.48 $1,158.54 $1,267.70 $1,655.54 |
$1,347.50 $1,450.56 $1,559.72 $1,947.56 |
Toc - Plan #100 Ambetter from Peach State Health Plan | ||||||||||||||||||||
Gold
(HMO) Standard Gold SELECT Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1180
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.48 $454.54 $511.81 $715.25 $1,086.89 |
$706.84 $760.90 $818.17 $1,021.61 |
$1,013.20 $1,067.26 $1,124.53 $1,327.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$800.96 $909.08 $1,023.62 $1,430.50 $2,173.78 |
$1,107.32 $1,215.44 $1,329.98 $1,736.86 |
$1,413.68 $1,521.80 $1,636.34 $2,043.22 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-877-336-3915 | Toll Free: 1-877-336-3915 |
Toc - Plan #101 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 5: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.13 $474.57 $534.36 $746.77 $1,134.79 |
$738.00 $794.44 $854.23 $1,066.64 |
$1,057.87 $1,114.31 $1,174.10 $1,386.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$836.26 $949.14 $1,068.72 $1,493.54 $2,269.58 |
$1,156.13 $1,269.01 $1,388.59 $1,813.41 |
$1,476.00 $1,588.88 $1,708.46 $2,133.28 |
Toc - Plan #102 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze S: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.55 $394.47 $444.16 $620.72 $943.24 |
$613.43 $660.35 $710.04 $886.60 |
$879.31 $926.23 $975.92 $1,152.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$695.10 $788.94 $888.32 $1,241.44 $1,886.48 |
$960.98 $1,054.82 $1,154.20 $1,507.32 |
$1,226.86 $1,320.70 $1,420.08 $1,773.20 |
Toc - Plan #103 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold S: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$465.29 $528.10 $594.63 $831.00 $1,262.78 |
$821.23 $884.04 $950.57 $1,186.94 |
$1,177.17 $1,239.98 $1,306.51 $1,542.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$930.58 $1,056.20 $1,189.26 $1,662.00 $2,525.56 |
$1,286.52 $1,412.14 $1,545.20 $2,017.94 |
$1,642.46 $1,768.08 $1,901.14 $2,373.88 |
Toc - Plan #104 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 6: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.66 $484.26 $545.27 $762.01 $1,157.94 |
$753.06 $810.66 $871.67 $1,088.41 |
$1,079.46 $1,137.06 $1,198.07 $1,414.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$853.32 $968.52 $1,090.54 $1,524.02 $2,315.88 |
$1,179.72 $1,294.92 $1,416.94 $1,850.42 |
$1,506.12 $1,621.32 $1,743.34 $2,176.82 |
Toc - Plan #105 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver S: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.17 $474.62 $534.42 $746.85 $1,134.91 |
$738.07 $794.52 $854.32 $1,066.75 |
$1,057.97 $1,114.42 $1,174.22 $1,386.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$836.34 $949.24 $1,068.84 $1,493.70 $2,269.82 |
$1,156.24 $1,269.14 $1,388.74 $1,813.60 |
$1,476.14 $1,589.04 $1,708.64 $2,133.50 |
Toc - Plan #106 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 2 HSA: Aetna network of doctors & hospitals + walk-in clinic + Virtual Care 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.36 $387.44 $436.26 $609.66 $926.44 |
$602.50 $648.58 $697.40 $870.80 |
$863.64 $909.72 $958.54 $1,131.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.72 $774.88 $872.52 $1,219.32 $1,852.88 |
$943.86 $1,036.02 $1,133.66 $1,480.46 |
$1,205.00 $1,297.16 $1,394.80 $1,741.60 |
Toc - Plan #107 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 4: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.45 $432.95 $487.50 $681.27 $1,035.26 |
$673.26 $724.76 $779.31 $973.08 |
$965.07 $1,016.57 $1,071.12 $1,264.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762.90 $865.90 $975.00 $1,362.54 $2,070.52 |
$1,054.71 $1,157.71 $1,266.81 $1,654.35 |
$1,346.52 $1,449.52 $1,558.62 $1,946.16 |
Toc - Plan #108 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold 3: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.45 $524.88 $591.01 $825.93 $1,255.08 |
$816.23 $878.66 $944.79 $1,179.71 |
$1,170.01 $1,232.44 $1,298.57 $1,533.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$924.90 $1,049.76 $1,182.02 $1,651.86 $2,510.16 |
$1,278.68 $1,403.54 $1,535.80 $2,005.64 |
$1,632.46 $1,757.32 $1,889.58 $2,359.42 |
Toc - Plan #109 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold 4: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$468.54 $531.80 $598.80 $836.81 $1,271.62 |
$826.98 $890.24 $957.24 $1,195.25 |
$1,185.42 $1,248.68 $1,315.68 $1,553.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$937.08 $1,063.60 $1,197.60 $1,673.62 $2,543.24 |
$1,295.52 $1,422.04 $1,556.04 $2,032.06 |
$1,653.96 $1,780.48 $1,914.48 $2,390.50 |
Toc - Plan #110 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 7: Aetna network of doctors & hospitals + $0 walk-in clinic + $0 Virtual Care options 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-336-3915
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.41 $483.97 $544.95 $761.56 $1,157.27 |
$752.61 $810.17 $871.15 $1,087.76 |
$1,078.81 $1,136.37 $1,197.35 $1,413.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$852.82 $967.94 $1,089.90 $1,523.12 $2,314.54 |
$1,179.02 $1,294.14 $1,416.10 $1,849.32 |
$1,505.22 $1,620.34 $1,742.30 $2,175.52 |
ADVERTISEMENT
Kaiser PermanenteLocal: 1-800-494-5314 | Toll Free: 1-800-494-5314 |
Toc - Plan #111 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Signature Gold 500 Ded/500 Rx Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.13 $482.53 $543.32 $759.29 $1,153.81 |
$750.36 $807.76 $868.55 $1,084.52 |
$1,075.59 $1,132.99 $1,193.78 $1,409.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$850.26 $965.06 $1,086.64 $1,518.58 $2,307.62 |
$1,175.49 $1,290.29 $1,411.87 $1,843.81 |
$1,500.72 $1,615.52 $1,737.10 $2,169.04 |
Toc - Plan #112 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Signature Silver 3400 Ded/500 Rx Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.34 $466.88 $525.70 $734.66 $1,116.39 |
$726.02 $781.56 $840.38 $1,049.34 |
$1,040.70 $1,096.24 $1,155.06 $1,364.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.68 $933.76 $1,051.40 $1,469.32 $2,232.78 |
$1,137.36 $1,248.44 $1,366.08 $1,784.00 |
$1,452.04 $1,563.12 $1,680.76 $2,098.68 |
Toc - Plan #113 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Signature Bronze Virtual Complete 5500/1500 RxDed |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.85 $352.81 $397.27 $555.18 $843.65 |
$548.65 $590.61 $635.07 $792.98 |
$786.45 $828.41 $872.87 $1,030.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.70 $705.62 $794.54 $1,110.36 $1,687.30 |
$859.50 $943.42 $1,032.34 $1,348.16 |
$1,097.30 $1,181.22 $1,270.14 $1,585.96 |
Toc - Plan #114 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Signature Bronze 6500/40%/HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306.28 $347.63 $391.42 $547.01 $831.24 |
$540.58 $581.93 $625.72 $781.31 |
$774.88 $816.23 $860.02 $1,015.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612.56 $695.26 $782.84 $1,094.02 $1,662.48 |
$846.86 $929.56 $1,017.14 $1,328.32 |
$1,081.16 $1,163.86 $1,251.44 $1,562.62 |
Toc - Plan #115 Kaiser Permanente | ||||||||||||||||||||
Catastrophic
(HMO) KP GA Signature Catastrophic 9450 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$267.78 $303.93 $342.22 $478.25 $726.74 |
$472.63 $508.78 $547.07 $683.10 |
$677.48 $713.63 $751.92 $887.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$535.56 $607.86 $684.44 $956.50 $1,453.48 |
$740.41 $812.71 $889.29 $1,161.35 |
$945.26 $1,017.56 $1,094.14 $1,366.20 |
Toc - Plan #116 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Signature Gold 1500 Ded/500 Rx Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.68 $463.85 $522.29 $729.90 $1,109.15 |
$721.32 $776.49 $834.93 $1,042.54 |
$1,033.96 $1,089.13 $1,147.57 $1,355.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$817.36 $927.70 $1,044.58 $1,459.80 $2,218.30 |
$1,130.00 $1,240.34 $1,357.22 $1,772.44 |
$1,442.64 $1,552.98 $1,669.86 $2,085.08 |
Toc - Plan #117 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Signature Silver 4500/35 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.86 $452.71 $509.75 $712.37 $1,082.52 |
$703.99 $757.84 $814.88 $1,017.50 |
$1,009.12 $1,062.97 $1,120.01 $1,322.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797.72 $905.42 $1,019.50 $1,424.74 $2,165.04 |
$1,102.85 $1,210.55 $1,324.63 $1,729.87 |
$1,407.98 $1,515.68 $1,629.76 $2,035.00 |
Toc - Plan #118 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Signature Gold 2000 Ded/500 Rx Ded |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.11 $440.50 $496.00 $693.16 $1,053.32 |
$685.01 $737.40 $792.90 $990.06 |
$981.91 $1,034.30 $1,089.80 $1,286.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.22 $881.00 $992.00 $1,386.32 $2,106.64 |
$1,073.12 $1,177.90 $1,288.90 $1,683.22 |
$1,370.02 $1,474.80 $1,585.80 $1,980.12 |
Toc - Plan #119 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Signature Silver Virtual Complete 5000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.90 $424.38 $477.85 $667.79 $1,014.77 |
$659.94 $710.42 $763.89 $953.83 |
$945.98 $996.46 $1,049.93 $1,239.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$747.80 $848.76 $955.70 $1,335.58 $2,029.54 |
$1,033.84 $1,134.80 $1,241.74 $1,621.62 |
$1,319.88 $1,420.84 $1,527.78 $1,907.66 |
Toc - Plan #120 Kaiser Permanente | ||||||||||||||||||||
Gold
(HMO) KP GA Signature Standard Gold 1500/30 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.50 $465.92 $524.63 $733.16 $1,114.11 |
$724.54 $779.96 $838.67 $1,047.20 |
$1,038.58 $1,094.00 $1,152.71 $1,361.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.00 $931.84 $1,049.26 $1,466.32 $2,228.22 |
$1,135.04 $1,245.88 $1,363.30 $1,780.36 |
$1,449.08 $1,559.92 $1,677.34 $2,094.40 |
Toc - Plan #121 Kaiser Permanente | ||||||||||||||||||||
Silver
(HMO) KP GA Signature Standard Silver 5900/40 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.74 $434.41 $489.15 $683.58 $1,038.76 |
$675.54 $727.21 $781.95 $976.38 |
$968.34 $1,020.01 $1,074.75 $1,269.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$765.48 $868.82 $978.30 $1,367.16 $2,077.52 |
$1,058.28 $1,161.62 $1,271.10 $1,659.96 |
$1,351.08 $1,454.42 $1,563.90 $1,952.76 |
Toc - Plan #122 Kaiser Permanente | ||||||||||||||||||||
Expanded Bronze
(HMO) KP GA Signature Standard Bronze 7500/50 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-494-5314
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.19 $366.82 $413.04 $577.22 $877.14 |
$570.43 $614.06 $660.28 $824.46 |
$817.67 $861.30 $907.52 $1,071.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646.38 $733.64 $826.08 $1,154.44 $1,754.28 |
$893.62 $980.88 $1,073.32 $1,401.68 |
$1,140.86 $1,228.12 $1,320.56 $1,648.92 |
‡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 Fulton County here.
Fulton County is in “Rating Area 3” of Georgia.
Currently, there are 122 plans offered in Rating Area 3.