Nebraska Obamacare 2024 Rates
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Counties in Nebraska
- Douglas County (Omaha)
- Lancaster County (Lincoln)
- Sarpy County (Papillion)
- Hall County (Grand Island)
- Buffalo County (Kearney)
- Dodge County (Fremont)
- Scotts Bluff County (Gering)
- Madison County (Madison)
- Lincoln County (North Platte)
- Platte County (Columbus)
- Adams County (Hastings)
- Cass County (Plattsmouth)
- Dawson County (Lexington)
- Saunders County (Wahoo)
- Gage County (Beatrice)
- Dakota County (Dakota City)
- Washington County (Blair)
- Seward County (Seward)
- Otoe County (Nebraska City)
- Saline County (Wilber)
- York County (York)
- Box Butte County (Alliance)
- Red Willow County (McCook)
- Colfax County (Schuyler)
- Custer County (Broken Bow)
- Holt County (O'Neill)
- Wayne County (Wayne)
- Cheyenne County (Sidney)
- Hamilton County (Aurora)
- Cuming County (West Point)
- Phelps County (Holdrege)
- Knox County (Center)
- Cedar County (Hartington)
- Butler County (David City)
- Keith County (Ogallala)
- Dawes County (Chadron)
- Richardson County (Falls City)
- Merrick County (Central City)
- Pierce County (Pierce)
- Jefferson County (Fairbury)
- Nemaha County (Auburn)
- Thurston County (Pender)
- Burt County (Tekamah)
- Kearney County (Minden)
- Howard County (Saint Paul)
- Antelope County (Neligh)
- Clay County (Clay Center)
- Stanton County (Stanton)
- Dixon County (Ponca)
- Fillmore County (Geneva)
- Cherry County (Valentine)
- Boone County (Albion)
- Johnson County (Tecumseh)
- Polk County (Osceola)
- Sheridan County (Rushville)
- Thayer County (Hebron)
- Furnas County (Beaver City)
- Morrill County (Bridgeport)
- Nuckolls County (Nelson)
- Valley County (Ord)
- Chase County (Imperial)
- Kimball County (Kimball)
- Webster County (Red Cloud)
- Nance County (Fullerton)
- Harlan County (Alma)
- Sherman County (Loup City)
- Brown County (Ainsworth)
- Franklin County (Franklin)
- Perkins County (Grant)
- Hitchcock County (Trenton)
- Pawnee County (Pawnee City)
- Frontier County (Stockville)
- Greeley County (Greeley)
- Gosper County (Elwood)
- Garden County (Oshkosh)
- Deuel County (Chappell)
- Garfield County (Burwell)
- Boyd County (Butte)
- Dundy County (Benkelman)
- Rock County (Bassett)
- Sioux County (Harrison)
- Hayes County (Hayes Center)
- Wheeler County (Bartlett)
- Keya Paha County (Springview)
- Logan County (Stapleton)
- Hooker County (Mullen)
- Banner County (Harrisburg)
- Thomas County (Thedford)
- Grant County (Hyannis)
- Loup County (Taylor)
- Arthur County (Arthur)
- Blaine County (Brewster)
- McPherson County (Tryon)
Obamacare Rates and Providers for Other Years
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MedicaLocal: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-800-833-7352 |
Toc - Plan #1 Medica | ||||||||||||||||||||
Gold
(EPO) Elevate by Medica Gold Share |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$501.35 $569.02 $640.71 $895.39 $1,360.63 |
$884.87 $952.54 $1,024.23 $1,278.91 |
$1,268.39 $1,336.06 $1,407.75 $1,662.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,002.70 $1,138.04 $1,281.42 $1,790.78 $2,721.26 |
$1,386.22 $1,521.56 $1,664.94 $2,174.30 |
$1,769.74 $1,905.08 $2,048.46 $2,557.82 |
Toc - Plan #2 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Elevate by Medica Bronze Copay $0 PCP Office Visits |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.38 $404.48 $455.44 $636.47 $967.18 |
$629.00 $677.10 $728.06 $909.09 |
$901.62 $949.72 $1,000.68 $1,181.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$712.76 $808.96 $910.88 $1,272.94 $1,934.36 |
$985.38 $1,081.58 $1,183.50 $1,545.56 |
$1,258.00 $1,354.20 $1,456.12 $1,818.18 |
Toc - Plan #3 Medica | ||||||||||||||||||||
Gold
(EPO) Elevate by Medica Gold Copay $0 PCP Office Visits |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$494.02 $560.70 $631.35 $882.31 $1,340.75 |
$871.94 $938.62 $1,009.27 $1,260.23 |
$1,249.86 $1,316.54 $1,387.19 $1,638.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$988.04 $1,121.40 $1,262.70 $1,764.62 $2,681.50 |
$1,365.96 $1,499.32 $1,640.62 $2,142.54 |
$1,743.88 $1,877.24 $2,018.54 $2,520.46 |
Toc - Plan #4 Medica | ||||||||||||||||||||
Silver
(EPO) Elevate by Medica Silver Copay $0 PCP Office Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$466.18 $529.11 $595.77 $832.59 $1,265.20 |
$822.80 $885.73 $952.39 $1,189.21 |
$1,179.42 $1,242.35 $1,309.01 $1,545.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$932.36 $1,058.22 $1,191.54 $1,665.18 $2,530.40 |
$1,288.98 $1,414.84 $1,548.16 $2,021.80 |
$1,645.60 $1,771.46 $1,904.78 $2,378.42 |
Toc - Plan #5 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Elevate by Medica Bronze Premier |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.49 $421.63 $474.76 $663.47 $1,008.21 |
$655.68 $705.82 $758.95 $947.66 |
$939.87 $990.01 $1,043.14 $1,231.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.98 $843.26 $949.52 $1,326.94 $2,016.42 |
$1,027.17 $1,127.45 $1,233.71 $1,611.13 |
$1,311.36 $1,411.64 $1,517.90 $1,895.32 |
Toc - Plan #6 Medica | ||||||||||||||||||||
Silver
(EPO) Elevate by Medica Silver Enhanced |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$489.38 $555.43 $625.41 $874.01 $1,328.14 |
$863.74 $929.79 $999.77 $1,248.37 |
$1,238.10 $1,304.15 $1,374.13 $1,622.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$978.76 $1,110.86 $1,250.82 $1,748.02 $2,656.28 |
$1,353.12 $1,485.22 $1,625.18 $2,122.38 |
$1,727.48 $1,859.58 $1,999.54 $2,496.74 |
Toc - Plan #7 Medica | ||||||||||||||||||||
Gold
(EPO) Elevate by Medica Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$506.98 $575.41 $647.91 $905.45 $1,375.92 |
$894.81 $963.24 $1,035.74 $1,293.28 |
$1,282.64 $1,351.07 $1,423.57 $1,681.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,013.96 $1,150.82 $1,295.82 $1,810.90 $2,751.84 |
$1,401.79 $1,538.65 $1,683.65 $2,198.73 |
$1,789.62 $1,926.48 $2,071.48 $2,586.56 |
Toc - Plan #8 Medica | ||||||||||||||||||||
Silver
(EPO) Elevate by Medica Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$477.78 $542.27 $610.59 $853.30 $1,296.67 |
$843.27 $907.76 $976.08 $1,218.79 |
$1,208.76 $1,273.25 $1,341.57 $1,584.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$955.56 $1,084.54 $1,221.18 $1,706.60 $2,593.34 |
$1,321.05 $1,450.03 $1,586.67 $2,072.09 |
$1,686.54 $1,815.52 $1,952.16 $2,437.58 |
Toc - Plan #9 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Elevate by Medica Expanded Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.07 $387.11 $435.88 $609.14 $925.64 |
$601.98 $648.02 $696.79 $870.05 |
$862.89 $908.93 $957.70 $1,130.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.14 $774.22 $871.76 $1,218.28 $1,851.28 |
$943.05 $1,035.13 $1,132.67 $1,479.19 |
$1,203.96 $1,296.04 $1,393.58 $1,740.10 |
Toc - Plan #10 Medica | ||||||||||||||||||||
Gold
(EPO) Medica Insure Gold Share |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$621.63 $705.54 $794.43 $1,110.21 $1,687.07 |
$1,097.17 $1,181.08 $1,269.97 $1,585.75 |
$1,572.71 $1,656.62 $1,745.51 $2,061.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,243.26 $1,411.08 $1,588.86 $2,220.42 $3,374.14 |
$1,718.80 $1,886.62 $2,064.40 $2,695.96 |
$2,194.34 $2,362.16 $2,539.94 $3,171.50 |
Toc - Plan #11 Medica | ||||||||||||||||||||
Silver
(EPO) Medica Insure Silver Enhanced |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$606.78 $688.69 $775.46 $1,083.70 $1,646.79 |
$1,070.96 $1,152.87 $1,239.64 $1,547.88 |
$1,535.14 $1,617.05 $1,703.82 $2,012.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,213.56 $1,377.38 $1,550.92 $2,167.40 $3,293.58 |
$1,677.74 $1,841.56 $2,015.10 $2,631.58 |
$2,141.92 $2,305.74 $2,479.28 $3,095.76 |
Toc - Plan #12 Medica | ||||||||||||||||||||
Gold
(EPO) Medica Insure Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$628.61 $713.46 $803.36 $1,122.69 $1,706.03 |
$1,109.49 $1,194.34 $1,284.24 $1,603.57 |
$1,590.37 $1,675.22 $1,765.12 $2,084.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,257.22 $1,426.92 $1,606.72 $2,245.38 $3,412.06 |
$1,738.10 $1,907.80 $2,087.60 $2,726.26 |
$2,218.98 $2,388.68 $2,568.48 $3,207.14 |
Toc - Plan #13 Medica | ||||||||||||||||||||
Silver
(EPO) Medica Insure Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$592.41 $672.37 $757.08 $1,058.02 $1,607.77 |
$1,045.59 $1,125.55 $1,210.26 $1,511.20 |
$1,498.77 $1,578.73 $1,663.44 $1,964.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,184.82 $1,344.74 $1,514.16 $2,116.04 $3,215.54 |
$1,638.00 $1,797.92 $1,967.34 $2,569.22 |
$2,091.18 $2,251.10 $2,420.52 $3,022.40 |
Toc - Plan #14 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica Insure Expanded Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.90 $479.98 $540.46 $755.28 $1,147.73 |
$746.41 $803.49 $863.97 $1,078.79 |
$1,069.92 $1,127.00 $1,187.48 $1,402.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.80 $959.96 $1,080.92 $1,510.56 $2,295.46 |
$1,169.31 $1,283.47 $1,404.43 $1,834.07 |
$1,492.82 $1,606.98 $1,727.94 $2,157.58 |
Toc - Plan #15 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Copay + Adult Eye Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.11 $393.95 $443.59 $619.91 $942.02 |
$612.64 $659.48 $709.12 $885.44 |
$878.17 $925.01 $974.65 $1,150.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.22 $787.90 $887.18 $1,239.82 $1,884.04 |
$959.75 $1,053.43 $1,152.71 $1,505.35 |
$1,225.28 $1,318.96 $1,418.24 $1,770.88 |
Toc - Plan #16 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with CHI Health Silver Share |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$487.69 $553.52 $623.26 $871.00 $1,323.57 |
$860.77 $926.60 $996.34 $1,244.08 |
$1,233.85 $1,299.68 $1,369.42 $1,617.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$975.38 $1,107.04 $1,246.52 $1,742.00 $2,647.14 |
$1,348.46 $1,480.12 $1,619.60 $2,115.08 |
$1,721.54 $1,853.20 $1,992.68 $2,488.16 |
Toc - Plan #17 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Share Plus + Adult Eye Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.22 $403.17 $453.96 $634.41 $964.05 |
$626.96 $674.91 $725.70 $906.15 |
$898.70 $946.65 $997.44 $1,177.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.44 $806.34 $907.92 $1,268.82 $1,928.10 |
$982.18 $1,078.08 $1,179.66 $1,540.56 |
$1,253.92 $1,349.82 $1,451.40 $1,812.30 |
Toc - Plan #18 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Bronze Copay $0 PCP Office Visits + Adult Eye Exam |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.24 $406.60 $457.82 $639.81 $972.25 |
$632.29 $680.65 $731.87 $913.86 |
$906.34 $954.70 $1,005.92 $1,187.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.48 $813.20 $915.64 $1,279.62 $1,944.50 |
$990.53 $1,087.25 $1,189.69 $1,553.67 |
$1,264.58 $1,361.30 $1,463.74 $1,827.72 |
Toc - Plan #19 Medica | ||||||||||||||||||||
Gold
(EPO) Medica with CHI Health Gold Copay $0 PCP Office Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$493.65 $560.28 $630.87 $881.64 $1,339.73 |
$871.28 $937.91 $1,008.50 $1,259.27 |
$1,248.91 $1,315.54 $1,386.13 $1,636.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$987.30 $1,120.56 $1,261.74 $1,763.28 $2,679.46 |
$1,364.93 $1,498.19 $1,639.37 $2,140.91 |
$1,742.56 $1,875.82 $2,017.00 $2,518.54 |
Toc - Plan #20 Medica | ||||||||||||||||||||
Gold
(EPO) Medica with CHI Health Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$506.60 $574.97 $647.42 $904.76 $1,374.87 |
$894.14 $962.51 $1,034.96 $1,292.30 |
$1,281.68 $1,350.05 $1,422.50 $1,679.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,013.20 $1,149.94 $1,294.84 $1,809.52 $2,749.74 |
$1,400.74 $1,537.48 $1,682.38 $2,197.06 |
$1,788.28 $1,925.02 $2,069.92 $2,584.60 |
Toc - Plan #21 Medica | ||||||||||||||||||||
Silver
(EPO) Medica with CHI Health Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$477.42 $541.86 $610.13 $852.65 $1,295.68 |
$842.64 $907.08 $975.35 $1,217.87 |
$1,207.86 $1,272.30 $1,340.57 $1,583.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$954.84 $1,083.72 $1,220.26 $1,705.30 $2,591.36 |
$1,320.06 $1,448.94 $1,585.48 $2,070.52 |
$1,685.28 $1,814.16 $1,950.70 $2,435.74 |
Toc - Plan #22 Medica | ||||||||||||||||||||
Expanded Bronze
(EPO) Medica with CHI Health Expanded Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8211
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.81 $386.81 $435.55 $608.68 $924.94 |
$601.53 $647.53 $696.27 $869.40 |
$862.25 $908.25 $956.99 $1,130.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$681.62 $773.62 $871.10 $1,217.36 $1,849.88 |
$942.34 $1,034.34 $1,131.82 $1,478.08 |
$1,203.06 $1,295.06 $1,392.54 $1,738.80 |
ADVERTISEMENT
Ambetter from Nebraska Total CareLocal: 1-833-890-0329 | Toll Free: 1-833-890-0329 | TTY: 1-833-890-0329 |
Toc - Plan #23 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.69 $394.62 $444.33 $620.96 $943.60 |
$613.67 $660.60 $710.31 $886.94 |
$879.65 $926.58 $976.29 $1,152.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$695.38 $789.24 $888.66 $1,241.92 $1,887.20 |
$961.36 $1,055.22 $1,154.64 $1,507.90 |
$1,227.34 $1,321.20 $1,420.62 $1,773.88 |
Toc - Plan #24 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.01 $385.90 $434.52 $607.24 $922.77 |
$600.11 $646.00 $694.62 $867.34 |
$860.21 $906.10 $954.72 $1,127.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$680.02 $771.80 $869.04 $1,214.48 $1,845.54 |
$940.12 $1,031.90 $1,129.14 $1,474.58 |
$1,200.22 $1,292.00 $1,389.24 $1,734.68 |
Toc - Plan #25 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383.74 $435.54 $490.41 $685.35 $1,041.45 |
$677.30 $729.10 $783.97 $978.91 |
$970.86 $1,022.66 $1,077.53 $1,272.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$767.48 $871.08 $980.82 $1,370.70 $2,082.90 |
$1,061.04 $1,164.64 $1,274.38 $1,664.26 |
$1,354.60 $1,458.20 $1,567.94 $1,957.82 |
Toc - Plan #26 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.22 $498.51 $561.31 $784.43 $1,192.02 |
$775.22 $834.51 $897.31 $1,120.43 |
$1,111.22 $1,170.51 $1,233.31 $1,456.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$878.44 $997.02 $1,122.62 $1,568.86 $2,384.04 |
$1,214.44 $1,333.02 $1,458.62 $1,904.86 |
$1,550.44 $1,669.02 $1,794.62 $2,240.86 |
Toc - Plan #27 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.27 $504.24 $567.76 $793.45 $1,205.72 |
$784.13 $844.10 $907.62 $1,133.31 |
$1,123.99 $1,183.96 $1,247.48 $1,473.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.54 $1,008.48 $1,135.52 $1,586.90 $2,411.44 |
$1,228.40 $1,348.34 $1,475.38 $1,926.76 |
$1,568.26 $1,688.20 $1,815.24 $2,266.62 |
Toc - Plan #28 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Elite Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$485.16 $550.64 $620.02 $866.48 $1,316.69 |
$856.30 $921.78 $991.16 $1,237.62 |
$1,227.44 $1,292.92 $1,362.30 $1,608.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$970.32 $1,101.28 $1,240.04 $1,732.96 $2,633.38 |
$1,341.46 $1,472.42 $1,611.18 $2,104.10 |
$1,712.60 $1,843.56 $1,982.32 $2,475.24 |
Toc - Plan #29 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Standard Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.20 $379.31 $427.10 $596.87 $907.00 |
$589.86 $634.97 $682.76 $852.53 |
$845.52 $890.63 $938.42 $1,108.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$668.40 $758.62 $854.20 $1,193.74 $1,814.00 |
$924.06 $1,014.28 $1,109.86 $1,449.40 |
$1,179.72 $1,269.94 $1,365.52 $1,705.06 |
Toc - Plan #30 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.17 $481.42 $542.07 $757.54 $1,151.16 |
$748.65 $805.90 $866.55 $1,082.02 |
$1,073.13 $1,130.38 $1,191.03 $1,406.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$848.34 $962.84 $1,084.14 $1,515.08 $2,302.32 |
$1,172.82 $1,287.32 $1,408.62 $1,839.56 |
$1,497.30 $1,611.80 $1,733.10 $2,164.04 |
Toc - Plan #31 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$427.39 $485.07 $546.19 $763.30 $1,159.91 |
$754.33 $812.01 $873.13 $1,090.24 |
$1,081.27 $1,138.95 $1,200.07 $1,417.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$854.78 $970.14 $1,092.38 $1,526.60 $2,319.82 |
$1,181.72 $1,297.08 $1,419.32 $1,853.54 |
$1,508.66 $1,624.02 $1,746.26 $2,180.48 |
Toc - Plan #32 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.17 $487.10 $548.47 $766.48 $1,164.74 |
$757.48 $815.41 $876.78 $1,094.79 |
$1,085.79 $1,143.72 $1,205.09 $1,423.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.34 $974.20 $1,096.94 $1,532.96 $2,329.48 |
$1,186.65 $1,302.51 $1,425.25 $1,861.27 |
$1,514.96 $1,630.82 $1,753.56 $2,189.58 |
Toc - Plan #33 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.03 $491.48 $553.40 $773.37 $1,175.22 |
$764.29 $822.74 $884.66 $1,104.63 |
$1,095.55 $1,154.00 $1,215.92 $1,435.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.06 $982.96 $1,106.80 $1,546.74 $2,350.44 |
$1,197.32 $1,314.22 $1,438.06 $1,878.00 |
$1,528.58 $1,645.48 $1,769.32 $2,209.26 |
Toc - Plan #34 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.16 $483.68 $544.62 $761.10 $1,156.57 |
$752.16 $809.68 $870.62 $1,087.10 |
$1,078.16 $1,135.68 $1,196.62 $1,413.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$852.32 $967.36 $1,089.24 $1,522.20 $2,313.14 |
$1,178.32 $1,293.36 $1,415.24 $1,848.20 |
$1,504.32 $1,619.36 $1,741.24 $2,174.20 |
Toc - Plan #35 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.63 $476.26 $536.27 $749.44 $1,138.84 |
$740.64 $797.27 $857.28 $1,070.45 |
$1,061.65 $1,118.28 $1,178.29 $1,391.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.26 $952.52 $1,072.54 $1,498.88 $2,277.68 |
$1,160.27 $1,273.53 $1,393.55 $1,819.89 |
$1,481.28 $1,594.54 $1,714.56 $2,140.90 |
Toc - Plan #36 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Choice Bronze HSA + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$361.24 $409.99 $461.65 $645.15 $980.37 |
$637.58 $686.33 $737.99 $921.49 |
$913.92 $962.67 $1,014.33 $1,197.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$722.48 $819.98 $923.30 $1,290.30 $1,960.74 |
$998.82 $1,096.32 $1,199.64 $1,566.64 |
$1,275.16 $1,372.66 $1,475.98 $1,842.98 |
Toc - Plan #37 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.26 $400.94 $451.45 $630.91 $958.72 |
$623.50 $671.18 $721.69 $901.15 |
$893.74 $941.42 $991.93 $1,171.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.52 $801.88 $902.90 $1,261.82 $1,917.44 |
$976.76 $1,072.12 $1,173.14 $1,532.06 |
$1,247.00 $1,342.36 $1,443.38 $1,802.30 |
Toc - Plan #38 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.70 $452.51 $509.52 $712.05 $1,082.03 |
$703.69 $757.50 $814.51 $1,017.04 |
$1,008.68 $1,062.49 $1,119.50 $1,322.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797.40 $905.02 $1,019.04 $1,424.10 $2,164.06 |
$1,102.39 $1,210.01 $1,324.03 $1,729.09 |
$1,407.38 $1,515.00 $1,629.02 $2,034.08 |
Toc - Plan #39 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$456.34 $517.93 $583.18 $815.00 $1,238.47 |
$805.43 $867.02 $932.27 $1,164.09 |
$1,154.52 $1,216.11 $1,281.36 $1,513.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$912.68 $1,035.86 $1,166.36 $1,630.00 $2,476.94 |
$1,261.77 $1,384.95 $1,515.45 $1,979.09 |
$1,610.86 $1,734.04 $1,864.54 $2,328.18 |
Toc - Plan #40 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.58 $523.88 $589.89 $824.36 $1,252.70 |
$814.68 $876.98 $942.99 $1,177.46 |
$1,167.78 $1,230.08 $1,296.09 $1,530.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$923.16 $1,047.76 $1,179.78 $1,648.72 $2,505.40 |
$1,276.26 $1,400.86 $1,532.88 $2,001.82 |
$1,629.36 $1,753.96 $1,885.98 $2,354.92 |
Toc - Plan #41 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Expanded Bronze
(HMO) Standard Expanded Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.22 $394.09 $443.74 $620.12 $942.34 |
$612.84 $659.71 $709.36 $885.74 |
$878.46 $925.33 $974.98 $1,151.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.44 $788.18 $887.48 $1,240.24 $1,884.68 |
$960.06 $1,053.80 $1,153.10 $1,505.86 |
$1,225.68 $1,319.42 $1,418.72 $1,771.48 |
Toc - Plan #42 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Standard Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.69 $500.17 $563.19 $787.06 $1,196.01 |
$777.81 $837.29 $900.31 $1,124.18 |
$1,114.93 $1,174.41 $1,237.43 $1,461.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$881.38 $1,000.34 $1,126.38 $1,574.12 $2,392.02 |
$1,218.50 $1,337.46 $1,463.50 $1,911.24 |
$1,555.62 $1,674.58 $1,800.62 $2,248.36 |
Toc - Plan #43 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Standard Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.04 $503.98 $567.47 $793.04 $1,205.10 |
$783.72 $843.66 $907.15 $1,132.72 |
$1,123.40 $1,183.34 $1,246.83 $1,472.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.08 $1,007.96 $1,134.94 $1,586.08 $2,410.20 |
$1,227.76 $1,347.64 $1,474.62 $1,925.76 |
$1,567.44 $1,687.32 $1,814.30 $2,265.44 |
Toc - Plan #44 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Elite Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$504.06 $572.10 $644.18 $900.24 $1,368.00 |
$889.66 $957.70 $1,029.78 $1,285.84 |
$1,275.26 $1,343.30 $1,415.38 $1,671.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,008.12 $1,144.20 $1,288.36 $1,800.48 $2,736.00 |
$1,393.72 $1,529.80 $1,673.96 $2,186.08 |
$1,779.32 $1,915.40 $2,059.56 $2,571.68 |
Toc - Plan #45 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$445.89 $506.08 $569.84 $796.35 $1,210.12 |
$786.99 $847.18 $910.94 $1,137.45 |
$1,128.09 $1,188.28 $1,252.04 $1,478.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$891.78 $1,012.16 $1,139.68 $1,592.70 $2,420.24 |
$1,232.88 $1,353.26 $1,480.78 $1,933.80 |
$1,573.98 $1,694.36 $1,821.88 $2,274.90 |
Toc - Plan #46 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Silver
(HMO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$449.90 $510.63 $574.96 $803.51 $1,221.01 |
$794.07 $854.80 $919.13 $1,147.68 |
$1,138.24 $1,198.97 $1,263.30 $1,491.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$899.80 $1,021.26 $1,149.92 $1,607.02 $2,442.02 |
$1,243.97 $1,365.43 $1,494.09 $1,951.19 |
$1,588.14 $1,709.60 $1,838.26 $2,295.36 |
Toc - Plan #47 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$442.76 $502.52 $565.84 $790.76 $1,201.63 |
$781.47 $841.23 $904.55 $1,129.47 |
$1,120.18 $1,179.94 $1,243.26 $1,468.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$885.52 $1,005.04 $1,131.68 $1,581.52 $2,403.26 |
$1,224.23 $1,343.75 $1,470.39 $1,920.23 |
$1,562.94 $1,682.46 $1,809.10 $2,258.94 |
Toc - Plan #48 Ambetter from Nebraska Total Care | ||||||||||||||||||||
Gold
(HMO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-890-0329
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$435.98 $494.82 $557.17 $778.64 $1,183.21 |
$769.49 $828.33 $890.68 $1,112.15 |
$1,103.00 $1,161.84 $1,224.19 $1,445.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$871.96 $989.64 $1,114.34 $1,557.28 $2,366.42 |
$1,205.47 $1,323.15 $1,447.85 $1,890.79 |
$1,538.98 $1,656.66 $1,781.36 $2,224.30 |
ADVERTISEMENT
Blue Cross and Blue Shield of NebraskaLocal: 1-888-592-8960 | Toll Free: 1-888-592-8960 | TTY: 1-800-821-4791 |
Toc - Plan #49 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Bronze
(EPO) HeartlandBlue Bronze 0% Coinsurance After Deductible 9450 NEtwork Blue |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$432.62 $491.03 $552.89 $772.66 $1,174.13 |
$763.58 $821.99 $883.85 $1,103.62 |
$1,094.54 $1,152.95 $1,214.81 $1,434.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$865.24 $982.06 $1,105.78 $1,545.32 $2,348.26 |
$1,196.20 $1,313.02 $1,436.74 $1,876.28 |
$1,527.16 $1,643.98 $1,767.70 $2,207.24 |
Toc - Plan #50 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) HeartlandBlue Silver $0 PCP Visit 5000 NEtwork Blue |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$577.33 $655.27 $737.83 $1,031.11 $1,566.87 |
$1,018.99 $1,096.93 $1,179.49 $1,472.77 |
$1,460.65 $1,538.59 $1,621.15 $1,914.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,154.66 $1,310.54 $1,475.66 $2,062.22 $3,133.74 |
$1,596.32 $1,752.20 $1,917.32 $2,503.88 |
$2,037.98 $2,193.86 $2,358.98 $2,945.54 |
Toc - Plan #51 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) HeartlandBlue Silver $0 Mental Health Visit 6000 NEtwork Blue |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$580.52 $658.89 $741.90 $1,036.80 $1,575.53 |
$1,024.62 $1,102.99 $1,186.00 $1,480.90 |
$1,468.72 $1,547.09 $1,630.10 $1,925.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,161.04 $1,317.78 $1,483.80 $2,073.60 $3,151.06 |
$1,605.14 $1,761.88 $1,927.90 $2,517.70 |
$2,049.24 $2,205.98 $2,372.00 $2,961.80 |
Toc - Plan #52 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$603.72 $685.22 $771.55 $1,078.24 $1,638.49 |
$1,065.56 $1,147.06 $1,233.39 $1,540.08 |
$1,527.40 $1,608.90 $1,695.23 $2,001.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,207.44 $1,370.44 $1,543.10 $2,156.48 $3,276.98 |
$1,669.28 $1,832.28 $2,004.94 $2,618.32 |
$2,131.12 $2,294.12 $2,466.78 $3,080.16 |
Toc - Plan #53 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) HeartlandBlue Gold $0 Deductible NEtwork Blue |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$610.66 $693.10 $780.42 $1,090.64 $1,657.33 |
$1,077.81 $1,160.25 $1,247.57 $1,557.79 |
$1,544.96 $1,627.40 $1,714.72 $2,024.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,221.32 $1,386.20 $1,560.84 $2,181.28 $3,314.66 |
$1,688.47 $1,853.35 $2,027.99 $2,648.43 |
$2,155.62 $2,320.50 $2,495.14 $3,115.58 |
Toc - Plan #54 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.47 $428.43 $482.41 $674.17 $1,024.47 |
$666.24 $717.20 $771.18 $962.94 |
$955.01 $1,005.97 $1,059.95 $1,251.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$754.94 $856.86 $964.82 $1,348.34 $2,048.94 |
$1,043.71 $1,145.63 $1,253.59 $1,637.11 |
$1,332.48 $1,434.40 $1,542.36 $1,925.88 |
Toc - Plan #55 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) HeartlandBlue Bronze Standard Copay 7500 Premier Select BlueChoice |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.32 $421.45 $474.55 $663.18 $1,007.77 |
$655.38 $705.51 $758.61 $947.24 |
$939.44 $989.57 $1,042.67 $1,231.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$742.64 $842.90 $949.10 $1,326.36 $2,015.54 |
$1,026.70 $1,126.96 $1,233.16 $1,610.42 |
$1,310.76 $1,411.02 $1,517.22 $1,894.48 |
Toc - Plan #56 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) HeartlandBlue Silver Standard 5900 Premier Select BlueChoice |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$470.65 $534.19 $601.49 $840.58 $1,277.35 |
$830.70 $894.24 $961.54 $1,200.63 |
$1,190.75 $1,254.29 $1,321.59 $1,560.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$941.30 $1,068.38 $1,202.98 $1,681.16 $2,554.70 |
$1,301.35 $1,428.43 $1,563.03 $2,041.21 |
$1,661.40 $1,788.48 $1,923.08 $2,401.26 |
Toc - Plan #57 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) HeartlandBlue Gold Standard 1500 Premier Select BlueChoice |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$493.93 $560.61 $631.25 $882.16 $1,340.53 |
$871.79 $938.47 $1,009.11 $1,260.02 |
$1,249.65 $1,316.33 $1,386.97 $1,637.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$987.86 $1,121.22 $1,262.50 $1,764.32 $2,681.06 |
$1,365.72 $1,499.08 $1,640.36 $2,142.18 |
$1,743.58 $1,876.94 $2,018.22 $2,520.04 |
Toc - Plan #58 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) HeartlandBlue Bronze HSA 6500 Blueprint Health |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$368.25 $417.97 $470.63 $657.70 $999.43 |
$649.96 $699.68 $752.34 $939.41 |
$931.67 $981.39 $1,034.05 $1,221.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$736.50 $835.94 $941.26 $1,315.40 $1,998.86 |
$1,018.21 $1,117.65 $1,222.97 $1,597.11 |
$1,299.92 $1,399.36 $1,504.68 $1,878.82 |
Toc - Plan #59 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Expanded Bronze
(EPO) HeartlandBlue Bronze Standard Copay 7500 Blueprint Health |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.25 $411.15 $462.95 $646.98 $983.14 |
$639.37 $688.27 $740.07 $924.10 |
$916.49 $965.39 $1,017.19 $1,201.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724.50 $822.30 $925.90 $1,293.96 $1,966.28 |
$1,001.62 $1,099.42 $1,203.02 $1,571.08 |
$1,278.74 $1,376.54 $1,480.14 $1,848.20 |
Toc - Plan #60 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Silver
(EPO) HeartlandBlue Silver Standard 5900 Blueprint Health |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$459.15 $521.14 $586.80 $820.04 $1,246.14 |
$810.40 $872.39 $938.05 $1,171.29 |
$1,161.65 $1,223.64 $1,289.30 $1,522.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$918.30 $1,042.28 $1,173.60 $1,640.08 $2,492.28 |
$1,269.55 $1,393.53 $1,524.85 $1,991.33 |
$1,620.80 $1,744.78 $1,876.10 $2,342.58 |
Toc - Plan #61 Blue Cross and Blue Shield of Nebraska | ||||||||||||||||||||
Gold
(EPO) HeartlandBlue Gold Standard 1500 Blueprint Health |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-592-8960
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$481.86 $546.92 $615.82 $860.61 $1,307.78 |
$850.49 $915.55 $984.45 $1,229.24 |
$1,219.12 $1,284.18 $1,353.08 $1,597.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$963.72 $1,093.84 $1,231.64 $1,721.22 $2,615.56 |
$1,332.35 $1,462.47 $1,600.27 $2,089.85 |
$1,700.98 $1,831.10 $1,968.90 $2,458.48 |
ADVERTISEMENT
Oscar Insurance CompanyLocal: 1-855-672-2755 | Toll Free: |
Toc - Plan #62 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic |
||||||||||||||||||||
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 |
$423.69 $480.88 $541.47 $756.70 $1,149.87 |
$747.81 $805.00 $865.59 $1,080.82 |
$1,071.93 $1,129.12 $1,189.71 $1,404.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.38 $961.76 $1,082.94 $1,513.40 $2,299.74 |
$1,171.50 $1,285.88 $1,407.06 $1,837.52 |
$1,495.62 $1,610.00 $1,731.18 $2,161.64 |
Toc - Plan #63 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite + PCP Saver Plus |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$468.19 $531.39 $598.34 $836.17 $1,270.64 |
$826.35 $889.55 $956.50 $1,194.33 |
$1,184.51 $1,247.71 $1,314.66 $1,552.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$936.38 $1,062.78 $1,196.68 $1,672.34 $2,541.28 |
$1,294.54 $1,420.94 $1,554.84 $2,030.50 |
$1,652.70 $1,779.10 $1,913.00 $2,388.66 |
Toc - Plan #64 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic |
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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 |
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21 30 40 50 60 |
$531.85 $603.64 $679.70 $949.87 $1,443.42 |
$938.71 $1,010.50 $1,086.56 $1,356.73 |
$1,345.57 $1,417.36 $1,493.42 $1,763.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,063.70 $1,207.28 $1,359.40 $1,899.74 $2,886.84 |
$1,470.56 $1,614.14 $1,766.26 $2,306.60 |
$1,877.42 $2,021.00 $2,173.12 $2,713.46 |
Toc - Plan #65 Oscar Insurance Company | ||||||||||||||||||||
Catastrophic
(EPO) Secure |
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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 |
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21 30 40 50 60 |
$335.53 $380.81 $428.79 $599.24 $910.60 |
$592.20 $637.48 $685.46 $855.91 |
$848.87 $894.15 $942.13 $1,112.58 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$671.06 $761.62 $857.58 $1,198.48 $1,821.20 |
$927.73 $1,018.29 $1,114.25 $1,455.15 |
$1,184.40 $1,274.96 $1,370.92 $1,711.82 |
Toc - Plan #66 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic PCP Saver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$443.20 $503.02 $566.40 $791.54 $1,202.81 |
$782.24 $842.06 $905.44 $1,130.58 |
$1,121.28 $1,181.10 $1,244.48 $1,469.62 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$886.40 $1,006.04 $1,132.80 $1,583.08 $2,405.62 |
$1,225.44 $1,345.08 $1,471.84 $1,922.12 |
$1,564.48 $1,684.12 $1,810.88 $2,261.16 |
Toc - Plan #67 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic 4700 |
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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 |
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21 30 40 50 60 |
$450.78 $511.62 $576.08 $805.07 $1,223.38 |
$795.62 $856.46 $920.92 $1,149.91 |
$1,140.46 $1,201.30 $1,265.76 $1,494.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$901.56 $1,023.24 $1,152.16 $1,610.14 $2,446.76 |
$1,246.40 $1,368.08 $1,497.00 $1,954.98 |
$1,591.24 $1,712.92 $1,841.84 $2,299.82 |
Toc - Plan #68 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple PCP Saver |
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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 |
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21 30 40 50 60 |
$518.15 $588.09 $662.18 $925.40 $1,406.23 |
$914.53 $984.47 $1,058.56 $1,321.78 |
$1,310.91 $1,380.85 $1,454.94 $1,718.16 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,036.30 $1,176.18 $1,324.36 $1,850.80 $2,812.46 |
$1,432.68 $1,572.56 $1,720.74 $2,247.18 |
$1,829.06 $1,968.94 $2,117.12 $2,643.56 |
Toc - Plan #69 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite Saver Plus |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone:
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$541.67 $614.79 $692.25 $967.41 $1,470.07 |
$956.04 $1,029.16 $1,106.62 $1,381.78 |
$1,370.41 $1,443.53 $1,520.99 $1,796.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,083.34 $1,229.58 $1,384.50 $1,934.82 $2,940.14 |
$1,497.71 $1,643.95 $1,798.87 $2,349.19 |
$1,912.08 $2,058.32 $2,213.24 $2,763.56 |
Toc - Plan #70 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite |
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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 |
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21 30 40 50 60 |
$586.16 $665.28 $749.10 $1,046.87 $1,590.82 |
$1,034.57 $1,113.69 $1,197.51 $1,495.28 |
$1,482.98 $1,562.10 $1,645.92 $1,943.69 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,172.32 $1,330.56 $1,498.20 $2,093.74 $3,181.64 |
$1,620.73 $1,778.97 $1,946.61 $2,542.15 |
$2,069.14 $2,227.38 $2,395.02 $2,990.56 |
Toc - Plan #71 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple Diabetes |
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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 |
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21 30 40 50 60 |
$529.89 $601.41 $677.18 $946.36 $1,438.09 |
$935.25 $1,006.77 $1,082.54 $1,351.72 |
$1,340.61 $1,412.13 $1,487.90 $1,757.08 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,059.78 $1,202.82 $1,354.36 $1,892.72 $2,876.18 |
$1,465.14 $1,608.18 $1,759.72 $2,298.08 |
$1,870.50 $2,013.54 $2,165.08 $2,703.44 |
Toc - Plan #72 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic Standard |
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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 |
$433.71 $492.25 $554.27 $774.60 $1,177.07 |
$765.49 $824.03 $886.05 $1,106.38 |
$1,097.27 $1,155.81 $1,217.83 $1,438.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$867.42 $984.50 $1,108.54 $1,549.20 $2,354.14 |
$1,199.20 $1,316.28 $1,440.32 $1,880.98 |
$1,530.98 $1,648.06 $1,772.10 $2,212.76 |
Toc - Plan #73 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic Standard |
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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 |
$515.04 $584.55 $658.20 $919.84 $1,397.78 |
$909.03 $978.54 $1,052.19 $1,313.83 |
$1,303.02 $1,372.53 $1,446.18 $1,707.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1,030.08 $1,169.10 $1,316.40 $1,839.68 $2,795.56 |
$1,424.07 $1,563.09 $1,710.39 $2,233.67 |
$1,818.06 $1,957.08 $2,104.38 $2,627.66 |
Toc - Plan #74 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic Standard |
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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 |
$529.50 $600.97 $676.69 $945.67 $1,437.04 |
$934.56 $1,006.03 $1,081.75 $1,350.73 |
$1,339.62 $1,411.09 $1,486.81 $1,755.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,059.00 $1,201.94 $1,353.38 $1,891.34 $2,874.08 |
$1,464.06 $1,607.00 $1,758.44 $2,296.40 |
$1,869.12 $2,012.06 $2,163.50 $2,701.46 |
‡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 Sarpy County here.
Sarpy County is in “Rating Area 1” of Nebraska.
Currently, there are 74 plans offered in Rating Area 1.