Texas Obamacare 2024 Rates
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Counties in Texas
- Harris County (Houston)
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- San Jacinto County (Coldspring)
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- Gaines County (Seminole)
- Hockley County (Levelland)
- Moore County (Dumas)
- Llano County (Llano)
- Gray County (Pampa)
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- Hutchinson County (Stinnett)
- Colorado County (Columbus)
- Lavaca County (Hallettsville)
- Willacy County (Raymondville)
- Calhoun County (Port Lavaca)
- Montague County (Montague)
- De Witt County (Cuero)
- Tyler County (Woodville)
- Jones County (Anson)
- Gonzales County (Gonzales)
- Freestone County (Fairfield)
- Andrews County (Andrews)
- Deaf Smith County (Hereford)
- Frio County (Pearsall)
- Bosque County (Meridian)
- Young County (Graham)
- Eastland County (Eastland)
- Burleson County (Caldwell)
- Lee County (Giddings)
- Falls County (Marlin)
- Scurry County (Snyder)
- Robertson County (Franklin)
- Leon County (Centerville)
- Pecos County (Fort Stockton)
- Jackson County (Edna)
- Reeves County (Pecos)
- Nolan County (Sweetwater)
- Karnes County (Karnes City)
- Zapata County (Zapata)
- Callahan County (Baird)
- Trinity County (Groveton)
- Comanche County (Comanche)
- Madison County (Madisonville)
- Lamb County (Littlefield)
- Wilbarger County (Vernon)
- Camp County (Pittsburg)
- Dawson County (Lamesa)
- Newton County (Newton)
- Rains County (Emory)
- Morris County (Daingerfield)
- Terry County (Brownfield)
- Ward County (Monahans)
- Red River County (Clarksville)
- Blanco County (Johnson City)
- Live Oak County (George West)
- Franklin County (Mount Vernon)
- Clay County (Henrietta)
- Ochiltree County (Perryton)
- Runnels County (Ballinger)
- Sabine County (Hemphill)
- Parmer County (Farwell)
- Duval County (San Diego)
- Marion County (Jefferson)
- Zavala County (Crystal City)
- Brewster County (Alpine)
- Somervell County (Glen Rose)
- Stephens County (Breckenridge)
- Mitchell County (Colorado City)
- Dimmit County (Carrizo Springs)
- Archer County (Archer City)
- Jack County (Jacksboro)
- Hamilton County (Hamilton)
- San Augustine County (San Augustine)
- Winkler County (Kermit)
- Yoakum County (Plains)
- Coleman County (Coleman)
- McCulloch County (Brady)
- Castro County (Dimmitt)
- Dallam County (Dalhart)
- Brooks County (Falfurrias)
- Goliad County (Goliad)
- Swisher County (Tulia)
- Bailey County (Muleshoe)
- Refugio County (Refugio)
- Childress County (Childress)
- La Salle County (Cotulla)
- Presidio County (Marfa)
- Garza County (Post)
- Carson County (Panhandle)
- San Saba County (San Saba)
- Lynn County (Tahoka)
- Haskell County (Haskell)
- Floyd County (Floydada)
- Hartley County (Channing)
- Hansford County (Spearman)
- Martin County (Stanton)
- Delta County (Cooper)
- Crosby County (Crosbyton)
- Wheeler County (Wheeler)
- Jim Hogg County (Hebbronville)
- Crane County (Crane)
- Mills County (Goldthwaite)
- Kimble County (Junction)
- Mason County (Mason)
- Fisher County (Roby)
- Hardeman County (Quanah)
- Baylor County (Seymour)
- Reagan County (Big Lake)
- Hemphill County (Canadian)
- Sutton County (Sonora)
- Knox County (Benjamin)
- Upton County (Rankin)
- Concho County (Paint Rock)
- Coke County (Robert Lee)
- Donley County (Clarendon)
- Hudspeth County (Sierra Blanca)
- Kinney County (Brackettville)
- Shackelford County (Albany)
- Crockett County (Ozona)
- Lipscomb County (Lipscomb)
- Hall County (Memphis)
- Sherman County (Stratford)
- Real County (Leakey)
- Collingsworth County (Wellington)
- Cochran County (Morton)
- Schleicher County (Eldorado)
- Culberson County (Van Horn)
- Jeff Davis County (Fort Davis)
- Menard County (Menard)
- Armstrong County (Claude)
- Dickens County (Dickens)
- Oldham County (Vega)
- Irion County (Mertzon)
- Throckmorton County (Throckmorton)
- Briscoe County (Silverton)
- Edwards County (Rocksprings)
- Cottle County (Paducah)
- Sterling County (Sterling City)
- Stonewall County (Aspermont)
- Glasscock County (Garden City)
- Foard County (Crowell)
- Motley County (Matador)
- Roberts County (Miami)
- Terrell County (Sanderson)
- Kent County (Jayton)
- Borden County (Gail)
- McMullen County (Tilden)
- Kenedy County (Sarita)
- King County (Guthrie)
- Loving County (Mentone)
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
ADVERTISEMENT
Oscar Insurance CompanyLocal: 1-855-672-2755 | Toll Free: 1-855-672-2755 |
Toc - Plan #1 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite + PCP Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.07 $367.81 $414.15 $578.77 $879.50 |
$571.98 $615.72 $662.06 $826.68 |
$819.89 $863.63 $909.97 $1,074.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$648.14 $735.62 $828.30 $1,157.54 $1,759.00 |
$896.05 $983.53 $1,076.21 $1,405.45 |
$1,143.96 $1,231.44 $1,324.12 $1,653.36 |
Toc - Plan #2 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple Specialist Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.64 $474.01 $533.73 $745.88 $1,133.44 |
$737.13 $793.50 $853.22 $1,065.37 |
$1,056.62 $1,112.99 $1,172.71 $1,384.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.28 $948.02 $1,067.46 $1,491.76 $2,266.88 |
$1,154.77 $1,267.51 $1,386.95 $1,811.25 |
$1,474.26 $1,587.00 $1,706.44 $2,130.74 |
Toc - Plan #3 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic 4700 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.98 $354.08 $398.69 $557.17 $846.67 |
$550.63 $592.73 $637.34 $795.82 |
$789.28 $831.38 $875.99 $1,034.47 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.96 $708.16 $797.38 $1,114.34 $1,693.34 |
$862.61 $946.81 $1,036.03 $1,352.99 |
$1,101.26 $1,185.46 $1,274.68 $1,591.64 |
Toc - Plan #4 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple PCP Saver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.04 $472.19 $531.68 $743.02 $1,129.09 |
$734.30 $790.45 $849.94 $1,061.28 |
$1,052.56 $1,108.71 $1,168.20 $1,379.54 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$832.08 $944.38 $1,063.36 $1,486.04 $2,258.18 |
$1,150.34 $1,262.64 $1,381.62 $1,804.30 |
$1,468.60 $1,580.90 $1,699.88 $2,122.56 |
Toc - Plan #5 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Elite Saver Plus |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$438.64 $497.85 $560.57 $783.40 $1,190.45 |
$774.19 $833.40 $896.12 $1,118.95 |
$1,109.74 $1,168.95 $1,231.67 $1,454.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$877.28 $995.70 $1,121.14 $1,566.80 $2,380.90 |
$1,212.83 $1,331.25 $1,456.69 $1,902.35 |
$1,548.38 $1,666.80 $1,792.24 $2,237.90 |
Toc - Plan #6 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306.17 $347.49 $391.27 $546.80 $830.91 |
$540.38 $581.70 $625.48 $781.01 |
$774.59 $815.91 $859.69 $1,015.22 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612.34 $694.98 $782.54 $1,093.60 $1,661.82 |
$846.55 $929.19 $1,016.75 $1,327.81 |
$1,080.76 $1,163.40 $1,250.96 $1,562.02 |
Toc - Plan #7 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.22 $466.73 $525.53 $734.43 $1,116.03 |
$725.80 $781.31 $840.11 $1,049.01 |
$1,040.38 $1,095.89 $1,154.69 $1,363.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.44 $933.46 $1,051.06 $1,468.86 $2,232.06 |
$1,137.02 $1,248.04 $1,365.64 $1,783.44 |
$1,451.60 $1,562.62 $1,680.22 $2,098.02 |
Toc - Plan #8 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.99 $401.77 $452.39 $632.21 $960.70 |
$624.79 $672.57 $723.19 $903.01 |
$895.59 $943.37 $993.99 $1,173.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.98 $803.54 $904.78 $1,264.42 $1,921.40 |
$978.78 $1,074.34 $1,175.58 $1,535.22 |
$1,249.58 $1,345.14 $1,446.38 $1,806.02 |
Toc - Plan #9 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.22 $414.52 $466.74 $652.27 $991.19 |
$644.61 $693.91 $746.13 $931.66 |
$924.00 $973.30 $1,025.52 $1,211.05 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.44 $829.04 $933.48 $1,304.54 $1,982.38 |
$1,009.83 $1,108.43 $1,212.87 $1,583.93 |
$1,289.22 $1,387.82 $1,492.26 $1,863.32 |
Toc - Plan #10 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$377.51 $428.46 $482.44 $674.21 $1,024.53 |
$666.30 $717.25 $771.23 $963.00 |
$955.09 $1,006.04 $1,060.02 $1,251.79 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$755.02 $856.92 $964.88 $1,348.42 $2,049.06 |
$1,043.81 $1,145.71 $1,253.67 $1,637.21 |
$1,332.60 $1,434.50 $1,542.46 $1,926.00 |
Toc - Plan #11 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Elite + PCP Saver Plus (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.47 $378.48 $426.17 $595.56 $905.02 |
$588.57 $633.58 $681.27 $850.66 |
$843.67 $888.68 $936.37 $1,105.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666.94 $756.96 $852.34 $1,191.12 $1,810.04 |
$922.04 $1,012.06 $1,107.44 $1,446.22 |
$1,177.14 $1,267.16 $1,362.54 $1,701.32 |
Toc - Plan #12 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic 4700 (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.01 $364.34 $410.24 $573.31 $871.20 |
$566.58 $609.91 $655.81 $818.88 |
$812.15 $855.48 $901.38 $1,064.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$642.02 $728.68 $820.48 $1,146.62 $1,742.40 |
$887.59 $974.25 $1,066.05 $1,392.19 |
$1,133.16 $1,219.82 $1,311.62 $1,637.76 |
Toc - Plan #13 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Simple PCP Saver (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$428.21 $486.01 $547.24 $764.76 $1,162.13 |
$755.78 $813.58 $874.81 $1,092.33 |
$1,083.35 $1,141.15 $1,202.38 $1,419.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$856.42 $972.02 $1,094.48 $1,529.52 $2,324.26 |
$1,183.99 $1,299.59 $1,422.05 $1,857.09 |
$1,511.56 $1,627.16 $1,749.62 $2,184.66 |
Toc - Plan #14 Oscar Insurance Company | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Classic Standard (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.03 $357.55 $402.59 $562.62 $854.96 |
$556.02 $598.54 $643.58 $803.61 |
$797.01 $839.53 $884.57 $1,044.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$630.06 $715.10 $805.18 $1,125.24 $1,709.92 |
$871.05 $956.09 $1,046.17 $1,366.23 |
$1,112.04 $1,197.08 $1,287.16 $1,607.22 |
Toc - Plan #15 Oscar Insurance Company | ||||||||||||||||||||
Silver
(EPO) Silver Classic Standard (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.25 $480.38 $540.90 $755.91 $1,148.68 |
$747.03 $804.16 $864.68 $1,079.69 |
$1,070.81 $1,127.94 $1,188.46 $1,403.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$846.50 $960.76 $1,081.80 $1,511.82 $2,297.36 |
$1,170.28 $1,284.54 $1,405.58 $1,835.60 |
$1,494.06 $1,608.32 $1,729.36 $2,159.38 |
Toc - Plan #16 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic Standard (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.29 $413.46 $465.55 $650.61 $988.67 |
$642.97 $692.14 $744.23 $929.29 |
$921.65 $970.82 $1,022.91 $1,207.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$728.58 $826.92 $931.10 $1,301.22 $1,977.34 |
$1,007.26 $1,105.60 $1,209.78 $1,579.90 |
$1,285.94 $1,384.28 $1,488.46 $1,858.58 |
Toc - Plan #17 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Classic (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.87 $426.60 $480.34 $671.28 $1,020.07 |
$663.40 $714.13 $767.87 $958.81 |
$950.93 $1,001.66 $1,055.40 $1,246.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.74 $853.20 $960.68 $1,342.56 $2,040.14 |
$1,039.27 $1,140.73 $1,248.21 $1,630.09 |
$1,326.80 $1,428.26 $1,535.74 $1,917.62 |
Toc - Plan #18 Oscar Insurance Company | ||||||||||||||||||||
Gold
(EPO) Gold Elite (Choice) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-672-2755
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.52 $440.96 $496.52 $693.88 $1,054.42 |
$685.73 $738.17 $793.73 $991.09 |
$982.94 $1,035.38 $1,090.94 $1,288.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$777.04 $881.92 $993.04 $1,387.76 $2,108.84 |
$1,074.25 $1,179.13 $1,290.25 $1,684.97 |
$1,371.46 $1,476.34 $1,587.46 $1,982.18 |
ADVERTISEMENT
Community Health ChoiceLocal: 1-713-295-6704 | Toll Free: 1-855-315-5386 | TTY: 1-855-315-5386 |
Toc - Plan #19 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Premier Bronze 003 (No deductible for PCP, Free Preventive Care, 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.17 $358.85 $404.07 $564.68 $858.09 |
$558.04 $600.72 $645.94 $806.55 |
$799.91 $842.59 $887.81 $1,048.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$632.34 $717.70 $808.14 $1,129.36 $1,716.18 |
$874.21 $959.57 $1,050.01 $1,371.23 |
$1,116.08 $1,201.44 $1,291.88 $1,613.10 |
Toc - Plan #20 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Premier Silver 004 (No deductible for PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$469.31 $532.67 $599.78 $838.19 $1,273.71 |
$828.33 $891.69 $958.80 $1,197.21 |
$1,187.35 $1,250.71 $1,317.82 $1,556.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$938.62 $1,065.34 $1,199.56 $1,676.38 $2,547.42 |
$1,297.64 $1,424.36 $1,558.58 $2,035.40 |
$1,656.66 $1,783.38 $1,917.60 $2,394.42 |
Toc - Plan #21 Community Health Choice | ||||||||||||||||||||
Gold
(HMO) Community Premier Gold 005 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.98 $455.11 $512.45 $716.15 $1,088.26 |
$707.73 $761.86 $819.20 $1,022.90 |
$1,014.48 $1,068.61 $1,125.95 $1,329.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$801.96 $910.22 $1,024.90 $1,432.30 $2,176.52 |
$1,108.71 $1,216.97 $1,331.65 $1,739.05 |
$1,415.46 $1,523.72 $1,638.40 $2,045.80 |
Toc - Plan #22 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Premier Virtual Bronze 011 (Unlimited Free 24/7 Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.34 $367.00 $413.23 $577.49 $877.56 |
$570.70 $614.36 $660.59 $824.85 |
$818.06 $861.72 $907.95 $1,072.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646.68 $734.00 $826.46 $1,154.98 $1,755.12 |
$894.04 $981.36 $1,073.82 $1,402.34 |
$1,141.40 $1,228.72 $1,321.18 $1,649.70 |
Toc - Plan #23 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Premier Silver 012 (No deductible for PCP, Urgent Care & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$465.02 $527.80 $594.30 $830.53 $1,262.07 |
$820.76 $883.54 $950.04 $1,186.27 |
$1,176.50 $1,239.28 $1,305.78 $1,542.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$930.04 $1,055.60 $1,188.60 $1,661.06 $2,524.14 |
$1,285.78 $1,411.34 $1,544.34 $2,016.80 |
$1,641.52 $1,767.08 $1,900.08 $2,372.54 |
Toc - Plan #24 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Premier Silver 013 (No deductible for PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$456.47 $518.09 $583.37 $815.25 $1,238.86 |
$805.67 $867.29 $932.57 $1,164.45 |
$1,154.87 $1,216.49 $1,281.77 $1,513.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$912.94 $1,036.18 $1,166.74 $1,630.50 $2,477.72 |
$1,262.14 $1,385.38 $1,515.94 $1,979.70 |
$1,611.34 $1,734.58 $1,865.14 $2,328.90 |
Toc - Plan #25 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Select Bronze 016 (No deductible for PCP & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$251.16 $285.06 $320.98 $448.56 $681.64 |
$443.29 $477.19 $513.11 $640.69 |
$635.42 $669.32 $705.24 $832.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$502.32 $570.12 $641.96 $897.12 $1,363.28 |
$694.45 $762.25 $834.09 $1,089.25 |
$886.58 $954.38 $1,026.22 $1,281.38 |
Toc - Plan #26 Community Health Choice | ||||||||||||||||||||
Expanded Bronze
(HMO) Community Premier Bronze 018 (No deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314.26 $356.68 $401.62 $561.26 $852.89 |
$554.67 $597.09 $642.03 $801.67 |
$795.08 $837.50 $882.44 $1,042.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628.52 $713.36 $803.24 $1,122.52 $1,705.78 |
$868.93 $953.77 $1,043.65 $1,362.93 |
$1,109.34 $1,194.18 $1,284.06 $1,603.34 |
Toc - Plan #27 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Select Silver 019 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$367.91 $417.58 $470.19 $657.08 $998.50 |
$649.36 $699.03 $751.64 $938.53 |
$930.81 $980.48 $1,033.09 $1,219.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$735.82 $835.16 $940.38 $1,314.16 $1,997.00 |
$1,017.27 $1,116.61 $1,221.83 $1,595.61 |
$1,298.72 $1,398.06 $1,503.28 $1,877.06 |
Toc - Plan #28 Community Health Choice | ||||||||||||||||||||
Silver
(HMO) Community Premier Silver 020 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$460.12 $522.23 $588.03 $821.77 $1,248.75 |
$812.11 $874.22 $940.02 $1,173.76 |
$1,164.10 $1,226.21 $1,292.01 $1,525.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$920.24 $1,044.46 $1,176.06 $1,643.54 $2,497.50 |
$1,272.23 $1,396.45 $1,528.05 $1,995.53 |
$1,624.22 $1,748.44 $1,880.04 $2,347.52 |
Toc - Plan #29 Community Health Choice | ||||||||||||||||||||
Gold
(HMO) Community Premier Gold 021 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.48 $479.52 $539.93 $754.56 $1,146.62 |
$745.68 $802.72 $863.13 $1,077.76 |
$1,068.88 $1,125.92 $1,186.33 $1,400.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$844.96 $959.04 $1,079.86 $1,509.12 $2,293.24 |
$1,168.16 $1,282.24 $1,403.06 $1,832.32 |
$1,491.36 $1,605.44 $1,726.26 $2,155.52 |
Toc - Plan #30 Community Health Choice | ||||||||||||||||||||
Gold
(HMO) Community Select Gold 022 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-315-5386
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317.92 $360.84 $406.31 $567.81 $862.84 |
$561.13 $604.05 $649.52 $811.02 |
$804.34 $847.26 $892.73 $1,054.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$635.84 $721.68 $812.62 $1,135.62 $1,725.68 |
$879.05 $964.89 $1,055.83 $1,378.83 |
$1,122.26 $1,208.10 $1,299.04 $1,622.04 |
ADVERTISEMENT
Ambetter from Superior HealthPlanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989 |
Toc - Plan #31 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Complete Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$470.61 $534.13 $601.43 $840.50 $1,277.21 |
$830.62 $894.14 $961.44 $1,200.51 |
$1,190.63 $1,254.15 $1,321.45 $1,560.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$941.22 $1,068.26 $1,202.86 $1,681.00 $2,554.42 |
$1,301.23 $1,428.27 $1,562.87 $2,041.01 |
$1,661.24 $1,788.28 $1,922.88 $2,401.02 |
Toc - Plan #32 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Complete Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$426.56 $484.14 $545.13 $761.82 $1,157.66 |
$752.87 $810.45 $871.44 $1,088.13 |
$1,079.18 $1,136.76 $1,197.75 $1,414.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$853.12 $968.28 $1,090.26 $1,523.64 $2,315.32 |
$1,179.43 $1,294.59 $1,416.57 $1,849.95 |
$1,505.74 $1,620.90 $1,742.88 $2,176.26 |
Toc - Plan #33 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Clear Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$463.01 $525.50 $591.71 $826.92 $1,256.58 |
$817.20 $879.69 $945.90 $1,181.11 |
$1,171.39 $1,233.88 $1,300.09 $1,535.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$926.02 $1,051.00 $1,183.42 $1,653.84 $2,513.16 |
$1,280.21 $1,405.19 $1,537.61 $2,008.03 |
$1,634.40 $1,759.38 $1,891.80 $2,362.22 |
Toc - Plan #34 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Focused Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$465.87 $528.75 $595.36 $832.02 $1,264.33 |
$822.25 $885.13 $951.74 $1,188.40 |
$1,178.63 $1,241.51 $1,308.12 $1,544.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$931.74 $1,057.50 $1,190.72 $1,664.04 $2,528.66 |
$1,288.12 $1,413.88 $1,547.10 $2,020.42 |
$1,644.50 $1,770.26 $1,903.48 $2,376.80 |
Toc - Plan #35 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Everyday Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.59 $471.69 $531.12 $742.23 $1,127.90 |
$733.51 $789.61 $849.04 $1,060.15 |
$1,051.43 $1,107.53 $1,166.96 $1,378.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.18 $943.38 $1,062.24 $1,484.46 $2,255.80 |
$1,149.10 $1,261.30 $1,380.16 $1,802.38 |
$1,467.02 $1,579.22 $1,698.08 $2,120.30 |
Toc - Plan #36 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Clear Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.18 $467.82 $526.76 $736.14 $1,118.64 |
$727.49 $783.13 $842.07 $1,051.45 |
$1,042.80 $1,098.44 $1,157.38 $1,366.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$824.36 $935.64 $1,053.52 $1,472.28 $2,237.28 |
$1,139.67 $1,250.95 $1,368.83 $1,787.59 |
$1,454.98 $1,566.26 $1,684.14 $2,102.90 |
Toc - Plan #37 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$460.80 $522.99 $588.89 $822.97 $1,250.58 |
$813.30 $875.49 $941.39 $1,175.47 |
$1,165.80 $1,227.99 $1,293.89 $1,527.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$921.60 $1,045.98 $1,177.78 $1,645.94 $2,501.16 |
$1,274.10 $1,398.48 $1,530.28 $1,998.44 |
$1,626.60 $1,750.98 $1,882.78 $2,350.94 |
Toc - Plan #38 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.98 $473.26 $532.88 $744.70 $1,131.65 |
$735.96 $792.24 $851.86 $1,063.68 |
$1,054.94 $1,111.22 $1,170.84 $1,382.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$833.96 $946.52 $1,065.76 $1,489.40 $2,263.30 |
$1,152.94 $1,265.50 $1,384.74 $1,808.38 |
$1,471.92 $1,584.48 $1,703.72 $2,127.36 |
Toc - Plan #39 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Complete Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$443.11 $502.92 $566.28 $791.38 $1,202.57 |
$782.08 $841.89 $905.25 $1,130.35 |
$1,121.05 $1,180.86 $1,244.22 $1,469.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$886.22 $1,005.84 $1,132.56 $1,582.76 $2,405.14 |
$1,225.19 $1,344.81 $1,471.53 $1,921.73 |
$1,564.16 $1,683.78 $1,810.50 $2,260.70 |
Toc - Plan #40 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Complete Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$488.87 $554.86 $624.76 $873.10 $1,326.77 |
$862.85 $928.84 $998.74 $1,247.08 |
$1,236.83 $1,302.82 $1,372.72 $1,621.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$977.74 $1,109.72 $1,249.52 $1,746.20 $2,653.54 |
$1,351.72 $1,483.70 $1,623.50 $2,120.18 |
$1,725.70 $1,857.68 $1,997.48 $2,494.16 |
Toc - Plan #41 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Standard Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$478.67 $543.28 $611.73 $854.89 $1,299.09 |
$844.85 $909.46 $977.91 $1,221.07 |
$1,211.03 $1,275.64 $1,344.09 $1,587.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$957.34 $1,086.56 $1,223.46 $1,709.78 $2,598.18 |
$1,323.52 $1,452.74 $1,589.64 $2,075.96 |
$1,689.70 $1,818.92 $1,955.82 $2,442.14 |
Toc - Plan #42 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Standard Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.15 $491.62 $553.56 $773.59 $1,175.55 |
$764.50 $822.97 $884.91 $1,104.94 |
$1,095.85 $1,154.32 $1,216.26 $1,436.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.30 $983.24 $1,107.12 $1,547.18 $2,351.10 |
$1,197.65 $1,314.59 $1,438.47 $1,878.53 |
$1,529.00 $1,645.94 $1,769.82 $2,209.88 |
Toc - Plan #43 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Focused Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$483.94 $549.26 $618.46 $864.30 $1,313.38 |
$854.15 $919.47 $988.67 $1,234.51 |
$1,224.36 $1,289.68 $1,358.88 $1,604.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$967.88 $1,098.52 $1,236.92 $1,728.60 $2,626.76 |
$1,338.09 $1,468.73 $1,607.13 $2,098.81 |
$1,708.30 $1,838.94 $1,977.34 $2,469.02 |
Toc - Plan #44 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Everyday Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.72 $489.99 $551.72 $771.03 $1,171.65 |
$761.98 $820.25 $881.98 $1,101.29 |
$1,092.24 $1,150.51 $1,212.24 $1,431.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$863.44 $979.98 $1,103.44 $1,542.06 $2,343.30 |
$1,193.70 $1,310.24 $1,433.70 $1,872.32 |
$1,523.96 $1,640.50 $1,763.96 $2,202.58 |
Toc - Plan #45 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(EPO) Clear Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$480.97 $545.89 $614.67 $859.00 $1,305.33 |
$848.91 $913.83 $982.61 $1,226.94 |
$1,216.85 $1,281.77 $1,350.55 $1,594.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$961.94 $1,091.78 $1,229.34 $1,718.00 $2,610.66 |
$1,329.88 $1,459.72 $1,597.28 $2,085.94 |
$1,697.82 $1,827.66 $1,965.22 $2,453.88 |
Toc - Plan #46 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(EPO) Clear Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$428.18 $485.97 $547.19 $764.70 $1,162.04 |
$755.73 $813.52 $874.74 $1,092.25 |
$1,083.28 $1,141.07 $1,202.29 $1,419.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$856.36 $971.94 $1,094.38 $1,529.40 $2,324.08 |
$1,183.91 $1,299.49 $1,421.93 $1,856.95 |
$1,511.46 $1,627.04 $1,749.48 $2,184.50 |
ADVERTISEMENT
Blue Cross and Blue Shield of TexasLocal: 1-888-697-0683 | Toll Free: 1-888-697-0683 | TTY: 1-800-735-2989 |
Toc - Plan #47 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO? 206 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381.85 $433.40 $488.01 $681.99 $1,036.35 |
$673.97 $725.52 $780.13 $974.11 |
$966.09 $1,017.64 $1,072.25 $1,266.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$763.70 $866.80 $976.02 $1,363.98 $2,072.70 |
$1,055.82 $1,158.92 $1,268.14 $1,656.10 |
$1,347.94 $1,451.04 $1,560.26 $1,948.22 |
Toc - Plan #48 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Catastrophic
(HMO) Blue Advantage Security HMO? 200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.85 $321.03 $361.48 $505.16 $767.65 |
$499.23 $537.41 $577.86 $721.54 |
$715.61 $753.79 $794.24 $937.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$565.70 $642.06 $722.96 $1,010.32 $1,535.30 |
$782.08 $858.44 $939.34 $1,226.70 |
$998.46 $1,074.82 $1,155.72 $1,443.08 |
Toc - Plan #49 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Silver HMO? 205 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$453.43 $514.65 $579.49 $809.83 $1,230.62 |
$800.31 $861.53 $926.37 $1,156.71 |
$1,147.19 $1,208.41 $1,273.25 $1,503.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$906.86 $1,029.30 $1,158.98 $1,619.66 $2,461.24 |
$1,253.74 $1,376.18 $1,505.86 $1,966.54 |
$1,600.62 $1,723.06 $1,852.74 $2,313.42 |
Toc - Plan #50 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Bronze HMO? 204 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.73 $359.49 $404.78 $565.68 $859.60 |
$559.03 $601.79 $647.08 $807.98 |
$801.33 $844.09 $889.38 $1,050.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$633.46 $718.98 $809.56 $1,131.36 $1,719.20 |
$875.76 $961.28 $1,051.86 $1,373.66 |
$1,118.06 $1,203.58 $1,294.16 $1,615.96 |
Toc - Plan #51 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Bronze HMO? 302 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.83 $372.08 $418.96 $585.50 $889.73 |
$578.62 $622.87 $669.75 $836.29 |
$829.41 $873.66 $920.54 $1,087.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655.66 $744.16 $837.92 $1,171.00 $1,779.46 |
$906.45 $994.95 $1,088.71 $1,421.79 |
$1,157.24 $1,245.74 $1,339.50 $1,672.58 |
Toc - Plan #52 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Bronze
(HMO) Blue Advantage Bronze HMO? 301 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$312.01 $354.13 $398.75 $557.25 $846.79 |
$550.70 $592.82 $637.44 $795.94 |
$789.39 $831.51 $876.13 $1,034.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$624.02 $708.26 $797.50 $1,114.50 $1,693.58 |
$862.71 $946.95 $1,036.19 $1,353.19 |
$1,101.40 $1,185.64 $1,274.88 $1,591.88 |
Toc - Plan #53 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO? 603 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$394.29 $447.52 $503.91 $704.21 $1,070.11 |
$695.93 $749.16 $805.55 $1,005.85 |
$997.57 $1,050.80 $1,107.19 $1,307.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$788.58 $895.04 $1,007.82 $1,408.42 $2,140.22 |
$1,090.22 $1,196.68 $1,309.46 $1,710.06 |
$1,391.86 $1,498.32 $1,611.10 $2,011.70 |
Toc - Plan #54 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) Blue Advantage Gold HMO? 706 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$391.69 $444.57 $500.58 $699.56 $1,063.04 |
$691.33 $744.21 $800.22 $999.20 |
$990.97 $1,043.85 $1,099.86 $1,298.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$783.38 $889.14 $1,001.16 $1,399.12 $2,126.08 |
$1,083.02 $1,188.78 $1,300.80 $1,698.76 |
$1,382.66 $1,488.42 $1,600.44 $1,998.40 |
Toc - Plan #55 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Silver HMO? 705 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$453.48 $514.70 $579.55 $809.91 $1,230.74 |
$800.39 $861.61 $926.46 $1,156.82 |
$1,147.30 $1,208.52 $1,273.37 $1,503.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$906.96 $1,029.40 $1,159.10 $1,619.82 $2,461.48 |
$1,253.87 $1,376.31 $1,506.01 $1,966.73 |
$1,600.78 $1,723.22 $1,852.92 $2,313.64 |
Toc - Plan #56 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Advantage Bronze HMO? 707 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.66 $358.27 $403.41 $563.76 $856.69 |
$557.14 $599.75 $644.89 $805.24 |
$798.62 $841.23 $886.37 $1,046.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$631.32 $716.54 $806.82 $1,127.52 $1,713.38 |
$872.80 $958.02 $1,048.30 $1,369.00 |
$1,114.28 $1,199.50 $1,289.78 $1,610.48 |
Toc - Plan #57 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) Blue Advantage Silver HMO? 801 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$451.55 $512.51 $577.09 $806.48 $1,225.52 |
$796.99 $857.95 $922.53 $1,151.92 |
$1,142.43 $1,203.39 $1,267.97 $1,497.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$903.10 $1,025.02 $1,154.18 $1,612.96 $2,451.04 |
$1,248.54 $1,370.46 $1,499.62 $1,958.40 |
$1,593.98 $1,715.90 $1,845.06 $2,303.84 |
Toc - Plan #58 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) MyBlue Health Bronze? 402 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$230.56 $261.69 $294.66 $411.79 $625.75 |
$406.94 $438.07 $471.04 $588.17 |
$583.32 $614.45 $647.42 $764.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$461.12 $523.38 $589.32 $823.58 $1,251.50 |
$637.50 $699.76 $765.70 $999.96 |
$813.88 $876.14 $942.08 $1,176.34 |
Toc - Plan #59 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) MyBlue Health Gold? 403 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$279.91 $317.70 $357.73 $499.93 $759.69 |
$494.04 $531.83 $571.86 $714.06 |
$708.17 $745.96 $785.99 $928.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$559.82 $635.40 $715.46 $999.86 $1,519.38 |
$773.95 $849.53 $929.59 $1,213.99 |
$988.08 $1,063.66 $1,143.72 $1,428.12 |
Toc - Plan #60 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) MyBlue Health Silver? 405 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.45 $383.00 $431.26 $602.68 $915.84 |
$595.60 $641.15 $689.41 $860.83 |
$853.75 $899.30 $947.56 $1,118.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$674.90 $766.00 $862.52 $1,205.36 $1,831.68 |
$933.05 $1,024.15 $1,120.67 $1,463.51 |
$1,191.20 $1,282.30 $1,378.82 $1,721.66 |
Toc - Plan #61 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(HMO) MyBlue Health Bronze? 806 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$232.53 $263.92 $297.18 $415.30 $631.09 |
$410.42 $441.81 $475.07 $593.19 |
$588.31 $619.70 $652.96 $771.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$465.06 $527.84 $594.36 $830.60 $1,262.18 |
$642.95 $705.73 $772.25 $1,008.49 |
$820.84 $883.62 $950.14 $1,186.38 |
Toc - Plan #62 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(HMO) MyBlue Health Gold? 808 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.33 $330.65 $372.31 $520.31 $790.66 |
$514.19 $553.51 $595.17 $743.17 |
$737.05 $776.37 $818.03 $966.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$582.66 $661.30 $744.62 $1,040.62 $1,581.32 |
$805.52 $884.16 $967.48 $1,263.48 |
$1,028.38 $1,107.02 $1,190.34 $1,486.34 |
Toc - Plan #63 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(HMO) MyBlue Health Silver? 807 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.92 $381.27 $429.31 $599.95 $911.69 |
$592.90 $638.25 $686.29 $856.93 |
$849.88 $895.23 $943.27 $1,113.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$671.84 $762.54 $858.62 $1,199.90 $1,823.38 |
$928.82 $1,019.52 $1,115.60 $1,456.88 |
$1,185.80 $1,276.50 $1,372.58 $1,713.86 |
Toc - Plan #64 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(POS) Blue Advantage Plus Bronze? 303 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$396.67 $450.23 $506.95 $708.46 $1,076.57 |
$700.13 $753.69 $810.41 $1,011.92 |
$1,003.59 $1,057.15 $1,113.87 $1,315.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$793.34 $900.46 $1,013.90 $1,416.92 $2,153.14 |
$1,096.80 $1,203.92 $1,317.36 $1,720.38 |
$1,400.26 $1,507.38 $1,620.82 $2,023.84 |
Toc - Plan #65 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Bronze
(POS) Blue Advantage Plus Bronze? 305 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$376.06 $426.82 $480.60 $671.64 $1,020.61 |
$663.74 $714.50 $768.28 $959.32 |
$951.42 $1,002.18 $1,055.96 $1,247.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$752.12 $853.64 $961.20 $1,343.28 $2,041.22 |
$1,039.80 $1,141.32 $1,248.88 $1,630.96 |
$1,327.48 $1,429.00 $1,536.56 $1,918.64 |
Toc - Plan #66 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Expanded Bronze
(POS) Blue Advantage Plus Bronze? 707 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$385.98 $438.09 $493.28 $689.36 $1,047.55 |
$681.25 $733.36 $788.55 $984.63 |
$976.52 $1,028.63 $1,083.82 $1,279.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$771.96 $876.18 $986.56 $1,378.72 $2,095.10 |
$1,067.23 $1,171.45 $1,281.83 $1,673.99 |
$1,362.50 $1,466.72 $1,577.10 $1,969.26 |
Toc - Plan #67 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(POS) Blue Advantage Plus Gold? 203 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$475.21 $539.37 $607.32 $848.73 $1,289.73 |
$838.75 $902.91 $970.86 $1,212.27 |
$1,202.29 $1,266.45 $1,334.40 $1,575.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$950.42 $1,078.74 $1,214.64 $1,697.46 $2,579.46 |
$1,313.96 $1,442.28 $1,578.18 $2,061.00 |
$1,677.50 $1,805.82 $1,941.72 $2,424.54 |
Toc - Plan #68 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(POS) Blue Advantage Plus Gold? 706 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$478.74 $543.37 $611.83 $855.02 $1,299.29 |
$844.97 $909.60 $978.06 $1,221.25 |
$1,211.20 $1,275.83 $1,344.29 $1,587.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$957.48 $1,086.74 $1,223.66 $1,710.04 $2,598.58 |
$1,323.71 $1,452.97 $1,589.89 $2,076.27 |
$1,689.94 $1,819.20 $1,956.12 $2,442.50 |
Toc - Plan #69 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(POS) Blue Advantage Plus Silver? 202 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$560.29 $635.93 $716.05 $1,000.68 $1,520.63 |
$988.91 $1,064.55 $1,144.67 $1,429.30 |
$1,417.53 $1,493.17 $1,573.29 $1,857.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,120.58 $1,271.86 $1,432.10 $2,001.36 $3,041.26 |
$1,549.20 $1,700.48 $1,860.72 $2,429.98 |
$1,977.82 $2,129.10 $2,289.34 $2,858.60 |
Toc - Plan #70 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(POS) Blue Advantage Plus Silver? 605 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$568.27 $644.99 $726.25 $1,014.94 $1,542.30 |
$1,003.00 $1,079.72 $1,160.98 $1,449.67 |
$1,437.73 $1,514.45 $1,595.71 $1,884.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,136.54 $1,289.98 $1,452.50 $2,029.88 $3,084.60 |
$1,571.27 $1,724.71 $1,887.23 $2,464.61 |
$2,006.00 $2,159.44 $2,321.96 $2,899.34 |
Toc - Plan #71 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Silver
(POS) Blue Advantage Plus Silver? 705 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$554.28 $629.10 $708.37 $989.94 $1,504.31 |
$978.30 $1,053.12 $1,132.39 $1,413.96 |
$1,402.32 $1,477.14 $1,556.41 $1,837.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,108.56 $1,258.20 $1,416.74 $1,979.88 $3,008.62 |
$1,532.58 $1,682.22 $1,840.76 $2,403.90 |
$1,956.60 $2,106.24 $2,264.78 $2,827.92 |
Toc - Plan #72 Blue Cross and Blue Shield of Texas | ||||||||||||||||||||
Gold
(POS) Blue Advantage Plus Gold? 803 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-697-0683
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$467.02 $530.07 $596.85 $834.10 $1,267.49 |
$824.29 $887.34 $954.12 $1,191.37 |
$1,181.56 $1,244.61 $1,311.39 $1,548.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$934.04 $1,060.14 $1,193.70 $1,668.20 $2,534.98 |
$1,291.31 $1,417.41 $1,550.97 $2,025.47 |
$1,648.58 $1,774.68 $1,908.24 $2,382.74 |
ADVERTISEMENT
Imperial Insurance Companies, Inc.Local: 1-626-838-5100x8 | Toll Free: 1-800-595-0619 | TTY: 1-800-595-0619 |
Toc - Plan #73 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Gold
(HMO) Imperial Preferred Gold Zero |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$463.11 $525.64 $591.86 $827.12 $1,256.89 |
$817.39 $879.92 $946.14 $1,181.40 |
$1,171.67 $1,234.20 $1,300.42 $1,535.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$926.22 $1,051.28 $1,183.72 $1,654.24 $2,513.78 |
$1,280.50 $1,405.56 $1,538.00 $2,008.52 |
$1,634.78 $1,759.84 $1,892.28 $2,362.80 |
Toc - Plan #74 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Expanded Bronze
(HMO) Imperial Standard Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320.67 $363.96 $409.81 $572.71 $870.29 |
$565.98 $609.27 $655.12 $818.02 |
$811.29 $854.58 $900.43 $1,063.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$641.34 $727.92 $819.62 $1,145.42 $1,740.58 |
$886.65 $973.23 $1,064.93 $1,390.73 |
$1,131.96 $1,218.54 $1,310.24 $1,636.04 |
Toc - Plan #75 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Silver
(HMO) Imperial Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$476.76 $541.12 $609.30 $851.49 $1,293.92 |
$841.48 $905.84 $974.02 $1,216.21 |
$1,206.20 $1,270.56 $1,338.74 $1,580.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$953.52 $1,082.24 $1,218.60 $1,702.98 $2,587.84 |
$1,318.24 $1,446.96 $1,583.32 $2,067.70 |
$1,682.96 $1,811.68 $1,948.04 $2,432.42 |
Toc - Plan #76 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Gold
(HMO) Imperial Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$436.33 $495.24 $557.63 $779.29 $1,184.21 |
$770.13 $829.04 $891.43 $1,113.09 |
$1,103.93 $1,162.84 $1,225.23 $1,446.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$872.66 $990.48 $1,115.26 $1,558.58 $2,368.42 |
$1,206.46 $1,324.28 $1,449.06 $1,892.38 |
$1,540.26 $1,658.08 $1,782.86 $2,226.18 |
Toc - Plan #77 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Bronze
(HMO) Imperial Preferred Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.21 $367.97 $414.33 $579.03 $879.89 |
$572.23 $615.99 $662.35 $827.05 |
$820.25 $864.01 $910.37 $1,075.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$648.42 $735.94 $828.66 $1,158.06 $1,759.78 |
$896.44 $983.96 $1,076.68 $1,406.08 |
$1,144.46 $1,231.98 $1,324.70 $1,654.10 |
Toc - Plan #78 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Silver
(HMO) Imperial Preferred Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$481.96 $547.03 $615.95 $860.79 $1,308.05 |
$850.66 $915.73 $984.65 $1,229.49 |
$1,219.36 $1,284.43 $1,353.35 $1,598.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$963.92 $1,094.06 $1,231.90 $1,721.58 $2,616.10 |
$1,332.62 $1,462.76 $1,600.60 $2,090.28 |
$1,701.32 $1,831.46 $1,969.30 $2,458.98 |
Toc - Plan #79 Imperial Insurance Companies, Inc. | ||||||||||||||||||||
Gold
(HMO) Imperial Preferred Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
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 $567.77 $793.46 $1,205.74 |
$784.13 $844.10 $907.63 $1,133.32 |
$1,123.99 $1,183.96 $1,247.49 $1,473.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.54 $1,008.48 $1,135.54 $1,586.92 $2,411.48 |
$1,228.40 $1,348.34 $1,475.40 $1,926.78 |
$1,568.26 $1,688.20 $1,815.26 $2,266.64 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-866-811-2704 | Toll Free: 1-866-811-2704 | TTY: 1-866-811-2704 |
Toc - Plan #80 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx, $0 Insulin) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.15 $487.09 $548.46 $766.46 $1,164.72 |
$757.45 $815.39 $876.76 $1,094.76 |
$1,085.75 $1,143.69 $1,205.06 $1,423.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.30 $974.18 $1,096.92 $1,532.92 $2,329.44 |
$1,186.60 $1,302.48 $1,425.22 $1,861.22 |
$1,514.90 $1,630.78 $1,753.52 $2,189.52 |
Toc - Plan #81 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$302.20 $342.99 $386.21 $539.73 $820.17 |
$533.38 $574.17 $617.39 $770.91 |
$764.56 $805.35 $848.57 $1,002.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$604.40 $685.98 $772.42 $1,079.46 $1,640.34 |
$835.58 $917.16 $1,003.60 $1,310.64 |
$1,066.76 $1,148.34 $1,234.78 $1,541.82 |
Toc - Plan #82 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx, $0 Insulin) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306.07 $347.39 $391.16 $546.65 $830.68 |
$540.22 $581.54 $625.31 $780.80 |
$774.37 $815.69 $859.46 $1,014.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$612.14 $694.78 $782.32 $1,093.30 $1,661.36 |
$846.29 $928.93 $1,016.47 $1,327.45 |
$1,080.44 $1,163.08 $1,250.62 $1,561.60 |
Toc - Plan #83 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Standard $0 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.65 $426.37 $480.09 $670.92 $1,019.53 |
$663.03 $713.75 $767.47 $958.30 |
$950.41 $1,001.13 $1,054.85 $1,245.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.30 $852.74 $960.18 $1,341.84 $2,039.06 |
$1,038.68 $1,140.12 $1,247.56 $1,629.22 |
$1,326.06 $1,427.50 $1,534.94 $1,916.60 |
Toc - Plan #84 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306.75 $348.16 $392.03 $547.86 $832.53 |
$541.42 $582.83 $626.70 $782.53 |
$776.09 $817.50 $861.37 $1,017.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$613.50 $696.32 $784.06 $1,095.72 $1,665.06 |
$848.17 $930.99 $1,018.73 $1,330.39 |
$1,082.84 $1,165.66 $1,253.40 $1,565.06 |
Toc - Plan #85 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$429.06 $486.99 $548.34 $766.31 $1,164.47 |
$757.29 $815.22 $876.57 $1,094.54 |
$1,085.52 $1,143.45 $1,204.80 $1,422.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$858.12 $973.98 $1,096.68 $1,532.62 $2,328.94 |
$1,186.35 $1,302.21 $1,424.91 $1,860.85 |
$1,514.58 $1,630.44 $1,753.14 $2,189.08 |
Toc - Plan #86 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.63 $441.09 $496.67 $694.09 $1,054.74 |
$685.93 $738.39 $793.97 $991.39 |
$983.23 $1,035.69 $1,091.27 $1,288.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$777.26 $882.18 $993.34 $1,388.18 $2,109.48 |
$1,074.56 $1,179.48 $1,290.64 $1,685.48 |
$1,371.86 $1,476.78 $1,587.94 $1,982.78 |
Toc - Plan #87 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.89 $474.31 $534.07 $746.36 $1,134.17 |
$737.58 $794.00 $853.76 $1,066.05 |
$1,057.27 $1,113.69 $1,173.45 $1,385.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.78 $948.62 $1,068.14 $1,492.72 $2,268.34 |
$1,155.47 $1,268.31 $1,387.83 $1,812.41 |
$1,475.16 $1,588.00 $1,707.52 $2,132.10 |
Toc - Plan #88 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.28 $482.69 $543.51 $759.55 $1,154.20 |
$750.62 $808.03 $868.85 $1,084.89 |
$1,075.96 $1,133.37 $1,194.19 $1,410.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$850.56 $965.38 $1,087.02 $1,519.10 $2,308.40 |
$1,175.90 $1,290.72 $1,412.36 $1,844.44 |
$1,501.24 $1,616.06 $1,737.70 $2,169.78 |
Toc - Plan #89 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Value ($0 Virtual Urgent Care + $0 PCP Visits, $1 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.48 $415.95 $468.36 $654.53 $994.63 |
$646.84 $696.31 $748.72 $934.89 |
$927.20 $976.67 $1,029.08 $1,215.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$732.96 $831.90 $936.72 $1,309.06 $1,989.26 |
$1,013.32 $1,112.26 $1,217.08 $1,589.42 |
$1,293.68 $1,392.62 $1,497.44 $1,869.78 |
Toc - Plan #90 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.96 $430.12 $484.31 $676.82 $1,028.49 |
$668.86 $720.02 $774.21 $966.72 |
$958.76 $1,009.92 $1,064.11 $1,256.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$757.92 $860.24 $968.62 $1,353.64 $2,056.98 |
$1,047.82 $1,150.14 $1,258.52 $1,643.54 |
$1,337.72 $1,440.04 $1,548.42 $1,933.44 |
Toc - Plan #91 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Kelsey-Seybold Bronze Copay Focus ($0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.11 $309.97 $349.03 $487.77 $741.21 |
$482.04 $518.90 $557.96 $696.70 |
$690.97 $727.83 $766.89 $905.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$546.22 $619.94 $698.06 $975.54 $1,482.42 |
$755.15 $828.87 $906.99 $1,184.47 |
$964.08 $1,037.80 $1,115.92 $1,393.40 |
Toc - Plan #92 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Kelsey-Seybold Silver Copay Focus ($0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.71 $426.43 $480.16 $671.02 $1,019.68 |
$663.13 $713.85 $767.58 $958.44 |
$950.55 $1,001.27 $1,055.00 $1,245.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.42 $852.86 $960.32 $1,342.04 $2,039.36 |
$1,038.84 $1,140.28 $1,247.74 $1,629.46 |
$1,326.26 $1,427.70 $1,535.16 $1,916.88 |
Toc - Plan #93 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Kelsey-Seybold Gold Copay Focus ($0 PCP Visits, $0 Insulin) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$330.40 $375.01 $422.25 $590.10 $896.71 |
$583.16 $627.77 $675.01 $842.86 |
$835.92 $880.53 $927.77 $1,095.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$660.80 $750.02 $844.50 $1,180.20 $1,793.42 |
$913.56 $1,002.78 $1,097.26 $1,432.96 |
$1,166.32 $1,255.54 $1,350.02 $1,685.72 |
Toc - Plan #94 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$303.15 $344.07 $387.42 $541.42 $822.74 |
$535.06 $575.98 $619.33 $773.33 |
$766.97 $807.89 $851.24 $1,005.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$606.30 $688.14 $774.84 $1,082.84 $1,645.48 |
$838.21 $920.05 $1,006.75 $1,314.75 |
$1,070.12 $1,151.96 $1,238.66 $1,546.66 |
Toc - Plan #95 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$444.19 $504.15 $567.67 $793.32 $1,205.53 |
$783.99 $843.95 $907.47 $1,133.12 |
$1,123.79 $1,183.75 $1,247.27 $1,472.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$888.38 $1,008.30 $1,135.34 $1,586.64 $2,411.06 |
$1,228.18 $1,348.10 $1,475.14 $1,926.44 |
$1,567.98 $1,687.90 $1,814.94 $2,266.24 |
Toc - Plan #96 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-811-2704
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$397.87 $451.58 $508.48 $710.59 $1,079.81 |
$702.24 $755.95 $812.85 $1,014.96 |
$1,006.61 $1,060.32 $1,117.22 $1,319.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$795.74 $903.16 $1,016.96 $1,421.18 $2,159.62 |
$1,100.11 $1,207.53 $1,321.33 $1,725.55 |
$1,404.48 $1,511.90 $1,625.70 $2,029.92 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-560-2025 | Toll Free: 1-888-560-2025 |
Toc - Plan #97 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 3 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$504.52 $572.63 $644.78 $901.08 $1,369.27 |
$890.48 $958.59 $1,030.74 $1,287.04 |
$1,276.44 $1,344.55 $1,416.70 $1,673.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,009.04 $1,145.26 $1,289.56 $1,802.16 $2,738.54 |
$1,395.00 $1,531.22 $1,675.52 $2,188.12 |
$1,780.96 $1,917.18 $2,061.48 $2,574.08 |
Toc - Plan #98 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.37 $474.85 $534.68 $747.21 $1,135.45 |
$738.42 $794.90 $854.73 $1,067.26 |
$1,058.47 $1,114.95 $1,174.78 $1,387.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$836.74 $949.70 $1,069.36 $1,494.42 $2,270.90 |
$1,156.79 $1,269.75 $1,389.41 $1,814.47 |
$1,476.84 $1,589.80 $1,709.46 $2,134.52 |
Toc - Plan #99 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 1 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473.60 $537.54 $605.26 $845.85 $1,285.36 |
$835.91 $899.85 $967.57 $1,208.16 |
$1,198.22 $1,262.16 $1,329.88 $1,570.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$947.20 $1,075.08 $1,210.52 $1,691.70 $2,570.72 |
$1,309.51 $1,437.39 $1,572.83 $2,054.01 |
$1,671.82 $1,799.70 $1,935.14 $2,416.32 |
Toc - Plan #100 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$434.05 $492.65 $554.72 $775.22 $1,178.02 |
$766.10 $824.70 $886.77 $1,107.27 |
$1,098.15 $1,156.75 $1,218.82 $1,439.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$868.10 $985.30 $1,109.44 $1,550.44 $2,356.04 |
$1,200.15 $1,317.35 $1,441.49 $1,882.49 |
$1,532.20 $1,649.40 $1,773.54 $2,214.54 |
Toc - Plan #101 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 8 250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$459.22 $521.22 $586.88 $820.17 $1,246.32 |
$810.52 $872.52 $938.18 $1,171.47 |
$1,161.82 $1,223.82 $1,289.48 $1,522.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$918.44 $1,042.44 $1,173.76 $1,640.34 $2,492.64 |
$1,269.74 $1,393.74 $1,525.06 $1,991.64 |
$1,621.04 $1,745.04 $1,876.36 $2,342.94 |
Toc - Plan #102 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 12 250 with First 4 Primary Care Visits Free |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.69 $524.02 $590.05 $824.59 $1,253.04 |
$814.89 $877.22 $943.25 $1,177.79 |
$1,168.09 $1,230.42 $1,296.45 $1,530.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$923.38 $1,048.04 $1,180.10 $1,649.18 $2,506.08 |
$1,276.58 $1,401.24 $1,533.30 $2,002.38 |
$1,629.78 $1,754.44 $1,886.50 $2,355.58 |
Toc - Plan #103 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 1 with Adult Vision Services |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.63 $478.55 $538.85 $753.04 $1,144.31 |
$744.18 $801.10 $861.40 $1,075.59 |
$1,066.73 $1,123.65 $1,183.95 $1,398.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$843.26 $957.10 $1,077.70 $1,506.08 $2,288.62 |
$1,165.81 $1,279.65 $1,400.25 $1,828.63 |
$1,488.36 $1,602.20 $1,722.80 $2,151.18 |
Toc - Plan #104 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 1 250 with Adult Vision Services |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2025
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$476.87 $541.24 $609.43 $851.68 $1,294.21 |
$841.67 $906.04 $974.23 $1,216.48 |
$1,206.47 $1,270.84 $1,339.03 $1,581.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$953.74 $1,082.48 $1,218.86 $1,703.36 $2,588.42 |
$1,318.54 $1,447.28 $1,583.66 $2,068.16 |
$1,683.34 $1,812.08 $1,948.46 $2,432.96 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-877-336-3915 | Toll Free: 1-877-336-3915 |
Toc - Plan #105 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 1: 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 |
$388.35 $440.78 $496.32 $693.60 $1,053.99 |
$685.44 $737.87 $793.41 $990.69 |
$982.53 $1,034.96 $1,090.50 $1,287.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.70 $881.56 $992.64 $1,387.20 $2,107.98 |
$1,073.79 $1,178.65 $1,289.73 $1,684.29 |
$1,370.88 $1,475.74 $1,586.82 $1,981.38 |
Toc - Plan #106 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 |
$348.90 $396.00 $445.89 $623.12 $946.89 |
$615.81 $662.91 $712.80 $890.03 |
$882.72 $929.82 $979.71 $1,156.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$697.80 $792.00 $891.78 $1,246.24 $1,893.78 |
$964.71 $1,058.91 $1,158.69 $1,513.15 |
$1,231.62 $1,325.82 $1,425.60 $1,780.06 |
Toc - Plan #107 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 |
$376.79 $427.66 $481.54 $672.94 $1,022.60 |
$665.04 $715.91 $769.79 $961.19 |
$953.29 $1,004.16 $1,058.04 $1,249.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$753.58 $855.32 $963.08 $1,345.88 $2,045.20 |
$1,041.83 $1,143.57 $1,251.33 $1,634.13 |
$1,330.08 $1,431.82 $1,539.58 $1,922.38 |
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 |
$347.78 $394.73 $444.46 $621.13 $943.87 |
$613.83 $660.78 $710.51 $887.18 |
$879.88 $926.83 $976.56 $1,153.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$695.56 $789.46 $888.92 $1,242.26 $1,887.74 |
$961.61 $1,055.51 $1,154.97 $1,508.31 |
$1,227.66 $1,321.56 $1,421.02 $1,774.36 |
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 |
$352.62 $400.22 $450.64 $629.77 $956.99 |
$622.37 $669.97 $720.39 $899.52 |
$892.12 $939.72 $990.14 $1,169.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$705.24 $800.44 $901.28 $1,259.54 $1,913.98 |
$974.99 $1,070.19 $1,171.03 $1,529.29 |
$1,244.74 $1,339.94 $1,440.78 $1,799.04 |
Toc - Plan #110 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 |
$376.35 $427.16 $480.98 $672.16 $1,021.41 |
$664.26 $715.07 $768.89 $960.07 |
$952.17 $1,002.98 $1,056.80 $1,247.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$752.70 $854.32 $961.96 $1,344.32 $2,042.82 |
$1,040.61 $1,142.23 $1,249.87 $1,632.23 |
$1,328.52 $1,430.14 $1,537.78 $1,920.14 |
Toc - Plan #111 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 |
$384.64 $436.56 $491.57 $686.96 $1,043.90 |
$678.89 $730.81 $785.82 $981.21 |
$973.14 $1,025.06 $1,080.07 $1,275.46 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$769.28 $873.12 $983.14 $1,373.92 $2,087.80 |
$1,063.53 $1,167.37 $1,277.39 $1,668.17 |
$1,357.78 $1,461.62 $1,571.64 $1,962.42 |
Toc - Plan #112 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 |
$385.08 $437.06 $492.13 $687.74 $1,045.09 |
$679.66 $731.64 $786.71 $982.32 |
$974.24 $1,026.22 $1,081.29 $1,276.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$770.16 $874.12 $984.26 $1,375.48 $2,090.18 |
$1,064.74 $1,168.70 $1,278.84 $1,670.06 |
$1,359.32 $1,463.28 $1,573.42 $1,964.64 |
ADVERTISEMENT
Ambetter from Superior HealthPlanLocal: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989 |
Toc - Plan #113 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(HMO) Ambetter Virtual Access Silver (Virtual PCP selection required) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$471.04 $534.62 $601.98 $841.27 $1,278.39 |
$831.38 $894.96 $962.32 $1,201.61 |
$1,191.72 $1,255.30 $1,322.66 $1,561.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$942.08 $1,069.24 $1,203.96 $1,682.54 $2,556.78 |
$1,302.42 $1,429.58 $1,564.30 $2,042.88 |
$1,662.76 $1,789.92 $1,924.64 $2,403.22 |
Toc - Plan #114 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(HMO) Ambetter Virtual Access Gold (Virtual PCP selection required) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$434.43 $493.06 $555.18 $775.87 $1,179.01 |
$766.76 $825.39 $887.51 $1,108.20 |
$1,099.09 $1,157.72 $1,219.84 $1,440.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$868.86 $986.12 $1,110.36 $1,551.74 $2,358.02 |
$1,201.19 $1,318.45 $1,442.69 $1,884.07 |
$1,533.52 $1,650.78 $1,775.02 $2,216.40 |
Toc - Plan #115 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(HMO) Standard Ambetter Virtual Access Silver (Virtual PCP selection required) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$470.44 $533.94 $601.22 $840.20 $1,276.76 |
$830.32 $893.82 $961.10 $1,200.08 |
$1,190.20 $1,253.70 $1,320.98 $1,559.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$940.88 $1,067.88 $1,202.44 $1,680.40 $2,553.52 |
$1,300.76 $1,427.76 $1,562.32 $2,040.28 |
$1,660.64 $1,787.64 $1,922.20 $2,400.16 |
Toc - Plan #116 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(HMO) Standard Ambetter Virtual Access Gold (Virtual PCP selection required) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$425.68 $483.14 $544.01 $760.25 $1,155.27 |
$751.32 $808.78 $869.65 $1,085.89 |
$1,076.96 $1,134.42 $1,195.29 $1,411.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$851.36 $966.28 $1,088.02 $1,520.50 $2,310.54 |
$1,177.00 $1,291.92 $1,413.66 $1,846.14 |
$1,502.64 $1,617.56 $1,739.30 $2,171.78 |
Toc - Plan #117 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(HMO) Complete VALUE Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$366.02 $415.43 $467.77 $653.70 $993.36 |
$646.02 $695.43 $747.77 $933.70 |
$926.02 $975.43 $1,027.77 $1,213.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$732.04 $830.86 $935.54 $1,307.40 $1,986.72 |
$1,012.04 $1,110.86 $1,215.54 $1,587.40 |
$1,292.04 $1,390.86 $1,495.54 $1,867.40 |
Toc - Plan #118 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(HMO) Clear VALUE Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$360.11 $408.72 $460.21 $643.15 $977.32 |
$635.59 $684.20 $735.69 $918.63 |
$911.07 $959.68 $1,011.17 $1,194.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$720.22 $817.44 $920.42 $1,286.30 $1,954.64 |
$995.70 $1,092.92 $1,195.90 $1,561.78 |
$1,271.18 $1,368.40 $1,471.38 $1,837.26 |
Toc - Plan #119 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(HMO) Focused VALUE Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.35 $411.26 $463.07 $647.14 $983.39 |
$639.54 $688.45 $740.26 $924.33 |
$916.73 $965.64 $1,017.45 $1,201.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724.70 $822.52 $926.14 $1,294.28 $1,966.78 |
$1,001.89 $1,099.71 $1,203.33 $1,571.47 |
$1,279.08 $1,376.90 $1,480.52 $1,848.66 |
Toc - Plan #120 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(HMO) Everyday VALUE Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.26 $366.89 $413.11 $577.32 $877.29 |
$570.54 $614.17 $660.39 $824.60 |
$817.82 $861.45 $907.67 $1,071.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646.52 $733.78 $826.22 $1,154.64 $1,754.58 |
$893.80 $981.06 $1,073.50 $1,401.92 |
$1,141.08 $1,228.34 $1,320.78 $1,649.20 |
Toc - Plan #121 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Silver
(HMO) Standard Silver VALUE |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.40 $406.77 $458.02 $640.08 $972.66 |
$632.57 $680.94 $732.19 $914.25 |
$906.74 $955.11 $1,006.36 $1,188.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.80 $813.54 $916.04 $1,280.16 $1,945.32 |
$990.97 $1,087.71 $1,190.21 $1,554.33 |
$1,265.14 $1,361.88 $1,464.38 $1,828.50 |
Toc - Plan #122 Ambetter from Superior HealthPlan | ||||||||||||||||||||
Gold
(HMO) Standard Gold VALUE |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-687-1196
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.29 $368.06 $414.44 $579.17 $880.11 |
$572.37 $616.14 $662.52 $827.25 |
$820.45 $864.22 $910.60 $1,075.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$648.58 $736.12 $828.88 $1,158.34 $1,760.22 |
$896.66 $984.20 $1,076.96 $1,406.42 |
$1,144.74 $1,232.28 $1,325.04 $1,654.50 |
‡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 Harris County here.
Harris County is in “Rating Area 10” of Texas.
Currently, there are 122 plans offered in Rating Area 10.