Obamacare 2024 Rates for Kane County, Illinois
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Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Gilberts, IL.
The health insurance rates listed below are for calendar year 2024.
For information on subsidies to make your coverage affordable, you must take one of the following actions:
- Contact a licensed health insurance agent
- Complete an application at Healthcare.gov
- Contact the provider directly
Obamacare Providers, 107 Plans and 2024 Rates for Kane County, Illinois
Below, you’ll find a summary of the 107 plans for Kane County, Illinois and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
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Ambetter of IllinoisLocal: 1-855-745-5507 | Toll Free: 1-855-745-5507 | TTY: 1-844-517-3431 |
Toc - Plan #1 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Complete Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$421.37 $478.24 $538.50 $752.55 $1,143.57 |
$743.71 $800.58 $860.84 $1,074.89 |
$1,066.05 $1,122.92 $1,183.18 $1,397.23 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$842.74 $956.48 $1,077.00 $1,505.10 $2,287.14 |
$1,165.08 $1,278.82 $1,399.34 $1,827.44 |
$1,487.42 $1,601.16 $1,721.68 $2,149.78 |
Toc - Plan #2 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$296.13 $336.10 $378.44 $528.87 $803.67 |
$522.66 $562.63 $604.97 $755.40 |
$749.19 $789.16 $831.50 $981.93 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$592.26 $672.20 $756.88 $1,057.74 $1,607.34 |
$818.79 $898.73 $983.41 $1,284.27 |
$1,045.32 $1,125.26 $1,209.94 $1,510.80 |
Toc - Plan #3 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$350.82 $398.17 $448.34 $626.55 $952.10 |
$619.19 $666.54 $716.71 $894.92 |
$887.56 $934.91 $985.08 $1,163.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$701.64 $796.34 $896.68 $1,253.10 $1,904.20 |
$970.01 $1,064.71 $1,165.05 $1,521.47 |
$1,238.38 $1,333.08 $1,433.42 $1,789.84 |
Toc - Plan #4 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Clear Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$332.12 $376.95 $424.44 $593.15 $901.35 |
$586.19 $631.02 $678.51 $847.22 |
$840.26 $885.09 $932.58 $1,101.29 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$664.24 $753.90 $848.88 $1,186.30 $1,802.70 |
$918.31 $1,007.97 $1,102.95 $1,440.37 |
$1,172.38 $1,262.04 $1,357.02 $1,694.44 |
Toc - Plan #5 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Focused Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$339.97 $385.85 $434.47 $607.17 $922.65 |
$600.04 $645.92 $694.54 $867.24 |
$860.11 $905.99 $954.61 $1,127.31 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$679.94 $771.70 $868.94 $1,214.34 $1,845.30 |
$940.01 $1,031.77 $1,129.01 $1,474.41 |
$1,200.08 $1,291.84 $1,389.08 $1,734.48 |
Toc - Plan #6 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Everyday Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$399.67 $453.61 $510.76 $713.79 $1,084.67 |
$705.41 $759.35 $816.50 $1,019.53 |
$1,011.15 $1,065.09 $1,122.24 $1,325.27 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$799.34 $907.22 $1,021.52 $1,427.58 $2,169.34 |
$1,105.08 $1,212.96 $1,327.26 $1,733.32 |
$1,410.82 $1,518.70 $1,633.00 $2,039.06 |
Toc - Plan #7 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Elite Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$471.22 $534.82 $602.20 $841.58 $1,278.86 |
$831.69 $895.29 $962.67 $1,202.05 |
$1,192.16 $1,255.76 $1,323.14 $1,562.52 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$942.44 $1,069.64 $1,204.40 $1,683.16 $2,557.72 |
$1,302.91 $1,430.11 $1,564.87 $2,043.63 |
$1,663.38 $1,790.58 $1,925.34 $2,404.10 |
Toc - Plan #8 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Central Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$293.79 $333.44 $375.45 $524.70 $797.33 |
$518.53 $558.18 $600.19 $749.44 |
$743.27 $782.92 $824.93 $974.18 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$587.58 $666.88 $750.90 $1,049.40 $1,594.66 |
$812.32 $891.62 $975.64 $1,274.14 |
$1,037.06 $1,116.36 $1,200.38 $1,498.88 |
Toc - Plan #9 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Central Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$359.17 $407.64 $459.00 $641.45 $974.75 |
$633.93 $682.40 $733.76 $916.21 |
$908.69 $957.16 $1,008.52 $1,190.97 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$718.34 $815.28 $918.00 $1,282.90 $1,949.50 |
$993.10 $1,090.04 $1,192.76 $1,557.66 |
$1,267.86 $1,364.80 $1,467.52 $1,832.42 |
Toc - Plan #10 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Central Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$407.11 $462.06 $520.28 $727.09 $1,104.88 |
$718.54 $773.49 $831.71 $1,038.52 |
$1,029.97 $1,084.92 $1,143.14 $1,349.95 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$814.22 $924.12 $1,040.56 $1,454.18 $2,209.76 |
$1,125.65 $1,235.55 $1,351.99 $1,765.61 |
$1,437.08 $1,546.98 $1,663.42 $2,077.04 |
Toc - Plan #11 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Standard Expanded Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$288.15 $327.04 $368.24 $514.62 $782.01 |
$508.58 $547.47 $588.67 $735.05 |
$729.01 $767.90 $809.10 $955.48 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$576.30 $654.08 $736.48 $1,029.24 $1,564.02 |
$796.73 $874.51 $956.91 $1,249.67 |
$1,017.16 $1,094.94 $1,177.34 $1,470.10 |
Toc - Plan #12 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Standard Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$333.89 $378.96 $426.70 $596.31 $906.16 |
$589.31 $634.38 $682.12 $851.73 |
$844.73 $889.80 $937.54 $1,107.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$667.78 $757.92 $853.40 $1,192.62 $1,812.32 |
$923.20 $1,013.34 $1,108.82 $1,448.04 |
$1,178.62 $1,268.76 $1,364.24 $1,703.46 |
Toc - Plan #13 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Standard Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$396.90 $450.47 $507.22 $708.84 $1,077.15 |
$700.52 $754.09 $810.84 $1,012.46 |
$1,004.14 $1,057.71 $1,114.46 $1,316.08 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$793.80 $900.94 $1,014.44 $1,417.68 $2,154.30 |
$1,097.42 $1,204.56 $1,318.06 $1,721.30 |
$1,401.04 $1,508.18 $1,621.68 $2,024.92 |
Toc - Plan #14 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Complete Gold + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$434.75 $493.43 $555.60 $776.44 $1,179.88 |
$767.32 $826.00 $888.17 $1,109.01 |
$1,099.89 $1,158.57 $1,220.74 $1,441.58 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$869.50 $986.86 $1,111.20 $1,552.88 $2,359.76 |
$1,202.07 $1,319.43 $1,443.77 $1,885.45 |
$1,534.64 $1,652.00 $1,776.34 $2,218.02 |
Toc - Plan #15 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Everyday Bronze + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$305.53 $346.77 $390.46 $545.66 $829.19 |
$539.25 $580.49 $624.18 $779.38 |
$772.97 $814.21 $857.90 $1,013.10 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$611.06 $693.54 $780.92 $1,091.32 $1,658.38 |
$844.78 $927.26 $1,014.64 $1,325.04 |
$1,078.50 $1,160.98 $1,248.36 $1,558.76 |
Toc - Plan #16 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Elite Bronze + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$361.96 $410.81 $462.57 $646.44 $982.33 |
$638.85 $687.70 $739.46 $923.33 |
$915.74 $964.59 $1,016.35 $1,200.22 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$723.92 $821.62 $925.14 $1,292.88 $1,964.66 |
$1,000.81 $1,098.51 $1,202.03 $1,569.77 |
$1,277.70 $1,375.40 $1,478.92 $1,846.66 |
Toc - Plan #17 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Focused Silver + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$350.76 $398.11 $448.26 $626.45 $951.94 |
$619.09 $666.44 $716.59 $894.78 |
$887.42 $934.77 $984.92 $1,163.11 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$701.52 $796.22 $896.52 $1,252.90 $1,903.88 |
$969.85 $1,064.55 $1,164.85 $1,521.23 |
$1,238.18 $1,332.88 $1,433.18 $1,789.56 |
Toc - Plan #18 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Everyday Gold + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$412.36 $468.01 $526.98 $736.45 $1,119.11 |
$727.81 $783.46 $842.43 $1,051.90 |
$1,043.26 $1,098.91 $1,157.88 $1,367.35 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$824.72 $936.02 $1,053.96 $1,472.90 $2,238.22 |
$1,140.17 $1,251.47 $1,369.41 $1,788.35 |
$1,455.62 $1,566.92 $1,684.86 $2,103.80 |
Toc - Plan #19 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Clear Silver + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$342.67 $388.92 $437.92 $611.99 $929.97 |
$604.80 $651.05 $700.05 $874.12 |
$866.93 $913.18 $962.18 $1,136.25 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$685.34 $777.84 $875.84 $1,223.98 $1,859.94 |
$947.47 $1,039.97 $1,137.97 $1,486.11 |
$1,209.60 $1,302.10 $1,400.10 $1,748.24 |
Toc - Plan #20 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Elite Gold + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$486.18 $551.80 $621.33 $868.30 $1,319.47 |
$858.10 $923.72 $993.25 $1,240.22 |
$1,230.02 $1,295.64 $1,365.17 $1,612.14 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$972.36 $1,103.60 $1,242.66 $1,736.60 $2,638.94 |
$1,344.28 $1,475.52 $1,614.58 $2,108.52 |
$1,716.20 $1,847.44 $1,986.50 $2,480.44 |
Toc - Plan #21 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Central Bronze + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$303.12 $344.03 $387.38 $541.36 $822.64 |
$535.00 $575.91 $619.26 $773.24 |
$766.88 $807.79 $851.14 $1,005.12 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$606.24 $688.06 $774.76 $1,082.72 $1,645.28 |
$838.12 $919.94 $1,006.64 $1,314.60 |
$1,070.00 $1,151.82 $1,238.52 $1,546.48 |
Toc - Plan #22 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Central Silver + Vision + Adult Dental |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$370.57 $420.59 $473.58 $661.82 $1,005.70 |
$654.05 $704.07 $757.06 $945.30 |
$937.53 $987.55 $1,040.54 $1,228.78 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.14 $841.18 $947.16 $1,323.64 $2,011.40 |
$1,024.62 $1,124.66 $1,230.64 $1,607.12 |
$1,308.10 $1,408.14 $1,514.12 $1,890.60 |
Toc - Plan #23 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Central Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$420.04 $476.73 $536.80 $750.17 $1,139.96 |
$741.36 $798.05 $858.12 $1,071.49 |
$1,062.68 $1,119.37 $1,179.44 $1,392.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$840.08 $953.46 $1,073.60 $1,500.34 $2,279.92 |
$1,161.40 $1,274.78 $1,394.92 $1,821.66 |
$1,482.72 $1,596.10 $1,716.24 $2,142.98 |
Toc - Plan #24 Ambetter of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Standard Expanded Bronze + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$297.30 $337.42 $379.94 $530.96 $806.84 |
$524.73 $564.85 $607.37 $758.39 |
$752.16 $792.28 $834.80 $985.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$594.60 $674.84 $759.88 $1,061.92 $1,613.68 |
$822.03 $902.27 $987.31 $1,289.35 |
$1,049.46 $1,129.70 $1,214.74 $1,516.78 |
Toc - Plan #25 Ambetter of Illinois | ||||||||||||||||||||
Silver
(HMO) Standard Silver + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.49 $390.99 $440.25 $615.25 $934.93 |
$608.02 $654.52 $703.78 $878.78 |
$871.55 $918.05 $967.31 $1,142.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.98 $781.98 $880.50 $1,230.50 $1,869.86 |
$952.51 $1,045.51 $1,144.03 $1,494.03 |
$1,216.04 $1,309.04 $1,407.56 $1,757.56 |
Toc - Plan #26 Ambetter of Illinois | ||||||||||||||||||||
Gold
(HMO) Standard Gold + Vision + Adult Dental |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-745-5507
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409.50 $464.77 $523.33 $731.35 $1,111.35 |
$722.76 $778.03 $836.59 $1,044.61 |
$1,036.02 $1,091.29 $1,149.85 $1,357.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$819.00 $929.54 $1,046.66 $1,462.70 $2,222.70 |
$1,132.26 $1,242.80 $1,359.92 $1,775.96 |
$1,445.52 $1,556.06 $1,673.18 $2,089.22 |
ADVERTISEMENT
Molina HealthcareLocal: 1-833-644-1623 | Toll Free: 1-833-644-1623 | TTY: 1-800-877-8339 |
Toc - Plan #27 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$375.95 $426.70 $480.46 $671.45 $1,020.33 |
$663.55 $714.30 $768.06 $959.05 |
$951.15 $1,001.90 $1,055.66 $1,246.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$751.90 $853.40 $960.92 $1,342.90 $2,040.66 |
$1,039.50 $1,141.00 $1,248.52 $1,630.50 |
$1,327.10 $1,428.60 $1,536.12 $1,918.10 |
Toc - Plan #28 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.53 $377.42 $424.97 $593.90 $902.48 |
$586.91 $631.80 $679.35 $848.28 |
$841.29 $886.18 $933.73 $1,102.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$665.06 $754.84 $849.94 $1,187.80 $1,804.96 |
$919.44 $1,009.22 $1,104.32 $1,442.18 |
$1,173.82 $1,263.60 $1,358.70 $1,696.56 |
Toc - Plan #29 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 8 with Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.49 $443.21 $499.05 $697.41 $1,059.79 |
$689.21 $741.93 $797.77 $996.13 |
$987.93 $1,040.65 $1,096.49 $1,294.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$780.98 $886.42 $998.10 $1,394.82 $2,119.58 |
$1,079.70 $1,185.14 $1,296.82 $1,693.54 |
$1,378.42 $1,483.86 $1,595.54 $1,992.26 |
Toc - Plan #30 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 8 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325.97 $369.98 $416.59 $582.18 $884.68 |
$575.34 $619.35 $665.96 $831.55 |
$824.71 $868.72 $915.33 $1,080.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$651.94 $739.96 $833.18 $1,164.36 $1,769.36 |
$901.31 $989.33 $1,082.55 $1,413.73 |
$1,150.68 $1,238.70 $1,331.92 $1,663.10 |
Toc - Plan #31 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 12 with first 4 free PCP or MH visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.15 $370.18 $416.82 $582.50 $885.17 |
$575.65 $619.68 $666.32 $832.00 |
$825.15 $869.18 $915.82 $1,081.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.30 $740.36 $833.64 $1,165.00 $1,770.34 |
$901.80 $989.86 $1,083.14 $1,414.50 |
$1,151.30 $1,239.36 $1,332.64 $1,664.00 |
Toc - Plan #32 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 1 with Adult Vision Services |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.87 $430.01 $484.19 $676.66 $1,028.25 |
$668.70 $719.84 $774.02 $966.49 |
$958.53 $1,009.67 $1,063.85 $1,256.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$757.74 $860.02 $968.38 $1,353.32 $2,056.50 |
$1,047.57 $1,149.85 $1,258.21 $1,643.15 |
$1,337.40 $1,439.68 $1,548.04 $1,932.98 |
Toc - Plan #33 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 1 with Rx Copay and Adult Vision Services |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-644-1623
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.72 $381.05 $429.06 $599.60 $911.16 |
$592.55 $637.88 $685.89 $856.43 |
$849.38 $894.71 $942.72 $1,113.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$671.44 $762.10 $858.12 $1,199.20 $1,822.32 |
$928.27 $1,018.93 $1,114.95 $1,456.03 |
$1,185.10 $1,275.76 $1,371.78 $1,712.86 |
ADVERTISEMENT
Blue Cross and Blue Shield of IllinoisLocal: 1-800-538-8833 | Toll Free: 1-800-538-8833 | TTY: 1-800-526-0844 |
Toc - Plan #34 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(HMO) Blue Precision Gold HMO? 207 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413.70 $469.55 $528.71 $738.87 $1,122.79 |
$730.18 $786.03 $845.19 $1,055.35 |
$1,046.66 $1,102.51 $1,161.67 $1,371.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827.40 $939.10 $1,057.42 $1,477.74 $2,245.58 |
$1,143.88 $1,255.58 $1,373.90 $1,794.22 |
$1,460.36 $1,572.06 $1,690.38 $2,110.70 |
Toc - Plan #35 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(HMO) Blue Precision Silver HMO? 206 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.12 $393.98 $443.62 $619.96 $942.08 |
$612.67 $659.53 $709.17 $885.51 |
$878.22 $925.08 $974.72 $1,151.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.24 $787.96 $887.24 $1,239.92 $1,884.16 |
$959.79 $1,053.51 $1,152.79 $1,505.47 |
$1,225.34 $1,319.06 $1,418.34 $1,771.02 |
Toc - Plan #36 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Precision Bronze HMO? 205 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.34 $339.75 $382.56 $534.62 $812.41 |
$528.34 $568.75 $611.56 $763.62 |
$757.34 $797.75 $840.56 $992.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598.68 $679.50 $765.12 $1,069.24 $1,624.82 |
$827.68 $908.50 $994.12 $1,298.24 |
$1,056.68 $1,137.50 $1,223.12 $1,527.24 |
Toc - Plan #37 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(HMO) Blue Precision Gold HMO? 703 - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.05 $481.30 $541.94 $757.36 $1,150.88 |
$748.45 $805.70 $866.34 $1,081.76 |
$1,072.85 $1,130.10 $1,190.74 $1,406.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$848.10 $962.60 $1,083.88 $1,514.72 $2,301.76 |
$1,172.50 $1,287.00 $1,408.28 $1,839.12 |
$1,496.90 $1,611.40 $1,732.68 $2,163.52 |
Toc - Plan #38 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(HMO) Blue Precision Silver HMO 704? - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.52 $411.46 $463.30 $647.46 $983.88 |
$639.85 $688.79 $740.63 $924.79 |
$917.18 $966.12 $1,017.96 $1,202.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$725.04 $822.92 $926.60 $1,294.92 $1,967.76 |
$1,002.37 $1,100.25 $1,203.93 $1,572.25 |
$1,279.70 $1,377.58 $1,481.26 $1,849.58 |
Toc - Plan #39 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Precision Bronze HMO? 701 - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$294.44 $334.19 $376.30 $525.87 $799.11 |
$519.69 $559.44 $601.55 $751.12 |
$744.94 $784.69 $826.80 $976.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$588.88 $668.38 $752.60 $1,051.74 $1,598.22 |
$814.13 $893.63 $977.85 $1,276.99 |
$1,039.38 $1,118.88 $1,203.10 $1,502.24 |
Toc - Plan #40 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(HMO) Blue Precision Gold HMO? 707 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.96 $474.39 $534.16 $746.48 $1,134.35 |
$737.70 $794.13 $853.90 $1,066.22 |
$1,057.44 $1,113.87 $1,173.64 $1,385.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.92 $948.78 $1,068.32 $1,492.96 $2,268.70 |
$1,155.66 $1,268.52 $1,388.06 $1,812.70 |
$1,475.40 $1,588.26 $1,707.80 $2,132.44 |
Toc - Plan #41 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(HMO) Blue Precision Silver HMO? 706 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373.11 $423.48 $476.84 $666.38 $1,012.62 |
$658.54 $708.91 $762.27 $951.81 |
$943.97 $994.34 $1,047.70 $1,237.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$746.22 $846.96 $953.68 $1,332.76 $2,025.24 |
$1,031.65 $1,132.39 $1,239.11 $1,618.19 |
$1,317.08 $1,417.82 $1,524.54 $1,903.62 |
Toc - Plan #42 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) Blue Precision Bronze HMO? 708 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.63 $359.37 $404.65 $565.50 $859.33 |
$558.85 $601.59 $646.87 $807.72 |
$801.07 $843.81 $889.09 $1,049.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$633.26 $718.74 $809.30 $1,131.00 $1,718.66 |
$875.48 $960.96 $1,051.52 $1,373.22 |
$1,117.70 $1,203.18 $1,293.74 $1,615.44 |
Toc - Plan #43 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Direct Bronze? 401 with Advocate - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.91 $361.97 $407.57 $569.58 $865.53 |
$562.88 $605.94 $651.54 $813.55 |
$806.85 $849.91 $895.51 $1,057.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$637.82 $723.94 $815.14 $1,139.16 $1,731.06 |
$881.79 $967.91 $1,059.11 $1,383.13 |
$1,125.76 $1,211.88 $1,303.08 $1,627.10 |
Toc - Plan #44 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(HMO) BlueCare Direct Gold? 409 with Advocate - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$442.94 $502.73 $566.07 $791.09 $1,202.13 |
$781.79 $841.58 $904.92 $1,129.94 |
$1,120.64 $1,180.43 $1,243.77 $1,468.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$885.88 $1,005.46 $1,132.14 $1,582.18 $2,404.26 |
$1,224.73 $1,344.31 $1,470.99 $1,921.03 |
$1,563.58 $1,683.16 $1,809.84 $2,259.88 |
Toc - Plan #45 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(HMO) BlueCare Direct Silver? 212 with Advocate - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.71 $420.75 $473.77 $662.09 $1,006.10 |
$654.30 $704.34 $757.36 $945.68 |
$937.89 $987.93 $1,040.95 $1,229.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.42 $841.50 $947.54 $1,324.18 $2,012.20 |
$1,025.01 $1,125.09 $1,231.13 $1,607.77 |
$1,308.60 $1,408.68 $1,514.72 $1,891.36 |
Toc - Plan #46 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(HMO) BlueCare Direct Gold? 804 with Advocate |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$448.70 $509.27 $573.44 $801.37 $1,217.76 |
$791.95 $852.52 $916.69 $1,144.62 |
$1,135.20 $1,195.77 $1,259.94 $1,487.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$897.40 $1,018.54 $1,146.88 $1,602.74 $2,435.52 |
$1,240.65 $1,361.79 $1,490.13 $1,945.99 |
$1,583.90 $1,705.04 $1,833.38 $2,289.24 |
Toc - Plan #47 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(HMO) BlueCare Direct Silver? 803 with Advocate |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$392.25 $445.20 $501.29 $700.56 $1,064.56 |
$692.32 $745.27 $801.36 $1,000.63 |
$992.39 $1,045.34 $1,101.43 $1,300.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$784.50 $890.40 $1,002.58 $1,401.12 $2,129.12 |
$1,084.57 $1,190.47 $1,302.65 $1,701.19 |
$1,384.64 $1,490.54 $1,602.72 $2,001.26 |
Toc - Plan #48 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(HMO) BlueCare Direct Bronze? 802 with Advocate |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.61 $333.25 $375.24 $524.39 $796.86 |
$518.22 $557.86 $599.85 $749.00 |
$742.83 $782.47 $824.46 $973.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$587.22 $666.50 $750.48 $1,048.78 $1,593.72 |
$811.83 $891.11 $975.09 $1,273.39 |
$1,036.44 $1,115.72 $1,199.70 $1,498.00 |
Toc - Plan #49 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(PPO) Blue Choice Preferred Gold PPO? 204 - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$556.30 $631.40 $710.95 $993.55 $1,509.79 |
$981.87 $1,056.97 $1,136.52 $1,419.12 |
$1,407.44 $1,482.54 $1,562.09 $1,844.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,112.60 $1,262.80 $1,421.90 $1,987.10 $3,019.58 |
$1,538.17 $1,688.37 $1,847.47 $2,412.67 |
$1,963.74 $2,113.94 $2,273.04 $2,838.24 |
Toc - Plan #50 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(PPO) Blue Choice Preferred Silver PPO? 203 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$468.20 $531.41 $598.36 $836.21 $1,270.70 |
$826.37 $889.58 $956.53 $1,194.38 |
$1,184.54 $1,247.75 $1,314.70 $1,552.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$936.40 $1,062.82 $1,196.72 $1,672.42 $2,541.40 |
$1,294.57 $1,420.99 $1,554.89 $2,030.59 |
$1,652.74 $1,779.16 $1,913.06 $2,388.76 |
Toc - Plan #51 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Choice Preferred Bronze PPO? 202 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.92 $461.86 $520.05 $726.77 $1,104.39 |
$718.22 $773.16 $831.35 $1,038.07 |
$1,029.52 $1,084.46 $1,142.65 $1,349.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.84 $923.72 $1,040.10 $1,453.54 $2,208.78 |
$1,125.14 $1,235.02 $1,351.40 $1,764.84 |
$1,436.44 $1,546.32 $1,662.70 $2,076.14 |
Toc - Plan #52 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Catastrophic
(PPO) Blue Choice Preferred Security PPO? 200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.88 $378.95 $426.69 $596.30 $906.14 |
$589.30 $634.37 $682.11 $851.72 |
$844.72 $889.79 $937.53 $1,107.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$667.76 $757.90 $853.38 $1,192.60 $1,812.28 |
$923.18 $1,013.32 $1,108.80 $1,448.02 |
$1,178.60 $1,268.74 $1,364.22 $1,703.44 |
Toc - Plan #53 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Choice Preferred Bronze PPO? 201 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.42 $414.76 $467.01 $652.65 $991.76 |
$644.97 $694.31 $746.56 $932.20 |
$924.52 $973.86 $1,026.11 $1,211.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.84 $829.52 $934.02 $1,305.30 $1,983.52 |
$1,010.39 $1,109.07 $1,213.57 $1,584.85 |
$1,289.94 $1,388.62 $1,493.12 $1,864.40 |
Toc - Plan #54 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Choice Preferred Bronze PPO? 601 - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.50 $405.76 $456.88 $638.49 $970.24 |
$630.98 $679.24 $730.36 $911.97 |
$904.46 $952.72 $1,003.84 $1,185.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$715.00 $811.52 $913.76 $1,276.98 $1,940.48 |
$988.48 $1,085.00 $1,187.24 $1,550.46 |
$1,261.96 $1,358.48 $1,460.72 $1,823.94 |
Toc - Plan #55 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Choice Preferred Bronze PPO? 701 - Rx Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.76 $381.09 $429.10 $599.67 $911.25 |
$592.62 $637.95 $685.96 $856.53 |
$849.48 $894.81 $942.82 $1,113.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$671.52 $762.18 $858.20 $1,199.34 $1,822.50 |
$928.38 $1,019.04 $1,115.06 $1,456.20 |
$1,185.24 $1,275.90 $1,371.92 $1,713.06 |
Toc - Plan #56 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Gold
(PPO) Blue Choice Preferred Gold PPO? 707 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$544.98 $618.56 $696.49 $973.34 $1,479.09 |
$961.89 $1,035.47 $1,113.40 $1,390.25 |
$1,378.80 $1,452.38 $1,530.31 $1,807.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,089.96 $1,237.12 $1,392.98 $1,946.68 $2,958.18 |
$1,506.87 $1,654.03 $1,809.89 $2,363.59 |
$1,923.78 $2,070.94 $2,226.80 $2,780.50 |
Toc - Plan #57 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(PPO) Blue Choice Preferred Silver PPO? 706 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$474.75 $538.84 $606.73 $847.91 $1,288.48 |
$837.94 $902.03 $969.92 $1,211.10 |
$1,201.13 $1,265.22 $1,333.11 $1,574.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$949.50 $1,077.68 $1,213.46 $1,695.82 $2,576.96 |
$1,312.69 $1,440.87 $1,576.65 $2,059.01 |
$1,675.88 $1,804.06 $1,939.84 $2,422.20 |
Toc - Plan #58 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Expanded Bronze
(PPO) Blue Choice Preferred Bronze PPO? 708 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.41 $463.54 $521.95 $729.42 $1,108.42 |
$720.84 $775.97 $834.38 $1,041.85 |
$1,033.27 $1,088.40 $1,146.81 $1,354.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$816.82 $927.08 $1,043.90 $1,458.84 $2,216.84 |
$1,129.25 $1,239.51 $1,356.33 $1,771.27 |
$1,441.68 $1,551.94 $1,668.76 $2,083.70 |
Toc - Plan #59 Blue Cross and Blue Shield of Illinois | ||||||||||||||||||||
Silver
(PPO) Blue Choice Preferred Silver PPO? 801 - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-8833
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.44 $523.73 $589.72 $824.13 $1,252.34 |
$814.44 $876.73 $942.72 $1,177.13 |
$1,167.44 $1,229.73 $1,295.72 $1,530.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$922.88 $1,047.46 $1,179.44 $1,648.26 $2,504.68 |
$1,275.88 $1,400.46 $1,532.44 $2,001.26 |
$1,628.88 $1,753.46 $1,885.44 $2,354.26 |
ADVERTISEMENT
UnitedHealthcareLocal: 1-888-200-0325 | Toll Free: 1-888-200-0325 | TTY: 1-888-200-0325 |
Toc - Plan #60 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Value (Virtual Urgent Care) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.17 $400.85 $451.35 $630.76 $958.51 |
$623.35 $671.03 $721.53 $900.94 |
$893.53 $941.21 $991.71 $1,171.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.34 $801.70 $902.70 $1,261.52 $1,917.02 |
$976.52 $1,071.88 $1,172.88 $1,531.70 |
$1,246.70 $1,342.06 $1,443.06 $1,801.88 |
Toc - Plan #61 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Virtual First (Unlimited App-based Care) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.00 $394.98 $444.75 $621.53 $944.48 |
$614.22 $661.20 $710.97 $887.75 |
$880.44 $927.42 $977.19 $1,153.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.00 $789.96 $889.50 $1,243.06 $1,888.96 |
$962.22 $1,056.18 $1,155.72 $1,509.28 |
$1,228.44 $1,322.40 $1,421.94 $1,775.50 |
Toc - Plan #62 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Standard (Rx Copay) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.91 $468.65 $527.70 $737.45 $1,120.63 |
$728.78 $784.52 $843.57 $1,053.32 |
$1,044.65 $1,100.39 $1,159.44 $1,369.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$825.82 $937.30 $1,055.40 $1,474.90 $2,241.26 |
$1,141.69 $1,253.17 $1,371.27 $1,790.77 |
$1,457.56 $1,569.04 $1,687.14 $2,106.64 |
Toc - Plan #63 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Copay Focus (Virtual Urgent Care + PCP Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.54 $411.49 $463.33 $647.51 $983.95 |
$639.89 $688.84 $740.68 $924.86 |
$917.24 $966.19 $1,018.03 $1,202.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$725.08 $822.98 $926.66 $1,295.02 $1,967.90 |
$1,002.43 $1,100.33 $1,204.01 $1,572.37 |
$1,279.78 $1,377.68 $1,481.36 $1,849.72 |
Toc - Plan #64 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.61 $402.48 $453.19 $633.33 $962.41 |
$625.89 $673.76 $724.47 $904.61 |
$897.17 $945.04 $995.75 $1,175.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$709.22 $804.96 $906.38 $1,266.66 $1,924.82 |
$980.50 $1,076.24 $1,177.66 $1,537.94 |
$1,251.78 $1,347.52 $1,448.94 $1,809.22 |
Toc - Plan #65 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value (Virtual Urgent Care + PCP Visits, Rx Copay) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.88 $331.28 $373.02 $521.29 $792.15 |
$515.17 $554.57 $596.31 $744.58 |
$738.46 $777.86 $819.60 $967.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$583.76 $662.56 $746.04 $1,042.58 $1,584.30 |
$807.05 $885.85 $969.33 $1,265.87 |
$1,030.34 $1,109.14 $1,192.62 $1,489.16 |
Toc - Plan #66 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Value HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.39 $319.38 $359.61 $502.56 $763.69 |
$496.65 $534.64 $574.87 $717.82 |
$711.91 $749.90 $790.13 $933.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$562.78 $638.76 $719.22 $1,005.12 $1,527.38 |
$778.04 $854.02 $934.48 $1,220.38 |
$993.30 $1,069.28 $1,149.74 $1,435.64 |
Toc - Plan #67 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$293.68 $333.32 $375.32 $524.51 $797.04 |
$518.34 $557.98 $599.98 $749.17 |
$743.00 $782.64 $824.64 $973.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$587.36 $666.64 $750.64 $1,049.02 $1,594.08 |
$812.02 $891.30 $975.30 $1,273.68 |
$1,036.68 $1,115.96 $1,199.96 $1,498.34 |
Toc - Plan #68 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Copay Focus (Virtual Urgent Care) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.96 $352.94 $397.40 $555.37 $843.94 |
$548.84 $590.82 $635.28 $793.25 |
$786.72 $828.70 $873.16 $1,031.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.92 $705.88 $794.80 $1,110.74 $1,687.88 |
$859.80 $943.76 $1,032.68 $1,348.62 |
$1,097.68 $1,181.64 $1,270.56 $1,586.50 |
Toc - Plan #69 UnitedHealthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) UHC Bronze Virtual First (Unlimited App-based Care, Rx Copay) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.02 $326.90 $368.09 $514.40 $781.68 |
$508.35 $547.23 $588.42 $734.73 |
$728.68 $767.56 $808.75 $955.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$576.04 $653.80 $736.18 $1,028.80 $1,563.36 |
$796.37 $874.13 $956.51 $1,249.13 |
$1,016.70 $1,094.46 $1,176.84 $1,469.46 |
Toc - Plan #70 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage (Virtual Urgent Care + PCP Visits, Rx Copay) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.19 $402.01 $452.66 $632.59 $961.28 |
$625.15 $672.97 $723.62 $903.55 |
$896.11 $943.93 $994.58 $1,174.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.38 $804.02 $905.32 $1,265.18 $1,922.56 |
$979.34 $1,074.98 $1,176.28 $1,536.14 |
$1,250.30 $1,345.94 $1,447.24 $1,807.10 |
Toc - Plan #71 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage (Virtual Urgent Care + PCP Visits, Rx Copay) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.36 $474.84 $534.66 $747.19 $1,135.42 |
$738.40 $794.88 $854.70 $1,067.23 |
$1,058.44 $1,114.92 $1,174.74 $1,387.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$836.72 $949.68 $1,069.32 $1,494.38 $2,270.84 |
$1,156.76 $1,269.72 $1,389.36 $1,814.42 |
$1,476.80 $1,589.76 $1,709.40 $2,134.46 |
Toc - Plan #72 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Copay Focus (Virtual Urgent Care + PCP Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.50 $476.13 $536.12 $749.22 $1,138.52 |
$740.42 $797.05 $857.04 $1,070.14 |
$1,061.34 $1,117.97 $1,177.96 $1,391.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.00 $952.26 $1,072.24 $1,498.44 $2,277.04 |
$1,159.92 $1,273.18 $1,393.16 $1,819.36 |
$1,480.84 $1,594.10 $1,714.08 $2,140.28 |
Toc - Plan #73 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Virtual First (Unlimited App-based Care) (Disponible en espanol) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$393.35 $446.46 $502.71 $702.53 $1,067.56 |
$694.26 $747.37 $803.62 $1,003.44 |
$995.17 $1,048.28 $1,104.53 $1,304.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$786.70 $892.92 $1,005.42 $1,405.06 $2,135.12 |
$1,087.61 $1,193.83 $1,306.33 $1,705.97 |
$1,388.52 $1,494.74 $1,607.24 $2,006.88 |
Toc - Plan #74 UnitedHealthcare | ||||||||||||||||||||
Silver
(HMO) UHC Silver Advantage+ (Virtual Urgent Care + PCP Visits, Rx Copay, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.68 $420.72 $473.72 $662.03 $1,006.01 |
$654.25 $704.29 $757.29 $945.60 |
$937.82 $987.86 $1,040.86 $1,229.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.36 $841.44 $947.44 $1,324.06 $2,012.02 |
$1,024.93 $1,125.01 $1,231.01 $1,607.63 |
$1,308.50 $1,408.58 $1,514.58 $1,891.20 |
Toc - Plan #75 UnitedHealthcare | ||||||||||||||||||||
Gold
(HMO) UHC Gold Advantage+ (Virtual Urgent Care + PCP Visits, Rx Copay, Dental + Vision) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-200-0325
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$434.84 $493.54 $555.72 $776.62 $1,180.15 |
$767.49 $826.19 $888.37 $1,109.27 |
$1,100.14 $1,158.84 $1,221.02 $1,441.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$869.68 $987.08 $1,111.44 $1,553.24 $2,360.30 |
$1,202.33 $1,319.73 $1,444.09 $1,885.89 |
$1,534.98 $1,652.38 $1,776.74 $2,218.54 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #76 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 5000 Indiv Med Deductible - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$316.28 $358.98 $404.21 $564.88 $858.39 |
$558.24 $600.94 $646.17 $806.84 |
$800.20 $842.90 $888.13 $1,048.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$632.56 $717.96 $808.42 $1,129.76 $1,716.78 |
$874.52 $959.92 $1,050.38 $1,371.72 |
$1,116.48 $1,201.88 $1,292.34 $1,613.68 |
Toc - Plan #77 Cigna Healthcare | ||||||||||||||||||||
Silver
(HMO) Connect Silver 3000 Indiv Med Deductible - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$354.30 $402.13 $452.80 $632.78 $961.57 |
$625.34 $673.17 $723.84 $903.82 |
$896.38 $944.21 $994.88 $1,174.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$708.60 $804.26 $905.60 $1,265.56 $1,923.14 |
$979.64 $1,075.30 $1,176.64 $1,536.60 |
$1,250.68 $1,346.34 $1,447.68 $1,807.64 |
Toc - Plan #78 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 0 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.17 $379.28 $427.07 $596.82 $906.93 |
$589.81 $634.92 $682.71 $852.46 |
$845.45 $890.56 $938.35 $1,108.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$668.34 $758.56 $854.14 $1,193.64 $1,813.86 |
$923.98 $1,014.20 $1,109.78 $1,449.28 |
$1,179.62 $1,269.84 $1,365.42 $1,704.92 |
Toc - Plan #79 Cigna Healthcare | ||||||||||||||||||||
Silver
(HMO) Connect Silver 5000 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.13 $400.81 $451.31 $630.70 $958.41 |
$623.28 $670.96 $721.46 $900.85 |
$893.43 $941.11 $991.61 $1,171.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$706.26 $801.62 $902.62 $1,261.40 $1,916.82 |
$976.41 $1,071.77 $1,172.77 $1,531.55 |
$1,246.56 $1,341.92 $1,442.92 $1,801.70 |
Toc - Plan #80 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Plus with Northwestern Medicine Bronze 5000 Indiv Med Ded - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.89 $415.29 $467.61 $653.48 $993.03 |
$645.80 $695.20 $747.52 $933.39 |
$925.71 $975.11 $1,027.43 $1,213.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$731.78 $830.58 $935.22 $1,306.96 $1,986.06 |
$1,011.69 $1,110.49 $1,215.13 $1,586.87 |
$1,291.60 $1,390.40 $1,495.04 $1,866.78 |
Toc - Plan #81 Cigna Healthcare | ||||||||||||||||||||
Silver
(HMO) Plus with Northwestern Medicine Silver 5000 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.92 $461.86 $520.05 $726.77 $1,104.39 |
$718.22 $773.16 $831.35 $1,038.07 |
$1,029.52 $1,084.46 $1,142.65 $1,349.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.84 $923.72 $1,040.10 $1,453.54 $2,208.78 |
$1,125.14 $1,235.02 $1,351.40 $1,764.84 |
$1,436.44 $1,546.32 $1,662.70 $2,076.14 |
Toc - Plan #82 Cigna Healthcare | ||||||||||||||||||||
Silver
(HMO) Plus with Northwestern Medicine Silver 3000 Indiv Med Ded - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$408.37 $463.50 $521.90 $729.36 $1,108.33 |
$720.78 $775.91 $834.31 $1,041.77 |
$1,033.19 $1,088.32 $1,146.72 $1,354.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$816.74 $927.00 $1,043.80 $1,458.72 $2,216.66 |
$1,129.15 $1,239.41 $1,356.21 $1,771.13 |
$1,441.56 $1,551.82 $1,668.62 $2,083.54 |
Toc - Plan #83 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$309.50 $351.28 $395.54 $552.77 $839.98 |
$546.27 $588.05 $632.31 $789.54 |
$783.04 $824.82 $869.08 $1,026.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$619.00 $702.56 $791.08 $1,105.54 $1,679.96 |
$855.77 $939.33 $1,027.85 $1,342.31 |
$1,092.54 $1,176.10 $1,264.62 $1,579.08 |
Toc - Plan #84 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Connect Bronze CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.77 $350.45 $394.60 $551.46 $837.99 |
$544.98 $586.66 $630.81 $787.67 |
$781.19 $822.87 $867.02 $1,023.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$617.54 $700.90 $789.20 $1,102.92 $1,675.98 |
$853.75 $937.11 $1,025.41 $1,339.13 |
$1,089.96 $1,173.32 $1,261.62 $1,575.34 |
Toc - Plan #85 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Plus Bronze CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.20 $405.42 $456.50 $637.95 $969.43 |
$630.46 $678.68 $729.76 $911.21 |
$903.72 $951.94 $1,003.02 $1,184.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.40 $810.84 $913.00 $1,275.90 $1,938.86 |
$987.66 $1,084.10 $1,186.26 $1,549.16 |
$1,260.92 $1,357.36 $1,459.52 $1,822.42 |
Toc - Plan #86 Cigna Healthcare | ||||||||||||||||||||
Silver
(HMO) Connect Silver CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.42 $396.59 $446.56 $624.06 $948.32 |
$616.73 $663.90 $713.87 $891.37 |
$884.04 $931.21 $981.18 $1,158.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.84 $793.18 $893.12 $1,248.12 $1,896.64 |
$966.15 $1,060.49 $1,160.43 $1,515.43 |
$1,233.46 $1,327.80 $1,427.74 $1,782.74 |
Toc - Plan #87 Cigna Healthcare | ||||||||||||||||||||
Silver
(HMO) Plus Silver CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.58 $456.92 $514.49 $719.00 $1,092.59 |
$710.55 $764.89 $822.46 $1,026.97 |
$1,018.52 $1,072.86 $1,130.43 $1,334.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.16 $913.84 $1,028.98 $1,438.00 $2,185.18 |
$1,113.13 $1,221.81 $1,336.95 $1,745.97 |
$1,421.10 $1,529.78 $1,644.92 $2,053.94 |
Toc - Plan #88 Cigna Healthcare | ||||||||||||||||||||
Gold
(HMO) Connect Gold CMS Standard - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409.73 $465.04 $523.63 $731.78 $1,112.00 |
$723.17 $778.48 $837.07 $1,045.22 |
$1,036.61 $1,091.92 $1,150.51 $1,358.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$819.46 $930.08 $1,047.26 $1,463.56 $2,224.00 |
$1,132.90 $1,243.52 $1,360.70 $1,777.00 |
$1,446.34 $1,556.96 $1,674.14 $2,090.44 |
Toc - Plan #89 Cigna Healthcare | ||||||||||||||||||||
Gold
(HMO) Plus Gold CMS Standard - Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$474.00 $537.99 $605.77 $846.56 $1,286.42 |
$836.61 $900.60 $968.38 $1,209.17 |
$1,199.22 $1,263.21 $1,330.99 $1,571.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$948.00 $1,075.98 $1,211.54 $1,693.12 $2,572.84 |
$1,310.61 $1,438.59 $1,574.15 $2,055.73 |
$1,673.22 $1,801.20 $1,936.76 $2,418.34 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-855-586-6962 | Toll Free: 1-855-586-6962 | TTY: 1-855-586-6962 |
Toc - Plan #90 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(PPO) Bronze 1 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.87 $473.15 $532.76 $744.53 $1,131.39 |
$735.78 $792.06 $851.67 $1,063.44 |
$1,054.69 $1,110.97 $1,170.58 $1,382.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$833.74 $946.30 $1,065.52 $1,489.06 $2,262.78 |
$1,152.65 $1,265.21 $1,384.43 $1,807.97 |
$1,471.56 $1,584.12 $1,703.34 $2,126.88 |
Toc - Plan #91 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(PPO) Bronze 4 PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$453.81 $515.08 $579.97 $810.51 $1,231.64 |
$800.98 $862.25 $927.14 $1,157.68 |
$1,148.15 $1,209.42 $1,274.31 $1,504.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$907.62 $1,030.16 $1,159.94 $1,621.02 $2,463.28 |
$1,254.79 $1,377.33 $1,507.11 $1,968.19 |
$1,601.96 $1,724.50 $1,854.28 $2,315.36 |
Toc - Plan #92 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(PPO) Bronze S PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.96 $466.44 $525.21 $733.98 $1,115.35 |
$725.35 $780.83 $839.60 $1,048.37 |
$1,039.74 $1,095.22 $1,153.99 $1,362.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.92 $932.88 $1,050.42 $1,467.96 $2,230.70 |
$1,136.31 $1,247.27 $1,364.81 $1,782.35 |
$1,450.70 $1,561.66 $1,679.20 $2,096.74 |
Toc - Plan #93 Aetna CVS Health | ||||||||||||||||||||
Gold
(PPO) Gold 3 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$632.51 $717.89 $808.34 $1,129.65 $1,716.61 |
$1,116.38 $1,201.76 $1,292.21 $1,613.52 |
$1,600.25 $1,685.63 $1,776.08 $2,097.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,265.02 $1,435.78 $1,616.68 $2,259.30 $3,433.22 |
$1,748.89 $1,919.65 $2,100.55 $2,743.17 |
$2,232.76 $2,403.52 $2,584.42 $3,227.04 |
Toc - Plan #94 Aetna CVS Health | ||||||||||||||||||||
Gold
(PPO) Gold S PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$627.41 $712.11 $801.83 $1,120.56 $1,702.79 |
$1,107.38 $1,192.08 $1,281.80 $1,600.53 |
$1,587.35 $1,672.05 $1,761.77 $2,080.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,254.82 $1,424.22 $1,603.66 $2,241.12 $3,405.58 |
$1,734.79 $1,904.19 $2,083.63 $2,721.09 |
$2,214.76 $2,384.16 $2,563.60 $3,201.06 |
Toc - Plan #95 Aetna CVS Health | ||||||||||||||||||||
Silver
(PPO) Silver 5 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$543.40 $616.76 $694.47 $970.51 $1,474.79 |
$959.10 $1,032.46 $1,110.17 $1,386.21 |
$1,374.80 $1,448.16 $1,525.87 $1,801.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,086.80 $1,233.52 $1,388.94 $1,941.02 $2,949.58 |
$1,502.50 $1,649.22 $1,804.64 $2,356.72 |
$1,918.20 $2,064.92 $2,220.34 $2,772.42 |
Toc - Plan #96 Aetna CVS Health | ||||||||||||||||||||
Silver
(PPO) Silver 7 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$544.45 $617.95 $695.81 $972.39 $1,477.64 |
$960.96 $1,034.46 $1,112.32 $1,388.90 |
$1,377.47 $1,450.97 $1,528.83 $1,805.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,088.90 $1,235.90 $1,391.62 $1,944.78 $2,955.28 |
$1,505.41 $1,652.41 $1,808.13 $2,361.29 |
$1,921.92 $2,068.92 $2,224.64 $2,777.80 |
Toc - Plan #97 Aetna CVS Health | ||||||||||||||||||||
Silver
(PPO) Silver S PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$530.68 $602.33 $678.21 $947.80 $1,440.27 |
$936.65 $1,008.30 $1,084.18 $1,353.77 |
$1,342.62 $1,414.27 $1,490.15 $1,759.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,061.36 $1,204.66 $1,356.42 $1,895.60 $2,880.54 |
$1,467.33 $1,610.63 $1,762.39 $2,301.57 |
$1,873.30 $2,016.60 $2,168.36 $2,707.54 |
Toc - Plan #98 Aetna CVS Health | ||||||||||||||||||||
Silver
(PPO) Silver 6 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-586-6962
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$543.81 $617.23 $694.99 $971.24 $1,475.90 |
$959.83 $1,033.25 $1,111.01 $1,387.26 |
$1,375.85 $1,449.27 $1,527.03 $1,803.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,087.62 $1,234.46 $1,389.98 $1,942.48 $2,951.80 |
$1,503.64 $1,650.48 $1,806.00 $2,358.50 |
$1,919.66 $2,066.50 $2,222.02 $2,774.52 |
Toc - Plan #99 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 1: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$288.68 $327.65 $368.93 $515.58 $783.47 |
$509.52 $548.49 $589.77 $736.42 |
$730.36 $769.33 $810.61 $957.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$577.36 $655.30 $737.86 $1,031.16 $1,566.94 |
$798.20 $876.14 $958.70 $1,252.00 |
$1,019.04 $1,096.98 $1,179.54 $1,472.84 |
Toc - Plan #100 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314.42 $356.87 $401.83 $561.55 $853.33 |
$554.95 $597.40 $642.36 $802.08 |
$795.48 $837.93 $882.89 $1,042.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628.84 $713.74 $803.66 $1,123.10 $1,706.66 |
$869.37 $954.27 $1,044.19 $1,363.63 |
$1,109.90 $1,194.80 $1,284.72 $1,604.16 |
Toc - Plan #101 Aetna CVS Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$285.15 $323.64 $364.42 $509.27 $773.89 |
$503.29 $541.78 $582.56 $727.41 |
$721.43 $759.92 $800.70 $945.55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$570.30 $647.28 $728.84 $1,018.54 $1,547.78 |
$788.44 $865.42 $946.98 $1,236.68 |
$1,006.58 $1,083.56 $1,165.12 $1,454.82 |
Toc - Plan #102 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold 3: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$371.84 $422.04 $475.22 $664.11 $1,009.18 |
$656.30 $706.50 $759.68 $948.57 |
$940.76 $990.96 $1,044.14 $1,233.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$743.68 $844.08 $950.44 $1,328.22 $2,018.36 |
$1,028.14 $1,128.54 $1,234.90 $1,612.68 |
$1,312.60 $1,413.00 $1,519.36 $1,897.14 |
Toc - Plan #103 Aetna CVS Health | ||||||||||||||||||||
Gold
(HMO) Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.66 $420.70 $473.71 $662.00 $1,005.97 |
$654.22 $704.26 $757.27 $945.56 |
$937.78 $987.82 $1,040.83 $1,229.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$741.32 $841.40 $947.42 $1,324.00 $2,011.94 |
$1,024.88 $1,124.96 $1,230.98 $1,607.56 |
$1,308.44 $1,408.52 $1,514.54 $1,891.12 |
Toc - Plan #104 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 5: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.26 $387.33 $436.13 $609.48 $926.17 |
$602.32 $648.39 $697.19 $870.54 |
$863.38 $909.45 $958.25 $1,131.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.52 $774.66 $872.26 $1,218.96 $1,852.34 |
$943.58 $1,035.72 $1,133.32 $1,480.02 |
$1,204.64 $1,296.78 $1,394.38 $1,741.08 |
Toc - Plan #105 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 6: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.14 $396.28 $446.20 $623.57 $947.57 |
$616.24 $663.38 $713.30 $890.67 |
$883.34 $930.48 $980.40 $1,157.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.28 $792.56 $892.40 $1,247.14 $1,895.14 |
$965.38 $1,059.66 $1,159.50 $1,514.24 |
$1,232.48 $1,326.76 $1,426.60 $1,781.34 |
Toc - Plan #106 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver 7: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.43 $396.61 $446.57 $624.08 $948.35 |
$616.75 $663.93 $713.89 $891.40 |
$884.07 $931.25 $981.21 $1,158.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.86 $793.22 $893.14 $1,248.16 $1,896.70 |
$966.18 $1,060.54 $1,160.46 $1,515.48 |
$1,233.50 $1,327.86 $1,427.78 $1,782.80 |
Toc - Plan #107 Aetna CVS Health | ||||||||||||||||||||
Silver
(HMO) Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.83 $386.84 $435.58 $608.71 $924.99 |
$601.56 $647.57 $696.31 $869.44 |
$862.29 $908.30 $957.04 $1,130.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$681.66 $773.68 $871.16 $1,217.42 $1,849.98 |
$942.39 $1,034.41 $1,131.89 $1,478.15 |
$1,203.12 $1,295.14 $1,392.62 $1,738.88 |
‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Kane County here.
Kane County is in “Rating Area 3” of Illinois.
Currently, there are 107 plans offered in Rating Area 3.