Independence County, Arkansas Obamacare 2024 Rates

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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 Independence County, AR.

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, 52 Plans and 2024 Rates for Independence County, Arkansas

Below, you’ll find a summary of the 52 plans for Independence County, Arkansas 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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Health Advantage

Local: 1-501-378-2363 | Toll Free: 1-800-800-4298

Toc - Plan #1 Health Advantage
Silver

(POS) HA Silver AH

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,400 $10,800 Annual Deductible
$6,200 $12,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$376.98
$427.87
$481.78
$673.29
$1,023.12
$665.37
$716.26
$770.17
$961.68
$953.76
$1,004.65
$1,058.56
$1,250.07
$1,242.15
$1,293.04
$1,346.95
$1,538.46
$288.39
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$753.96
$855.74
$963.56
$1,346.58
$2,046.24
$1,042.35
$1,144.13
$1,251.95
$1,634.97
$1,330.74
$1,432.52
$1,540.34
$1,923.36
$1,619.13
$1,720.91
$1,828.73
$2,211.75
$288.39
Toc - Plan #2 Health Advantage
Gold

(POS) HA Gold Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$459.22
$521.21
$586.88
$820.17
$1,246.32
$810.52
$872.51
$938.18
$1,171.47
$1,161.82
$1,223.81
$1,289.48
$1,522.77
$1,513.12
$1,575.11
$1,640.78
$1,874.07
$351.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$918.44
$1,042.42
$1,173.76
$1,640.34
$2,492.64
$1,269.74
$1,393.72
$1,525.06
$1,991.64
$1,621.04
$1,745.02
$1,876.36
$2,342.94
$1,972.34
$2,096.32
$2,227.66
$2,694.24
$351.30
Toc - Plan #3 Health Advantage
Silver

(POS) HA Silver Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$347.00
$393.84
$443.47
$619.74
$941.76
$612.46
$659.30
$708.93
$885.20
$877.92
$924.76
$974.39
$1,150.66
$1,143.38
$1,190.22
$1,239.85
$1,416.12
$265.46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$694.00
$787.68
$886.94
$1,239.48
$1,883.52
$959.46
$1,053.14
$1,152.40
$1,504.94
$1,224.92
$1,318.60
$1,417.86
$1,770.40
$1,490.38
$1,584.06
$1,683.32
$2,035.86
$265.46
Toc - Plan #4 Health Advantage
Expanded Bronze

(POS) HA Bronze Suitcase

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$9,250 $18,500 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$294.53
$334.29
$376.41
$526.03
$799.35
$519.85
$559.61
$601.73
$751.35
$745.17
$784.93
$827.05
$976.67
$970.49
$1,010.25
$1,052.37
$1,201.99
$225.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$589.06
$668.58
$752.82
$1,052.06
$1,598.70
$814.38
$893.90
$978.14
$1,277.38
$1,039.70
$1,119.22
$1,203.46
$1,502.70
$1,265.02
$1,344.54
$1,428.78
$1,728.02
$225.32
Toc - Plan #5 Health Advantage
Expanded Bronze

(POS) HA Bronze Exp Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$298.27
$338.54
$381.19
$532.71
$809.50
$526.45
$566.72
$609.37
$760.89
$754.63
$794.90
$837.55
$989.07
$982.81
$1,023.08
$1,065.73
$1,217.25
$228.18
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$596.54
$677.08
$762.38
$1,065.42
$1,619.00
$824.72
$905.26
$990.56
$1,293.60
$1,052.90
$1,133.44
$1,218.74
$1,521.78
$1,281.08
$1,361.62
$1,446.92
$1,749.96
$228.18

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Ambetter from Arkansas Health & Wellness

Local: 1-877-617-0390 | Toll Free: 1-877-617-0390 | TTY: 1-877-617-0392

Toc - Plan #6 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Connected Silver (QualChoiceLife)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,350 $14,700 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$359.51
$408.03
$459.44
$642.07
$975.68
$634.53
$683.05
$734.46
$917.09
$909.55
$958.07
$1,009.48
$1,192.11
$1,184.57
$1,233.09
$1,284.50
$1,467.13
$275.02
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$719.02
$816.06
$918.88
$1,284.14
$1,951.36
$994.04
$1,091.08
$1,193.90
$1,559.16
$1,269.06
$1,366.10
$1,468.92
$1,834.18
$1,544.08
$1,641.12
$1,743.94
$2,109.20
$275.02
Toc - Plan #7 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Elite Silver (QualChoiceLife)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$362.75
$411.70
$463.58
$647.85
$984.46
$640.24
$689.19
$741.07
$925.34
$917.73
$966.68
$1,018.56
$1,202.83
$1,195.22
$1,244.17
$1,296.05
$1,480.32
$277.49
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$725.50
$823.40
$927.16
$1,295.70
$1,968.92
$1,002.99
$1,100.89
$1,204.65
$1,573.19
$1,280.48
$1,378.38
$1,482.14
$1,850.68
$1,557.97
$1,655.87
$1,759.63
$2,128.17
$277.49
Toc - Plan #8 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Elite Gold (QualChoiceLife)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$5,500 $11,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$481.52
$546.52
$615.38
$859.98
$1,306.83
$849.88
$914.88
$983.74
$1,228.34
$1,218.24
$1,283.24
$1,352.10
$1,596.70
$1,586.60
$1,651.60
$1,720.46
$1,965.06
$368.36
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$963.04
$1,093.04
$1,230.76
$1,719.96
$2,613.66
$1,331.40
$1,461.40
$1,599.12
$2,088.32
$1,699.76
$1,829.76
$1,967.48
$2,456.68
$2,068.12
$2,198.12
$2,335.84
$2,825.04
$368.36
Toc - Plan #9 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Standard Silver (QualChoiceLife)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$334.17
$379.27
$427.05
$596.80
$906.90
$589.80
$634.90
$682.68
$852.43
$845.43
$890.53
$938.31
$1,108.06
$1,101.06
$1,146.16
$1,193.94
$1,363.69
$255.63
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$668.34
$758.54
$854.10
$1,193.60
$1,813.80
$923.97
$1,014.17
$1,109.73
$1,449.23
$1,179.60
$1,269.80
$1,365.36
$1,704.86
$1,435.23
$1,525.43
$1,620.99
$1,960.49
$255.63
Toc - Plan #10 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Standard Gold (QualChoiceLife)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$417.82
$474.22
$533.96
$746.21
$1,133.94
$737.45
$793.85
$853.59
$1,065.84
$1,057.08
$1,113.48
$1,173.22
$1,385.47
$1,376.71
$1,433.11
$1,492.85
$1,705.10
$319.63
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$835.64
$948.44
$1,067.92
$1,492.42
$2,267.88
$1,155.27
$1,268.07
$1,387.55
$1,812.05
$1,474.90
$1,587.70
$1,707.18
$2,131.68
$1,794.53
$1,907.33
$2,026.81
$2,451.31
$319.63

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Octave

Local: 1-800-800-4298 | Toll Free: 1-800-800-4298 | TTY: 1-800-800-4298

Toc - Plan #11 Octave
Gold

(POS) Octave Gold Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$450.22
$511.00
$575.38
$804.09
$1,221.90
$794.64
$855.42
$919.80
$1,148.51
$1,139.06
$1,199.84
$1,264.22
$1,492.93
$1,483.48
$1,544.26
$1,608.64
$1,837.35
$344.42
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$900.44
$1,022.00
$1,150.76
$1,608.18
$2,443.80
$1,244.86
$1,366.42
$1,495.18
$1,952.60
$1,589.28
$1,710.84
$1,839.60
$2,297.02
$1,933.70
$2,055.26
$2,184.02
$2,641.44
$344.42
Toc - Plan #12 Octave
Silver

(POS) Octave Silver Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$340.47
$386.43
$435.12
$608.08
$924.04
$600.93
$646.89
$695.58
$868.54
$861.39
$907.35
$956.04
$1,129.00
$1,121.85
$1,167.81
$1,216.50
$1,389.46
$260.46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$680.94
$772.86
$870.24
$1,216.16
$1,848.08
$941.40
$1,033.32
$1,130.70
$1,476.62
$1,201.86
$1,293.78
$1,391.16
$1,737.08
$1,462.32
$1,554.24
$1,651.62
$1,997.54
$260.46
Toc - Plan #13 Octave
Silver

(POS) Octave Silver AH

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,350 $10,700 Annual Deductible
$6,150 $12,300 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$370.50
$420.52
$473.50
$661.71
$1,005.54
$653.93
$703.95
$756.93
$945.14
$937.36
$987.38
$1,040.36
$1,228.57
$1,220.79
$1,270.81
$1,323.79
$1,512.00
$283.43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$741.00
$841.04
$947.00
$1,323.42
$2,011.08
$1,024.43
$1,124.47
$1,230.43
$1,606.85
$1,307.86
$1,407.90
$1,513.86
$1,890.28
$1,591.29
$1,691.33
$1,797.29
$2,173.71
$283.43
Toc - Plan #14 Octave
Expanded Bronze

(POS) Octave Bronze Exp Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$292.90
$332.44
$374.33
$523.12
$794.93
$516.97
$556.51
$598.40
$747.19
$741.04
$780.58
$822.47
$971.26
$965.11
$1,004.65
$1,046.54
$1,195.33
$224.07
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$585.80
$664.88
$748.66
$1,046.24
$1,589.86
$809.87
$888.95
$972.73
$1,270.31
$1,033.94
$1,113.02
$1,196.80
$1,494.38
$1,258.01
$1,337.09
$1,420.87
$1,718.45
$224.07
Toc - Plan #15 Octave
Expanded Bronze

(POS) Octave Bronze Value

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$8,800 $17,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$327.68
$371.92
$418.78
$585.24
$889.32
$578.36
$622.60
$669.46
$835.92
$829.04
$873.28
$920.14
$1,086.60
$1,079.72
$1,123.96
$1,170.82
$1,337.28
$250.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$655.36
$743.84
$837.56
$1,170.48
$1,778.64
$906.04
$994.52
$1,088.24
$1,421.16
$1,156.72
$1,245.20
$1,338.92
$1,671.84
$1,407.40
$1,495.88
$1,589.60
$1,922.52
$250.68

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Ambetter from Arkansas Health & Wellness

Local: 1-877-617-0390 | Toll Free: 1-877-617-0390 | TTY: 1-877-617-0392

Toc - Plan #16 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Connected Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,350 $14,700 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$357.26
$405.48
$456.57
$638.05
$969.58
$630.56
$678.78
$729.87
$911.35
$903.86
$952.08
$1,003.17
$1,184.65
$1,177.16
$1,225.38
$1,276.47
$1,457.95
$273.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$714.52
$810.96
$913.14
$1,276.10
$1,939.16
$987.82
$1,084.26
$1,186.44
$1,549.40
$1,261.12
$1,357.56
$1,459.74
$1,822.70
$1,534.42
$1,630.86
$1,733.04
$2,096.00
$273.30
Toc - Plan #17 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Complete Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$345.36
$391.98
$441.36
$616.80
$937.29
$609.56
$656.18
$705.56
$881.00
$873.76
$920.38
$969.76
$1,145.20
$1,137.96
$1,184.58
$1,233.96
$1,409.40
$264.20
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$690.72
$783.96
$882.72
$1,233.60
$1,874.58
$954.92
$1,048.16
$1,146.92
$1,497.80
$1,219.12
$1,312.36
$1,411.12
$1,762.00
$1,483.32
$1,576.56
$1,675.32
$2,026.20
$264.20
Toc - Plan #18 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Everyday Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$341.65
$387.76
$436.61
$610.17
$927.21
$603.00
$649.11
$697.96
$871.52
$864.35
$910.46
$959.31
$1,132.87
$1,125.70
$1,171.81
$1,220.66
$1,394.22
$261.35
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$683.30
$775.52
$873.22
$1,220.34
$1,854.42
$944.65
$1,036.87
$1,134.57
$1,481.69
$1,206.00
$1,298.22
$1,395.92
$1,743.04
$1,467.35
$1,559.57
$1,657.27
$2,004.39
$261.35
Toc - Plan #19 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Complete Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$417.92
$474.33
$534.09
$746.39
$1,134.21
$737.62
$794.03
$853.79
$1,066.09
$1,057.32
$1,113.73
$1,173.49
$1,385.79
$1,377.02
$1,433.43
$1,493.19
$1,705.49
$319.70
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$835.84
$948.66
$1,068.18
$1,492.78
$2,268.42
$1,155.54
$1,268.36
$1,387.88
$1,812.48
$1,475.24
$1,588.06
$1,707.58
$2,132.18
$1,794.94
$1,907.76
$2,027.28
$2,451.88
$319.70
Toc - Plan #20 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(PPO) Everyday Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$8,450 $16,900 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$304.67
$345.79
$389.36
$544.13
$826.85
$537.74
$578.86
$622.43
$777.20
$770.81
$811.93
$855.50
$1,010.27
$1,003.88
$1,045.00
$1,088.57
$1,243.34
$233.07
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$609.34
$691.58
$778.72
$1,088.26
$1,653.70
$842.41
$924.65
$1,011.79
$1,321.33
$1,075.48
$1,157.72
$1,244.86
$1,554.40
$1,308.55
$1,390.79
$1,477.93
$1,787.47
$233.07
Toc - Plan #21 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(PPO) Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$352.01
$399.52
$449.85
$628.67
$955.32
$621.29
$668.80
$719.13
$897.95
$890.57
$938.08
$988.41
$1,167.23
$1,159.85
$1,207.36
$1,257.69
$1,436.51
$269.28
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$704.02
$799.04
$899.70
$1,257.34
$1,910.64
$973.30
$1,068.32
$1,168.98
$1,526.62
$1,242.58
$1,337.60
$1,438.26
$1,795.90
$1,511.86
$1,606.88
$1,707.54
$2,065.18
$269.28
Toc - Plan #22 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Focused Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$6,300 $12,600 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$338.72
$384.43
$432.87
$604.93
$919.26
$597.83
$643.54
$691.98
$864.04
$856.94
$902.65
$951.09
$1,123.15
$1,116.05
$1,161.76
$1,210.20
$1,382.26
$259.11
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$677.44
$768.86
$865.74
$1,209.86
$1,838.52
$936.55
$1,027.97
$1,124.85
$1,468.97
$1,195.66
$1,287.08
$1,383.96
$1,728.08
$1,454.77
$1,546.19
$1,643.07
$1,987.19
$259.11
Toc - Plan #23 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Everyday Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$398.34
$452.11
$509.07
$711.42
$1,081.08
$703.07
$756.84
$813.80
$1,016.15
$1,007.80
$1,061.57
$1,118.53
$1,320.88
$1,312.53
$1,366.30
$1,423.26
$1,625.61
$304.73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$796.68
$904.22
$1,018.14
$1,422.84
$2,162.16
$1,101.41
$1,208.95
$1,322.87
$1,727.57
$1,406.14
$1,513.68
$1,627.60
$2,032.30
$1,710.87
$1,818.41
$1,932.33
$2,337.03
$304.73
Toc - Plan #24 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(PPO) Standard Expanded Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$298.39
$338.66
$381.32
$532.90
$809.79
$526.65
$566.92
$609.58
$761.16
$754.91
$795.18
$837.84
$989.42
$983.17
$1,023.44
$1,066.10
$1,217.68
$228.26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$596.78
$677.32
$762.64
$1,065.80
$1,619.58
$825.04
$905.58
$990.90
$1,294.06
$1,053.30
$1,133.84
$1,219.16
$1,522.32
$1,281.56
$1,362.10
$1,447.42
$1,750.58
$228.26
Toc - Plan #25 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Standard Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$332.07
$376.89
$424.38
$593.07
$901.22
$586.10
$630.92
$678.41
$847.10
$840.13
$884.95
$932.44
$1,101.13
$1,094.16
$1,138.98
$1,186.47
$1,355.16
$254.03
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$664.14
$753.78
$848.76
$1,186.14
$1,802.44
$918.17
$1,007.81
$1,102.79
$1,440.17
$1,172.20
$1,261.84
$1,356.82
$1,694.20
$1,426.23
$1,515.87
$1,610.85
$1,948.23
$254.03
Toc - Plan #26 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Standard Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$398.49
$452.27
$509.25
$711.68
$1,081.47
$703.32
$757.10
$814.08
$1,016.51
$1,008.15
$1,061.93
$1,118.91
$1,321.34
$1,312.98
$1,366.76
$1,423.74
$1,626.17
$304.83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$796.98
$904.54
$1,018.50
$1,423.36
$2,162.94
$1,101.81
$1,209.37
$1,323.33
$1,728.19
$1,406.64
$1,514.20
$1,628.16
$2,033.02
$1,711.47
$1,819.03
$1,932.99
$2,337.85
$304.83
Toc - Plan #27 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Connected Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,350 $14,700 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$372.94
$423.28
$476.60
$666.05
$1,012.13
$658.23
$708.57
$761.89
$951.34
$943.52
$993.86
$1,047.18
$1,236.63
$1,228.81
$1,279.15
$1,332.47
$1,521.92
$285.29
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$745.88
$846.56
$953.20
$1,332.10
$2,024.26
$1,031.17
$1,131.85
$1,238.49
$1,617.39
$1,316.46
$1,417.14
$1,523.78
$1,902.68
$1,601.75
$1,702.43
$1,809.07
$2,187.97
$285.29
Toc - Plan #28 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Complete Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$360.52
$409.18
$460.73
$643.87
$978.43
$636.31
$684.97
$736.52
$919.66
$912.10
$960.76
$1,012.31
$1,195.45
$1,187.89
$1,236.55
$1,288.10
$1,471.24
$275.79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$721.04
$818.36
$921.46
$1,287.74
$1,956.86
$996.83
$1,094.15
$1,197.25
$1,563.53
$1,272.62
$1,369.94
$1,473.04
$1,839.32
$1,548.41
$1,645.73
$1,748.83
$2,115.11
$275.79
Toc - Plan #29 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Complete Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$436.26
$495.15
$557.53
$779.15
$1,183.99
$769.99
$828.88
$891.26
$1,112.88
$1,103.72
$1,162.61
$1,224.99
$1,446.61
$1,437.45
$1,496.34
$1,558.72
$1,780.34
$333.73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$872.52
$990.30
$1,115.06
$1,558.30
$2,367.98
$1,206.25
$1,324.03
$1,448.79
$1,892.03
$1,539.98
$1,657.76
$1,782.52
$2,225.76
$1,873.71
$1,991.49
$2,116.25
$2,559.49
$333.73
Toc - Plan #30 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(PPO) Everyday Bronze + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$8,450 $16,900 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$318.04
$360.97
$406.45
$568.01
$863.15
$561.34
$604.27
$649.75
$811.31
$804.64
$847.57
$893.05
$1,054.61
$1,047.94
$1,090.87
$1,136.35
$1,297.91
$243.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$636.08
$721.94
$812.90
$1,136.02
$1,726.30
$879.38
$965.24
$1,056.20
$1,379.32
$1,122.68
$1,208.54
$1,299.50
$1,622.62
$1,365.98
$1,451.84
$1,542.80
$1,865.92
$243.30
Toc - Plan #31 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(PPO) Elite Bronze + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$367.46
$417.05
$469.60
$656.26
$997.25
$648.56
$698.15
$750.70
$937.36
$929.66
$979.25
$1,031.80
$1,218.46
$1,210.76
$1,260.35
$1,312.90
$1,499.56
$281.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$734.92
$834.10
$939.20
$1,312.52
$1,994.50
$1,016.02
$1,115.20
$1,220.30
$1,593.62
$1,297.12
$1,396.30
$1,501.40
$1,874.72
$1,578.22
$1,677.40
$1,782.50
$2,155.82
$281.10
Toc - Plan #32 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Everyday Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$415.83
$471.95
$531.41
$742.65
$1,128.53
$733.93
$790.05
$849.51
$1,060.75
$1,052.03
$1,108.15
$1,167.61
$1,378.85
$1,370.13
$1,426.25
$1,485.71
$1,696.95
$318.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$831.66
$943.90
$1,062.82
$1,485.30
$2,257.06
$1,149.76
$1,262.00
$1,380.92
$1,803.40
$1,467.86
$1,580.10
$1,699.02
$2,121.50
$1,785.96
$1,898.20
$2,017.12
$2,439.60
$318.10
Toc - Plan #33 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Everyday Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$356.64
$404.78
$455.78
$636.95
$967.90
$629.46
$677.60
$728.60
$909.77
$902.28
$950.42
$1,001.42
$1,182.59
$1,175.10
$1,223.24
$1,274.24
$1,455.41
$272.82
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$713.28
$809.56
$911.56
$1,273.90
$1,935.80
$986.10
$1,082.38
$1,184.38
$1,546.72
$1,258.92
$1,355.20
$1,457.20
$1,819.54
$1,531.74
$1,628.02
$1,730.02
$2,092.36
$272.82
Toc - Plan #34 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Focused Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$6,300 $12,600 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$353.58
$401.31
$451.87
$631.48
$959.60
$624.06
$671.79
$722.35
$901.96
$894.54
$942.27
$992.83
$1,172.44
$1,165.02
$1,212.75
$1,263.31
$1,442.92
$270.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$707.16
$802.62
$903.74
$1,262.96
$1,919.20
$977.64
$1,073.10
$1,174.22
$1,533.44
$1,248.12
$1,343.58
$1,444.70
$1,803.92
$1,518.60
$1,614.06
$1,715.18
$2,074.40
$270.48
Toc - Plan #35 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(PPO) Standard Expanded Bronze + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$311.48
$353.52
$398.06
$556.29
$845.33
$549.76
$591.80
$636.34
$794.57
$788.04
$830.08
$874.62
$1,032.85
$1,026.32
$1,068.36
$1,112.90
$1,271.13
$238.28
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$622.96
$707.04
$796.12
$1,112.58
$1,690.66
$861.24
$945.32
$1,034.40
$1,350.86
$1,099.52
$1,183.60
$1,272.68
$1,589.14
$1,337.80
$1,421.88
$1,510.96
$1,827.42
$238.28
Toc - Plan #36 Ambetter from Arkansas Health & Wellness
Silver

(PPO) Standard Silver + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$346.65
$393.43
$443.00
$619.10
$940.78
$611.83
$658.61
$708.18
$884.28
$877.01
$923.79
$973.36
$1,149.46
$1,142.19
$1,188.97
$1,238.54
$1,414.64
$265.18
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$693.30
$786.86
$886.00
$1,238.20
$1,881.56
$958.48
$1,052.04
$1,151.18
$1,503.38
$1,223.66
$1,317.22
$1,416.36
$1,768.56
$1,488.84
$1,582.40
$1,681.54
$2,033.74
$265.18
Toc - Plan #37 Ambetter from Arkansas Health & Wellness
Gold

(PPO) Standard Gold + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$415.98
$472.12
$531.60
$742.92
$1,128.93
$734.19
$790.33
$849.81
$1,061.13
$1,052.40
$1,108.54
$1,168.02
$1,379.34
$1,370.61
$1,426.75
$1,486.23
$1,697.55
$318.21
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$831.96
$944.24
$1,063.20
$1,485.84
$2,257.86
$1,150.17
$1,262.45
$1,381.41
$1,804.05
$1,468.38
$1,580.66
$1,699.62
$2,122.26
$1,786.59
$1,898.87
$2,017.83
$2,440.47
$318.21
Toc - Plan #38 Ambetter from Arkansas Health & Wellness
Silver

(POS) Connected Silver (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,350 $14,700 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$359.74
$408.29
$459.73
$642.48
$976.31
$634.93
$683.48
$734.92
$917.67
$910.12
$958.67
$1,010.11
$1,192.86
$1,185.31
$1,233.86
$1,285.30
$1,468.05
$275.19
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$719.48
$816.58
$919.46
$1,284.96
$1,952.62
$994.67
$1,091.77
$1,194.65
$1,560.15
$1,269.86
$1,366.96
$1,469.84
$1,835.34
$1,545.05
$1,642.15
$1,745.03
$2,110.53
$275.19
Toc - Plan #39 Ambetter from Arkansas Health & Wellness
Silver

(POS) Elite Silver (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$362.98
$411.97
$463.87
$648.26
$985.09
$640.65
$689.64
$741.54
$925.93
$918.32
$967.31
$1,019.21
$1,203.60
$1,195.99
$1,244.98
$1,296.88
$1,481.27
$277.67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$725.96
$823.94
$927.74
$1,296.52
$1,970.18
$1,003.63
$1,101.61
$1,205.41
$1,574.19
$1,281.30
$1,379.28
$1,483.08
$1,851.86
$1,558.97
$1,656.95
$1,760.75
$2,129.53
$277.67
Toc - Plan #40 Ambetter from Arkansas Health & Wellness
Gold

(POS) Elite Gold (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$5,500 $11,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$482.26
$547.36
$616.32
$861.31
$1,308.84
$851.18
$916.28
$985.24
$1,230.23
$1,220.10
$1,285.20
$1,354.16
$1,599.15
$1,589.02
$1,654.12
$1,723.08
$1,968.07
$368.92
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$964.52
$1,094.72
$1,232.64
$1,722.62
$2,617.68
$1,333.44
$1,463.64
$1,601.56
$2,091.54
$1,702.36
$1,832.56
$1,970.48
$2,460.46
$2,071.28
$2,201.48
$2,339.40
$2,829.38
$368.92
Toc - Plan #41 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(POS) Choice Bronze HSA (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,250 $14,500 Annual Deductible
$7,250 $14,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$322.40
$365.91
$412.01
$575.79
$874.97
$569.03
$612.54
$658.64
$822.42
$815.66
$859.17
$905.27
$1,069.05
$1,062.29
$1,105.80
$1,151.90
$1,315.68
$246.63
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$644.80
$731.82
$824.02
$1,151.58
$1,749.94
$891.43
$978.45
$1,070.65
$1,398.21
$1,138.06
$1,225.08
$1,317.28
$1,644.84
$1,384.69
$1,471.71
$1,563.91
$1,891.47
$246.63
Toc - Plan #42 Ambetter from Arkansas Health & Wellness
Expanded Bronze

(POS) Standard Expanded Bronze (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$313.33
$355.62
$400.43
$559.60
$850.36
$553.02
$595.31
$640.12
$799.29
$792.71
$835.00
$879.81
$1,038.98
$1,032.40
$1,074.69
$1,119.50
$1,278.67
$239.69
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$626.66
$711.24
$800.86
$1,119.20
$1,700.72
$866.35
$950.93
$1,040.55
$1,358.89
$1,106.04
$1,190.62
$1,280.24
$1,598.58
$1,345.73
$1,430.31
$1,519.93
$1,838.27
$239.69
Toc - Plan #43 Ambetter from Arkansas Health & Wellness
Silver

(POS) Standard Silver (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$334.38
$379.51
$427.32
$597.18
$907.48
$590.17
$635.30
$683.11
$852.97
$845.96
$891.09
$938.90
$1,108.76
$1,101.75
$1,146.88
$1,194.69
$1,364.55
$255.79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$668.76
$759.02
$854.64
$1,194.36
$1,814.96
$924.55
$1,014.81
$1,110.43
$1,450.15
$1,180.34
$1,270.60
$1,366.22
$1,705.94
$1,436.13
$1,526.39
$1,622.01
$1,961.73
$255.79
Toc - Plan #44 Ambetter from Arkansas Health & Wellness
Gold

(POS) Standard Gold (QualChoice)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-617-0390

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$418.45
$474.93
$534.76
$747.33
$1,135.64
$738.56
$795.04
$854.87
$1,067.44
$1,058.67
$1,115.15
$1,174.98
$1,387.55
$1,378.78
$1,435.26
$1,495.09
$1,707.66
$320.11
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$836.90
$949.86
$1,069.52
$1,494.66
$2,271.28
$1,157.01
$1,269.97
$1,389.63
$1,814.77
$1,477.12
$1,590.08
$1,709.74
$2,134.88
$1,797.23
$1,910.19
$2,029.85
$2,454.99
$320.11

ADVERTISEMENT

Arkansas Blue Cross and Blue Shield

Local: 1-800-800-4298 | Toll Free: 1-800-800-4298 | TTY: 1-800-800-4298

Toc - Plan #45 Arkansas Blue Cross and Blue Shield
Silver

(PPO) Silver Premier Suitcase

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$4,050 $8,100 Annual Deductible
$8,950 $17,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$387.01
$439.26
$494.60
$691.20
$1,050.35
$683.07
$735.32
$790.66
$987.26
$979.13
$1,031.38
$1,086.72
$1,283.32
$1,275.19
$1,327.44
$1,382.78
$1,579.38
$296.06
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$774.02
$878.52
$989.20
$1,382.40
$2,100.70
$1,070.08
$1,174.58
$1,285.26
$1,678.46
$1,366.14
$1,470.64
$1,581.32
$1,974.52
$1,662.20
$1,766.70
$1,877.38
$2,270.58
$296.06
Toc - Plan #46 Arkansas Blue Cross and Blue Shield
Silver

(PPO) Silver AH

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,450 $10,900 Annual Deductible
$6,250 $12,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$377.59
$428.56
$482.56
$674.38
$1,024.78
$666.45
$717.42
$771.42
$963.24
$955.31
$1,006.28
$1,060.28
$1,252.10
$1,244.17
$1,295.14
$1,349.14
$1,540.96
$288.86
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$755.18
$857.12
$965.12
$1,348.76
$2,049.56
$1,044.04
$1,145.98
$1,253.98
$1,637.62
$1,332.90
$1,434.84
$1,542.84
$1,926.48
$1,621.76
$1,723.70
$1,831.70
$2,215.34
$288.86
Toc - Plan #47 Arkansas Blue Cross and Blue Shield
Silver

(PPO) Silver Classic Suitcase

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$391.25
$444.07
$500.02
$698.77
$1,061.85
$690.56
$743.38
$799.33
$998.08
$989.87
$1,042.69
$1,098.64
$1,297.39
$1,289.18
$1,342.00
$1,397.95
$1,596.70
$299.31
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$782.50
$888.14
$1,000.04
$1,397.54
$2,123.70
$1,081.81
$1,187.45
$1,299.35
$1,696.85
$1,381.12
$1,486.76
$1,598.66
$1,996.16
$1,680.43
$1,786.07
$1,897.97
$2,295.47
$299.31
Toc - Plan #48 Arkansas Blue Cross and Blue Shield
Silver

(PPO) Silver Value

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$426.68
$484.28
$545.30
$762.05
$1,158.01
$753.09
$810.69
$871.71
$1,088.46
$1,079.50
$1,137.10
$1,198.12
$1,414.87
$1,405.91
$1,463.51
$1,524.53
$1,741.28
$326.41
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$853.36
$968.56
$1,090.60
$1,524.10
$2,316.02
$1,179.77
$1,294.97
$1,417.01
$1,850.51
$1,506.18
$1,621.38
$1,743.42
$2,176.92
$1,832.59
$1,947.79
$2,069.83
$2,503.33
$326.41
Toc - Plan #49 Arkansas Blue Cross and Blue Shield
Expanded Bronze

(PPO) Bronze Value

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$8,800 $17,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$335.84
$381.18
$429.20
$599.81
$911.47
$592.76
$638.10
$686.12
$856.73
$849.68
$895.02
$943.04
$1,113.65
$1,106.60
$1,151.94
$1,199.96
$1,370.57
$256.92
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$671.68
$762.36
$858.40
$1,199.62
$1,822.94
$928.60
$1,019.28
$1,115.32
$1,456.54
$1,185.52
$1,276.20
$1,372.24
$1,713.46
$1,442.44
$1,533.12
$1,629.16
$1,970.38
$256.92
Toc - Plan #50 Arkansas Blue Cross and Blue Shield
Gold

(PPO) Gold Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$468.85
$532.14
$599.19
$837.37
$1,272.46
$827.52
$890.81
$957.86
$1,196.04
$1,186.19
$1,249.48
$1,316.53
$1,554.71
$1,544.86
$1,608.15
$1,675.20
$1,913.38
$358.67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$937.70
$1,064.28
$1,198.38
$1,674.74
$2,544.92
$1,296.37
$1,422.95
$1,557.05
$2,033.41
$1,655.04
$1,781.62
$1,915.72
$2,392.08
$2,013.71
$2,140.29
$2,274.39
$2,750.75
$358.67
Toc - Plan #51 Arkansas Blue Cross and Blue Shield
Silver

(PPO) Silver Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$363.13
$412.15
$464.08
$648.55
$985.53
$640.92
$689.94
$741.87
$926.34
$918.71
$967.73
$1,019.66
$1,204.13
$1,196.50
$1,245.52
$1,297.45
$1,481.92
$277.79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$726.26
$824.30
$928.16
$1,297.10
$1,971.06
$1,004.05
$1,102.09
$1,205.95
$1,574.89
$1,281.84
$1,379.88
$1,483.74
$1,852.68
$1,559.63
$1,657.67
$1,761.53
$2,130.47
$277.79
Toc - Plan #52 Arkansas Blue Cross and Blue Shield
Expanded Bronze

(PPO) Bronze Exp Standardized

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-800-4298

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$302.09
$342.87
$386.07
$539.53
$819.87
$533.19
$573.97
$617.17
$770.63
$764.29
$805.07
$848.27
$1,001.73
$995.39
$1,036.17
$1,079.37
$1,232.83
$231.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$604.18
$685.74
$772.14
$1,079.06
$1,639.74
$835.28
$916.84
$1,003.24
$1,310.16
$1,066.38
$1,147.94
$1,234.34
$1,541.26
$1,297.48
$1,379.04
$1,465.44
$1,772.36
$231.10

‡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 Independence County here.

Independence County is in “Rating Area 2” of Arkansas.

Currently, there are 52 plans offered in Rating Area 2.

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2024 Obamacare Plans for Independence County, AR

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