Florida Obamacare

2017 Obamacare Rates for Gilchrist County

Florida 2017 Obamacare Rates for Gilchrist County

 
Trenton, FL

Providers for Zip Code 32693

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Obamacare Providers, Plans and 2017 Rates for Gilchrist County

The health insurance rates listed below are for calendar year 2017.

2017 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Gilchrist County, Florida.

Currently, there are 25 plans offered in Gilchrist County.

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

 

The table below shows premiums for the following scenarios:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

 

Note: If you are over 65, you qualify for Medicare. Click here to see listings of 2017 Medicare Advantage plans for Gilchrist County

 

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Trenton, FL area accept this insurance coverage as within the plan's "network".

‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Gilchrist County here.

Blue Cross and Blue Shield of Florida

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583

TTY: 1-800-955-8771

Plan: (EPO) BlueOptions Silver 1423

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $5,950 : Family: $11,900
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $355.44
$403.42
$454.25
$634.82
$964.66		 $710.88
$806.84
$908.50
$1269.64
$1929.32		 $936.58
$1032.54
$1134.20
$1495.34		 $1162.28
$1258.24
$1359.90
$1721.04		 $1387.98
$1483.94
$1585.60
$1946.74		 $581.14
$629.12
$679.95
$860.52		 $806.84
$854.82
$905.65
$1086.22		 $1032.54
$1080.52
$1131.35
$1311.92		 $225.70

Plan: (EPO) BlueOptions Bronze 1419

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $289.09
$328.12
$369.46
$516.31
$784.59		 $578.18
$656.24
$738.92
$1032.62
$1569.18		 $761.75
$839.81
$922.49
$1216.19		 $945.32
$1023.38
$1106.06
$1399.76		 $1128.89
$1206.95
$1289.63
$1583.33		 $472.66
$511.69
$553.03
$699.88		 $656.23
$695.26
$736.60
$883.45		 $839.80
$878.83
$920.17
$1067.02		 $183.57

Plan: (EPO) BlueOptions Silver 1431

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $384.42
$436.32
$491.29
$686.57
$1043.32		 $768.84
$872.64
$982.58
$1373.14
$2086.64		 $1012.95
$1116.75
$1226.69
$1617.25		 $1257.06
$1360.86
$1470.80
$1861.36		 $1501.17
$1604.97
$1714.91
$2105.47		 $628.53
$680.43
$735.40
$930.68		 $872.64
$924.54
$979.51
$1174.79		 $1116.75
$1168.65
$1223.62
$1418.90		 $244.11

Plan: (EPO) BlueOptions Platinum 1418

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $800 : Family: $1,600
Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $562.42
$638.35
$718.77
$1004.48
$1526.41		 $1124.84
$1276.70
$1437.54
$2008.96
$3052.82		 $1481.98
$1633.84
$1794.68
$2366.10		 $1839.12
$1990.98
$2151.82
$2723.24		 $2196.26
$2348.12
$2508.96
$3080.38		 $919.56
$995.49
$1075.91
$1361.62		 $1276.70
$1352.63
$1433.05
$1718.76		 $1633.84
$1709.77
$1790.19
$2075.90		 $357.14

Plan: (EPO) BlueOptions Platinum Premier 1418V

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $800 : Family: $1,600
Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $584.97
$663.94
$747.59
$1044.76
$1587.61		 $1169.94
$1327.88
$1495.18
$2089.52
$3175.22		 $1541.40
$1699.34
$1866.64
$2460.98		 $1912.86
$2070.80
$2238.10
$2832.44		 $2284.32
$2442.26
$2609.56
$3203.90		 $956.43
$1035.40
$1119.05
$1416.22		 $1327.89
$1406.86
$1490.51
$1787.68		 $1699.35
$1778.32
$1861.97
$2159.14		 $371.46

Plan: (EPO) BlueOptions Bronze 1416

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,900 : Family: $13,800
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $313.04
$355.30
$400.07
$559.09
$849.59		 $626.08
$710.60
$800.14
$1118.18
$1699.18		 $824.86
$909.38
$998.92
$1316.96		 $1023.64
$1108.16
$1197.70
$1515.74		 $1222.42
$1306.94
$1396.48
$1714.52		 $511.82
$554.08
$598.85
$757.87		 $710.60
$752.86
$797.63
$956.65		 $909.38
$951.64
$996.41
$1155.43		 $198.78

Plan: (EPO) BlueOptions Platinum 1424

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $579.86
$658.14
$741.06
$1035.63
$1573.74		 $1159.72
$1316.28
$1482.12
$2071.26
$3147.48		 $1527.93
$1684.49
$1850.33
$2439.47		 $1896.14
$2052.70
$2218.54
$2807.68		 $2264.35
$2420.91
$2586.75
$3175.89		 $948.07
$1026.35
$1109.27
$1403.84		 $1316.28
$1394.56
$1477.48
$1772.05		 $1684.49
$1762.77
$1845.69
$2140.26		 $368.21

Plan: (EPO) BlueOptions Silver 1410

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $336.96
$382.45
$430.63
$601.81
$914.51		 $673.92
$764.90
$861.26
$1203.62
$1829.02		 $887.89
$978.87
$1075.23
$1417.59		 $1101.86
$1192.84
$1289.20
$1631.56		 $1315.83
$1406.81
$1503.17
$1845.53		 $550.93
$596.42
$644.60
$815.78		 $764.90
$810.39
$858.57
$1029.75		 $978.87
$1024.36
$1072.54
$1243.72		 $213.97

Plan: (EPO) BlueOptions Gold 1505

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $496.32
$563.32
$634.30
$886.43
$1347.01		 $992.64
$1126.64
$1268.60
$1772.86
$2694.02		 $1307.80
$1441.80
$1583.76
$2088.02		 $1622.96
$1756.96
$1898.92
$2403.18		 $1938.12
$2072.12
$2214.08
$2718.34		 $811.48
$878.48
$949.46
$1201.59		 $1126.64
$1193.64
$1264.62
$1516.75		 $1441.80
$1508.80
$1579.78
$1831.91		 $315.16

Plan: (EPO) BlueOptions Bronze (HSA) 1705

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,350 : Family: $12,700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $297.62
$337.80
$380.36
$531.55
$807.74		 $595.24
$675.60
$760.72
$1063.10
$1615.48		 $784.23
$864.59
$949.71
$1252.09		 $973.22
$1053.58
$1138.70
$1441.08		 $1162.21
$1242.57
$1327.69
$1630.07		 $486.61
$526.79
$569.35
$720.54		 $675.60
$715.78
$758.34
$909.53		 $864.59
$904.77
$947.33
$1098.52		 $188.99

Plan: (EPO) BlueOptions Silver 1706S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $373.31
$423.71
$477.09
$666.73
$1013.16		 $746.62
$847.42
$954.18
$1333.46
$2026.32		 $983.67
$1084.47
$1191.23
$1570.51		 $1220.72
$1321.52
$1428.28
$1807.56		 $1457.77
$1558.57
$1665.33
$2044.61		 $610.36
$660.76
$714.14
$903.78		 $847.41
$897.81
$951.19
$1140.83		 $1084.46
$1134.86
$1188.24
$1377.88		 $237.05

Plan: (EPO) BlueOptions Bronze 1707S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $292.75
$332.27
$374.13
$522.85
$794.52		 $585.50
$664.54
$748.26
$1045.70
$1589.04		 $771.40
$850.44
$934.16
$1231.60		 $957.30
$1036.34
$1120.06
$1417.50		 $1143.20
$1222.24
$1305.96
$1603.40		 $478.65
$518.17
$560.03
$708.75		 $664.55
$704.07
$745.93
$894.65		 $850.45
$889.97
$931.83
$1080.55		 $185.90

Plan: (EPO) BlueOptions Gold 1708S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $1,250 : Family: $2,500
Out of Pocket Maximum per year: Individual: $4,750 : Family: $9,500

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $482.84
$548.02
$617.07
$862.35
$1310.43		 $965.68
$1096.04
$1234.14
$1724.70
$2620.86		 $1272.28
$1402.64
$1540.74
$2031.30		 $1578.88
$1709.24
$1847.34
$2337.90		 $1885.48
$2015.84
$2153.94
$2644.50		 $789.44
$854.62
$923.67
$1168.95		 $1096.04
$1161.22
$1230.27
$1475.55		 $1402.64
$1467.82
$1536.87
$1782.15		 $306.60

Health Options, Inc.

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583

TTY: 1-800-955-8771

Plan: (HMO) BlueCare Silver 1490

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $5,950 : Family: $11,900
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $329.58
$374.07
$421.20
$588.63
$894.48		 $659.16
$748.14
$842.40
$1177.26
$1788.96		 $868.44
$957.42
$1051.68
$1386.54		 $1077.72
$1166.70
$1260.96
$1595.82		 $1287.00
$1375.98
$1470.24
$1805.10		 $538.86
$583.35
$630.48
$797.91		 $748.14
$792.63
$839.76
$1007.19		 $957.42
$1001.91
$1049.04
$1216.47		 $209.28

Plan: (HMO) BlueCare Bronze 1486

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $259.45
$294.48
$331.58
$463.38
$704.15		 $518.90
$588.96
$663.16
$926.76
$1408.30		 $683.65
$753.71
$827.91
$1091.51		 $848.40
$918.46
$992.66
$1256.26		 $1013.15
$1083.21
$1157.41
$1421.01		 $424.20
$459.23
$496.33
$628.13		 $588.95
$623.98
$661.08
$792.88		 $753.70
$788.73
$825.83
$957.63		 $164.75

Plan: (HMO) BlueCare Silver 1498

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $345.51
$392.15
$441.56
$617.08
$937.71		 $691.02
$784.30
$883.12
$1234.16
$1875.42		 $910.42
$1003.70
$1102.52
$1453.56		 $1129.82
$1223.10
$1321.92
$1672.96		 $1349.22
$1442.50
$1541.32
$1892.36		 $564.91
$611.55
$660.96
$836.48		 $784.31
$830.95
$880.36
$1055.88		 $1003.71
$1050.35
$1099.76
$1275.28		 $219.40

Plan: (HMO) BlueCare Platinum 1485

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $800 : Family: $1,600
Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $481.44
$546.43
$615.28
$859.85
$1306.63		 $962.88
$1092.86
$1230.56
$1719.70
$2613.26		 $1268.59
$1398.57
$1536.27
$2025.41		 $1574.30
$1704.28
$1841.98
$2331.12		 $1880.01
$2009.99
$2147.69
$2636.83		 $787.15
$852.14
$920.99
$1165.56		 $1092.86
$1157.85
$1226.70
$1471.27		 $1398.57
$1463.56
$1532.41
$1776.98		 $305.71

Plan: (HMO) BlueCare Bronze 1483

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $6,900 : Family: $13,800
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $285.39
$323.92
$364.73
$509.71
$774.55		 $570.78
$647.84
$729.46
$1019.42
$1549.10		 $752.00
$829.06
$910.68
$1200.64		 $933.22
$1010.28
$1091.90
$1381.86		 $1114.44
$1191.50
$1273.12
$1563.08		 $466.61
$505.14
$545.95
$690.93		 $647.83
$686.36
$727.17
$872.15		 $829.05
$867.58
$908.39
$1053.37		 $181.22

Plan: (HMO) BlueCare Platinum 1491

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $497.62
$564.80
$635.96
$888.75
$1350.54		 $995.24
$1129.60
$1271.92
$1777.50
$2701.08		 $1311.23
$1445.59
$1587.91
$2093.49		 $1627.22
$1761.58
$1903.90
$2409.48		 $1943.21
$2077.57
$2219.89
$2725.47		 $813.61
$880.79
$951.95
$1204.74		 $1129.60
$1196.78
$1267.94
$1520.73		 $1445.59
$1512.77
$1583.93
$1836.72		 $315.99

Plan: (HMO) BlueCare Gold 1768S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $1,250 : Family: $2,500
Out of Pocket Maximum per year: Individual: $4,750 : Family: $9,500

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $417.22
$473.54
$533.21
$745.15
$1132.34		 $834.44
$947.08
$1066.42
$1490.30
$2264.68		 $1099.37
$1212.01
$1331.35
$1755.23		 $1364.30
$1476.94
$1596.28
$2020.16		 $1629.23
$1741.87
$1861.21
$2285.09		 $682.15
$738.47
$798.14
$1010.08		 $947.08
$1003.40
$1063.07
$1275.01		 $1212.01
$1268.33
$1328.00
$1539.94		 $264.93

Plan: (HMO) BlueCare Silver 1477

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $297.74
$337.93
$380.51
$531.76
$808.07		 $595.48
$675.86
$761.02
$1063.52
$1616.14		 $784.54
$864.92
$950.08
$1252.58		 $973.60
$1053.98
$1139.14
$1441.64		 $1162.66
$1243.04
$1328.20
$1630.70		 $486.80
$526.99
$569.57
$720.82		 $675.86
$716.05
$758.63
$909.88		 $864.92
$905.11
$947.69
$1098.94		 $189.06

Plan: (HMO) BlueCare Gold 1565

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $429.02
$486.94
$548.29
$766.23
$1164.36		 $858.04
$973.88
$1096.58
$1532.46
$2328.72		 $1130.47
$1246.31
$1369.01
$1804.89		 $1402.90
$1518.74
$1641.44
$2077.32		 $1675.33
$1791.17
$1913.87
$2349.75		 $701.45
$759.37
$820.72
$1038.66		 $973.88
$1031.80
$1093.15
$1311.09		 $1246.31
$1304.23
$1365.58
$1583.52		 $272.43

Plan: (HMO) BlueCare Bronze (HSA) 1765

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $6,350 : Family: $12,700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $267.73
$303.87
$342.16
$478.17
$726.62		 $535.46
$607.74
$684.32
$956.34
$1453.24		 $705.47
$777.75
$854.33
$1126.35		 $875.48
$947.76
$1024.34
$1296.36		 $1045.49
$1117.77
$1194.35
$1466.37		 $437.74
$473.88
$512.17
$648.18		 $607.75
$643.89
$682.18
$818.19		 $777.76
$813.90
$852.19
$988.20		 $170.01

Plan: (HMO) BlueCare Silver 1766S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $334.39
$379.53
$427.35
$597.22
$907.53		 $668.78
$759.06
$854.70
$1194.44
$1815.06		 $881.12
$971.40
$1067.04
$1406.78		 $1093.46
$1183.74
$1279.38
$1619.12		 $1305.80
$1396.08
$1491.72
$1831.46		 $546.73
$591.87
$639.69
$809.56		 $759.07
$804.21
$852.03
$1021.90		 $971.41
$1016.55
$1064.37
$1234.24		 $212.34

Plan: (HMO) BlueCare Bronze 1767S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $264.25
$299.92
$337.71
$471.95
$717.17		 $528.50
$599.84
$675.42
$943.90
$1434.34		 $696.30
$767.64
$843.22
$1111.70		 $864.10
$935.44
$1011.02
$1279.50		 $1031.90
$1103.24
$1178.82
$1447.30		 $432.05
$467.72
$505.51
$639.75		 $599.85
$635.52
$673.31
$807.55		 $767.65
$803.32
$841.11
$975.35		 $167.80