Gilchrist County, Florida - Obamacare

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Obamacare 2021 Rates and Health Insurance Providers for Gilchrist County , Florida

Obamacare > Rates > Florida > Gilchrist County

Obamacare Rates and Providers for Other Years

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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 Gilchrist County, Florida.

The health insurance rates listed below are for calendar year 2021.

Obamacare Providers, Plans and 2021 Rates for Gilchrist County, Florida

Below, you’ll find a summary of the 51 plans for Gilchrist County, Florida and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

  • Florida Blue (BlueCross BlueShield FL)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

  • Ambetter from Sunshine Health

    Local: 1-877-687-1169 | Toll Free: 1-877-687-1169 | TTY: 1-800-955-8770

  • Florida Blue HMO (a BlueCross BlueShield FL company)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

    • For detailed information on available subsidies to make your coverage affordable, you must take one of the following actions:

    The table below shows premiums for the following profiles at various ages:

    • Individuals
    • Couples
    • Couples with 1, 2, or 3 children
    • Individuals with 1, 2, or 3 children
    • A child alone

    Each plan links to the insurance provider's website. You can find the following:

    • Summary of plan benefits and costs
    • Plan brochure
    • 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.

    2021 Obamacare Rates, Providers, and Plans for Gilchrist County

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    Florida Blue (BlueCross BlueShield FL)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771
    Toc - Plan #1

    Silver

    (EPO) BlueOptions Silver 1423 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,950 $11,900 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$631,41
    $716,65
    $806,94
    $1 127,70
    $1 713,65     		$1 262,82
    $1 433,30
    $1 613,88
    $2 255,40
    $3 427,30     		$1 745,85
    $1 916,33
    $2 096,91
    $2 738,43     		$2 228,88
    $2 399,36
    $2 579,94
    $3 221,46     		$2 711,91
    $2 882,39
    $3 062,97
    $3 704,49     		$1 114,44
    $1 199,68
    $1 289,97
    $1 610,73     		$1 597,47
    $1 682,71
    $1 773,00
    $2 093,76     		$2 080,50
    $2 165,74
    $2 256,03
    $2 576,79     		$483,03
    Toc - Plan #2

    Bronze

    (EPO) BlueOptions Bronze 1419 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$390,38
    $443,08
    $498,91
    $697,22
    $1 059,49     		$780,76
    $886,16
    $997,82
    $1 394,44
    $2 118,98     		$1 079,40
    $1 184,80
    $1 296,46
    $1 693,08     		$1 378,04
    $1 483,44
    $1 595,10
    $1 991,72     		$1 676,68
    $1 782,08
    $1 893,74
    $2 290,36     		$689,02
    $741,72
    $797,55
    $995,86     		$987,66
    $1 040,36
    $1 096,19
    $1 294,50     		$1 286,30
    $1 339,00
    $1 394,83
    $1 593,14     		$298,64
    Toc - Plan #3

    Silver

    (EPO) BlueOptions Silver 1431 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,800 $15,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$650,24
    $738,02
    $831,01
    $1 161,33
    $1 764,75     		$1 300,48
    $1 476,04
    $1 662,02
    $2 322,66
    $3 529,50     		$1 797,91
    $1 973,47
    $2 159,45
    $2 820,09     		$2 295,34
    $2 470,90
    $2 656,88
    $3 317,52     		$2 792,77
    $2 968,33
    $3 154,31
    $3 814,95     		$1 147,67
    $1 235,45
    $1 328,44
    $1 658,76     		$1 645,10
    $1 732,88
    $1 825,87
    $2 156,19     		$2 142,53
    $2 230,31
    $2 323,30
    $2 653,62     		$497,43
    Toc - Plan #4

    Platinum

    (EPO) BlueOptions Platinum 1418 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,250 $2,500 Annual Deductible
    $4,250 $8,500 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$761,10
    $863,85
    $972,69
    $1 359,32
    $2 065,63     		$1 522,20
    $1 727,70
    $1 945,38
    $2 718,64
    $4 131,26     		$2 104,44
    $2 309,94
    $2 527,62
    $3 300,88     		$2 686,68
    $2 892,18
    $3 109,86
    $3 883,12     		$3 268,92
    $3 474,42
    $3 692,10
    $4 465,36     		$1 343,34
    $1 446,09
    $1 554,93
    $1 941,56     		$1 925,58
    $2 028,33
    $2 137,17
    $2 523,80     		$2 507,82
    $2 610,57
    $2 719,41
    $3 106,04     		$582,24
    Toc - Plan #5

    Expanded Bronze

    (EPO) BlueOptions Bronze 1416 ($0 Virtual Visits / 3 PCP Visits for $20)

    Annual Out of Pocket Expenses
    Individual Family
    $8,500 $17,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$420,74
    $477,54
    $537,71
    $751,44
    $1 141,89     		$841,48
    $955,08
    $1 075,42
    $1 502,88
    $2 283,78     		$1 163,35
    $1 276,95
    $1 397,29
    $1 824,75     		$1 485,22
    $1 598,82
    $1 719,16
    $2 146,62     		$1 807,09
    $1 920,69
    $2 041,03
    $2 468,49     		$742,61
    $799,41
    $859,58
    $1 073,31     		$1 064,48
    $1 121,28
    $1 181,45
    $1 395,18     		$1 386,35
    $1 443,15
    $1 503,32
    $1 717,05     		$321,87
    Toc - Plan #6

    Platinum

    (EPO) BlueOptions Platinum 1424 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$806,49
    $915,37
    $1 030,69
    $1 440,39
    $2 188,81     		$1 612,98
    $1 830,74
    $2 061,38
    $2 880,78
    $4 377,62     		$2 229,94
    $2 447,70
    $2 678,34
    $3 497,74     		$2 846,90
    $3 064,66
    $3 295,30
    $4 114,70     		$3 463,86
    $3 681,62
    $3 912,26
    $4 731,66     		$1 423,45
    $1 532,33
    $1 647,65
    $2 057,35     		$2 040,41
    $2 149,29
    $2 264,61
    $2 674,31     		$2 657,37
    $2 766,25
    $2 881,57
    $3 291,27     		$616,96
    Toc - Plan #7

    Silver

    (EPO) BlueOptions Silver 1410 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $8,000 $16,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$575,59
    $653,29
    $735,60
    $1 028,00
    $1 562,15     		$1 151,18
    $1 306,58
    $1 471,20
    $2 056,00
    $3 124,30     		$1 591,51
    $1 746,91
    $1 911,53
    $2 496,33     		$2 031,84
    $2 187,24
    $2 351,86
    $2 936,66     		$2 472,17
    $2 627,57
    $2 792,19
    $3 376,99     		$1 015,92
    $1 093,62
    $1 175,93
    $1 468,33     		$1 456,25
    $1 533,95
    $1 616,26
    $1 908,66     		$1 896,58
    $1 974,28
    $2 056,59
    $2 348,99     		$440,33
    Toc - Plan #8

    Gold

    (EPO) BlueOptions Gold 1505 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$640,71
    $727,21
    $818,83
    $1 144,31
    $1 738,89     		$1 281,42
    $1 454,42
    $1 637,66
    $2 288,62
    $3 477,78     		$1 771,56
    $1 944,56
    $2 127,80
    $2 778,76     		$2 261,70
    $2 434,70
    $2 617,94
    $3 268,90     		$2 751,84
    $2 924,84
    $3 108,08
    $3 759,04     		$1 130,85
    $1 217,35
    $1 308,97
    $1 634,45     		$1 620,99
    $1 707,49
    $1 799,11
    $2 124,59     		$2 111,13
    $2 197,63
    $2 289,25
    $2 614,73     		$490,14
    Toc - Plan #9

    Expanded Bronze

    (EPO) BlueOptions Bronze (HSA) 1705 ($100+ in Rewards / $4 Condition Care Rx)

    Annual Out of Pocket Expenses
    Individual Family
    $6,850 $13,700 Annual Deductible
    $6,850 $13,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$407,70
    $462,74
    $521,04
    $728,15
    $1 106,50     		$815,40
    $925,48
    $1 042,08
    $1 456,30
    $2 213,00     		$1 127,29
    $1 237,37
    $1 353,97
    $1 768,19     		$1 439,18
    $1 549,26
    $1 665,86
    $2 080,08     		$1 751,07
    $1 861,15
    $1 977,75
    $2 391,97     		$719,59
    $774,63
    $832,93
    $1 040,04     		$1 031,48
    $1 086,52
    $1 144,82
    $1 351,93     		$1 343,37
    $1 398,41
    $1 456,71
    $1 663,82     		$311,89
    Toc - Plan #10

    Silver

    (EPO) BlueOptions Silver 1706S ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $3,600 $7,200 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$643,56
    $730,44
    $822,47
    $1 149,40
    $1 746,62     		$1 287,12
    $1 460,88
    $1 644,94
    $2 298,80
    $3 493,24     		$1 779,44
    $1 953,20
    $2 137,26
    $2 791,12     		$2 271,76
    $2 445,52
    $2 629,58
    $3 283,44     		$2 764,08
    $2 937,84
    $3 121,90
    $3 775,76     		$1 135,88
    $1 222,76
    $1 314,79
    $1 641,72     		$1 628,20
    $1 715,08
    $1 807,11
    $2 134,04     		$2 120,52
    $2 207,40
    $2 299,43
    $2 626,36     		$492,32
    Toc - Plan #11

    Expanded Bronze

    (EPO) BlueOptions Bronze 1707S ($0 Virtual Visits / $40 PCP Visits)

    Annual Out of Pocket Expenses
    Individual Family
    $8,150 $16,300 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$419,62
    $476,27
    $536,27
    $749,44
    $1 138,85     		$839,24
    $952,54
    $1 072,54
    $1 498,88
    $2 277,70     		$1 160,25
    $1 273,55
    $1 393,55
    $1 819,89     		$1 481,26
    $1 594,56
    $1 714,56
    $2 140,90     		$1 802,27
    $1 915,57
    $2 035,57
    $2 461,91     		$740,63
    $797,28
    $857,28
    $1 070,45     		$1 061,64
    $1 118,29
    $1 178,29
    $1 391,46     		$1 382,65
    $1 439,30
    $1 499,30
    $1 712,47     		$321,01
    Toc - Plan #12

    Gold

    (EPO) BlueOptions Gold 1805 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,500 $3,000 Annual Deductible
    $5,500 $11,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$620,44
    $704,20
    $792,92
    $1 108,11
    $1 683,87     		$1 240,88
    $1 408,40
    $1 585,84
    $2 216,22
    $3 367,74     		$1 715,52
    $1 883,04
    $2 060,48
    $2 690,86     		$2 190,16
    $2 357,68
    $2 535,12
    $3 165,50     		$2 664,80
    $2 832,32
    $3 009,76
    $3 640,14     		$1 095,08
    $1 178,84
    $1 267,56
    $1 582,75     		$1 569,72
    $1 653,48
    $1 742,20
    $2 057,39     		$2 044,36
    $2 128,12
    $2 216,84
    $2 532,03     		$474,64
    Toc - Plan #13

    Expanded Bronze

    (EPO) BlueOptions Bronze 2119 ($0 Deductible / $50 PCP Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$448,92
    $509,52
    $573,72
    $801,77
    $1 218,37     		$897,84
    $1 019,04
    $1 147,44
    $1 603,54
    $2 436,74     		$1 241,26
    $1 362,46
    $1 490,86
    $1 946,96     		$1 584,68
    $1 705,88
    $1 834,28
    $2 290,38     		$1 928,10
    $2 049,30
    $2 177,70
    $2 633,80     		$792,34
    $852,94
    $917,14
    $1 145,19     		$1 135,76
    $1 196,36
    $1 260,56
    $1 488,61     		$1 479,18
    $1 539,78
    $1 603,98
    $1 832,03     		$343,42
    ADVERTISEMENT

    Ambetter from Sunshine Health

    Local: 1-877-687-1169 | Toll Free: 1-877-687-1169 | TTY: 1-800-955-8770
    Toc - Plan #14

    Gold

    (EPO) Ambetter Secure Care 5 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $1,450 $2,900 Annual Deductible
    $6,300 $12,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$481,79
    $546,82
    $615,71
    $860,46
    $1 307,55     		$963,58
    $1 093,64
    $1 231,42
    $1 720,92
    $2 615,10     		$1 332,14
    $1 462,20
    $1 599,98
    $2 089,48     		$1 700,70
    $1 830,76
    $1 968,54
    $2 458,04     		$2 069,26
    $2 199,32
    $2 337,10
    $2 826,60     		$850,35
    $915,38
    $984,27
    $1 229,02     		$1 218,91
    $1 283,94
    $1 352,83
    $1 597,58     		$1 587,47
    $1 652,50
    $1 721,39
    $1 966,14     		$368,56
    Toc - Plan #15

    Bronze

    (EPO) Ambetter Essential Care 1 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $8,300 $16,600 Annual Deductible
    $8,300 $16,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$336,95
    $382,43
    $430,61
    $601,78
    $914,46     		$673,90
    $764,86
    $861,22
    $1 203,56
    $1 828,92     		$931,66
    $1 022,62
    $1 118,98
    $1 461,32     		$1 189,42
    $1 280,38
    $1 376,74
    $1 719,08     		$1 447,18
    $1 538,14
    $1 634,50
    $1 976,84     		$594,71
    $640,19
    $688,37
    $859,54     		$852,47
    $897,95
    $946,13
    $1 117,30     		$1 110,23
    $1 155,71
    $1 203,89
    $1 375,06     		$257,76
    Toc - Plan #16

    Expanded Bronze

    (EPO) Ambetter Essential Care 2 HSA (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $6,900 $13,800 Annual Deductible
    $6,900 $13,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$344,66
    $391,18
    $440,46
    $615,55
    $935,38     		$689,32
    $782,36
    $880,92
    $1 231,10
    $1 870,76     		$952,98
    $1 046,02
    $1 144,58
    $1 494,76     		$1 216,64
    $1 309,68
    $1 408,24
    $1 758,42     		$1 480,30
    $1 573,34
    $1 671,90
    $2 022,08     		$608,32
    $654,84
    $704,12
    $879,21     		$871,98
    $918,50
    $967,78
    $1 142,87     		$1 135,64
    $1 182,16
    $1 231,44
    $1 406,53     		$263,66
    Toc - Plan #17

    Expanded Bronze

    (EPO) Ambetter Essential Care 10 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$345,29
    $391,89
    $441,26
    $616,66
    $937,08     		$690,58
    $783,78
    $882,52
    $1 233,32
    $1 874,16     		$954,72
    $1 047,92
    $1 146,66
    $1 497,46     		$1 218,86
    $1 312,06
    $1 410,80
    $1 761,60     		$1 483,00
    $1 576,20
    $1 674,94
    $2 025,74     		$609,43
    $656,03
    $705,40
    $880,80     		$873,57
    $920,17
    $969,54
    $1 144,94     		$1 137,71
    $1 184,31
    $1 233,68
    $1 409,08     		$264,14
    Toc - Plan #18

    Silver

    (EPO) Ambetter Balanced Care 4 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $7,200 $14,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$481,84
    $546,87
    $615,77
    $860,54
    $1 307,68     		$963,68
    $1 093,74
    $1 231,54
    $1 721,08
    $2 615,36     		$1 332,28
    $1 462,34
    $1 600,14
    $2 089,68     		$1 700,88
    $1 830,94
    $1 968,74
    $2 458,28     		$2 069,48
    $2 199,54
    $2 337,34
    $2 826,88     		$850,44
    $915,47
    $984,37
    $1 229,14     		$1 219,04
    $1 284,07
    $1 352,97
    $1 597,74     		$1 587,64
    $1 652,67
    $1 721,57
    $1 966,34     		$368,60
    Toc - Plan #19

    Silver

    (EPO) Ambetter Balanced Care 11 (2021)

    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:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$469,89
    $533,31
    $600,50
    $839,20
    $1 275,25     		$939,78
    $1 066,62
    $1 201,00
    $1 678,40
    $2 550,50     		$1 299,24
    $1 426,08
    $1 560,46
    $2 037,86     		$1 658,70
    $1 785,54
    $1 919,92
    $2 397,32     		$2 018,16
    $2 145,00
    $2 279,38
    $2 756,78     		$829,35
    $892,77
    $959,96
    $1 198,66     		$1 188,81
    $1 252,23
    $1 319,42
    $1 558,12     		$1 548,27
    $1 611,69
    $1 678,88
    $1 917,58     		$359,46
    Toc - Plan #20

    Silver

    (EPO) Ambetter Balanced Care 12 (2021)

    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:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$459,58
    $521,61
    $587,33
    $820,79
    $1 247,26     		$919,16
    $1 043,22
    $1 174,66
    $1 641,58
    $2 494,52     		$1 270,73
    $1 394,79
    $1 526,23
    $1 993,15     		$1 622,30
    $1 746,36
    $1 877,80
    $2 344,72     		$1 973,87
    $2 097,93
    $2 229,37
    $2 696,29     		$811,15
    $873,18
    $938,90
    $1 172,36     		$1 162,72
    $1 224,75
    $1 290,47
    $1 523,93     		$1 514,29
    $1 576,32
    $1 642,04
    $1 875,50     		$351,57
    Toc - Plan #21

    Silver

    (EPO) Ambetter Balanced Care 24 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $7,450 $14,900 Annual Deductible
    $7,450 $14,900 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$476,44
    $540,75
    $608,88
    $850,90
    $1 293,03     		$952,88
    $1 081,50
    $1 217,76
    $1 701,80
    $2 586,06     		$1 317,35
    $1 445,97
    $1 582,23
    $2 066,27     		$1 681,82
    $1 810,44
    $1 946,70
    $2 430,74     		$2 046,29
    $2 174,91
    $2 311,17
    $2 795,21     		$840,91
    $905,22
    $973,35
    $1 215,37     		$1 205,38
    $1 269,69
    $1 337,82
    $1 579,84     		$1 569,85
    $1 634,16
    $1 702,29
    $1 944,31     		$364,47
    Toc - Plan #22

    Silver

    (EPO) Ambetter Balanced Care 29 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $5,450 $10,900 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$455,43
    $516,90
    $582,03
    $813,38
    $1 236,02     		$910,86
    $1 033,80
    $1 164,06
    $1 626,76
    $2 472,04     		$1 259,26
    $1 382,20
    $1 512,46
    $1 975,16     		$1 607,66
    $1 730,60
    $1 860,86
    $2 323,56     		$1 956,06
    $2 079,00
    $2 209,26
    $2 671,96     		$803,83
    $865,30
    $930,43
    $1 161,78     		$1 152,23
    $1 213,70
    $1 278,83
    $1 510,18     		$1 500,63
    $1 562,10
    $1 627,23
    $1 858,58     		$348,40
    Toc - Plan #23

    Silver

    (EPO) Ambetter Balanced Care 25 HSA (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $4,800 $9,600 Annual Deductible
    $4,800 $9,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$475,19
    $539,33
    $607,28
    $848,67
    $1 289,63     		$950,38
    $1 078,66
    $1 214,56
    $1 697,34
    $2 579,26     		$1 313,89
    $1 442,17
    $1 578,07
    $2 060,85     		$1 677,40
    $1 805,68
    $1 941,58
    $2 424,36     		$2 040,91
    $2 169,19
    $2 305,09
    $2 787,87     		$838,70
    $902,84
    $970,79
    $1 212,18     		$1 202,21
    $1 266,35
    $1 334,30
    $1 575,69     		$1 565,72
    $1 629,86
    $1 697,81
    $1 939,20     		$363,51
    Toc - Plan #24

    Silver

    (EPO) Ambetter Balanced Care 26 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $5,450 $10,900 Annual Deductible
    $8,100 $16,200 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$484,49
    $549,88
    $619,16
    $865,28
    $1 314,87     		$968,98
    $1 099,76
    $1 238,32
    $1 730,56
    $2 629,74     		$1 339,60
    $1 470,38
    $1 608,94
    $2 101,18     		$1 710,22
    $1 841,00
    $1 979,56
    $2 471,80     		$2 080,84
    $2 211,62
    $2 350,18
    $2 842,42     		$855,11
    $920,50
    $989,78
    $1 235,90     		$1 225,73
    $1 291,12
    $1 360,40
    $1 606,52     		$1 596,35
    $1 661,74
    $1 731,02
    $1 977,14     		$370,62
    Toc - Plan #25

    Silver

    (EPO) Ambetter Balanced Care 27 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $2,750 $5,500 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$506,02
    $574,33
    $646,69
    $903,74
    $1 373,32     		$1 012,04
    $1 148,66
    $1 293,38
    $1 807,48
    $2 746,64     		$1 399,14
    $1 535,76
    $1 680,48
    $2 194,58     		$1 786,24
    $1 922,86
    $2 067,58
    $2 581,68     		$2 173,34
    $2 309,96
    $2 454,68
    $2 968,78     		$893,12
    $961,43
    $1 033,79
    $1 290,84     		$1 280,22
    $1 348,53
    $1 420,89
    $1 677,94     		$1 667,32
    $1 735,63
    $1 807,99
    $2 065,04     		$387,10
    Toc - Plan #26

    Silver

    (EPO) Ambetter Balanced Care 28 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,200 $16,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$515,47
    $585,05
    $658,76
    $920,61
    $1 398,95     		$1 030,94
    $1 170,10
    $1 317,52
    $1 841,22
    $2 797,90     		$1 425,27
    $1 564,43
    $1 711,85
    $2 235,55     		$1 819,60
    $1 958,76
    $2 106,18
    $2 629,88     		$2 213,93
    $2 353,09
    $2 500,51
    $3 024,21     		$909,80
    $979,38
    $1 053,09
    $1 314,94     		$1 304,13
    $1 373,71
    $1 447,42
    $1 709,27     		$1 698,46
    $1 768,04
    $1 841,75
    $2 103,60     		$394,33
    Toc - Plan #27

    Silver

    (EPO) Ambetter Balanced Care 12 (2021) + Vision + Adult Dental

    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:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$477,67
    $542,14
    $610,44
    $853,09
    $1 296,36     		$955,34
    $1 084,28
    $1 220,88
    $1 706,18
    $2 592,72     		$1 320,75
    $1 449,69
    $1 586,29
    $2 071,59     		$1 686,16
    $1 815,10
    $1 951,70
    $2 437,00     		$2 051,57
    $2 180,51
    $2 317,11
    $2 802,41     		$843,08
    $907,55
    $975,85
    $1 218,50     		$1 208,49
    $1 272,96
    $1 341,26
    $1 583,91     		$1 573,90
    $1 638,37
    $1 706,67
    $1 949,32     		$365,41
    Toc - Plan #28

    Expanded Bronze

    (EPO) Ambetter Essential Care 2 HSA (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $6,900 $13,800 Annual Deductible
    $6,900 $13,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$358,23
    $406,58
    $457,80
    $639,77
    $972,20     		$716,46
    $813,16
    $915,60
    $1 279,54
    $1 944,40     		$990,50
    $1 087,20
    $1 189,64
    $1 553,58     		$1 264,54
    $1 361,24
    $1 463,68
    $1 827,62     		$1 538,58
    $1 635,28
    $1 737,72
    $2 101,66     		$632,27
    $680,62
    $731,84
    $913,81     		$906,31
    $954,66
    $1 005,88
    $1 187,85     		$1 180,35
    $1 228,70
    $1 279,92
    $1 461,89     		$274,04
    Toc - Plan #29

    Gold

    (EPO) Ambetter Secure Care 5 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $1,450 $2,900 Annual Deductible
    $6,300 $12,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$500,75
    $568,34
    $639,95
    $894,32
    $1 359,01     		$1 001,50
    $1 136,68
    $1 279,90
    $1 788,64
    $2 718,02     		$1 384,57
    $1 519,75
    $1 662,97
    $2 171,71     		$1 767,64
    $1 902,82
    $2 046,04
    $2 554,78     		$2 150,71
    $2 285,89
    $2 429,11
    $2 937,85     		$883,82
    $951,41
    $1 023,02
    $1 277,39     		$1 266,89
    $1 334,48
    $1 406,09
    $1 660,46     		$1 649,96
    $1 717,55
    $1 789,16
    $2 043,53     		$383,07
    Toc - Plan #30

    Bronze

    (EPO) Ambetter Essential Care 1 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $8,300 $16,600 Annual Deductible
    $8,300 $16,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$350,21
    $397,48
    $447,56
    $625,46
    $950,45     		$700,42
    $794,96
    $895,12
    $1 250,92
    $1 900,90     		$968,33
    $1 062,87
    $1 163,03
    $1 518,83     		$1 236,24
    $1 330,78
    $1 430,94
    $1 786,74     		$1 504,15
    $1 598,69
    $1 698,85
    $2 054,65     		$618,12
    $665,39
    $715,47
    $893,37     		$886,03
    $933,30
    $983,38
    $1 161,28     		$1 153,94
    $1 201,21
    $1 251,29
    $1 429,19     		$267,91
    Toc - Plan #31

    Expanded Bronze

    (EPO) Ambetter Essential Care 10 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$358,88
    $407,31
    $458,63
    $640,94
    $973,97     		$717,76
    $814,62
    $917,26
    $1 281,88
    $1 947,94     		$992,29
    $1 089,15
    $1 191,79
    $1 556,41     		$1 266,82
    $1 363,68
    $1 466,32
    $1 830,94     		$1 541,35
    $1 638,21
    $1 740,85
    $2 105,47     		$633,41
    $681,84
    $733,16
    $915,47     		$907,94
    $956,37
    $1 007,69
    $1 190,00     		$1 182,47
    $1 230,90
    $1 282,22
    $1 464,53     		$274,53
    Toc - Plan #32

    Silver

    (EPO) Ambetter Balanced Care 4 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $7,200 $14,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$500,80
    $568,40
    $640,01
    $894,41
    $1 359,15     		$1 001,60
    $1 136,80
    $1 280,02
    $1 788,82
    $2 718,30     		$1 384,71
    $1 519,91
    $1 663,13
    $2 171,93     		$1 767,82
    $1 903,02
    $2 046,24
    $2 555,04     		$2 150,93
    $2 286,13
    $2 429,35
    $2 938,15     		$883,91
    $951,51
    $1 023,12
    $1 277,52     		$1 267,02
    $1 334,62
    $1 406,23
    $1 660,63     		$1 650,13
    $1 717,73
    $1 789,34
    $2 043,74     		$383,11
    Toc - Plan #33

    Silver

    (EPO) Ambetter Balanced Care 11 (2021) + Vision + Adult Dental

    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:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$488,38
    $554,30
    $624,14
    $872,23
    $1 325,44     		$976,76
    $1 108,60
    $1 248,28
    $1 744,46
    $2 650,88     		$1 350,36
    $1 482,20
    $1 621,88
    $2 118,06     		$1 723,96
    $1 855,80
    $1 995,48
    $2 491,66     		$2 097,56
    $2 229,40
    $2 369,08
    $2 865,26     		$861,98
    $927,90
    $997,74
    $1 245,83     		$1 235,58
    $1 301,50
    $1 371,34
    $1 619,43     		$1 609,18
    $1 675,10
    $1 744,94
    $1 993,03     		$373,60
    Toc - Plan #34

    Silver

    (EPO) Ambetter Balanced Care 24 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $7,450 $14,900 Annual Deductible
    $7,450 $14,900 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$495,19
    $562,03
    $632,84
    $884,40
    $1 343,93     		$990,38
    $1 124,06
    $1 265,68
    $1 768,80
    $2 687,86     		$1 369,19
    $1 502,87
    $1 644,49
    $2 147,61     		$1 748,00
    $1 881,68
    $2 023,30
    $2 526,42     		$2 126,81
    $2 260,49
    $2 402,11
    $2 905,23     		$874,00
    $940,84
    $1 011,65
    $1 263,21     		$1 252,81
    $1 319,65
    $1 390,46
    $1 642,02     		$1 631,62
    $1 698,46
    $1 769,27
    $2 020,83     		$378,81
    Toc - Plan #35

    Silver

    (EPO) Ambetter Balanced Care 25 HSA (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $4,800 $9,600 Annual Deductible
    $4,800 $9,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$493,89
    $560,55
    $631,18
    $882,07
    $1 340,39     		$987,78
    $1 121,10
    $1 262,36
    $1 764,14
    $2 680,78     		$1 365,60
    $1 498,92
    $1 640,18
    $2 141,96     		$1 743,42
    $1 876,74
    $2 018,00
    $2 519,78     		$2 121,24
    $2 254,56
    $2 395,82
    $2 897,60     		$871,71
    $938,37
    $1 009,00
    $1 259,89     		$1 249,53
    $1 316,19
    $1 386,82
    $1 637,71     		$1 627,35
    $1 694,01
    $1 764,64
    $2 015,53     		$377,82
    Toc - Plan #36

    Silver

    (EPO) Ambetter Balanced Care 26 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $5,450 $10,900 Annual Deductible
    $8,100 $16,200 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$503,56
    $571,52
    $643,53
    $899,33
    $1 366,62     		$1 007,12
    $1 143,04
    $1 287,06
    $1 798,66
    $2 733,24     		$1 392,33
    $1 528,25
    $1 672,27
    $2 183,87     		$1 777,54
    $1 913,46
    $2 057,48
    $2 569,08     		$2 162,75
    $2 298,67
    $2 442,69
    $2 954,29     		$888,77
    $956,73
    $1 028,74
    $1 284,54     		$1 273,98
    $1 341,94
    $1 413,95
    $1 669,75     		$1 659,19
    $1 727,15
    $1 799,16
    $2 054,96     		$385,21
    Toc - Plan #37

    Silver

    (EPO) Ambetter Balanced Care 27 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $2,750 $5,500 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$525,94
    $596,93
    $672,14
    $939,31
    $1 427,38     		$1 051,88
    $1 193,86
    $1 344,28
    $1 878,62
    $2 854,76     		$1 454,22
    $1 596,20
    $1 746,62
    $2 280,96     		$1 856,56
    $1 998,54
    $2 148,96
    $2 683,30     		$2 258,90
    $2 400,88
    $2 551,30
    $3 085,64     		$928,28
    $999,27
    $1 074,48
    $1 341,65     		$1 330,62
    $1 401,61
    $1 476,82
    $1 743,99     		$1 732,96
    $1 803,95
    $1 879,16
    $2 146,33     		$402,34
    Toc - Plan #38

    Silver

    (EPO) Ambetter Balanced Care 28 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,200 $16,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$535,76
    $608,07
    $684,68
    $956,84
    $1 454,02     		$1 071,52
    $1 216,14
    $1 369,36
    $1 913,68
    $2 908,04     		$1 481,37
    $1 625,99
    $1 779,21
    $2 323,53     		$1 891,22
    $2 035,84
    $2 189,06
    $2 733,38     		$2 301,07
    $2 445,69
    $2 598,91
    $3 143,23     		$945,61
    $1 017,92
    $1 094,53
    $1 366,69     		$1 355,46
    $1 427,77
    $1 504,38
    $1 776,54     		$1 765,31
    $1 837,62
    $1 914,23
    $2 186,39     		$409,85
    ADVERTISEMENT

    Florida Blue HMO (a BlueCross BlueShield FL company)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771
    Toc - Plan #39

    Silver

    (HMO) BlueCare Silver 1490 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,950 $11,900 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$566,59
    $643,08
    $724,10
    $1 011,93
    $1 537,73     		$1 133,18
    $1 286,16
    $1 448,20
    $2 023,86
    $3 075,46     		$1 566,62
    $1 719,60
    $1 881,64
    $2 457,30     		$2 000,06
    $2 153,04
    $2 315,08
    $2 890,74     		$2 433,50
    $2 586,48
    $2 748,52
    $3 324,18     		$1 000,03
    $1 076,52
    $1 157,54
    $1 445,37     		$1 433,47
    $1 509,96
    $1 590,98
    $1 878,81     		$1 866,91
    $1 943,40
    $2 024,42
    $2 312,25     		$433,44
    Toc - Plan #40

    Bronze

    (HMO) BlueCare Bronze 1486 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$359,26
    $407,76
    $459,13
    $641,64
    $975,03     		$718,52
    $815,52
    $918,26
    $1 283,28
    $1 950,06     		$993,35
    $1 090,35
    $1 193,09
    $1 558,11     		$1 268,18
    $1 365,18
    $1 467,92
    $1 832,94     		$1 543,01
    $1 640,01
    $1 742,75
    $2 107,77     		$634,09
    $682,59
    $733,96
    $916,47     		$908,92
    $957,42
    $1 008,79
    $1 191,30     		$1 183,75
    $1 232,25
    $1 283,62
    $1 466,13     		$274,83
    Toc - Plan #41

    Silver

    (HMO) BlueCare Silver 1498 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,800 $15,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$571,29
    $648,41
    $730,11
    $1 020,32
    $1 550,48     		$1 142,58
    $1 296,82
    $1 460,22
    $2 040,64
    $3 100,96     		$1 579,62
    $1 733,86
    $1 897,26
    $2 477,68     		$2 016,66
    $2 170,90
    $2 334,30
    $2 914,72     		$2 453,70
    $2 607,94
    $2 771,34
    $3 351,76     		$1 008,33
    $1 085,45
    $1 167,15
    $1 457,36     		$1 445,37
    $1 522,49
    $1 604,19
    $1 894,40     		$1 882,41
    $1 959,53
    $2 041,23
    $2 331,44     		$437,04
    Toc - Plan #42

    Platinum

    (HMO) BlueCare Platinum 1485 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,250 $2,500 Annual Deductible
    $4,250 $8,500 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$617,11
    $700,42
    $788,67
    $1 102,16
    $1 674,84     		$1 234,22
    $1 400,84
    $1 577,34
    $2 204,32
    $3 349,68     		$1 706,31
    $1 872,93
    $2 049,43
    $2 676,41     		$2 178,40
    $2 345,02
    $2 521,52
    $3 148,50     		$2 650,49
    $2 817,11
    $2 993,61
    $3 620,59     		$1 089,20
    $1 172,51
    $1 260,76
    $1 574,25     		$1 561,29
    $1 644,60
    $1 732,85
    $2 046,34     		$2 033,38
    $2 116,69
    $2 204,94
    $2 518,43     		$472,09
    Toc - Plan #43

    Expanded Bronze

    (HMO) BlueCare Bronze 1483 ($0 Virtual Visits / 3 PCP Visits for $20)

    Annual Out of Pocket Expenses
    Individual Family
    $8,500 $17,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$398,94
    $452,80
    $509,85
    $712,51
    $1 082,72     		$797,88
    $905,60
    $1 019,70
    $1 425,02
    $2 165,44     		$1 103,07
    $1 210,79
    $1 324,89
    $1 730,21     		$1 408,26
    $1 515,98
    $1 630,08
    $2 035,40     		$1 713,45
    $1 821,17
    $1 935,27
    $2 340,59     		$704,13
    $757,99
    $815,04
    $1 017,70     		$1 009,32
    $1 063,18
    $1 120,23
    $1 322,89     		$1 314,51
    $1 368,37
    $1 425,42
    $1 628,08     		$305,19
    Toc - Plan #44

    Platinum

    (HMO) BlueCare Platinum 1491 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$666,09
    $756,01
    $851,26
    $1 189,64
    $1 807,77     		$1 332,18
    $1 512,02
    $1 702,52
    $2 379,28
    $3 615,54     		$1 841,74
    $2 021,58
    $2 212,08
    $2 888,84     		$2 351,30
    $2 531,14
    $2 721,64
    $3 398,40     		$2 860,86
    $3 040,70
    $3 231,20
    $3 907,96     		$1 175,65
    $1 265,57
    $1 360,82
    $1 699,20     		$1 685,21
    $1 775,13
    $1 870,38
    $2 208,76     		$2 194,77
    $2 284,69
    $2 379,94
    $2 718,32     		$509,56
    Toc - Plan #45

    Silver

    (HMO) BlueCare Silver 1477 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $8,000 $16,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$484,44
    $549,84
    $619,11
    $865,21
    $1 314,77     		$968,88
    $1 099,68
    $1 238,22
    $1 730,42
    $2 629,54     		$1 339,48
    $1 470,28
    $1 608,82
    $2 101,02     		$1 710,08
    $1 840,88
    $1 979,42
    $2 471,62     		$2 080,68
    $2 211,48
    $2 350,02
    $2 842,22     		$855,04
    $920,44
    $989,71
    $1 235,81     		$1 225,64
    $1 291,04
    $1 360,31
    $1 606,41     		$1 596,24
    $1 661,64
    $1 730,91
    $1 977,01     		$370,60
    Toc - Plan #46

    Gold

    (HMO) BlueCare Gold 1565 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$569,71
    $646,62
    $728,09
    $1 017,50
    $1 546,19     		$1 139,42
    $1 293,24
    $1 456,18
    $2 035,00
    $3 092,38     		$1 575,25
    $1 729,07
    $1 892,01
    $2 470,83     		$2 011,08
    $2 164,90
    $2 327,84
    $2 906,66     		$2 446,91
    $2 600,73
    $2 763,67
    $3 342,49     		$1 005,54
    $1 082,45
    $1 163,92
    $1 453,33     		$1 441,37
    $1 518,28
    $1 599,75
    $1 889,16     		$1 877,20
    $1 954,11
    $2 035,58
    $2 324,99     		$435,83
    Toc - Plan #47

    Expanded Bronze

    (HMO) BlueCare Bronze (HSA) 1765 ($100+ in Rewards / $4 Condition Care Rx)

    Annual Out of Pocket Expenses
    Individual Family
    $6,850 $13,700 Annual Deductible
    $6,850 $13,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$379,57
    $430,81
    $485,09
    $677,91
    $1 030,15     		$759,14
    $861,62
    $970,18
    $1 355,82
    $2 060,30     		$1 049,51
    $1 151,99
    $1 260,55
    $1 646,19     		$1 339,88
    $1 442,36
    $1 550,92
    $1 936,56     		$1 630,25
    $1 732,73
    $1 841,29
    $2 226,93     		$669,94
    $721,18
    $775,46
    $968,28     		$960,31
    $1 011,55
    $1 065,83
    $1 258,65     		$1 250,68
    $1 301,92
    $1 356,20
    $1 549,02     		$290,37
    Toc - Plan #48

    Silver

    (HMO) BlueCare Silver 1766S ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $3,600 $7,200 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$562,16
    $638,05
    $718,44
    $1 004,02
    $1 525,70     		$1 124,32
    $1 276,10
    $1 436,88
    $2 008,04
    $3 051,40     		$1 554,37
    $1 706,15
    $1 866,93
    $2 438,09     		$1 984,42
    $2 136,20
    $2 296,98
    $2 868,14     		$2 414,47
    $2 566,25
    $2 727,03
    $3 298,19     		$992,21
    $1 068,10
    $1 148,49
    $1 434,07     		$1 422,26
    $1 498,15
    $1 578,54
    $1 864,12     		$1 852,31
    $1 928,20
    $2 008,59
    $2 294,17     		$430,05
    Toc - Plan #49

    Expanded Bronze

    (HMO) BlueCare Bronze 1767S ($0 Virtual Visits / $40 PCP Visits)

    Annual Out of Pocket Expenses
    Individual Family
    $8,150 $16,300 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$396,87
    $450,45
    $507,20
    $708,81
    $1 077,11     		$793,74
    $900,90
    $1 014,40
    $1 417,62
    $2 154,22     		$1 097,35
    $1 204,51
    $1 318,01
    $1 721,23     		$1 400,96
    $1 508,12
    $1 621,62
    $2 024,84     		$1 704,57
    $1 811,73
    $1 925,23
    $2 328,45     		$700,48
    $754,06
    $810,81
    $1 012,42     		$1 004,09
    $1 057,67
    $1 114,42
    $1 316,03     		$1 307,70
    $1 361,28
    $1 418,03
    $1 619,64     		$303,61
    Toc - Plan #50

    Gold

    (HMO) BlueCare Gold 1865 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,500 $3,000 Annual Deductible
    $5,500 $11,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$546,28
    $620,03
    $698,15
    $975,66
    $1 482,60     		$1 092,56
    $1 240,06
    $1 396,30
    $1 951,32
    $2 965,20     		$1 510,46
    $1 657,96
    $1 814,20
    $2 369,22     		$1 928,36
    $2 075,86
    $2 232,10
    $2 787,12     		$2 346,26
    $2 493,76
    $2 650,00
    $3 205,02     		$964,18
    $1 037,93
    $1 116,05
    $1 393,56     		$1 382,08
    $1 455,83
    $1 533,95
    $1 811,46     		$1 799,98
    $1 873,73
    $1 951,85
    $2 229,36     		$417,90
    Toc - Plan #51

    Expanded Bronze

    (HMO) BlueCare Bronze 2179 ($0 Deductible / $50 PCP Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$435,23
    $493,99
    $556,22
    $777,32
    $1 181,21     		$870,46
    $987,98
    $1 112,44
    $1 554,64
    $2 362,42     		$1 203,41
    $1 320,93
    $1 445,39
    $1 887,59     		$1 536,36
    $1 653,88
    $1 778,34
    $2 220,54     		$1 869,31
    $1 986,83
    $2 111,29
    $2 553,49     		$768,18
    $826,94
    $889,17
    $1 110,27     		$1 101,13
    $1 159,89
    $1 222,12
    $1 443,22     		$1 434,08
    $1 492,84
    $1 555,07
    $1 776,17     		$332,95

    ‡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 Gilchrist County here.

    Gilchrist County is in “Rating Area 20” of Florida.

    Currently, there are 51 plans offered in Rating Area 20.

    Obamacare Rates and Providers for Other Years

    2014 | 2015 | 2016| 2017 | 2018 | 2019 2020 2021

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