ADVERTISEMENT
|
Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.
Local: 1-855-738-6652 | Toll Free: 1-855-738-6652
|
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,850 |
$13,700 |
Maximum Out of Pocket Per Year |
$6,850 |
$13,700 |
Deductible: Individual:
$6,850
| Family:
$13,700
Out of Pocket Maximum per year: Individual:
$6,850
| Family:
$13,700
Monthly Premiums:
|
21
30
40
50
60
|
$286.13
$324.76
$365.67
$511.03
$776.56 |
$572.26
$649.52
$731.34
$1,022.06
$1,553.12 |
$791.15
$868.41
$950.23
$1,240.95 |
$1,010.04
$1,087.30
$1,169.12
$1,459.84 |
$1,228.93
$1,306.19
$1,388.01
$1,678.73 |
$505.02
$543.65
$584.56
$729.92 |
$723.91
$762.54
$803.45
$948.81 |
$942.80
$981.43
$1,022.34
$1,167.70 |
$218.89 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,000 |
$4,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$2,000
| Family:
$4,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$379.96
$431.25
$485.59
$678.61
$1,031.21 |
$759.92
$862.50
$971.18
$1,357.22
$2,062.42 |
$1,050.59
$1,153.17
$1,261.85
$1,647.89 |
$1,341.26
$1,443.84
$1,552.52
$1,938.56 |
$1,631.93
$1,734.51
$1,843.19
$2,229.23 |
$670.63
$721.92
$776.26
$969.28 |
$961.30
$1,012.59
$1,066.93
$1,259.95 |
$1,251.97
$1,303.26
$1,357.60
$1,550.62 |
$290.67 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,500 |
$11,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,500
| Family:
$11,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$348.21
$395.22
$445.01
$621.90
$945.04 |
$696.42
$790.44
$890.02
$1,243.80
$1,890.08 |
$962.80
$1,056.82
$1,156.40
$1,510.18 |
$1,229.18
$1,323.20
$1,422.78
$1,776.56 |
$1,495.56
$1,589.58
$1,689.16
$2,042.94 |
$614.59
$661.60
$711.39
$888.28 |
$880.97
$927.98
$977.77
$1,154.66 |
$1,147.35
$1,194.36
$1,244.15
$1,421.04 |
$266.38 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,200 |
$10,400 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,200
| Family:
$10,400
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$290.92
$330.19
$371.80
$519.58
$789.56 |
$581.84
$660.38
$743.60
$1,039.16
$1,579.12 |
$804.39
$882.93
$966.15
$1,261.71 |
$1,026.94
$1,105.48
$1,188.70
$1,484.26 |
$1,249.49
$1,328.03
$1,411.25
$1,706.81 |
$513.47
$552.74
$594.35
$742.13 |
$736.02
$775.29
$816.90
$964.68 |
$958.57
$997.84
$1,039.45
$1,187.23 |
$222.55 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,500 |
$11,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,500
| Family:
$11,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$283.83
$322.15
$362.73
$506.92
$770.31 |
$567.66
$644.30
$725.46
$1,013.84
$1,540.62 |
$784.79
$861.43
$942.59
$1,230.97 |
$1,001.92
$1,078.56
$1,159.72
$1,448.10 |
$1,219.05
$1,295.69
$1,376.85
$1,665.23 |
$500.96
$539.28
$579.86
$724.05 |
$718.09
$756.41
$796.99
$941.18 |
$935.22
$973.54
$1,014.12
$1,158.31 |
$217.13 |
|
Catastrophic
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$201.00
$228.14
$256.88
$358.99
$545.51 |
$402.00
$456.28
$513.76
$717.98
$1,091.02 |
$555.77
$610.05
$667.53
$871.75 |
$709.54
$763.82
$821.30
$1,025.52 |
$863.31
$917.59
$975.07
$1,179.29 |
$354.77
$381.91
$410.65
$512.76 |
$508.54
$535.68
$564.42
$666.53 |
$662.31
$689.45
$718.19
$820.30 |
$153.77 |
|
Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,750 |
$13,500 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,750
| Family:
$13,500
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$273.49
$310.41
$349.52
$488.45
$742.25 |
$546.98
$620.82
$699.04
$976.90
$1,484.50 |
$756.20
$830.04
$908.26
$1,186.12 |
$965.42
$1,039.26
$1,117.48
$1,395.34 |
$1,174.64
$1,248.48
$1,326.70
$1,604.56 |
$482.71
$519.63
$558.74
$697.67 |
$691.93
$728.85
$767.96
$906.89 |
$901.15
$938.07
$977.18
$1,116.11 |
$209.22 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,950 |
$9,900 |
Maximum Out of Pocket Per Year |
$6,500 |
$13,000 |
Deductible: Individual:
$4,950
| Family:
$9,900
Out of Pocket Maximum per year: Individual:
$6,500
| Family:
$13,000
Monthly Premiums:
|
21
30
40
50
60
|
$365.24
$414.55
$466.78
$652.32
$991.26 |
$730.48
$829.10
$933.56
$1,304.64
$1,982.52 |
$1,009.89
$1,108.51
$1,212.97
$1,584.05 |
$1,289.30
$1,387.92
$1,492.38
$1,863.46 |
$1,568.71
$1,667.33
$1,771.79
$2,142.87 |
$644.65
$693.96
$746.19
$931.73 |
$924.06
$973.37
$1,025.60
$1,211.14 |
$1,203.47
$1,252.78
$1,305.01
$1,490.55 |
$279.41 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,850 |
$3,700 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$1,850
| Family:
$3,700
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$515.30
$584.87
$658.55
$920.33
$1,398.52 |
$1,030.60
$1,169.74
$1,317.10
$1,840.66
$2,797.04 |
$1,424.80
$1,563.94
$1,711.30
$2,234.86 |
$1,819.00
$1,958.14
$2,105.50
$2,629.06 |
$2,213.20
$2,352.34
$2,499.70
$3,023.26 |
$909.50
$979.07
$1,052.75
$1,314.53 |
$1,303.70
$1,373.27
$1,446.95
$1,708.73 |
$1,697.90
$1,767.47
$1,841.15
$2,102.93 |
$394.20 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,800 |
$9,600 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$4,800
| Family:
$9,600
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$302.43
$343.26
$386.51
$540.14
$820.80 |
$604.86
$686.52
$773.02
$1,080.28
$1,641.60 |
$836.22
$917.88
$1,004.38
$1,311.64 |
$1,067.58
$1,149.24
$1,235.74
$1,543.00 |
$1,298.94
$1,380.60
$1,467.10
$1,774.36 |
$533.79
$574.62
$617.87
$771.50 |
$765.15
$805.98
$849.23
$1,002.86 |
$996.51
$1,037.34
$1,080.59
$1,234.22 |
$231.36 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,600 |
$5,200 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$2,600
| Family:
$5,200
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$394.03
$447.22
$503.57
$703.74
$1,069.40 |
$788.06
$894.44
$1,007.14
$1,407.48
$2,138.80 |
$1,089.49
$1,195.87
$1,308.57
$1,708.91 |
$1,390.92
$1,497.30
$1,610.00
$2,010.34 |
$1,692.35
$1,798.73
$1,911.43
$2,311.77 |
$695.46
$748.65
$805.00
$1,005.17 |
$996.89
$1,050.08
$1,106.43
$1,306.60 |
$1,298.32
$1,351.51
$1,407.86
$1,608.03 |
$301.43 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,000 |
$12,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,000
| Family:
$12,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$344.26
$390.74
$439.96
$614.85
$934.32 |
$688.52
$781.48
$879.92
$1,229.70
$1,868.64 |
$951.88
$1,044.84
$1,143.28
$1,493.06 |
$1,215.24
$1,308.20
$1,406.64
$1,756.42 |
$1,478.60
$1,571.56
$1,670.00
$2,019.78 |
$607.62
$654.10
$703.32
$878.21 |
$870.98
$917.46
$966.68
$1,141.57 |
$1,134.34
$1,180.82
$1,230.04
$1,404.93 |
$263.36 |
ADVERTISEMENT
|
CareSource Georgia Co.
Local: 1-833-230-2030 | Toll Free: 1-833-230-2030 | TTY: 1-800-255-0056
|
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,700 |
$15,400 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$7,700
| Family:
$15,400
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$263.77
$299.38
$337.10
$471.09
$715.87 |
$527.54
$598.76
$674.20
$942.18
$1,431.74 |
$729.32
$800.54
$875.98
$1,143.96 |
$931.10
$1,002.32
$1,077.76
$1,345.74 |
$1,132.88
$1,204.10
$1,279.54
$1,547.52 |
$465.55
$501.16
$538.88
$672.87 |
$667.33
$702.94
$740.66
$874.65 |
$869.11
$904.72
$942.44
$1,076.43 |
$201.78 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,000 |
$4,000 |
Maximum Out of Pocket Per Year |
$6,500 |
$13,000 |
Deductible: Individual:
$2,000
| Family:
$4,000
Out of Pocket Maximum per year: Individual:
$6,500
| Family:
$13,000
Monthly Premiums:
|
21
30
40
50
60
|
$396.18
$449.66
$506.32
$707.57
$1,075.23 |
$792.36
$899.32
$1,012.64
$1,415.14
$2,150.46 |
$1,095.44
$1,202.40
$1,315.72
$1,718.22 |
$1,398.52
$1,505.48
$1,618.80
$2,021.30 |
$1,701.60
$1,808.56
$1,921.88
$2,324.38 |
$699.26
$752.74
$809.40
$1,010.65 |
$1,002.34
$1,055.82
$1,112.48
$1,313.73 |
$1,305.42
$1,358.90
$1,415.56
$1,616.81 |
$303.08 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,800 |
$13,600 |
Maximum Out of Pocket Per Year |
$7,300 |
$14,600 |
Deductible: Individual:
$6,800
| Family:
$13,600
Out of Pocket Maximum per year: Individual:
$7,300
| Family:
$14,600
Monthly Premiums:
|
21
30
40
50
60
|
$370.42
$420.42
$473.39
$661.56
$1,005.31 |
$740.84
$840.84
$946.78
$1,323.12
$2,010.62 |
$1,024.21
$1,124.21
$1,230.15
$1,606.49 |
$1,307.58
$1,407.58
$1,513.52
$1,889.86 |
$1,590.95
$1,690.95
$1,796.89
$2,173.23 |
$653.79
$703.79
$756.76
$944.93 |
$937.16
$987.16
$1,040.13
$1,228.30 |
$1,220.53
$1,270.53
$1,323.50
$1,511.67 |
$283.37 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,900 |
$11,800 |
Maximum Out of Pocket Per Year |
$6,800 |
$13,600 |
Deductible: Individual:
$5,900
| Family:
$11,800
Out of Pocket Maximum per year: Individual:
$6,800
| Family:
$13,600
Monthly Premiums:
|
21
30
40
50
60
|
$388.89
$441.39
$497.00
$694.56
$1,055.45 |
$777.78
$882.78
$994.00
$1,389.12
$2,110.90 |
$1,075.28
$1,180.28
$1,291.50
$1,686.62 |
$1,372.78
$1,477.78
$1,589.00
$1,984.12 |
$1,670.28
$1,775.28
$1,886.50
$2,281.62 |
$686.39
$738.89
$794.50
$992.06 |
$983.89
$1,036.39
$1,092.00
$1,289.56 |
$1,281.39
$1,333.89
$1,389.50
$1,587.06 |
$297.50 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,100 |
$10,200 |
Maximum Out of Pocket Per Year |
$6,600 |
$13,200 |
Deductible: Individual:
$5,100
| Family:
$10,200
Out of Pocket Maximum per year: Individual:
$6,600
| Family:
$13,200
Monthly Premiums:
|
21
30
40
50
60
|
$404.47
$459.08
$516.91
$722.39
$1,097.74 |
$808.94
$918.16
$1,033.82
$1,444.78
$2,195.48 |
$1,118.36
$1,227.58
$1,343.24
$1,754.20 |
$1,427.78
$1,537.00
$1,652.66
$2,063.62 |
$1,737.20
$1,846.42
$1,962.08
$2,373.04 |
$713.89
$768.50
$826.33
$1,031.81 |
$1,023.31
$1,077.92
$1,135.75
$1,341.23 |
$1,332.73
$1,387.34
$1,445.17
$1,650.65 |
$309.42 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,300 |
$10,600 |
Maximum Out of Pocket Per Year |
$6,750 |
$13,500 |
Deductible: Individual:
$5,300
| Family:
$10,600
Out of Pocket Maximum per year: Individual:
$6,750
| Family:
$13,500
Monthly Premiums:
|
21
30
40
50
60
|
$298.09
$338.33
$380.96
$532.38
$809.01 |
$596.18
$676.66
$761.92
$1,064.76
$1,618.02 |
$824.22
$904.70
$989.96
$1,292.80 |
$1,052.26
$1,132.74
$1,218.00
$1,520.84 |
$1,280.30
$1,360.78
$1,446.04
$1,748.88 |
$526.13
$566.37
$609.00
$760.42 |
$754.17
$794.41
$837.04
$988.46 |
$982.21
$1,022.45
$1,065.08
$1,216.50 |
$228.04 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,700 |
$15,400 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$7,700
| Family:
$15,400
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$279.16
$316.84
$356.76
$498.57
$757.62 |
$558.32
$633.68
$713.52
$997.14
$1,515.24 |
$771.87
$847.23
$927.07
$1,210.69 |
$985.42
$1,060.78
$1,140.62
$1,424.24 |
$1,198.97
$1,274.33
$1,354.17
$1,637.79 |
$492.71
$530.39
$570.31
$712.12 |
$706.26
$743.94
$783.86
$925.67 |
$919.81
$957.49
$997.41
$1,139.22 |
$213.55 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,000 |
$4,000 |
Maximum Out of Pocket Per Year |
$6,500 |
$13,000 |
Deductible: Individual:
$2,000
| Family:
$4,000
Out of Pocket Maximum per year: Individual:
$6,500
| Family:
$13,000
Monthly Premiums:
|
21
30
40
50
60
|
$416.45
$472.67
$532.22
$743.78
$1,130.24 |
$832.90
$945.34
$1,064.44
$1,487.56
$2,260.48 |
$1,151.48
$1,263.92
$1,383.02
$1,806.14 |
$1,470.06
$1,582.50
$1,701.60
$2,124.72 |
$1,788.64
$1,901.08
$2,020.18
$2,443.30 |
$735.03
$791.25
$850.80
$1,062.36 |
$1,053.61
$1,109.83
$1,169.38
$1,380.94 |
$1,372.19
$1,428.41
$1,487.96
$1,699.52 |
$318.58 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,800 |
$13,600 |
Maximum Out of Pocket Per Year |
$7,300 |
$14,600 |
Deductible: Individual:
$6,800
| Family:
$13,600
Out of Pocket Maximum per year: Individual:
$7,300
| Family:
$14,600
Monthly Premiums:
|
21
30
40
50
60
|
$387.83
$440.18
$495.64
$692.66
$1,052.56 |
$775.66
$880.36
$991.28
$1,385.32
$2,105.12 |
$1,072.35
$1,177.05
$1,287.97
$1,682.01 |
$1,369.04
$1,473.74
$1,584.66
$1,978.70 |
$1,665.73
$1,770.43
$1,881.35
$2,275.39 |
$684.52
$736.87
$792.33
$989.35 |
$981.21
$1,033.56
$1,089.02
$1,286.04 |
$1,277.90
$1,330.25
$1,385.71
$1,582.73 |
$296.69 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,900 |
$11,800 |
Maximum Out of Pocket Per Year |
$6,800 |
$13,600 |
Deductible: Individual:
$5,900
| Family:
$11,800
Out of Pocket Maximum per year: Individual:
$6,800
| Family:
$13,600
Monthly Premiums:
|
21
30
40
50
60
|
$407.56
$462.57
$520.85
$727.89
$1,106.10 |
$815.12
$925.14
$1,041.70
$1,455.78
$2,212.20 |
$1,126.90
$1,236.92
$1,353.48
$1,767.56 |
$1,438.68
$1,548.70
$1,665.26
$2,079.34 |
$1,750.46
$1,860.48
$1,977.04
$2,391.12 |
$719.34
$774.35
$832.63
$1,039.67 |
$1,031.12
$1,086.13
$1,144.41
$1,351.45 |
$1,342.90
$1,397.91
$1,456.19
$1,663.23 |
$311.78 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,100 |
$10,200 |
Maximum Out of Pocket Per Year |
$6,600 |
$13,200 |
Deductible: Individual:
$5,100
| Family:
$10,200
Out of Pocket Maximum per year: Individual:
$6,600
| Family:
$13,200
Monthly Premiums:
|
21
30
40
50
60
|
$424.30
$481.58
$542.26
$757.80
$1,151.55 |
$848.60
$963.16
$1,084.52
$1,515.60
$2,303.10 |
$1,173.19
$1,287.75
$1,409.11
$1,840.19 |
$1,497.78
$1,612.34
$1,733.70
$2,164.78 |
$1,822.37
$1,936.93
$2,058.29
$2,489.37 |
$748.89
$806.17
$866.85
$1,082.39 |
$1,073.48
$1,130.76
$1,191.44
$1,406.98 |
$1,398.07
$1,455.35
$1,516.03
$1,731.57 |
$324.59 |
ADVERTISEMENT
|
Ambetter of Peach State Inc.
Local: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231
|
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,650 |
$11,300 |
Maximum Out of Pocket Per Year |
$6,950 |
$13,900 |
Deductible: Individual:
$5,650
| Family:
$11,300
Out of Pocket Maximum per year: Individual:
$6,950
| Family:
$13,900
Monthly Premiums:
|
21
30
40
50
60
|
$353.76
$401.51
$452.09
$631.80
$960.08 |
$707.52
$803.02
$904.18
$1,263.60
$1,920.16 |
$978.14
$1,073.64
$1,174.80
$1,534.22 |
$1,248.76
$1,344.26
$1,445.42
$1,804.84 |
$1,519.38
$1,614.88
$1,716.04
$2,075.46 |
$624.38
$672.13
$722.71
$902.42 |
$895.00
$942.75
$993.33
$1,173.04 |
$1,165.62
$1,213.37
$1,263.95
$1,443.66 |
$270.62 |
|
Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$288.59
$327.54
$368.81
$515.41
$783.22 |
$577.18
$655.08
$737.62
$1,030.82
$1,566.44 |
$797.95
$875.85
$958.39
$1,251.59 |
$1,018.72
$1,096.62
$1,179.16
$1,472.36 |
$1,239.49
$1,317.39
$1,399.93
$1,693.13 |
$509.36
$548.31
$589.58
$736.18 |
$730.13
$769.08
$810.35
$956.95 |
$950.90
$989.85
$1,031.12
$1,177.72 |
$220.77 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,050 |
$14,100 |
Maximum Out of Pocket Per Year |
$7,050 |
$14,100 |
Deductible: Individual:
$7,050
| Family:
$14,100
Out of Pocket Maximum per year: Individual:
$7,050
| Family:
$14,100
Monthly Premiums:
|
21
30
40
50
60
|
$343.36
$389.70
$438.80
$613.22
$931.84 |
$686.72
$779.40
$877.60
$1,226.44
$1,863.68 |
$949.38
$1,042.06
$1,140.26
$1,489.10 |
$1,212.04
$1,304.72
$1,402.92
$1,751.76 |
$1,474.70
$1,567.38
$1,665.58
$2,014.42 |
$606.02
$652.36
$701.46
$875.88 |
$868.68
$915.02
$964.12
$1,138.54 |
$1,131.34
$1,177.68
$1,226.78
$1,401.20 |
$262.66 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,000 |
$12,000 |
Maximum Out of Pocket Per Year |
$8,100 |
$16,200 |
Deductible: Individual:
$6,000
| Family:
$12,000
Out of Pocket Maximum per year: Individual:
$8,100
| Family:
$16,200
Monthly Premiums:
|
21
30
40
50
60
|
$332.51
$377.38
$424.93
$593.84
$902.40 |
$665.02
$754.76
$849.86
$1,187.68
$1,804.80 |
$919.38
$1,009.12
$1,104.22
$1,442.04 |
$1,173.74
$1,263.48
$1,358.58
$1,696.40 |
$1,428.10
$1,517.84
$1,612.94
$1,950.76 |
$586.87
$631.74
$679.29
$848.20 |
$841.23
$886.10
$933.65
$1,102.56 |
$1,095.59
$1,140.46
$1,188.01
$1,356.92 |
$254.36 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,250 |
$2,500 |
Maximum Out of Pocket Per Year |
$5,900 |
$11,800 |
Deductible: Individual:
$1,250
| Family:
$2,500
Out of Pocket Maximum per year: Individual:
$5,900
| Family:
$11,800
Monthly Premiums:
|
21
30
40
50
60
|
$372.89
$423.21
$476.53
$665.96
$1,011.98 |
$745.78
$846.42
$953.06
$1,331.92
$2,023.96 |
$1,031.03
$1,131.67
$1,238.31
$1,617.17 |
$1,316.28
$1,416.92
$1,523.56
$1,902.42 |
$1,601.53
$1,702.17
$1,808.81
$2,187.67 |
$658.14
$708.46
$761.78
$951.21 |
$943.39
$993.71
$1,047.03
$1,236.46 |
$1,228.64
$1,278.96
$1,332.28
$1,521.71 |
$285.25 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,500 |
$13,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,500
| Family:
$13,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$327.56
$371.77
$418.61
$585.01
$888.98 |
$655.12
$743.54
$837.22
$1,170.02
$1,777.96 |
$905.70
$994.12
$1,087.80
$1,420.60 |
$1,156.28
$1,244.70
$1,338.38
$1,671.18 |
$1,406.86
$1,495.28
$1,588.96
$1,921.76 |
$578.14
$622.35
$669.19
$835.59 |
$828.72
$872.93
$919.77
$1,086.17 |
$1,079.30
$1,123.51
$1,170.35
$1,336.75 |
$250.58 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,950 |
$5,900 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$2,950
| Family:
$5,900
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$362.04
$410.90
$462.67
$646.58
$982.54 |
$724.08
$821.80
$925.34
$1,293.16
$1,965.08 |
$1,001.03
$1,098.75
$1,202.29
$1,570.11 |
$1,277.98
$1,375.70
$1,479.24
$1,847.06 |
$1,554.93
$1,652.65
$1,756.19
$2,124.01 |
$638.99
$687.85
$739.62
$923.53 |
$915.94
$964.80
$1,016.57
$1,200.48 |
$1,192.89
$1,241.75
$1,293.52
$1,477.43 |
$276.95 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,750 |
$13,500 |
Maximum Out of Pocket Per Year |
$6,750 |
$13,500 |
Deductible: Individual:
$6,750
| Family:
$13,500
Out of Pocket Maximum per year: Individual:
$6,750
| Family:
$13,500
Monthly Premiums:
|
21
30
40
50
60
|
$307.17
$348.62
$392.55
$548.59
$833.63 |
$614.34
$697.24
$785.10
$1,097.18
$1,667.26 |
$849.32
$932.22
$1,020.08
$1,332.16 |
$1,084.30
$1,167.20
$1,255.06
$1,567.14 |
$1,319.28
$1,402.18
$1,490.04
$1,802.12 |
$542.15
$583.60
$627.53
$783.57 |
$777.13
$818.58
$862.51
$1,018.55 |
$1,012.11
$1,053.56
$1,097.49
$1,253.53 |
$234.98 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,650 |
$11,300 |
Maximum Out of Pocket Per Year |
$6,950 |
$13,900 |
Deductible: Individual:
$5,650
| Family:
$11,300
Out of Pocket Maximum per year: Individual:
$6,950
| Family:
$13,900
Monthly Premiums:
|
21
30
40
50
60
|
$369.63
$419.52
$472.37
$660.14
$1,003.14 |
$739.26
$839.04
$944.74
$1,320.28
$2,006.28 |
$1,022.02
$1,121.80
$1,227.50
$1,603.04 |
$1,304.78
$1,404.56
$1,510.26
$1,885.80 |
$1,587.54
$1,687.32
$1,793.02
$2,168.56 |
$652.39
$702.28
$755.13
$942.90 |
$935.15
$985.04
$1,037.89
$1,225.66 |
$1,217.91
$1,267.80
$1,320.65
$1,508.42 |
$282.76 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,050 |
$14,100 |
Maximum Out of Pocket Per Year |
$7,050 |
$14,100 |
Deductible: Individual:
$7,050
| Family:
$14,100
Out of Pocket Maximum per year: Individual:
$7,050
| Family:
$14,100
Monthly Premiums:
|
21
30
40
50
60
|
$358.76
$407.18
$458.48
$640.72
$973.64 |
$717.52
$814.36
$916.96
$1,281.44
$1,947.28 |
$991.96
$1,088.80
$1,191.40
$1,555.88 |
$1,266.40
$1,363.24
$1,465.84
$1,830.32 |
$1,540.84
$1,637.68
$1,740.28
$2,104.76 |
$633.20
$681.62
$732.92
$915.16 |
$907.64
$956.06
$1,007.36
$1,189.60 |
$1,182.08
$1,230.50
$1,281.80
$1,464.04 |
$274.44 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,000 |
$12,000 |
Maximum Out of Pocket Per Year |
$8,100 |
$16,200 |
Deductible: Individual:
$6,000
| Family:
$12,000
Out of Pocket Maximum per year: Individual:
$8,100
| Family:
$16,200
Monthly Premiums:
|
21
30
40
50
60
|
$347.42
$394.31
$443.99
$620.48
$942.87 |
$694.84
$788.62
$887.98
$1,240.96
$1,885.74 |
$960.61
$1,054.39
$1,153.75
$1,506.73 |
$1,226.38
$1,320.16
$1,419.52
$1,772.50 |
$1,492.15
$1,585.93
$1,685.29
$2,038.27 |
$613.19
$660.08
$709.76
$886.25 |
$878.96
$925.85
$975.53
$1,152.02 |
$1,144.73
$1,191.62
$1,241.30
$1,417.79 |
$265.77 |
|
Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$301.54
$342.23
$385.35
$538.53
$818.34 |
$603.08
$684.46
$770.70
$1,077.06
$1,636.68 |
$833.75
$915.13
$1,001.37
$1,307.73 |
$1,064.42
$1,145.80
$1,232.04
$1,538.40 |
$1,295.09
$1,376.47
$1,462.71
$1,769.07 |
$532.21
$572.90
$616.02
$769.20 |
$762.88
$803.57
$846.69
$999.87 |
$993.55
$1,034.24
$1,077.36
$1,230.54 |
$230.67 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,250 |
$2,500 |
Maximum Out of Pocket Per Year |
$5,900 |
$11,800 |
Deductible: Individual:
$1,250
| Family:
$2,500
Out of Pocket Maximum per year: Individual:
$5,900
| Family:
$11,800
Monthly Premiums:
|
21
30
40
50
60
|
$389.61
$442.20
$497.91
$695.83
$1,057.37 |
$779.22
$884.40
$995.82
$1,391.66
$2,114.74 |
$1,077.26
$1,182.44
$1,293.86
$1,689.70 |
$1,375.30
$1,480.48
$1,591.90
$1,987.74 |
$1,673.34
$1,778.52
$1,889.94
$2,285.78 |
$687.65
$740.24
$795.95
$993.87 |
$985.69
$1,038.28
$1,093.99
$1,291.91 |
$1,283.73
$1,336.32
$1,392.03
$1,589.95 |
$298.04 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,950 |
$5,900 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$2,950
| Family:
$5,900
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$378.27
$429.33
$483.42
$675.58
$1,026.61 |
$756.54
$858.66
$966.84
$1,351.16
$2,053.22 |
$1,045.91
$1,148.03
$1,256.21
$1,640.53 |
$1,335.28
$1,437.40
$1,545.58
$1,929.90 |
$1,624.65
$1,726.77
$1,834.95
$2,219.27 |
$667.64
$718.70
$772.79
$964.95 |
$957.01
$1,008.07
$1,062.16
$1,254.32 |
$1,246.38
$1,297.44
$1,351.53
$1,543.69 |
$289.37 |
ADVERTISEMENT
|
Kaiser Foundation Health Plan of Georgia
Local: 1-800-494-5314 | Toll Free: 1-800-494-5314
|
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$500 |
$1,000 |
Maximum Out of Pocket Per Year |
$7,150 |
$14,300 |
Deductible: Individual:
$500
| Family:
$1,000
Out of Pocket Maximum per year: Individual:
$7,150
| Family:
$14,300
Monthly Premiums:
|
21
30
40
50
60
|
$516.52
$586.25
$660.11
$922.51
$1,401.84 |
$1,033.04
$1,172.50
$1,320.22
$1,845.02
$2,803.68 |
$1,428.18
$1,567.64
$1,715.36
$2,240.16 |
$1,823.32
$1,962.78
$2,110.50
$2,635.30 |
$2,218.46
$2,357.92
$2,505.64
$3,030.44 |
$911.66
$981.39
$1,055.25
$1,317.65 |
$1,306.80
$1,376.53
$1,450.39
$1,712.79 |
$1,701.94
$1,771.67
$1,845.53
$2,107.93 |
$395.14 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$3,000 |
$6,000 |
Maximum Out of Pocket Per Year |
$7,900 |
$15,800 |
Deductible: Individual:
$3,000
| Family:
$6,000
Out of Pocket Maximum per year: Individual:
$7,900
| Family:
$15,800
Monthly Premiums:
|
21
30
40
50
60
|
$496.32
$563.32
$634.29
$886.42
$1,347.00 |
$992.64
$1,126.64
$1,268.58
$1,772.84
$2,694.00 |
$1,372.32
$1,506.32
$1,648.26
$2,152.52 |
$1,752.00
$1,886.00
$2,027.94
$2,532.20 |
$2,131.68
$2,265.68
$2,407.62
$2,911.88 |
$876.00
$943.00
$1,013.97
$1,266.10 |
$1,255.68
$1,322.68
$1,393.65
$1,645.78 |
$1,635.36
$1,702.36
$1,773.33
$2,025.46 |
$379.68 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$3,200 |
$6,400 |
Maximum Out of Pocket Per Year |
$6,000 |
$12,000 |
Deductible: Individual:
$3,200
| Family:
$6,400
Out of Pocket Maximum per year: Individual:
$6,000
| Family:
$12,000
Monthly Premiums:
|
21
30
40
50
60
|
$480.49
$545.35
$614.06
$858.15
$1,304.05 |
$960.98
$1,090.70
$1,228.12
$1,716.30
$2,608.10 |
$1,328.55
$1,458.27
$1,595.69
$2,083.87 |
$1,696.12
$1,825.84
$1,963.26
$2,451.44 |
$2,063.69
$2,193.41
$2,330.83
$2,819.01 |
$848.06
$912.92
$981.63
$1,225.72 |
$1,215.63
$1,280.49
$1,349.20
$1,593.29 |
$1,583.20
$1,648.06
$1,716.77
$1,960.86 |
$367.57 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,000 |
$10,000 |
Maximum Out of Pocket Per Year |
$7,350 |
$14,700 |
Deductible: Individual:
$5,000
| Family:
$10,000
Out of Pocket Maximum per year: Individual:
$7,350
| Family:
$14,700
Monthly Premiums:
|
21
30
40
50
60
|
$370.71
$420.75
$473.76
$662.08
$1,006.10 |
$741.42
$841.50
$947.52
$1,324.16
$2,012.20 |
$1,025.01
$1,125.09
$1,231.11
$1,607.75 |
$1,308.60
$1,408.68
$1,514.70
$1,891.34 |
$1,592.19
$1,692.27
$1,798.29
$2,174.93 |
$654.30
$704.34
$757.35
$945.67 |
$937.89
$987.93
$1,040.94
$1,229.26 |
$1,221.48
$1,271.52
$1,324.53
$1,512.85 |
$283.59 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,200 |
$12,400 |
Maximum Out of Pocket Per Year |
$6,550 |
$13,100 |
Deductible: Individual:
$6,200
| Family:
$12,400
Out of Pocket Maximum per year: Individual:
$6,550
| Family:
$13,100
Monthly Premiums:
|
21
30
40
50
60
|
$365.10
$414.39
$466.60
$652.06
$990.88 |
$730.20
$828.78
$933.20
$1,304.12
$1,981.76 |
$1,009.50
$1,108.08
$1,212.50
$1,583.42 |
$1,288.80
$1,387.38
$1,491.80
$1,862.72 |
$1,568.10
$1,666.68
$1,771.10
$2,142.02 |
$644.40
$693.69
$745.90
$931.36 |
$923.70
$972.99
$1,025.20
$1,210.66 |
$1,203.00
$1,252.29
$1,304.50
$1,489.96 |
$279.30 |
|
Catastrophic
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$319.32
$362.43
$408.09
$570.31
$866.64 |
$638.64
$724.86
$816.18
$1,140.62
$1,733.28 |
$882.92
$969.14
$1,060.46
$1,384.90 |
$1,127.20
$1,213.42
$1,304.74
$1,629.18 |
$1,371.48
$1,457.70
$1,549.02
$1,873.46 |
$563.60
$606.71
$652.37
$814.59 |
$807.88
$850.99
$896.65
$1,058.87 |
$1,052.16
$1,095.27
$1,140.93
$1,303.15 |
$244.28 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,500 |
$3,000 |
Maximum Out of Pocket Per Year |
$5,000 |
$10,000 |
Deductible: Individual:
$1,500
| Family:
$3,000
Out of Pocket Maximum per year: Individual:
$5,000
| Family:
$10,000
Monthly Premiums:
|
21
30
40
50
60
|
$505.87
$574.16
$646.50
$903.48
$1,372.92 |
$1,011.74
$1,148.32
$1,293.00
$1,806.96
$2,745.84 |
$1,398.73
$1,535.31
$1,679.99
$2,193.95 |
$1,785.72
$1,922.30
$2,066.98
$2,580.94 |
$2,172.71
$2,309.29
$2,453.97
$2,967.93 |
$892.86
$961.15
$1,033.49
$1,290.47 |
$1,279.85
$1,348.14
$1,420.48
$1,677.46 |
$1,666.84
$1,735.13
$1,807.47
$2,064.45 |
$386.99 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,500 |
$9,000 |
Maximum Out of Pocket Per Year |
$7,350 |
$14,700 |
Deductible: Individual:
$4,500
| Family:
$9,000
Out of Pocket Maximum per year: Individual:
$7,350
| Family:
$14,700
Monthly Premiums:
|
21
30
40
50
60
|
$468.46
$531.70
$598.69
$836.67
$1,271.40 |
$936.92
$1,063.40
$1,197.38
$1,673.34
$2,542.80 |
$1,295.29
$1,421.77
$1,555.75
$2,031.71 |
$1,653.66
$1,780.14
$1,914.12
$2,390.08 |
$2,012.03
$2,138.51
$2,272.49
$2,748.45 |
$826.83
$890.07
$957.06
$1,195.04 |
$1,185.20
$1,248.44
$1,315.43
$1,553.41 |
$1,543.57
$1,606.81
$1,673.80
$1,911.78 |
$358.37 |
Fayette County is in “Rating Area 3” of Georgia.
Currently, there are 45 plans offered in Rating Area 3.