Obamacare 2022 Rates and Health Insurance Providers for Fayette County , Georgia

Obamacare > Rates > Georgia > Fayette County

Obamacare Rates and Providers for Other Years

2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 |

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 Fayette County, GA.

The health insurance rates listed below are for calendar year 2022.

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

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

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 Peachtree City, GA area accept this insurance coverage as within the plan's network.

Obamacare Providers, Plans and 2022 Rates for Fayette County, Georgia

Below, you’ll find a summary of the 53 plans for Fayette County, Georgia and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

Obamacare Rates and Providers for Other Years

2014 | 2015 | 2016| 2017 | 2018 | 2019 2020 2021 2022

You may also be interested in:

How to Sign Up for Obamacare in Georgia

For 2022 health plans, Georgia open enrollment has ended. However, you may still be able to purchase health insurance for this year if you qualify for a special enrollment period. For example, if you’ve recently lost your job or income due to the COVID-19 crisis or for any other reason, you might qualify for a 60-day special enrollment period that will allow you to sign up for a new health insurance plan. (See What Happens If I Missed the Enrollment Deadline for 2022?)

To get covered, you can go directly to the online health insurance marketplace for Georgia. If you need personalized help, you can reach out to an enrollment assistant. Most enrollment helpers are working remotely during the COVID crisis.

Where's the Georgia Health Care Exchange?

In Georgia, you may have heard that you can no longer buy health insurance through Healthcare.gov, but that's not true. While the Trump administration approved a plan to close Healthcare.gov to Georgians, that decision would not take effect until 2023 and will likely change before then. Georgia residents can still use Healthcare.gov to compare plans, sign up for coverage, and get financial assistance.

more...  

Georgia Medicaid Expansion: Do I Qualify for Medicaid Under the ACA?

The Affordable Care Act (Obamacare) expanded Medicaid eligibility to include more people who couldn’t otherwise obtain health insurance. As written, the ACA would extend Medicaid to all adults with incomes at or below 138% of the federal poverty level. (For a single person in Georgia in 2021, that’s $17,609. For a family of four, it’s $36,156.)

However, the U.S. Supreme Court later ruled that it was up to individual states to decide whether to expand Medicaid. As of October 2021, 12 states have not expanded their programs.

Georgia Has Not Expanded Medicaid

Because Georgia has not yet expanded Medicaid eligibility, you may have fewer options for health coverage than people in states where Medicaid is more inclusive.

The Medicaid Coverage Gap

The Affordable Care Act assumed that Medicaid would be expanded to cover all Americans with incomes at or below 138% of the federal poverty level. And it created health plan subsidies for people with incomes between 100% - 400% of the poverty level.

That means Georgia residents with incomes below the poverty level may fall into a coverage gap where they can get neither Medicaid nor ACA subsidies.

more...  

Get Help Finding a Health Insurance Plan in Georgia

Get Help From Georgia's Health Insurance Exchange

The following links and telephone numbers take you to the official help resources for Healthcare.gov, the health insurance marketplace for Georgia.

Help by phone: 800-318-2596 (TTY: 855-889-4325)

In-person help: Go to Find Local Help, where you can enter your city and state or zip code to find an application assister, insurance agent, or health insurance broker in your area.

Get Help From a Licensed Insurance Broker

To directly connect with a Georgia insurance broker who can help you evaluate insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)

More Information

For more detailed information, see How Do I Sign Up for Obamacare in Georgia?

  • Fayette County, GA Obamacare Rates
  • General Info
  • Rates
Obamacare Basics for Georgia - (Basics)
Obamacare Rates for Fayette County - (Rates)
Obamacare Enrollment - (How to Enroll)
Obamacare Financial Assistance - (Financial Help)
Obamacare for Different Life Situations - (Life Situations)
Using Your Obamacare Health Insurance Plan - (Using Your Plan)
Obamacare News - (News)

ADVERTISEMENT

Blue Cross Blue Shield Healthcare Plan of Georgia, Inc

Local: 1-855-738-6652 | Toll Free: 1-855-738-6652

Toc - Plan #1 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 0 for HSA

Annual Out of Pocket Expenses
Individual Family
$7,000 $14,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$310,25
$352,13
$396,50
$554,11
$842,02 		$547,59
$589,47
$633,84
$791,45 		$784,93
$826,81
$871,18
$1 028,79 		$1 022,27
$1 064,15
$1 108,52
$1 266,13 		$237,34
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$620,50
$704,26
$793,00
$1 108,22
$1 684,04 		$857,84
$941,60
$1 030,34
$1 345,56 		$1 095,18
$1 178,94
$1 267,68
$1 582,90 		$1 332,52
$1 416,28
$1 505,02
$1 820,24 		$237,34
Toc - Plan #2 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 3000

Annual Out of Pocket Expenses
Individual Family
$3,000 $6,000 Annual Deductible
$7,700 $15,400 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$365,79
$415,17
$467,48
$653,30
$992,75 		$645,62
$695,00
$747,31
$933,13 		$925,45
$974,83
$1 027,14
$1 212,96 		$1 205,28
$1 254,66
$1 306,97
$1 492,79 		$279,83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$731,58
$830,34
$934,96
$1 306,60
$1 985,50 		$1 011,41
$1 110,17
$1 214,79
$1 586,43 		$1 291,24
$1 390,00
$1 494,62
$1 866,26 		$1 571,07
$1 669,83
$1 774,45
$2 146,09 		$279,83
Toc - Plan #3 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 5500

Annual Out of Pocket Expenses
Individual Family
$5,500 $11,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$348,84
$395,93
$445,82
$623,03
$946,75 		$615,70
$662,79
$712,68
$889,89 		$882,56
$929,65
$979,54
$1 156,75 		$1 149,42
$1 196,51
$1 246,40
$1 423,61 		$266,86
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$697,68
$791,86
$891,64
$1 246,06
$1 893,50 		$964,54
$1 058,72
$1 158,50
$1 512,92 		$1 231,40
$1 325,58
$1 425,36
$1 779,78 		$1 498,26
$1 592,44
$1 692,22
$2 046,64 		$266,86
Toc - Plan #4 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 5600

Annual Out of Pocket Expenses
Individual Family
$5,600 $11,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$308,12
$349,72
$393,78
$550,30
$836,24 		$543,83
$585,43
$629,49
$786,01 		$779,54
$821,14
$865,20
$1 021,72 		$1 015,25
$1 056,85
$1 100,91
$1 257,43 		$235,71
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$616,24
$699,44
$787,56
$1 100,60
$1 672,48 		$851,95
$935,15
$1 023,27
$1 336,31 		$1 087,66
$1 170,86
$1 258,98
$1 572,02 		$1 323,37
$1 406,57
$1 494,69
$1 807,73 		$235,71
Toc - Plan #5 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 6000

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$303,55
$344,53
$387,94
$542,14
$823,83 		$535,77
$576,75
$620,16
$774,36 		$767,99
$808,97
$852,38
$1 006,58 		$1 000,21
$1 041,19
$1 084,60
$1 238,80 		$232,22
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$607,10
$689,06
$775,88
$1 084,28
$1 647,66 		$839,32
$921,28
$1 008,10
$1 316,50 		$1 071,54
$1 153,50
$1 240,32
$1 548,72 		$1 303,76
$1 385,72
$1 472,54
$1 780,94 		$232,22
Toc - Plan #6 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Catastrophic

(HMO) Anthem Catastrophic Pathway X Guided Access HMO 8550

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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$211,59
$240,15
$270,41
$377,90
$574,26 		$373,46
$402,02
$432,28
$539,77 		$535,33
$563,89
$594,15
$701,64 		$697,20
$725,76
$756,02
$863,51 		$161,87
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$423,18
$480,30
$540,82
$755,80
$1 148,52 		$585,05
$642,17
$702,69
$917,67 		$746,92
$804,04
$864,56
$1 079,54 		$908,79
$965,91
$1 026,43
$1 241,41 		$161,87
Toc - Plan #7 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 6750

Annual Out of Pocket Expenses
Individual Family
$6,750 $13,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$293,18
$332,76
$374,68
$523,62
$795,69 		$517,46
$557,04
$598,96
$747,90 		$741,74
$781,32
$823,24
$972,18 		$966,02
$1 005,60
$1 047,52
$1 196,46 		$224,28
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$586,36
$665,52
$749,36
$1 047,24
$1 591,38 		$810,64
$889,80
$973,64
$1 271,52 		$1 034,92
$1 114,08
$1 197,92
$1 495,80 		$1 259,20
$1 338,36
$1 422,20
$1 720,08 		$224,28
Toc - Plan #8 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 4950

Annual Out of Pocket Expenses
Individual Family
$4,950 $9,900 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$359,09
$407,57
$458,92
$641,33
$974,57 		$633,79
$682,27
$733,62
$916,03 		$908,49
$956,97
$1 008,32
$1 190,73 		$1 183,19
$1 231,67
$1 283,02
$1 465,43 		$274,70
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$718,18
$815,14
$917,84
$1 282,66
$1 949,14 		$992,88
$1 089,84
$1 192,54
$1 557,36 		$1 267,58
$1 364,54
$1 467,24
$1 832,06 		$1 542,28
$1 639,24
$1 741,94
$2 106,76 		$274,70
Toc - Plan #9 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Gold

(HMO) Anthem Gold Pathway X Guided Access HMO 1850

Annual Out of Pocket Expenses
Individual Family
$1,850 $3,700 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$428,49
$486,34
$547,61
$765,28
$1 162,92 		$756,28
$814,13
$875,40
$1 093,07 		$1 084,07
$1 141,92
$1 203,19
$1 420,86 		$1 411,86
$1 469,71
$1 530,98
$1 748,65 		$327,79
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$856,98
$972,68
$1 095,22
$1 530,56
$2 325,84 		$1 184,77
$1 300,47
$1 423,01
$1 858,35 		$1 512,56
$1 628,26
$1 750,80
$2 186,14 		$1 840,35
$1 956,05
$2 078,59
$2 513,93 		$327,79
Toc - Plan #10 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 4900

Annual Out of Pocket Expenses
Individual Family
$4,900 $9,800 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$320,54
$363,81
$409,65
$572,48
$869,95 		$565,75
$609,02
$654,86
$817,69 		$810,96
$854,23
$900,07
$1 062,90 		$1 056,17
$1 099,44
$1 145,28
$1 308,11 		$245,21
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$641,08
$727,62
$819,30
$1 144,96
$1 739,90 		$886,29
$972,83
$1 064,51
$1 390,17 		$1 131,50
$1 218,04
$1 309,72
$1 635,38 		$1 376,71
$1 463,25
$1 554,93
$1 880,59 		$245,21
Toc - Plan #11 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 2600

Annual Out of Pocket Expenses
Individual Family
$2,600 $5,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$395,74
$449,16
$505,76
$706,79
$1 074,04 		$698,48
$751,90
$808,50
$1 009,53 		$1 001,22
$1 054,64
$1 111,24
$1 312,27 		$1 303,96
$1 357,38
$1 413,98
$1 615,01 		$302,74
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$791,48
$898,32
$1 011,52
$1 413,58
$2 148,08 		$1 094,22
$1 201,06
$1 314,26
$1 716,32 		$1 396,96
$1 503,80
$1 617,00
$2 019,06 		$1 699,70
$1 806,54
$1 919,74
$2 321,80 		$302,74
Toc - Plan #12 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 6250

Annual Out of Pocket Expenses
Individual Family
$6,250 $12,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$342,29
$388,50
$437,45
$611,33
$928,98 		$604,14
$650,35
$699,30
$873,18 		$865,99
$912,20
$961,15
$1 135,03 		$1 127,84
$1 174,05
$1 223,00
$1 396,88 		$261,85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$684,58
$777,00
$874,90
$1 222,66
$1 857,96 		$946,43
$1 038,85
$1 136,75
$1 484,51 		$1 208,28
$1 300,70
$1 398,60
$1 746,36 		$1 470,13
$1 562,55
$1 660,45
$2 008,21 		$261,85

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CareSource

Local: 1-833-230-2030 | Toll Free: 1-833-230-2030 | TTY: 1-800-255-0056
Toc - Plan #13 CareSource
Expanded Bronze

(HMO) CareSource Marketplace Bronze

Annual Out of Pocket Expenses
Individual Family
$7,700 $15,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$278,42
$316,00
$355,81
$497,25
$755,61 		$491,41
$528,99
$568,80
$710,24 		$704,40
$741,98
$781,79
$923,23 		$917,39
$954,97
$994,78
$1 136,22 		$212,99
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$556,84
$632,00
$711,62
$994,50
$1 511,22 		$769,83
$844,99
$924,61
$1 207,49 		$982,82
$1 057,98
$1 137,60
$1 420,48 		$1 195,81
$1 270,97
$1 350,59
$1 633,47 		$212,99
Toc - Plan #14 CareSource
Gold

(HMO) CareSource Marketplace Gold

Annual Out of Pocket Expenses
Individual Family
$2,000 $4,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$389,09
$441,61
$497,25
$694,90
$1 055,97 		$686,74
$739,26
$794,90
$992,55 		$984,39
$1 036,91
$1 092,55
$1 290,20 		$1 282,04
$1 334,56
$1 390,20
$1 587,85 		$297,65
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$778,18
$883,22
$994,50
$1 389,80
$2 111,94 		$1 075,83
$1 180,87
$1 292,15
$1 687,45 		$1 373,48
$1 478,52
$1 589,80
$1 985,10 		$1 671,13
$1 776,17
$1 887,45
$2 282,75 		$297,65
Toc - Plan #15 CareSource
Silver

(HMO) CareSource Marketplace Low Premium Silver

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$390,09
$442,75
$498,53
$696,69
$1 058,69 		$688,51
$741,17
$796,95
$995,11 		$986,93
$1 039,59
$1 095,37
$1 293,53 		$1 285,35
$1 338,01
$1 393,79
$1 591,95 		$298,42
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$780,18
$885,50
$997,06
$1 393,38
$2 117,38 		$1 078,60
$1 183,92
$1 295,48
$1 691,80 		$1 377,02
$1 482,34
$1 593,90
$1 990,22 		$1 675,44
$1 780,76
$1 892,32
$2 288,64 		$298,42
Toc - Plan #16 CareSource
Silver

(HMO) CareSource Marketplace Standard Silver

Annual Out of Pocket Expenses
Individual Family
$5,800 $11,600 Annual Deductible
$7,900 $15,800 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$408,98
$464,19
$522,67
$730,44
$1 109,97 		$721,85
$777,06
$835,54
$1 043,31 		$1 034,72
$1 089,93
$1 148,41
$1 356,18 		$1 347,59
$1 402,80
$1 461,28
$1 669,05 		$312,87
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$817,96
$928,38
$1 045,34
$1 460,88
$2 219,94 		$1 130,83
$1 241,25
$1 358,21
$1 773,75 		$1 443,70
$1 554,12
$1 671,08
$2 086,62 		$1 756,57
$1 866,99
$1 983,95
$2 399,49 		$312,87
Toc - Plan #17 CareSource
Silver

(HMO) CareSource Marketplace Low Deductible Silver

Annual Out of Pocket Expenses
Individual Family
$5,100 $10,200 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$419,57
$476,21
$536,20
$749,34
$1 138,70 		$740,54
$797,18
$857,17
$1 070,31 		$1 061,51
$1 118,15
$1 178,14
$1 391,28 		$1 382,48
$1 439,12
$1 499,11
$1 712,25 		$320,97
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$839,14
$952,42
$1 072,40
$1 498,68
$2 277,40 		$1 160,11
$1 273,39
$1 393,37
$1 819,65 		$1 481,08
$1 594,36
$1 714,34
$2 140,62 		$1 802,05
$1 915,33
$2 035,31
$2 461,59 		$320,97
Toc - Plan #18 CareSource
Expanded Bronze

(HMO) CareSource Marketplace HSA Eligible Bronze

Annual Out of Pocket Expenses
Individual Family
$5,400 $10,800 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$303,99
$345,03
$388,50
$542,93
$825,03 		$536,54
$577,58
$621,05
$775,48 		$769,09
$810,13
$853,60
$1 008,03 		$1 001,64
$1 042,68
$1 086,15
$1 240,58 		$232,55
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$607,98
$690,06
$777,00
$1 085,86
$1 650,06 		$840,53
$922,61
$1 009,55
$1 318,41 		$1 073,08
$1 155,16
$1 242,10
$1 550,96 		$1 305,63
$1 387,71
$1 474,65
$1 783,51 		$232,55
Toc - Plan #19 CareSource
Expanded Bronze

(HMO) CareSource Marketplace Bronze Dental, Vision, & Fitness

Annual Out of Pocket Expenses
Individual Family
$7,700 $15,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$293,78
$333,44
$375,45
$524,69
$797,32 		$518,52
$558,18
$600,19
$749,43 		$743,26
$782,92
$824,93
$974,17 		$968,00
$1 007,66
$1 049,67
$1 198,91 		$224,74
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$587,56
$666,88
$750,90
$1 049,38
$1 594,64 		$812,30
$891,62
$975,64
$1 274,12 		$1 037,04
$1 116,36
$1 200,38
$1 498,86 		$1 261,78
$1 341,10
$1 425,12
$1 723,60 		$224,74
Toc - Plan #20 CareSource
Gold

(HMO) CareSource Marketplace Gold Dental, Vision, & Fitness

Annual Out of Pocket Expenses
Individual Family
$2,000 $4,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$409,61
$464,90
$523,48
$731,56
$1 111,67 		$722,96
$778,25
$836,83
$1 044,91 		$1 036,31
$1 091,60
$1 150,18
$1 358,26 		$1 349,66
$1 404,95
$1 463,53
$1 671,61 		$313,35
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$819,22
$929,80
$1 046,96
$1 463,12
$2 223,34 		$1 132,57
$1 243,15
$1 360,31
$1 776,47 		$1 445,92
$1 556,50
$1 673,66
$2 089,82 		$1 759,27
$1 869,85
$1 987,01
$2 403,17 		$313,35
Toc - Plan #21 CareSource
Silver

(HMO) CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$407,59
$462,62
$520,90
$727,96
$1 106,20 		$719,40
$774,43
$832,71
$1 039,77 		$1 031,21
$1 086,24
$1 144,52
$1 351,58 		$1 343,02
$1 398,05
$1 456,33
$1 663,39 		$311,81
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$815,18
$925,24
$1 041,80
$1 455,92
$2 212,40 		$1 126,99
$1 237,05
$1 353,61
$1 767,73 		$1 438,80
$1 548,86
$1 665,42
$2 079,54 		$1 750,61
$1 860,67
$1 977,23
$2 391,35 		$311,81
Toc - Plan #22 CareSource
Silver

(HMO) CareSource Marketplace Standard Silver Dental, Vision, & Fitness

Annual Out of Pocket Expenses
Individual Family
$5,800 $11,600 Annual Deductible
$7,900 $15,800 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$427,81
$485,56
$546,74
$764,07
$1 161,08 		$755,08
$812,83
$874,01
$1 091,34 		$1 082,35
$1 140,10
$1 201,28
$1 418,61 		$1 409,62
$1 467,37
$1 528,55
$1 745,88 		$327,27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$855,62
$971,12
$1 093,48
$1 528,14
$2 322,16 		$1 182,89
$1 298,39
$1 420,75
$1 855,41 		$1 510,16
$1 625,66
$1 748,02
$2 182,68 		$1 837,43
$1 952,93
$2 075,29
$2 509,95 		$327,27
Toc - Plan #23 CareSource
Silver

(HMO) CareSource Marketplace Low Deductible Silver Dental, Vision, & Fitness

Annual Out of Pocket Expenses
Individual Family
$5,100 $10,200 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$439,63
$498,97
$561,84
$785,16
$1 193,13 		$775,94
$835,28
$898,15
$1 121,47 		$1 112,25
$1 171,59
$1 234,46
$1 457,78 		$1 448,56
$1 507,90
$1 570,77
$1 794,09 		$336,31
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$879,26
$997,94
$1 123,68
$1 570,32
$2 386,26 		$1 215,57
$1 334,25
$1 459,99
$1 906,63 		$1 551,88
$1 670,56
$1 796,30
$2 242,94 		$1 888,19
$2 006,87
$2 132,61
$2 579,25 		$336,31

ADVERTISEMENT

Ambetter from Peach State Health Plan

Local: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231
Toc - Plan #24 Ambetter from Peach State Health Plan
Bronze

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$276,61
$313,94
$353,49
$494,00
$750,69 		$488,21
$525,54
$565,09
$705,60 		$699,81
$737,14
$776,69
$917,20 		$911,41
$948,74
$988,29
$1 128,80 		$211,60
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$553,22
$627,88
$706,98
$988,00
$1 501,38 		$764,82
$839,48
$918,58
$1 199,60 		$976,42
$1 051,08
$1 130,18
$1 411,20 		$1 188,02
$1 262,68
$1 341,78
$1 622,80 		$211,60
Toc - Plan #25 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$372,13
$422,36
$475,57
$664,61
$1 009,94 		$656,80
$707,03
$760,24
$949,28 		$941,47
$991,70
$1 044,91
$1 233,95 		$1 226,14
$1 276,37
$1 329,58
$1 518,62 		$284,67
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$744,26
$844,72
$951,14
$1 329,22
$2 019,88 		$1 028,93
$1 129,39
$1 235,81
$1 613,89 		$1 313,60
$1 414,06
$1 520,48
$1 898,56 		$1 598,27
$1 698,73
$1 805,15
$2 183,23 		$284,67
Toc - Plan #26 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$360,97
$409,69
$461,30
$644,67
$979,64 		$637,10
$685,82
$737,43
$920,80 		$913,23
$961,95
$1 013,56
$1 196,93 		$1 189,36
$1 238,08
$1 289,69
$1 473,06 		$276,13
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$721,94
$819,38
$922,60
$1 289,34
$1 959,28 		$998,07
$1 095,51
$1 198,73
$1 565,47 		$1 274,20
$1 371,64
$1 474,86
$1 841,60 		$1 550,33
$1 647,77
$1 750,99
$2 117,73 		$276,13
Toc - Plan #27 Ambetter from Peach State Health Plan
Gold

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$372,02
$422,23
$475,43
$664,41
$1 009,64 		$656,61
$706,82
$760,02
$949,00 		$941,20
$991,41
$1 044,61
$1 233,59 		$1 225,79
$1 276,00
$1 329,20
$1 518,18 		$284,59
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$744,04
$844,46
$950,86
$1 328,82
$2 019,28 		$1 028,63
$1 129,05
$1 235,45
$1 613,41 		$1 313,22
$1 413,64
$1 520,04
$1 898,00 		$1 597,81
$1 698,23
$1 804,63
$2 182,59 		$284,59
Toc - Plan #28 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$353,67
$401,41
$451,98
$631,65
$959,85 		$624,22
$671,96
$722,53
$902,20 		$894,77
$942,51
$993,08
$1 172,75 		$1 165,32
$1 213,06
$1 263,63
$1 443,30 		$270,55
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$707,34
$802,82
$903,96
$1 263,30
$1 919,70 		$977,89
$1 073,37
$1 174,51
$1 533,85 		$1 248,44
$1 343,92
$1 445,06
$1 804,40 		$1 518,99
$1 614,47
$1 715,61
$2 074,95 		$270,55
Toc - Plan #29 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$350,66
$397,99
$448,13
$626,26
$951,67 		$618,91
$666,24
$716,38
$894,51 		$887,16
$934,49
$984,63
$1 162,76 		$1 155,41
$1 202,74
$1 252,88
$1 431,01 		$268,25
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$701,32
$795,98
$896,26
$1 252,52
$1 903,34 		$969,57
$1 064,23
$1 164,51
$1 520,77 		$1 237,82
$1 332,48
$1 432,76
$1 789,02 		$1 506,07
$1 600,73
$1 701,01
$2 057,27 		$268,25
Toc - Plan #30 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$367,52
$417,12
$469,68
$656,37
$997,42 		$648,66
$698,26
$750,82
$937,51 		$929,80
$979,40
$1 031,96
$1 218,65 		$1 210,94
$1 260,54
$1 313,10
$1 499,79 		$281,14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$735,04
$834,24
$939,36
$1 312,74
$1 994,84 		$1 016,18
$1 115,38
$1 220,50
$1 593,88 		$1 297,32
$1 396,52
$1 501,64
$1 875,02 		$1 578,46
$1 677,66
$1 782,78
$2 156,16 		$281,14
Toc - Plan #31 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$371,09
$421,18
$474,24
$662,75
$1 007,11 		$654,97
$705,06
$758,12
$946,63 		$938,85
$988,94
$1 042,00
$1 230,51 		$1 222,73
$1 272,82
$1 325,88
$1 514,39 		$283,88
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$742,18
$842,36
$948,48
$1 325,50
$2 014,22 		$1 026,06
$1 126,24
$1 232,36
$1 609,38 		$1 309,94
$1 410,12
$1 516,24
$1 893,26 		$1 593,82
$1 694,00
$1 800,12
$2 177,14 		$283,88
Toc - Plan #32 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$386,76
$438,96
$494,26
$690,73
$1 049,63 		$682,62
$734,82
$790,12
$986,59 		$978,48
$1 030,68
$1 085,98
$1 282,45 		$1 274,34
$1 326,54
$1 381,84
$1 578,31 		$295,86
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$773,52
$877,92
$988,52
$1 381,46
$2 099,26 		$1 069,38
$1 173,78
$1 284,38
$1 677,32 		$1 365,24
$1 469,64
$1 580,24
$1 973,18 		$1 661,10
$1 765,50
$1 876,10
$2 269,04 		$295,86
Toc - Plan #33 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$389,55
$442,13
$497,83
$695,71
$1 057,20 		$687,55
$740,13
$795,83
$993,71 		$985,55
$1 038,13
$1 093,83
$1 291,71 		$1 283,55
$1 336,13
$1 391,83
$1 589,71 		$298,00
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$779,10
$884,26
$995,66
$1 391,42
$2 114,40 		$1 077,10
$1 182,26
$1 293,66
$1 689,42 		$1 375,10
$1 480,26
$1 591,66
$1 987,42 		$1 673,10
$1 778,26
$1 889,66
$2 285,42 		$298,00
Toc - Plan #34 Ambetter from Peach State Health Plan
Expanded Bronze

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$301,32
$341,98
$385,07
$538,13
$817,75 		$531,82
$572,48
$615,57
$768,63 		$762,32
$802,98
$846,07
$999,13 		$992,82
$1 033,48
$1 076,57
$1 229,63 		$230,50
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$602,64
$683,96
$770,14
$1 076,26
$1 635,50 		$833,14
$914,46
$1 000,64
$1 306,76 		$1 063,64
$1 144,96
$1 231,14
$1 537,26 		$1 294,14
$1 375,46
$1 461,64
$1 767,76 		$230,50
Toc - Plan #35 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$368,01
$417,68
$470,31
$657,25
$998,76 		$649,53
$699,20
$751,83
$938,77 		$931,05
$980,72
$1 033,35
$1 220,29 		$1 212,57
$1 262,24
$1 314,87
$1 501,81 		$281,52
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$736,02
$835,36
$940,62
$1 314,50
$1 997,52 		$1 017,54
$1 116,88
$1 222,14
$1 596,02 		$1 299,06
$1 398,40
$1 503,66
$1 877,54 		$1 580,58
$1 679,92
$1 785,18
$2 159,06 		$281,52
Toc - Plan #36 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$387,22
$439,48
$494,85
$691,55
$1 050,88 		$683,43
$735,69
$791,06
$987,76 		$979,64
$1 031,90
$1 087,27
$1 283,97 		$1 275,85
$1 328,11
$1 383,48
$1 580,18 		$296,21
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$774,44
$878,96
$989,70
$1 383,10
$2 101,76 		$1 070,65
$1 175,17
$1 285,91
$1 679,31 		$1 366,86
$1 471,38
$1 582,12
$1 975,52 		$1 663,07
$1 767,59
$1 878,33
$2 271,73 		$296,21
Toc - Plan #37 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$375,60
$426,30
$480,01
$670,81
$1 019,35 		$662,93
$713,63
$767,34
$958,14 		$950,26
$1 000,96
$1 054,67
$1 245,47 		$1 237,59
$1 288,29
$1 342,00
$1 532,80 		$287,33
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$751,20
$852,60
$960,02
$1 341,62
$2 038,70 		$1 038,53
$1 139,93
$1 247,35
$1 628,95 		$1 325,86
$1 427,26
$1 534,68
$1 916,28 		$1 613,19
$1 714,59
$1 822,01
$2 203,61 		$287,33
Toc - Plan #38 Ambetter from Peach State Health Plan
Bronze

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$287,82
$326,67
$367,82
$514,03
$781,12 		$508,00
$546,85
$588,00
$734,21 		$728,18
$767,03
$808,18
$954,39 		$948,36
$987,21
$1 028,36
$1 174,57 		$220,18
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$575,64
$653,34
$735,64
$1 028,06
$1 562,24 		$795,82
$873,52
$955,82
$1 248,24 		$1 016,00
$1 093,70
$1 176,00
$1 468,42 		$1 236,18
$1 313,88
$1 396,18
$1 688,60 		$220,18
Toc - Plan #39 Ambetter from Peach State Health Plan
Gold

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$387,10
$439,35
$494,70
$691,34
$1 050,57 		$683,22
$735,47
$790,82
$987,46 		$979,34
$1 031,59
$1 086,94
$1 283,58 		$1 275,46
$1 327,71
$1 383,06
$1 579,70 		$296,12
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$774,20
$878,70
$989,40
$1 382,68
$2 101,14 		$1 070,32
$1 174,82
$1 285,52
$1 678,80 		$1 366,44
$1 470,94
$1 581,64
$1 974,92 		$1 662,56
$1 767,06
$1 877,76
$2 271,04 		$296,12
Toc - Plan #40 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$382,42
$434,03
$488,71
$682,98
$1 037,85 		$674,96
$726,57
$781,25
$975,52 		$967,50
$1 019,11
$1 073,79
$1 268,06 		$1 260,04
$1 311,65
$1 366,33
$1 560,60 		$292,54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$764,84
$868,06
$977,42
$1 365,96
$2 075,70 		$1 057,38
$1 160,60
$1 269,96
$1 658,50 		$1 349,92
$1 453,14
$1 562,50
$1 951,04 		$1 642,46
$1 745,68
$1 855,04
$2 243,58 		$292,54
Toc - Plan #41 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$386,13
$438,25
$493,47
$689,62
$1 047,94 		$681,51
$733,63
$788,85
$985,00 		$976,89
$1 029,01
$1 084,23
$1 280,38 		$1 272,27
$1 324,39
$1 379,61
$1 575,76 		$295,38
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$772,26
$876,50
$986,94
$1 379,24
$2 095,88 		$1 067,64
$1 171,88
$1 282,32
$1 674,62 		$1 363,02
$1 467,26
$1 577,70
$1 970,00 		$1 658,40
$1 762,64
$1 873,08
$2 265,38 		$295,38
Toc - Plan #42 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$402,43
$456,75
$514,30
$718,73
$1 092,18 		$710,28
$764,60
$822,15
$1 026,58 		$1 018,13
$1 072,45
$1 130,00
$1 334,43 		$1 325,98
$1 380,30
$1 437,85
$1 642,28 		$307,85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$804,86
$913,50
$1 028,60
$1 437,46
$2 184,36 		$1 112,71
$1 221,35
$1 336,45
$1 745,31 		$1 420,56
$1 529,20
$1 644,30
$2 053,16 		$1 728,41
$1 837,05
$1 952,15
$2 361,01 		$307,85
Toc - Plan #43 Ambetter from Peach State Health Plan
Silver

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$405,34
$460,05
$518,01
$723,92
$1 100,06 		$715,42
$770,13
$828,09
$1 034,00 		$1 025,50
$1 080,21
$1 138,17
$1 344,08 		$1 335,58
$1 390,29
$1 448,25
$1 654,16 		$310,08
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$810,68
$920,10
$1 036,02
$1 447,84
$2 200,12 		$1 120,76
$1 230,18
$1 346,10
$1 757,92 		$1 430,84
$1 540,26
$1 656,18
$2 068,00 		$1 740,92
$1 850,34
$1 966,26
$2 378,08 		$310,08
Toc - Plan #44 Ambetter from Peach State Health Plan
Expanded Bronze

(HMO) 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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$313,53
$355,85
$400,68
$559,95
$850,90 		$553,37
$595,69
$640,52
$799,79 		$793,21
$835,53
$880,36
$1 039,63 		$1 033,05
$1 075,37
$1 120,20
$1 279,47 		$239,84
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$627,06
$711,70
$801,36
$1 119,90
$1 701,80 		$866,90
$951,54
$1 041,20
$1 359,74 		$1 106,74
$1 191,38
$1 281,04
$1 599,58 		$1 346,58
$1 431,22
$1 520,88
$1 839,42 		$239,84

ADVERTISEMENT

Kaiser Permanente

Local: 1-800-494-5314 | Toll Free: 1-800-494-5314

Toc - Plan #45 Kaiser Permanente
Gold

(HMO) KP GA Gold 500/20

Annual Out of Pocket Expenses
Individual Family
$500 $1,000 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$415,68
$471,79
$531,23
$742,40
$1 128,15 		$733,67
$789,78
$849,22
$1 060,39 		$1 051,66
$1 107,77
$1 167,21
$1 378,38 		$1 369,65
$1 425,76
$1 485,20
$1 696,37 		$317,99
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$831,36
$943,58
$1 062,46
$1 484,80
$2 256,30 		$1 149,35
$1 261,57
$1 380,45
$1 802,79 		$1 467,34
$1 579,56
$1 698,44
$2 120,78 		$1 785,33
$1 897,55
$2 016,43
$2 438,77 		$317,99
Toc - Plan #46 Kaiser Permanente
Silver

(HMO) KP GA Silver 3000/30

Annual Out of Pocket Expenses
Individual Family
$3,000 $6,000 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$407,68
$462,72
$521,01
$728,11
$1 106,44 		$719,55
$774,59
$832,88
$1 039,98 		$1 031,42
$1 086,46
$1 144,75
$1 351,85 		$1 343,29
$1 398,33
$1 456,62
$1 663,72 		$311,87
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$815,36
$925,44
$1 042,02
$1 456,22
$2 212,88 		$1 127,23
$1 237,31
$1 353,89
$1 768,09 		$1 439,10
$1 549,18
$1 665,76
$2 079,96 		$1 750,97
$1 861,05
$1 977,63
$2 391,83 		$311,87
Toc - Plan #47 Kaiser Permanente
Silver

(HMO) KP GA Silver 3500/20% HSA

Annual Out of Pocket Expenses
Individual Family
$3,500 $7,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$384,09
$435,94
$490,87
$685,99
$1 042,42 		$677,92
$729,77
$784,70
$979,82 		$971,75
$1 023,60
$1 078,53
$1 273,65 		$1 265,58
$1 317,43
$1 372,36
$1 567,48 		$293,83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$768,18
$871,88
$981,74
$1 371,98
$2 084,84 		$1 062,01
$1 165,71
$1 275,57
$1 665,81 		$1 355,84
$1 459,54
$1 569,40
$1 959,64 		$1 649,67
$1 753,37
$1 863,23
$2 253,47 		$293,83
Toc - Plan #48 Kaiser Permanente
Expanded Bronze

(HMO) KP GA Bronze 5000/50

Annual Out of Pocket Expenses
Individual Family
$5,000 $10,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$296,65
$336,70
$379,12
$529,82
$805,11 		$523,59
$563,64
$606,06
$756,76 		$750,53
$790,58
$833,00
$983,70 		$977,47
$1 017,52
$1 059,94
$1 210,64 		$226,94
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$593,30
$673,40
$758,24
$1 059,64
$1 610,22 		$820,24
$900,34
$985,18
$1 286,58 		$1 047,18
$1 127,28
$1 212,12
$1 513,52 		$1 274,12
$1 354,22
$1 439,06
$1 740,46 		$226,94
Toc - Plan #49 Kaiser Permanente
Expanded Bronze

(HMO) KP GA Bronze 6500/40%/HSA

Annual Out of Pocket Expenses
Individual Family
$6,500 $13,000 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$296,65
$336,70
$379,12
$529,82
$805,11 		$523,59
$563,64
$606,06
$756,76 		$750,53
$790,58
$833,00
$983,70 		$977,47
$1 017,52
$1 059,94
$1 210,64 		$226,94
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$593,30
$673,40
$758,24
$1 059,64
$1 610,22 		$820,24
$900,34
$985,18
$1 286,58 		$1 047,18
$1 127,28
$1 212,12
$1 513,52 		$1 274,12
$1 354,22
$1 439,06
$1 740,46 		$226,94
Toc - Plan #50 Kaiser Permanente
Catastrophic

(HMO) KP GA Catastrophic 8550/0

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
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$260,73
$295,93
$333,21
$465,67
$707,62 		$460,19
$495,39
$532,67
$665,13 		$659,65
$694,85
$732,13
$864,59 		$859,11
$894,31
$931,59
$1 064,05 		$199,46
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$521,46
$591,86
$666,42
$931,34
$1 415,24 		$720,92
$791,32
$865,88
$1 130,80 		$920,38
$990,78
$1 065,34
$1 330,26 		$1 119,84
$1 190,24
$1 264,80
$1 529,72 		$199,46
Toc - Plan #51 Kaiser Permanente
Gold

(HMO) KP GA Gold 1500/20

Annual Out of Pocket Expenses
Individual Family
$1,500 $3,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$404,32
$458,90
$516,72
$722,11
$1 097,32 		$713,62
$768,20
$826,02
$1 031,41 		$1 022,92
$1 077,50
$1 135,32
$1 340,71 		$1 332,22
$1 386,80
$1 444,62
$1 650,01 		$309,30
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$808,64
$917,80
$1 033,44
$1 444,22
$2 194,64 		$1 117,94
$1 227,10
$1 342,74
$1 753,52 		$1 427,24
$1 536,40
$1 652,04
$2 062,82 		$1 736,54
$1 845,70
$1 961,34
$2 372,12 		$309,30
Toc - Plan #52 Kaiser Permanente
Silver

(HMO) KP GA Silver 4500/35

Annual Out of Pocket Expenses
Individual Family
$4,500 $9,000 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$383,06
$434,78
$489,56
$684,15
$1 039,64 		$676,10
$727,82
$782,60
$977,19 		$969,14
$1 020,86
$1 075,64
$1 270,23 		$1 262,18
$1 313,90
$1 368,68
$1 563,27 		$293,04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$766,12
$869,56
$979,12
$1 368,30
$2 079,28 		$1 059,16
$1 162,60
$1 272,16
$1 661,34 		$1 352,20
$1 455,64
$1 565,20
$1 954,38 		$1 645,24
$1 748,68
$1 858,24
$2 247,42 		$293,04
Toc - Plan #53 Kaiser Permanente
Gold

(HMO) KP GA Gold 1700/25

Annual Out of Pocket Expenses
Individual Family
$1,700 $3,400 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$385,69
$437,76
$492,92
$688,85
$1 046,77 		$680,75
$732,82
$787,98
$983,91 		$975,81
$1 027,88
$1 083,04
$1 278,97 		$1 270,87
$1 322,94
$1 378,10
$1 574,03 		$295,06
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$771,38
$875,52
$985,84
$1 377,70
$2 093,54 		$1 066,44
$1 170,58
$1 280,90
$1 672,76 		$1 361,50
$1 465,64
$1 575,96
$1 967,82 		$1 656,56
$1 760,70
$1 871,02
$2 262,88 		$295,06

‡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 Fayette County here.

Fayette County is in “Rating Area 3” of Georgia.

Currently, there are 53 plans offered in Rating Area 3.

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2022 Obamacare Rates for Fayette County

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