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Obamacare 2023 Rates for Pulaski County

Obamacare > Rates > Illinois > Pulaski County

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 Pulaski County, IL.

The health insurance rates listed below are for calendar year 2023.

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

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

Obamacare Providers, 25 Plans and 2023 Rates for Pulaski County, Illinois

Below, you’ll find a summary of the 25 plans for Pulaski County, Illinois and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Health Alliance

Local: 1-866-247-3296 | Toll Free: 1-866-247-3296 | TTY: 1-800-526-0844

Toc - Plan #1 Health Alliance
Catastrophic

(HMO) 2023 HMO 9100 Elite Catastrophic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$345.16
$391.75
$441.11
$616.46
$936.76
$609.21
$655.80
$705.16
$880.51
$873.26
$919.85
$969.21
$1,144.56
$1,137.31
$1,183.90
$1,233.26
$1,408.61
$264.05
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$690.32
$783.50
$882.22
$1,232.92
$1,873.52
$954.37
$1,047.55
$1,146.27
$1,496.97
$1,218.42
$1,311.60
$1,410.32
$1,761.02
$1,482.47
$1,575.65
$1,674.37
$2,025.07
$264.05
Toc - Plan #2 Health Alliance
Expanded Bronze

(POS) 2023 POS 6500 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$469.70
$533.11
$600.28
$838.89
$1,274.77
$829.03
$892.44
$959.61
$1,198.22
$1,188.36
$1,251.77
$1,318.94
$1,557.55
$1,547.69
$1,611.10
$1,678.27
$1,916.88
$359.33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$939.40
$1,066.22
$1,200.56
$1,677.78
$2,549.54
$1,298.73
$1,425.55
$1,559.89
$2,037.11
$1,658.06
$1,784.88
$1,919.22
$2,396.44
$2,017.39
$2,144.21
$2,278.55
$2,755.77
$359.33
Toc - Plan #3 Health Alliance
Silver

(POS) 2023 POS 7250 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$7,250 $14,500 Annual Deductible
$8,600 $17,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$576.94
$654.83
$737.33
$1,030.42
$1,565.82
$1,018.30
$1,096.19
$1,178.69
$1,471.78
$1,459.66
$1,537.55
$1,620.05
$1,913.14
$1,901.02
$1,978.91
$2,061.41
$2,354.50
$441.36
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,153.88
$1,309.66
$1,474.66
$2,060.84
$3,131.64
$1,595.24
$1,751.02
$1,916.02
$2,502.20
$2,036.60
$2,192.38
$2,357.38
$2,943.56
$2,477.96
$2,633.74
$2,798.74
$3,384.92
$441.36
Toc - Plan #4 Health Alliance
Expanded Bronze

(POS) 2023 POS 6900 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

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:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$461.85
$524.19
$590.25
$824.86
$1,253.45
$815.16
$877.50
$943.56
$1,178.17
$1,168.47
$1,230.81
$1,296.87
$1,531.48
$1,521.78
$1,584.12
$1,650.18
$1,884.79
$353.31
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$923.70
$1,048.38
$1,180.50
$1,649.72
$2,506.90
$1,277.01
$1,401.69
$1,533.81
$2,003.03
$1,630.32
$1,755.00
$1,887.12
$2,356.34
$1,983.63
$2,108.31
$2,240.43
$2,709.65
$353.31
Toc - Plan #5 Health Alliance
Gold

(POS) 2023 POS 1000 Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$6,600 $13,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$653.07
$741.24
$834.63
$1,166.39
$1,772.44
$1,152.68
$1,240.85
$1,334.24
$1,666.00
$1,652.29
$1,740.46
$1,833.85
$2,165.61
$2,151.90
$2,240.07
$2,333.46
$2,665.22
$499.61
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,306.14
$1,482.48
$1,669.26
$2,332.78
$3,544.88
$1,805.75
$1,982.09
$2,168.87
$2,832.39
$2,305.36
$2,481.70
$2,668.48
$3,332.00
$2,804.97
$2,981.31
$3,168.09
$3,831.61
$499.61
Toc - Plan #6 Health Alliance
Silver

(POS) 2023 POS 7000 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$593.66
$673.80
$758.69
$1,060.27
$1,611.18
$1,047.80
$1,127.94
$1,212.83
$1,514.41
$1,501.94
$1,582.08
$1,666.97
$1,968.55
$1,956.08
$2,036.22
$2,121.11
$2,422.69
$454.14
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,187.32
$1,347.60
$1,517.38
$2,120.54
$3,222.36
$1,641.46
$1,801.74
$1,971.52
$2,574.68
$2,095.60
$2,255.88
$2,425.66
$3,028.82
$2,549.74
$2,710.02
$2,879.80
$3,482.96
$454.14
Toc - Plan #7 Health Alliance
Gold

(POS) 2023 POS 2500 Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$6,000 $12,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$624.56
$708.87
$798.19
$1,115.47
$1,695.05
$1,102.35
$1,186.66
$1,275.98
$1,593.26
$1,580.14
$1,664.45
$1,753.77
$2,071.05
$2,057.93
$2,142.24
$2,231.56
$2,548.84
$477.79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,249.12
$1,417.74
$1,596.38
$2,230.94
$3,390.10
$1,726.91
$1,895.53
$2,074.17
$2,708.73
$2,204.70
$2,373.32
$2,551.96
$3,186.52
$2,682.49
$2,851.11
$3,029.75
$3,664.31
$477.79
Toc - Plan #8 Health Alliance
Silver

(POS) 2023 POS 3000 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$8,600 $17,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$592.26
$672.22
$756.91
$1,057.78
$1,607.40
$1,045.34
$1,125.30
$1,209.99
$1,510.86
$1,498.42
$1,578.38
$1,663.07
$1,963.94
$1,951.50
$2,031.46
$2,116.15
$2,417.02
$453.08
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,184.52
$1,344.44
$1,513.82
$2,115.56
$3,214.80
$1,637.60
$1,797.52
$1,966.90
$2,568.64
$2,090.68
$2,250.60
$2,419.98
$3,021.72
$2,543.76
$2,703.68
$2,873.06
$3,474.80
$453.08
Toc - Plan #9 Health Alliance
Silver

(POS) 2023 POS 4200 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$4,200 $8,400 Annual Deductible
$8,750 $17,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$605.06
$686.74
$773.26
$1,080.63
$1,642.12
$1,067.92
$1,149.60
$1,236.12
$1,543.49
$1,530.78
$1,612.46
$1,698.98
$2,006.35
$1,993.64
$2,075.32
$2,161.84
$2,469.21
$462.86
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,210.12
$1,373.48
$1,546.52
$2,161.26
$3,284.24
$1,672.98
$1,836.34
$2,009.38
$2,624.12
$2,135.84
$2,299.20
$2,472.24
$3,086.98
$2,598.70
$2,762.06
$2,935.10
$3,549.84
$462.86
Toc - Plan #10 Health Alliance
Expanded Bronze

(POS) 2023 POS 8000 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$8,000 $16,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$450.72
$511.56
$576.02
$804.99
$1,223.25
$795.52
$856.36
$920.82
$1,149.79
$1,140.32
$1,201.16
$1,265.62
$1,494.59
$1,485.12
$1,545.96
$1,610.42
$1,839.39
$344.80
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$901.44
$1,023.12
$1,152.04
$1,609.98
$2,446.50
$1,246.24
$1,367.92
$1,496.84
$1,954.78
$1,591.04
$1,712.72
$1,841.64
$2,299.58
$1,935.84
$2,057.52
$2,186.44
$2,644.38
$344.80
Toc - Plan #11 Health Alliance
Platinum

(POS) 2023 POS 0 Elite Platinum

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$3,000 $6,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$760.04
$862.64
$971.33
$1,357.43
$2,062.74
$1,341.47
$1,444.07
$1,552.76
$1,938.86
$1,922.90
$2,025.50
$2,134.19
$2,520.29
$2,504.33
$2,606.93
$2,715.62
$3,101.72
$581.43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,520.08
$1,725.28
$1,942.66
$2,714.86
$4,125.48
$2,101.51
$2,306.71
$2,524.09
$3,296.29
$2,682.94
$2,888.14
$3,105.52
$3,877.72
$3,264.37
$3,469.57
$3,686.95
$4,459.15
$581.43
Toc - Plan #12 Health Alliance
Gold

(POS) 2023 POS 2000 Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$594.26
$674.48
$759.47
$1,061.35
$1,612.82
$1,048.87
$1,129.09
$1,214.08
$1,515.96
$1,503.48
$1,583.70
$1,668.69
$1,970.57
$1,958.09
$2,038.31
$2,123.30
$2,425.18
$454.61
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,188.52
$1,348.96
$1,518.94
$2,122.70
$3,225.64
$1,643.13
$1,803.57
$1,973.55
$2,577.31
$2,097.74
$2,258.18
$2,428.16
$3,031.92
$2,552.35
$2,712.79
$2,882.77
$3,486.53
$454.61
Toc - Plan #13 Health Alliance
Silver

(POS) 2023 POS 5800 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$581.47
$659.97
$743.12
$1,038.51
$1,578.10
$1,026.30
$1,104.80
$1,187.95
$1,483.34
$1,471.13
$1,549.63
$1,632.78
$1,928.17
$1,915.96
$1,994.46
$2,077.61
$2,373.00
$444.83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,162.94
$1,319.94
$1,486.24
$2,077.02
$3,156.20
$1,607.77
$1,764.77
$1,931.07
$2,521.85
$2,052.60
$2,209.60
$2,375.90
$2,966.68
$2,497.43
$2,654.43
$2,820.73
$3,411.51
$444.83
Toc - Plan #14 Health Alliance
Expanded Bronze

(POS) 2023 POS 7500 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$478.37
$542.95
$611.35
$854.36
$1,298.29
$844.32
$908.90
$977.30
$1,220.31
$1,210.27
$1,274.85
$1,343.25
$1,586.26
$1,576.22
$1,640.80
$1,709.20
$1,952.21
$365.95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$956.74
$1,085.90
$1,222.70
$1,708.72
$2,596.58
$1,322.69
$1,451.85
$1,588.65
$2,074.67
$1,688.64
$1,817.80
$1,954.60
$2,440.62
$2,054.59
$2,183.75
$2,320.55
$2,806.57
$365.95

ADVERTISEMENT

Blue Cross and Blue Shield of Illinois

Local: 1-800-538-8833 | Toll Free: 1-800-538-8833 | TTY: 1-800-526-0844

Toc - Plan #15 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 204

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$750 $2,250 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$720.52
$817.79
$920.82
$1,286.84
$1,955.48
$1,271.72
$1,368.99
$1,472.02
$1,838.04
$1,822.92
$1,920.19
$2,023.22
$2,389.24
$2,374.12
$2,471.39
$2,574.42
$2,940.44
$551.20
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,441.04
$1,635.58
$1,841.64
$2,573.68
$3,910.96
$1,992.24
$2,186.78
$2,392.84
$3,124.88
$2,543.44
$2,737.98
$2,944.04
$3,676.08
$3,094.64
$3,289.18
$3,495.24
$4,227.28
$551.20
Toc - Plan #16 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 203

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$2,250 $6,750 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$617.02
$700.31
$788.55
$1,101.99
$1,674.58
$1,089.04
$1,172.33
$1,260.57
$1,574.01
$1,561.06
$1,644.35
$1,732.59
$2,046.03
$2,033.08
$2,116.37
$2,204.61
$2,518.05
$472.02
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,234.04
$1,400.62
$1,577.10
$2,203.98
$3,349.16
$1,706.06
$1,872.64
$2,049.12
$2,676.00
$2,178.08
$2,344.66
$2,521.14
$3,148.02
$2,650.10
$2,816.68
$2,993.16
$3,620.04
$472.02
Toc - Plan #17 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 202

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$4,500 $13,500 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$547.50
$621.42
$699.71
$977.84
$1,485.93
$966.34
$1,040.26
$1,118.55
$1,396.68
$1,385.18
$1,459.10
$1,537.39
$1,815.52
$1,804.02
$1,877.94
$1,956.23
$2,234.36
$418.84
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,095.00
$1,242.84
$1,399.42
$1,955.68
$2,971.86
$1,513.84
$1,661.68
$1,818.26
$2,374.52
$1,932.68
$2,080.52
$2,237.10
$2,793.36
$2,351.52
$2,499.36
$2,655.94
$3,212.20
$418.84
Toc - Plan #18 Blue Cross and Blue Shield of Illinois
Catastrophic

(PPO) Blue Choice Preferred Security PPO? 200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$457.92
$519.73
$585.22
$817.84
$1,242.78
$808.23
$870.04
$935.53
$1,168.15
$1,158.54
$1,220.35
$1,285.84
$1,518.46
$1,508.85
$1,570.66
$1,636.15
$1,868.77
$350.31
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$915.84
$1,039.46
$1,170.44
$1,635.68
$2,485.56
$1,266.15
$1,389.77
$1,520.75
$1,985.99
$1,616.46
$1,740.08
$1,871.06
$2,336.30
$1,966.77
$2,090.39
$2,221.37
$2,686.61
$350.31
Toc - Plan #19 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 201

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,000 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$493.30
$559.90
$630.44
$881.04
$1,338.82
$870.68
$937.28
$1,007.82
$1,258.42
$1,248.06
$1,314.66
$1,385.20
$1,635.80
$1,625.44
$1,692.04
$1,762.58
$2,013.18
$377.38
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$986.60
$1,119.80
$1,260.88
$1,762.08
$2,677.64
$1,363.98
$1,497.18
$1,638.26
$2,139.46
$1,741.36
$1,874.56
$2,015.64
$2,516.84
$2,118.74
$2,251.94
$2,393.02
$2,894.22
$377.38
Toc - Plan #20 Blue Cross and Blue Shield of Illinois
Bronze

(PPO) Blue Choice Preferred Bronze PPO? 601

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,000 $17,400 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$483.77
$549.08
$618.26
$864.02
$1,312.96
$853.86
$919.17
$988.35
$1,234.11
$1,223.95
$1,289.26
$1,358.44
$1,604.20
$1,594.04
$1,659.35
$1,728.53
$1,974.29
$370.09
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$967.54
$1,098.16
$1,236.52
$1,728.04
$2,625.92
$1,337.63
$1,468.25
$1,606.61
$2,098.13
$1,707.72
$1,838.34
$1,976.70
$2,468.22
$2,077.81
$2,208.43
$2,346.79
$2,838.31
$370.09
Toc - Plan #21 Blue Cross and Blue Shield of Illinois
Bronze

(PPO) Blue Choice Preferred Bronze PPO? 701

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$8,600 $17,400 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$460.73
$522.93
$588.82
$822.87
$1,250.43
$813.19
$875.39
$941.28
$1,175.33
$1,165.65
$1,227.85
$1,293.74
$1,527.79
$1,518.11
$1,580.31
$1,646.20
$1,880.25
$352.46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$921.46
$1,045.86
$1,177.64
$1,645.74
$2,500.86
$1,273.92
$1,398.32
$1,530.10
$1,998.20
$1,626.38
$1,750.78
$1,882.56
$2,350.66
$1,978.84
$2,103.24
$2,235.02
$2,703.12
$352.46
Toc - Plan #22 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 707

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$703.36
$798.32
$898.90
$1,256.21
$1,908.93
$1,241.43
$1,336.39
$1,436.97
$1,794.28
$1,779.50
$1,874.46
$1,975.04
$2,332.35
$2,317.57
$2,412.53
$2,513.11
$2,870.42
$538.07
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,406.72
$1,596.64
$1,797.80
$2,512.42
$3,817.86
$1,944.79
$2,134.71
$2,335.87
$3,050.49
$2,482.86
$2,672.78
$2,873.94
$3,588.56
$3,020.93
$3,210.85
$3,412.01
$4,126.63
$538.07
Toc - Plan #23 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 708

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$544.42
$617.91
$695.76
$972.33
$1,477.55
$960.90
$1,034.39
$1,112.24
$1,388.81
$1,377.38
$1,450.87
$1,528.72
$1,805.29
$1,793.86
$1,867.35
$1,945.20
$2,221.77
$416.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,088.84
$1,235.82
$1,391.52
$1,944.66
$2,955.10
$1,505.32
$1,652.30
$1,808.00
$2,361.14
$1,921.80
$2,068.78
$2,224.48
$2,777.62
$2,338.28
$2,485.26
$2,640.96
$3,194.10
$416.48
Toc - Plan #24 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 706

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$617.42
$700.77
$789.06
$1,102.71
$1,675.67
$1,089.74
$1,173.09
$1,261.38
$1,575.03
$1,562.06
$1,645.41
$1,733.70
$2,047.35
$2,034.38
$2,117.73
$2,206.02
$2,519.67
$472.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,234.84
$1,401.54
$1,578.12
$2,205.42
$3,351.34
$1,707.16
$1,873.86
$2,050.44
$2,677.74
$2,179.48
$2,346.18
$2,522.76
$3,150.06
$2,651.80
$2,818.50
$2,995.08
$3,622.38
$472.32
Toc - Plan #25 Blue Cross and Blue Shield of Illinois
Bronze

(PPO) Blue Choice Preferred Bronze PPO? 705

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$480.27
$545.11
$613.78
$857.76
$1,303.45
$847.68
$912.52
$981.19
$1,225.17
$1,215.09
$1,279.93
$1,348.60
$1,592.58
$1,582.50
$1,647.34
$1,716.01
$1,959.99
$367.41
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$960.54
$1,090.22
$1,227.56
$1,715.52
$2,606.90
$1,327.95
$1,457.63
$1,594.97
$2,082.93
$1,695.36
$1,825.04
$1,962.38
$2,450.34
$2,062.77
$2,192.45
$2,329.79
$2,817.75
$367.41

‡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 Pulaski County here.

Pulaski County is in “Rating Area 13” of Illinois.

Currently, there are 25 plans offered in Rating Area 13.