ADVERTISEMENT
|
CareSource Indiana, Inc.
Local: 1-800-479-9502 | Toll Free: 1-877-806-9284
|
|
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
|
$302.19
$342.98
$386.19
$539.70
$820.13 |
$604.38
$685.96
$772.38
$1,079.40
$1,640.26 |
$835.55
$917.13
$1,003.55
$1,310.57 |
$1,066.72
$1,148.30
$1,234.72
$1,541.74 |
$1,297.89
$1,379.47
$1,465.89
$1,772.91 |
$533.36
$574.15
$617.36
$770.87 |
$764.53
$805.32
$848.53
$1,002.04 |
$995.70
$1,036.49
$1,079.70
$1,233.21 |
$231.17 |
|
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
|
$329.67
$374.17
$421.31
$588.78
$894.71 |
$659.34
$748.34
$842.62
$1,177.56
$1,789.42 |
$911.53
$1,000.53
$1,094.81
$1,429.75 |
$1,163.72
$1,252.72
$1,347.00
$1,681.94 |
$1,415.91
$1,504.91
$1,599.19
$1,934.13 |
$581.86
$626.36
$673.50
$840.97 |
$834.05
$878.55
$925.69
$1,093.16 |
$1,086.24
$1,130.74
$1,177.88
$1,345.35 |
$252.19 |
|
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
|
$511.88
$580.98
$654.18
$914.22
$1,389.24 |
$1,023.76
$1,161.96
$1,308.36
$1,828.44
$2,778.48 |
$1,415.35
$1,553.55
$1,699.95
$2,220.03 |
$1,806.94
$1,945.14
$2,091.54
$2,611.62 |
$2,198.53
$2,336.73
$2,483.13
$3,003.21 |
$903.47
$972.57
$1,045.77
$1,305.81 |
$1,295.06
$1,364.16
$1,437.36
$1,697.40 |
$1,686.65
$1,755.75
$1,828.95
$2,088.99 |
$391.59 |
|
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
|
$347.12
$393.97
$443.61
$619.94
$942.06 |
$694.24
$787.94
$887.22
$1,239.88
$1,884.12 |
$959.78
$1,053.48
$1,152.76
$1,505.42 |
$1,225.32
$1,319.02
$1,418.30
$1,770.96 |
$1,490.86
$1,584.56
$1,683.84
$2,036.50 |
$612.66
$659.51
$709.15
$885.48 |
$878.20
$925.05
$974.69
$1,151.02 |
$1,143.74
$1,190.59
$1,240.23
$1,416.56 |
$265.54 |
|
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
|
$263.95
$299.58
$337.32
$471.41
$716.35 |
$527.90
$599.16
$674.64
$942.82
$1,432.70 |
$729.82
$801.08
$876.56
$1,144.74 |
$931.74
$1,003.00
$1,078.48
$1,346.66 |
$1,133.66
$1,204.92
$1,280.40
$1,548.58 |
$465.87
$501.50
$539.24
$673.33 |
$667.79
$703.42
$741.16
$875.25 |
$869.71
$905.34
$943.08
$1,077.17 |
$201.92 |
|
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
|
$361.66
$410.48
$462.20
$645.92
$981.53 |
$723.32
$820.96
$924.40
$1,291.84
$1,963.06 |
$999.99
$1,097.63
$1,201.07
$1,568.51 |
$1,276.66
$1,374.30
$1,477.74
$1,845.18 |
$1,553.33
$1,650.97
$1,754.41
$2,121.85 |
$638.33
$687.15
$738.87
$922.59 |
$915.00
$963.82
$1,015.54
$1,199.26 |
$1,191.67
$1,240.49
$1,292.21
$1,475.93 |
$276.67 |
|
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
|
$348.88
$395.97
$445.86
$623.09
$946.84 |
$697.76
$791.94
$891.72
$1,246.18
$1,893.68 |
$964.65
$1,058.83
$1,158.61
$1,513.07 |
$1,231.54
$1,325.72
$1,425.50
$1,779.96 |
$1,498.43
$1,592.61
$1,692.39
$2,046.85 |
$615.77
$662.86
$712.75
$889.98 |
$882.66
$929.75
$979.64
$1,156.87 |
$1,149.55
$1,196.64
$1,246.53
$1,423.76 |
$266.89 |
|
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
|
$534.30
$606.42
$682.83
$954.25
$1,450.07 |
$1,068.60
$1,212.84
$1,365.66
$1,908.50
$2,900.14 |
$1,477.33
$1,621.57
$1,774.39
$2,317.23 |
$1,886.06
$2,030.30
$2,183.12
$2,725.96 |
$2,294.79
$2,439.03
$2,591.85
$3,134.69 |
$943.03
$1,015.15
$1,091.56
$1,362.98 |
$1,351.76
$1,423.88
$1,500.29
$1,771.71 |
$1,760.49
$1,832.61
$1,909.02
$2,180.44 |
$408.73 |
|
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
|
$367.69
$417.33
$469.91
$656.69
$997.91 |
$735.38
$834.66
$939.82
$1,313.38
$1,995.82 |
$1,016.66
$1,115.94
$1,221.10
$1,594.66 |
$1,297.94
$1,397.22
$1,502.38
$1,875.94 |
$1,579.22
$1,678.50
$1,783.66
$2,157.22 |
$648.97
$698.61
$751.19
$937.97 |
$930.25
$979.89
$1,032.47
$1,219.25 |
$1,211.53
$1,261.17
$1,313.75
$1,500.53 |
$281.28 |
|
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
|
$280.82
$318.73
$358.88
$501.54
$762.13 |
$561.64
$637.46
$717.76
$1,003.08
$1,524.26 |
$776.46
$852.28
$932.58
$1,217.90 |
$991.28
$1,067.10
$1,147.40
$1,432.72 |
$1,206.10
$1,281.92
$1,362.22
$1,647.54 |
$495.64
$533.55
$573.70
$716.36 |
$710.46
$748.37
$788.52
$931.18 |
$925.28
$963.19
$1,003.34
$1,146.00 |
$214.82 |
|
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
|
$383.57
$435.35
$490.20
$685.06
$1,041.01 |
$767.14
$870.70
$980.40
$1,370.12
$2,082.02 |
$1,060.57
$1,164.13
$1,273.83
$1,663.55 |
$1,354.00
$1,457.56
$1,567.26
$1,956.98 |
$1,647.43
$1,750.99
$1,860.69
$2,250.41 |
$677.00
$728.78
$783.63
$978.49 |
$970.43
$1,022.21
$1,077.06
$1,271.92 |
$1,263.86
$1,315.64
$1,370.49
$1,565.35 |
$293.43 |
ADVERTISEMENT
|
Celtic Insurance Company
Local: 1-877-687-1182 | Toll Free: 1-877-687-1182 | TTY: 1-877-941-9232
|
|
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
|
$379.46
$430.68
$484.94
$677.70
$1,029.84 |
$758.92
$861.36
$969.88
$1,355.40
$2,059.68 |
$1,049.20
$1,151.64
$1,260.16
$1,645.68 |
$1,339.48
$1,441.92
$1,550.44
$1,935.96 |
$1,629.76
$1,732.20
$1,840.72
$2,226.24 |
$669.74
$720.96
$775.22
$967.98 |
$960.02
$1,011.24
$1,065.50
$1,258.26 |
$1,250.30
$1,301.52
$1,355.78
$1,548.54 |
$290.28 |
|
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
|
$368.91
$418.71
$471.46
$658.86
$1,001.20 |
$737.82
$837.42
$942.92
$1,317.72
$2,002.40 |
$1,020.03
$1,119.63
$1,225.13
$1,599.93 |
$1,302.24
$1,401.84
$1,507.34
$1,882.14 |
$1,584.45
$1,684.05
$1,789.55
$2,164.35 |
$651.12
$700.92
$753.67
$941.07 |
$933.33
$983.13
$1,035.88
$1,223.28 |
$1,215.54
$1,265.34
$1,318.09
$1,505.49 |
$282.21 |
|
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
|
$350.98
$398.36
$448.55
$626.84
$952.54 |
$701.96
$796.72
$897.10
$1,253.68
$1,905.08 |
$970.46
$1,065.22
$1,165.60
$1,522.18 |
$1,238.96
$1,333.72
$1,434.10
$1,790.68 |
$1,507.46
$1,602.22
$1,702.60
$2,059.18 |
$619.48
$666.86
$717.05
$895.34 |
$887.98
$935.36
$985.55
$1,163.84 |
$1,156.48
$1,203.86
$1,254.05
$1,432.34 |
$268.50 |
|
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
|
$345.23
$391.82
$441.19
$616.56
$936.93 |
$690.46
$783.64
$882.38
$1,233.12
$1,873.86 |
$954.55
$1,047.73
$1,146.47
$1,497.21 |
$1,218.64
$1,311.82
$1,410.56
$1,761.30 |
$1,482.73
$1,575.91
$1,674.65
$2,025.39 |
$609.32
$655.91
$705.28
$880.65 |
$873.41
$920.00
$969.37
$1,144.74 |
$1,137.50
$1,184.09
$1,233.46
$1,408.83 |
$264.09 |
|
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
|
$464.05
$526.69
$593.05
$828.78
$1,259.41 |
$928.10
$1,053.38
$1,186.10
$1,657.56
$2,518.82 |
$1,283.09
$1,408.37
$1,541.09
$2,012.55 |
$1,638.08
$1,763.36
$1,896.08
$2,367.54 |
$1,993.07
$2,118.35
$2,251.07
$2,722.53 |
$819.04
$881.68
$948.04
$1,183.77 |
$1,174.03
$1,236.67
$1,303.03
$1,538.76 |
$1,529.02
$1,591.66
$1,658.02
$1,893.75 |
$354.99 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$0 |
$0 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$0
| Family:
$0
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$386.73
$438.93
$494.23
$690.68
$1,049.56 |
$773.46
$877.86
$988.46
$1,381.36
$2,099.12 |
$1,069.30
$1,173.70
$1,284.30
$1,677.20 |
$1,365.14
$1,469.54
$1,580.14
$1,973.04 |
$1,660.98
$1,765.38
$1,875.98
$2,268.88 |
$682.57
$734.77
$790.07
$986.52 |
$978.41
$1,030.61
$1,085.91
$1,282.36 |
$1,274.25
$1,326.45
$1,381.75
$1,578.20 |
$295.84 |
|
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
|
$387.10
$439.35
$494.70
$691.34
$1,050.56 |
$774.20
$878.70
$989.40
$1,382.68
$2,101.12 |
$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 |
$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 |
|
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
|
$311.77
$353.85
$398.43
$556.80
$846.12 |
$623.54
$707.70
$796.86
$1,113.60
$1,692.24 |
$862.04
$946.20
$1,035.36
$1,352.10 |
$1,100.54
$1,184.70
$1,273.86
$1,590.60 |
$1,339.04
$1,423.20
$1,512.36
$1,829.10 |
$550.27
$592.35
$636.93
$795.30 |
$788.77
$830.85
$875.43
$1,033.80 |
$1,027.27
$1,069.35
$1,113.93
$1,272.30 |
$238.50 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$950 |
$1,900 |
Maximum Out of Pocket Per Year |
$3,950 |
$7,900 |
Deductible: Individual:
$950
| Family:
$1,900
Out of Pocket Maximum per year: Individual:
$3,950
| Family:
$7,900
Monthly Premiums:
|
21
30
40
50
60
|
$468.92
$532.22
$599.27
$837.48
$1,272.63 |
$937.84
$1,064.44
$1,198.54
$1,674.96
$2,545.26 |
$1,296.56
$1,423.16
$1,557.26
$2,033.68 |
$1,655.28
$1,781.88
$1,915.98
$2,392.40 |
$2,014.00
$2,140.60
$2,274.70
$2,751.12 |
$827.64
$890.94
$957.99
$1,196.20 |
$1,186.36
$1,249.66
$1,316.71
$1,554.92 |
$1,545.08
$1,608.38
$1,675.43
$1,913.64 |
$358.72 |
|
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
|
$333.65
$378.68
$426.39
$595.87
$905.49 |
$667.30
$757.36
$852.78
$1,191.74
$1,810.98 |
$922.53
$1,012.59
$1,108.01
$1,446.97 |
$1,177.76
$1,267.82
$1,363.24
$1,702.20 |
$1,432.99
$1,523.05
$1,618.47
$1,957.43 |
$588.88
$633.91
$681.62
$851.10 |
$844.11
$889.14
$936.85
$1,106.33 |
$1,099.34
$1,144.37
$1,192.08
$1,361.56 |
$255.23 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,350 |
$14,700 |
Maximum Out of Pocket Per Year |
$7,350 |
$14,700 |
Deductible: Individual:
$7,350
| Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
| Family:
$14,700
Monthly Premiums:
|
21
30
40
50
60
|
$353.27
$400.95
$451.47
$630.93
$958.75 |
$706.54
$801.90
$902.94
$1,261.86
$1,917.50 |
$976.79
$1,072.15
$1,173.19
$1,532.11 |
$1,247.04
$1,342.40
$1,443.44
$1,802.36 |
$1,517.29
$1,612.65
$1,713.69
$2,072.61 |
$623.52
$671.20
$721.72
$901.18 |
$893.77
$941.45
$991.97
$1,171.43 |
$1,164.02
$1,211.70
$1,262.22
$1,441.68 |
$270.25 |
|
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
|
$397.97
$451.68
$508.59
$710.75
$1,080.06 |
$795.94
$903.36
$1,017.18
$1,421.50
$2,160.12 |
$1,100.38
$1,207.80
$1,321.62
$1,725.94 |
$1,404.82
$1,512.24
$1,626.06
$2,030.38 |
$1,709.26
$1,816.68
$1,930.50
$2,334.82 |
$702.41
$756.12
$813.03
$1,015.19 |
$1,006.85
$1,060.56
$1,117.47
$1,319.63 |
$1,311.29
$1,365.00
$1,421.91
$1,624.07 |
$304.44 |
|
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
|
$386.90
$439.12
$494.45
$690.99
$1,050.02 |
$773.80
$878.24
$988.90
$1,381.98
$2,100.04 |
$1,069.77
$1,174.21
$1,284.87
$1,677.95 |
$1,365.74
$1,470.18
$1,580.84
$1,973.92 |
$1,661.71
$1,766.15
$1,876.81
$2,269.89 |
$682.87
$735.09
$790.42
$986.96 |
$978.84
$1,031.06
$1,086.39
$1,282.93 |
$1,274.81
$1,327.03
$1,382.36
$1,578.90 |
$295.97 |
|
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
|
$368.10
$417.78
$470.42
$657.41
$998.99 |
$736.20
$835.56
$940.84
$1,314.82
$1,997.98 |
$1,017.79
$1,117.15
$1,222.43
$1,596.41 |
$1,299.38
$1,398.74
$1,504.02
$1,878.00 |
$1,580.97
$1,680.33
$1,785.61
$2,159.59 |
$649.69
$699.37
$752.01
$939.00 |
$931.28
$980.96
$1,033.60
$1,220.59 |
$1,212.87
$1,262.55
$1,315.19
$1,502.18 |
$281.59 |
|
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
|
$486.68
$552.37
$621.97
$869.19
$1,320.83 |
$973.36
$1,104.74
$1,243.94
$1,738.38
$2,641.66 |
$1,345.66
$1,477.04
$1,616.24
$2,110.68 |
$1,717.96
$1,849.34
$1,988.54
$2,482.98 |
$2,090.26
$2,221.64
$2,360.84
$2,855.28 |
$858.98
$924.67
$994.27
$1,241.49 |
$1,231.28
$1,296.97
$1,366.57
$1,613.79 |
$1,603.58
$1,669.27
$1,738.87
$1,986.09 |
$372.30 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$0 |
$0 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$0
| Family:
$0
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$405.59
$460.33
$518.33
$724.36
$1,100.74 |
$811.18
$920.66
$1,036.66
$1,448.72
$2,201.48 |
$1,121.45
$1,230.93
$1,346.93
$1,758.99 |
$1,431.72
$1,541.20
$1,657.20
$2,069.26 |
$1,741.99
$1,851.47
$1,967.47
$2,379.53 |
$715.86
$770.60
$828.60
$1,034.63 |
$1,026.13
$1,080.87
$1,138.87
$1,344.90 |
$1,336.40
$1,391.14
$1,449.14
$1,655.17 |
$310.27 |
|
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
|
$405.98
$460.77
$518.82
$725.05
$1,101.79 |
$811.96
$921.54
$1,037.64
$1,450.10
$2,203.58 |
$1,122.52
$1,232.10
$1,348.20
$1,760.66 |
$1,433.08
$1,542.66
$1,658.76
$2,071.22 |
$1,743.64
$1,853.22
$1,969.32
$2,381.78 |
$716.54
$771.33
$829.38
$1,035.61 |
$1,027.10
$1,081.89
$1,139.94
$1,346.17 |
$1,337.66
$1,392.45
$1,450.50
$1,656.73 |
$310.56 |
|
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
|
$326.97
$371.10
$417.86
$583.95
$887.38 |
$653.94
$742.20
$835.72
$1,167.90
$1,774.76 |
$904.07
$992.33
$1,085.85
$1,418.03 |
$1,154.20
$1,242.46
$1,335.98
$1,668.16 |
$1,404.33
$1,492.59
$1,586.11
$1,918.29 |
$577.10
$621.23
$667.99
$834.08 |
$827.23
$871.36
$918.12
$1,084.21 |
$1,077.36
$1,121.49
$1,168.25
$1,334.34 |
$250.13 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$950 |
$1,900 |
Maximum Out of Pocket Per Year |
$3,950 |
$7,900 |
Deductible: Individual:
$950
| Family:
$1,900
Out of Pocket Maximum per year: Individual:
$3,950
| Family:
$7,900
Monthly Premiums:
|
21
30
40
50
60
|
$491.79
$558.17
$628.49
$878.32
$1,334.69 |
$983.58
$1,116.34
$1,256.98
$1,756.64
$2,669.38 |
$1,359.79
$1,492.55
$1,633.19
$2,132.85 |
$1,736.00
$1,868.76
$2,009.40
$2,509.06 |
$2,112.21
$2,244.97
$2,385.61
$2,885.27 |
$868.00
$934.38
$1,004.70
$1,254.53 |
$1,244.21
$1,310.59
$1,380.91
$1,630.74 |
$1,620.42
$1,686.80
$1,757.12
$2,006.95 |
$376.21 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,350 |
$14,700 |
Maximum Out of Pocket Per Year |
$7,350 |
$14,700 |
Deductible: Individual:
$7,350
| Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
| Family:
$14,700
Monthly Premiums:
|
21
30
40
50
60
|
$370.50
$420.50
$473.48
$661.69
$1,005.50 |
$741.00
$841.00
$946.96
$1,323.38
$2,011.00 |
$1,024.42
$1,124.42
$1,230.38
$1,606.80 |
$1,307.84
$1,407.84
$1,513.80
$1,890.22 |
$1,591.26
$1,691.26
$1,797.22
$2,173.64 |
$653.92
$703.92
$756.90
$945.11 |
$937.34
$987.34
$1,040.32
$1,228.53 |
$1,220.76
$1,270.76
$1,323.74
$1,511.95 |
$283.42 |
Shelby County is in “Rating Area 10” of Indiana.
Currently, there are 31 plans offered in Rating Area 10.