ADVERTISEMENT
|
Wellmark Health Plan of Iowa, Inc.
Local: 1-800-819-0893 | Toll Free: 1-800-819-0893 | TTY: 1-888-781-4262
|
|
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
|
$418.09
$474.53
$534.31
$746.70
$1,134.68 |
$836.18
$949.06
$1,068.62
$1,493.40
$2,269.36 |
$1,156.02
$1,268.90
$1,388.46
$1,813.24 |
$1,475.86
$1,588.74
$1,708.30
$2,133.08 |
$1,795.70
$1,908.58
$2,028.14
$2,452.92 |
$737.93
$794.37
$854.15
$1,066.54 |
$1,057.77
$1,114.21
$1,173.99
$1,386.38 |
$1,377.61
$1,434.05
$1,493.83
$1,706.22 |
$319.84 |
|
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
|
$398.12
$451.86
$508.79
$711.04
$1,080.49 |
$796.24
$903.72
$1,017.58
$1,422.08
$2,160.98 |
$1,100.80
$1,208.28
$1,322.14
$1,726.64 |
$1,405.36
$1,512.84
$1,626.70
$2,031.20 |
$1,709.92
$1,817.40
$1,931.26
$2,335.76 |
$702.68
$756.42
$813.35
$1,015.60 |
$1,007.24
$1,060.98
$1,117.91
$1,320.16 |
$1,311.80
$1,365.54
$1,422.47
$1,624.72 |
$304.56 |
|
Silver
|
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
|
$614.54
$697.50
$785.38
$1,097.57
$1,667.86 |
$1,229.08
$1,395.00
$1,570.76
$2,195.14
$3,335.72 |
$1,699.20
$1,865.12
$2,040.88
$2,665.26 |
$2,169.32
$2,335.24
$2,511.00
$3,135.38 |
$2,639.44
$2,805.36
$2,981.12
$3,605.50 |
$1,084.66
$1,167.62
$1,255.50
$1,567.69 |
$1,554.78
$1,637.74
$1,725.62
$2,037.81 |
$2,024.90
$2,107.86
$2,195.74
$2,507.93 |
$470.12 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,500 |
$9,000 |
Maximum Out of Pocket Per Year |
$4,500 |
$9,000 |
Deductible: Individual:
$4,500
| Family:
$9,000
Out of Pocket Maximum per year: Individual:
$4,500
| Family:
$9,000
Monthly Premiums:
|
21
30
40
50
60
|
$620.05
$703.75
$792.42
$1,107.40
$1,682.80 |
$1,240.10
$1,407.50
$1,584.84
$2,214.80
$3,365.60 |
$1,714.43
$1,881.83
$2,059.17
$2,689.13 |
$2,188.76
$2,356.16
$2,533.50
$3,163.46 |
$2,663.09
$2,830.49
$3,007.83
$3,637.79 |
$1,094.38
$1,178.08
$1,266.75
$1,581.73 |
$1,568.71
$1,652.41
$1,741.08
$2,056.06 |
$2,043.04
$2,126.74
$2,215.41
$2,530.39 |
$474.33 |
ADVERTISEMENT
|
Wellmark Value Health Plan, Inc.
Local: 1-800-819-0893 | Toll Free: 1-800-819-0893 | TTY: 1-888-781-4262
|
|
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
|
$409.15
$464.39
$522.90
$730.75
$1,110.45 |
$818.30
$928.78
$1,045.80
$1,461.50
$2,220.90 |
$1,131.30
$1,241.78
$1,358.80
$1,774.50 |
$1,444.30
$1,554.78
$1,671.80
$2,087.50 |
$1,757.30
$1,867.78
$1,984.80
$2,400.50 |
$722.15
$777.39
$835.90
$1,043.75 |
$1,035.15
$1,090.39
$1,148.90
$1,356.75 |
$1,348.15
$1,403.39
$1,461.90
$1,669.75 |
$313.00 |
|
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
|
$389.62
$442.22
$497.93
$695.86
$1,057.42 |
$779.24
$884.44
$995.86
$1,391.72
$2,114.84 |
$1,077.30
$1,182.50
$1,293.92
$1,689.78 |
$1,375.36
$1,480.56
$1,591.98
$1,987.84 |
$1,673.42
$1,778.62
$1,890.04
$2,285.90 |
$687.68
$740.28
$795.99
$993.92 |
$985.74
$1,038.34
$1,094.05
$1,291.98 |
$1,283.80
$1,336.40
$1,392.11
$1,590.04 |
$298.06 |
|
Silver
|
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
|
$601.42
$682.62
$768.62
$1,074.14
$1,632.26 |
$1,202.84
$1,365.24
$1,537.24
$2,148.28
$3,264.52 |
$1,662.93
$1,825.33
$1,997.33
$2,608.37 |
$2,123.02
$2,285.42
$2,457.42
$3,068.46 |
$2,583.11
$2,745.51
$2,917.51
$3,528.55 |
$1,061.51
$1,142.71
$1,228.71
$1,534.23 |
$1,521.60
$1,602.80
$1,688.80
$1,994.32 |
$1,981.69
$2,062.89
$2,148.89
$2,454.41 |
$460.09 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,500 |
$9,000 |
Maximum Out of Pocket Per Year |
$4,500 |
$9,000 |
Deductible: Individual:
$4,500
| Family:
$9,000
Out of Pocket Maximum per year: Individual:
$4,500
| Family:
$9,000
Monthly Premiums:
|
21
30
40
50
60
|
$606.81
$688.73
$775.51
$1,083.77
$1,646.89 |
$1,213.62
$1,377.46
$1,551.02
$2,167.54
$3,293.78 |
$1,677.83
$1,841.67
$2,015.23
$2,631.75 |
$2,142.04
$2,305.88
$2,479.44
$3,095.96 |
$2,606.25
$2,770.09
$2,943.65
$3,560.17 |
$1,071.02
$1,152.94
$1,239.72
$1,547.98 |
$1,535.23
$1,617.15
$1,703.93
$2,012.19 |
$1,999.44
$2,081.36
$2,168.14
$2,476.40 |
$464.21 |
ADVERTISEMENT
|
Medica Insurance Company
Local: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-888-516-4692
|
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$850 |
$2,550 |
Maximum Out of Pocket Per Year |
$7,400 |
$14,800 |
Deductible: Individual:
$850
| Family:
$2,550
Out of Pocket Maximum per year: Individual:
$7,400
| Family:
$14,800
Monthly Premiums:
|
21
30
40
50
60
|
$469.39
$532.76
$599.89
$838.34
$1,273.94 |
$938.78
$1,065.52
$1,199.78
$1,676.68
$2,547.88 |
$1,297.87
$1,424.61
$1,558.87
$2,035.77 |
$1,656.96
$1,783.70
$1,917.96
$2,394.86 |
$2,016.05
$2,142.79
$2,277.05
$2,753.95 |
$828.48
$891.85
$958.98
$1,197.43 |
$1,187.57
$1,250.94
$1,318.07
$1,556.52 |
$1,546.66
$1,610.03
$1,677.16
$1,915.61 |
$359.09 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,600 |
$13,800 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$4,600
| Family:
$13,800
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$565.15
$641.45
$722.26
$1,009.36
$1,533.82 |
$1,130.30
$1,282.90
$1,444.52
$2,018.72
$3,067.64 |
$1,562.64
$1,715.24
$1,876.86
$2,451.06 |
$1,994.98
$2,147.58
$2,309.20
$2,883.40 |
$2,427.32
$2,579.92
$2,741.54
$3,315.74 |
$997.49
$1,073.79
$1,154.60
$1,441.70 |
$1,429.83
$1,506.13
$1,586.94
$1,874.04 |
$1,862.17
$1,938.47
$2,019.28
$2,306.38 |
$432.34 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,200 |
$14,400 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$7,200
| Family:
$14,400
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$353.82
$401.58
$452.18
$631.92
$960.26 |
$707.64
$803.16
$904.36
$1,263.84
$1,920.52 |
$978.31
$1,073.83
$1,175.03
$1,534.51 |
$1,248.98
$1,344.50
$1,445.70
$1,805.18 |
$1,519.65
$1,615.17
$1,716.37
$2,075.85 |
$624.49
$672.25
$722.85
$902.59 |
$895.16
$942.92
$993.52
$1,173.26 |
$1,165.83
$1,213.59
$1,264.19
$1,443.93 |
$270.67 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,400 |
$12,800 |
Maximum Out of Pocket Per Year |
$6,900 |
$13,800 |
Deductible: Individual:
$6,400
| Family:
$12,800
Out of Pocket Maximum per year: Individual:
$6,900
| Family:
$13,800
Monthly Premiums:
|
21
30
40
50
60
|
$377.79
$428.79
$482.81
$674.73
$1,025.31 |
$755.58
$857.58
$965.62
$1,349.46
$2,050.62 |
$1,044.59
$1,146.59
$1,254.63
$1,638.47 |
$1,333.60
$1,435.60
$1,543.64
$1,927.48 |
$1,622.61
$1,724.61
$1,832.65
$2,216.49 |
$666.80
$717.80
$771.82
$963.74 |
$955.81
$1,006.81
$1,060.83
$1,252.75 |
$1,244.82
$1,295.82
$1,349.84
$1,541.76 |
$289.01 |
|
Catastrophic
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$262.88
$298.37
$335.97
$469.51
$713.47 |
$525.76
$596.74
$671.94
$939.02
$1,426.94 |
$726.87
$797.85
$873.05
$1,140.13 |
$927.98
$998.96
$1,074.16
$1,341.24 |
$1,129.09
$1,200.07
$1,275.27
$1,542.35 |
$463.99
$499.48
$537.08
$670.62 |
$665.10
$700.59
$738.19
$871.73 |
$866.21
$901.70
$939.30
$1,072.84 |
$201.11 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$3,700 |
$7,400 |
Maximum Out of Pocket Per Year |
$6,900 |
$13,800 |
Deductible: Individual:
$3,700
| Family:
$7,400
Out of Pocket Maximum per year: Individual:
$6,900
| Family:
$13,800
Monthly Premiums:
|
21
30
40
50
60
|
$391.84
$444.74
$500.78
$699.83
$1,063.47 |
$783.68
$889.48
$1,001.56
$1,399.66
$2,126.94 |
$1,083.44
$1,189.24
$1,301.32
$1,699.42 |
$1,383.20
$1,489.00
$1,601.08
$1,999.18 |
$1,682.96
$1,788.76
$1,900.84
$2,298.94 |
$691.60
$744.50
$800.54
$999.59 |
$991.36
$1,044.26
$1,100.30
$1,299.35 |
$1,291.12
$1,344.02
$1,400.06
$1,599.11 |
$299.76 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,600 |
$3,200 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$1,600
| Family:
$3,200
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$385.91
$438.01
$493.19
$689.23
$1,047.36 |
$771.82
$876.02
$986.38
$1,378.46
$2,094.72 |
$1,067.04
$1,171.24
$1,281.60
$1,673.68 |
$1,362.26
$1,466.46
$1,576.82
$1,968.90 |
$1,657.48
$1,761.68
$1,872.04
$2,264.12 |
$681.13
$733.23
$788.41
$984.45 |
$976.35
$1,028.45
$1,083.63
$1,279.67 |
$1,271.57
$1,323.67
$1,378.85
$1,574.89 |
$295.22 |
Wayne County is in “Rating Area 5” of Iowa.
Currently, there are 15 plans offered in Rating Area 5.