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
|
$445.80
$505.99
$569.73
$796.20
$1,209.91 |
$891.60
$1,011.98
$1,139.46
$1,592.40
$2,419.82 |
$1,232.64
$1,353.02
$1,480.50
$1,933.44 |
$1,573.68
$1,694.06
$1,821.54
$2,274.48 |
$1,914.72
$2,035.10
$2,162.58
$2,615.52 |
$786.84
$847.03
$910.77
$1,137.24 |
$1,127.88
$1,188.07
$1,251.81
$1,478.28 |
$1,468.92
$1,529.11
$1,592.85
$1,819.32 |
$341.04 |
|
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
|
$424.51
$481.82
$542.52
$758.17
$1,152.12 |
$849.02
$963.64
$1,085.04
$1,516.34
$2,304.24 |
$1,173.77
$1,288.39
$1,409.79
$1,841.09 |
$1,498.52
$1,613.14
$1,734.54
$2,165.84 |
$1,823.27
$1,937.89
$2,059.29
$2,490.59 |
$749.26
$806.57
$867.27
$1,082.92 |
$1,074.01
$1,131.32
$1,192.02
$1,407.67 |
$1,398.76
$1,456.07
$1,516.77
$1,732.42 |
$324.75 |
|
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
|
$655.28
$743.74
$837.45
$1,170.33
$1,778.43 |
$1,310.56
$1,487.48
$1,674.90
$2,340.66
$3,556.86 |
$1,811.85
$1,988.77
$2,176.19
$2,841.95 |
$2,313.14
$2,490.06
$2,677.48
$3,343.24 |
$2,814.43
$2,991.35
$3,178.77
$3,844.53 |
$1,156.57
$1,245.03
$1,338.74
$1,671.62 |
$1,657.86
$1,746.32
$1,840.03
$2,172.91 |
$2,159.15
$2,247.61
$2,341.32
$2,674.20 |
$501.29 |
|
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
|
$661.15
$750.41
$844.95
$1,180.81
$1,794.36 |
$1,322.30
$1,500.82
$1,689.90
$2,361.62
$3,588.72 |
$1,828.08
$2,006.60
$2,195.68
$2,867.40 |
$2,333.86
$2,512.38
$2,701.46
$3,373.18 |
$2,839.64
$3,018.16
$3,207.24
$3,878.96 |
$1,166.93
$1,256.19
$1,350.73
$1,686.59 |
$1,672.71
$1,761.97
$1,856.51
$2,192.37 |
$2,178.49
$2,267.75
$2,362.29
$2,698.15 |
$505.78 |
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
|
$436.28
$495.18
$557.56
$779.19
$1,184.06 |
$872.56
$990.36
$1,115.12
$1,558.38
$2,368.12 |
$1,206.31
$1,324.11
$1,448.87
$1,892.13 |
$1,540.06
$1,657.86
$1,782.62
$2,225.88 |
$1,873.81
$1,991.61
$2,116.37
$2,559.63 |
$770.03
$828.93
$891.31
$1,112.94 |
$1,103.78
$1,162.68
$1,225.06
$1,446.69 |
$1,437.53
$1,496.43
$1,558.81
$1,780.44 |
$333.75 |
|
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
|
$415.45
$471.53
$530.94
$741.99
$1,127.52 |
$830.90
$943.06
$1,061.88
$1,483.98
$2,255.04 |
$1,148.72
$1,260.88
$1,379.70
$1,801.80 |
$1,466.54
$1,578.70
$1,697.52
$2,119.62 |
$1,784.36
$1,896.52
$2,015.34
$2,437.44 |
$733.27
$789.35
$848.76
$1,059.81 |
$1,051.09
$1,107.17
$1,166.58
$1,377.63 |
$1,368.91
$1,424.99
$1,484.40
$1,695.45 |
$317.82 |
|
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
|
$641.29
$727.87
$819.57
$1,145.35
$1,740.47 |
$1,282.58
$1,455.74
$1,639.14
$2,290.70
$3,480.94 |
$1,773.17
$1,946.33
$2,129.73
$2,781.29 |
$2,263.76
$2,436.92
$2,620.32
$3,271.88 |
$2,754.35
$2,927.51
$3,110.91
$3,762.47 |
$1,131.88
$1,218.46
$1,310.16
$1,635.94 |
$1,622.47
$1,709.05
$1,800.75
$2,126.53 |
$2,113.06
$2,199.64
$2,291.34
$2,617.12 |
$490.59 |
|
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
|
$647.04
$734.39
$826.92
$1,155.61
$1,756.07 |
$1,294.08
$1,468.78
$1,653.84
$2,311.22
$3,512.14 |
$1,789.07
$1,963.77
$2,148.83
$2,806.21 |
$2,284.06
$2,458.76
$2,643.82
$3,301.20 |
$2,779.05
$2,953.75
$3,138.81
$3,796.19 |
$1,142.03
$1,229.38
$1,321.91
$1,650.60 |
$1,637.02
$1,724.37
$1,816.90
$2,145.59 |
$2,132.01
$2,219.36
$2,311.89
$2,640.58 |
$494.99 |
ADVERTISEMENT
|
Medica Insurance Company
Local: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-888-516-4692
|
|
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
|
$527.40
$598.60
$674.02
$941.94
$1,431.37 |
$1,054.80
$1,197.20
$1,348.04
$1,883.88
$2,862.74 |
$1,458.26
$1,600.66
$1,751.50
$2,287.34 |
$1,861.72
$2,004.12
$2,154.96
$2,690.80 |
$2,265.18
$2,407.58
$2,558.42
$3,094.26 |
$930.86
$1,002.06
$1,077.48
$1,345.40 |
$1,334.32
$1,405.52
$1,480.94
$1,748.86 |
$1,737.78
$1,808.98
$1,884.40
$2,152.32 |
$403.46 |
|
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
|
$330.18
$374.76
$421.98
$589.71
$896.12 |
$660.36
$749.52
$843.96
$1,179.42
$1,792.24 |
$912.95
$1,002.11
$1,096.55
$1,432.01 |
$1,165.54
$1,254.70
$1,349.14
$1,684.60 |
$1,418.13
$1,507.29
$1,601.73
$1,937.19 |
$582.77
$627.35
$674.57
$842.30 |
$835.36
$879.94
$927.16
$1,094.89 |
$1,087.95
$1,132.53
$1,179.75
$1,347.48 |
$252.59 |
|
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
|
$352.55
$400.15
$450.56
$629.66
$956.83 |
$705.10
$800.30
$901.12
$1,259.32
$1,913.66 |
$974.80
$1,070.00
$1,170.82
$1,529.02 |
$1,244.50
$1,339.70
$1,440.52
$1,798.72 |
$1,514.20
$1,609.40
$1,710.22
$2,068.42 |
$622.25
$669.85
$720.26
$899.36 |
$891.95
$939.55
$989.96
$1,169.06 |
$1,161.65
$1,209.25
$1,259.66
$1,438.76 |
$269.70 |
|
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
|
$245.33
$278.44
$313.53
$438.15
$665.81 |
$490.66
$556.88
$627.06
$876.30
$1,331.62 |
$678.33
$744.55
$814.73
$1,063.97 |
$866.00
$932.22
$1,002.40
$1,251.64 |
$1,053.67
$1,119.89
$1,190.07
$1,439.31 |
$433.00
$466.11
$501.20
$625.82 |
$620.67
$653.78
$688.87
$813.49 |
$808.34
$841.45
$876.54
$1,001.16 |
$187.67 |
|
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
|
$365.67
$415.04
$467.33
$653.09
$992.43 |
$731.34
$830.08
$934.66
$1,306.18
$1,984.86 |
$1,011.08
$1,109.82
$1,214.40
$1,585.92 |
$1,290.82
$1,389.56
$1,494.14
$1,865.66 |
$1,570.56
$1,669.30
$1,773.88
$2,145.40 |
$645.41
$694.78
$747.07
$932.83 |
$925.15
$974.52
$1,026.81
$1,212.57 |
$1,204.89
$1,254.26
$1,306.55
$1,492.31 |
$279.74 |
|
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
|
$360.13
$408.75
$460.25
$643.20
$977.40 |
$720.26
$817.50
$920.50
$1,286.40
$1,954.80 |
$995.76
$1,093.00
$1,196.00
$1,561.90 |
$1,271.26
$1,368.50
$1,471.50
$1,837.40 |
$1,546.76
$1,644.00
$1,747.00
$2,112.90 |
$635.63
$684.25
$735.75
$918.70 |
$911.13
$959.75
$1,011.25
$1,194.20 |
$1,186.63
$1,235.25
$1,286.75
$1,469.70 |
$275.50 |
|
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
|
$372.33
$422.59
$475.83
$664.98
$1,010.50 |
$744.66
$845.18
$951.66
$1,329.96
$2,021.00 |
$1,029.49
$1,130.01
$1,236.49
$1,614.79 |
$1,314.32
$1,414.84
$1,521.32
$1,899.62 |
$1,599.15
$1,699.67
$1,806.15
$2,184.45 |
$657.16
$707.42
$760.66
$949.81 |
$941.99
$992.25
$1,045.49
$1,234.64 |
$1,226.82
$1,277.08
$1,330.32
$1,519.47 |
$284.83 |
|
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
|
$448.28
$508.80
$572.91
$800.63
$1,216.64 |
$896.56
$1,017.60
$1,145.82
$1,601.26
$2,433.28 |
$1,239.50
$1,360.54
$1,488.76
$1,944.20 |
$1,582.44
$1,703.48
$1,831.70
$2,287.14 |
$1,925.38
$2,046.42
$2,174.64
$2,630.08 |
$791.22
$851.74
$915.85
$1,143.57 |
$1,134.16
$1,194.68
$1,258.79
$1,486.51 |
$1,477.10
$1,537.62
$1,601.73
$1,829.45 |
$342.94 |
|
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
|
$280.65
$318.54
$358.67
$501.24
$761.69 |
$561.30
$637.08
$717.34
$1,002.48
$1,523.38 |
$776.00
$851.78
$932.04
$1,217.18 |
$990.70
$1,066.48
$1,146.74
$1,431.88 |
$1,205.40
$1,281.18
$1,361.44
$1,646.58 |
$495.35
$533.24
$573.37
$715.94 |
$710.05
$747.94
$788.07
$930.64 |
$924.75
$962.64
$1,002.77
$1,145.34 |
$214.70 |
|
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
|
$299.66
$340.12
$382.97
$535.20
$813.29 |
$599.32
$680.24
$765.94
$1,070.40
$1,626.58 |
$828.56
$909.48
$995.18
$1,299.64 |
$1,057.80
$1,138.72
$1,224.42
$1,528.88 |
$1,287.04
$1,367.96
$1,453.66
$1,758.12 |
$528.90
$569.36
$612.21
$764.44 |
$758.14
$798.60
$841.45
$993.68 |
$987.38
$1,027.84
$1,070.69
$1,222.92 |
$229.24 |
|
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
|
$208.52
$236.67
$266.49
$372.42
$565.93 |
$417.04
$473.34
$532.98
$744.84
$1,131.86 |
$576.56
$632.86
$692.50
$904.36 |
$736.08
$792.38
$852.02
$1,063.88 |
$895.60
$951.90
$1,011.54
$1,223.40 |
$368.04
$396.19
$426.01
$531.94 |
$527.56
$555.71
$585.53
$691.46 |
$687.08
$715.23
$745.05
$850.98 |
$159.52 |
|
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
|
$310.81
$352.77
$397.22
$555.11
$843.55 |
$621.62
$705.54
$794.44
$1,110.22
$1,687.10 |
$859.39
$943.31
$1,032.21
$1,347.99 |
$1,097.16
$1,181.08
$1,269.98
$1,585.76 |
$1,334.93
$1,418.85
$1,507.75
$1,823.53 |
$548.58
$590.54
$634.99
$792.88 |
$786.35
$828.31
$872.76
$1,030.65 |
$1,024.12
$1,066.08
$1,110.53
$1,268.42 |
$237.77 |
|
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
|
$306.11
$347.43
$391.20
$546.71
$830.77 |
$612.22
$694.86
$782.40
$1,093.42
$1,661.54 |
$846.39
$929.03
$1,016.57
$1,327.59 |
$1,080.56
$1,163.20
$1,250.74
$1,561.76 |
$1,314.73
$1,397.37
$1,484.91
$1,795.93 |
$540.28
$581.60
$625.37
$780.88 |
$774.45
$815.77
$859.54
$1,015.05 |
$1,008.62
$1,049.94
$1,093.71
$1,249.22 |
$234.17 |
Woodbury County is in “Rating Area 3” of Iowa.
Currently, there are 21 plans offered in Rating Area 3.