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Obamacare 2021 Rates and Health Insurance Providers for Woodbury County , Iowa

Obamacare > Rates > Iowa > Woodbury County

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Obamacare Rates and Providers for Other Years

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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 Woodbury County, IA.

The health insurance rates listed below are for calendar year 2021.

Obamacare Providers, Plans and 2021 Rates for Woodbury County, Iowa

Below, you’ll find a summary of the 32 plans for Woodbury County, Iowa and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

Wellmark Health Plan of Iowa, Inc.

Local: 1-800-819-0893 | Toll Free: 1-800-819-0893 | TTY: 1-888-781-4262

1. Expanded Bronze Wellmark Bronze Modified HMO

2. Expanded Bronze Wellmark Bronze HDHP HMO

3. Silver Wellmark Silver Modified HMO

4. Gold Wellmark Gold Modified HMO

5. Expanded Bronze Wellmark Bronze Traditional HMO

6. Gold Wellmark Gold Traditional HMO

Oscar Insurance Company

Local: | Toll Free:

7. Expanded Bronze Oscar Bronze Classic PCP Copay

8. Expanded Bronze Oscar Bronze Classic

9. Expanded Bronze Oscar Bronze Classic Next

10. Silver Oscar Silver Saver

11. Silver Oscar Silver Classic Next

12. Catastrophic Oscar Secure

13. Gold Oscar Gold Classic

14. Expanded Bronze Oscar Bronze HDHP

15. Silver Oscar Silver Saver 2

16. Silver Oscar Silver Classic Copay

17. Silver Oscar Silver Classic $0 Ded

18. Gold Oscar Gold Classic 2

Medica

Local: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-888-516-4692

19. Silver Medica Insure Silver Copay

20. Expanded Bronze Medica Insure Bronze Copay

21. Expanded Bronze Medica Insure Bronze HSA

22. Catastrophic Medica Insure Catastrophic

23. Silver Medica Insure Silver Share

24. Expanded Bronze Medica Insure Bronze Share Plus

25. Expanded Bronze Medica Insure Bronze Share

26. Gold Inspire by Medica Gold Copay

27. Silver Inspire by Medica Silver Copay

28. Expanded Bronze Inspire by Medica Bronze HSA

29. Catastrophic Inspire by Medica Catastrophic

30. Expanded Bronze Inspire by Medica Bronze Share Plus

31. Expanded Bronze Inspire by Medica Bronze Share

32. Expanded Bronze Inspire by Medica Bronze Copay Preferred Primary Care

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 Sioux City, IA area accept this insurance coverage as within the plan's network.

Counties in Iowa

2021 Obamacare Rates, Providers, and Plans for Woodbury County

Wellmark Health Plan of Iowa, Inc.

Local: 1-800-819-0893 | Toll Free: 1-800-819-0893 | TTY: 1-888-781-4262

Toc - Plan #1

Expanded Bronze

(HMO) Wellmark Bronze Modified HMO

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Wellmark Health Plan of Iowa, Inc.
Customer Service Phone: 1-800-819-0893

Annual Out of Pocket Expenses

Individual Family

$8,150 $16,300 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $8,150 | Family: $16,300
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$264,31
$299,99
$337,79
$472,05
$717,33

$528,62
$599,98
$675,58
$944,10
$1 434,66

$730,82
$802,18
$877,78
$1 146,30

$933,02
$1 004,38
$1 079,98
$1 348,50

$1 135,22
$1 206,58
$1 282,18
$1 550,70

$466,51
$502,19
$539,99
$674,25

$668,71
$704,39
$742,19
$876,45

$870,91
$906,59
$944,39
$1 078,65

$202,20

Toc - Plan #2

Expanded Bronze

(HMO) Wellmark Bronze HDHP HMO

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Wellmark Health Plan of Iowa, Inc.
Customer Service Phone: 1-800-819-0893

Annual Out of Pocket Expenses

Individual Family

$6,900 $13,800 Annual Deductible

$6,900 $13,800 Maximum Out of Pocket Per Year

Deductible: Individual: $6,900 | Family: $13,800
Out of Pocket Maximum per year: Individual: $6,900 | Family: $13,800

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$249,51
$283,19
$318,87
$445,63
$677,17

$499,02
$566,38
$637,74
$891,26
$1 354,34

$689,90
$757,26
$828,62
$1 082,14

$880,78
$948,14
$1 019,50
$1 273,02

$1 071,66
$1 139,02
$1 210,38
$1 463,90

$440,39
$474,07
$509,75
$636,51

$631,27
$664,95
$700,63
$827,39

$822,15
$855,83
$891,51
$1 018,27

$190,88

Toc - Plan #3

Silver

(HMO) Wellmark Silver Modified HMO

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Wellmark Health Plan of Iowa, Inc.
Customer Service Phone: 1-800-819-0893

Annual Out of Pocket Expenses

Individual Family

$8,150 $16,300 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $8,150 | Family: $16,300
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$392,61
$445,62
$501,76
$701,21
$1 065,55

$785,22
$891,24
$1 003,52
$1 402,42
$2 131,10

$1 085,57
$1 191,59
$1 303,87
$1 702,77

$1 385,92
$1 491,94
$1 604,22
$2 003,12

$1 686,27
$1 792,29
$1 904,57
$2 303,47

$692,96
$745,97
$802,11
$1 001,56

$993,31
$1 046,32
$1 102,46
$1 301,91

$1 293,66
$1 346,67
$1 402,81
$1 602,26

$300,35

Toc - Plan #4

Gold

(HMO) Wellmark Gold Modified HMO

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Wellmark Health Plan of Iowa, Inc.
Customer Service Phone: 1-800-819-0893

Annual Out of Pocket Expenses

Individual Family

$5,250 $10,500 Annual Deductible

$5,250 $10,500 Maximum Out of Pocket Per Year

Deductible: Individual: $5,250 | Family: $10,500
Out of Pocket Maximum per year: Individual: $5,250 | Family: $10,500

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$355,96
$404,01
$454,91
$635,74
$966,07

$711,92
$808,02
$909,82
$1 271,48
$1 932,14

$984,23
$1 080,33
$1 182,13
$1 543,79

$1 256,54
$1 352,64
$1 454,44
$1 816,10

$1 528,85
$1 624,95
$1 726,75
$2 088,41

$628,27
$676,32
$727,22
$908,05

$900,58
$948,63
$999,53
$1 180,36

$1 172,89
$1 220,94
$1 271,84
$1 452,67

$272,31

Toc - Plan #5

Expanded Bronze

(HMO) Wellmark Bronze Traditional HMO

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Wellmark Health Plan of Iowa, Inc.
Customer Service Phone: 1-800-819-0893

Annual Out of Pocket Expenses

Individual Family

$7,200 $14,400 Annual Deductible

$8,500 $17,000 Maximum Out of Pocket Per Year

Deductible: Individual: $7,200 | Family: $14,400
Out of Pocket Maximum per year: Individual: $8,500 | Family: $17,000

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$263,71
$299,31
$337,03
$470,99
$715,72

$527,42
$598,62
$674,06
$941,98
$1 431,44

$729,16
$800,36
$875,80
$1 143,72

$930,90
$1 002,10
$1 077,54
$1 345,46

$1 132,64
$1 203,84
$1 279,28
$1 547,20

$465,45
$501,05
$538,77
$672,73

$667,19
$702,79
$740,51
$874,47

$868,93
$904,53
$942,25
$1 076,21

$201,74

Toc - Plan #6

Gold

(HMO) Wellmark Gold Traditional HMO

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Wellmark Health Plan of Iowa, Inc.
Customer Service Phone: 1-800-819-0893

Annual Out of Pocket Expenses

Individual Family

$1,500 $3,000 Annual Deductible

$6,300 $12,600 Maximum Out of Pocket Per Year

Deductible: Individual: $1,500 | Family: $3,000
Out of Pocket Maximum per year: Individual: $6,300 | Family: $12,600

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$356,05
$404,12
$455,03
$635,91
$966,32

$712,10
$808,24
$910,06
$1 271,82
$1 932,64

$984,48
$1 080,62
$1 182,44
$1 544,20

$1 256,86
$1 353,00
$1 454,82
$1 816,58

$1 529,24
$1 625,38
$1 727,20
$2 088,96

$628,43
$676,50
$727,41
$908,29

$900,81
$948,88
$999,79
$1 180,67

$1 173,19
$1 221,26
$1 272,17
$1 453,05

$272,38

Oscar Insurance Company

Local: | Toll Free:

Toc - Plan #7

Expanded Bronze

(EPO) Oscar Bronze Classic PCP Copay

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$6,000 $12,000 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$287,14
$325,89
$366,95
$512,81
$779,26

$574,28
$651,78
$733,90
$1 025,62
$1 558,52

$793,93
$871,43
$953,55
$1 245,27

$1 013,58
$1 091,08
$1 173,20
$1 464,92

$1 233,23
$1 310,73
$1 392,85
$1 684,57

$506,79
$545,54
$586,60
$732,46

$726,44
$765,19
$806,25
$952,11

$946,09
$984,84
$1 025,90
$1 171,76

$219,65

Toc - Plan #8

Expanded Bronze

(EPO) Oscar Bronze Classic

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$6,000 $12,000 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$279,39
$317,09
$357,04
$498,97
$758,23

$558,78
$634,18
$714,08
$997,94
$1 516,46

$772,50
$847,90
$927,80
$1 211,66

$986,22
$1 061,62
$1 141,52
$1 425,38

$1 199,94
$1 275,34
$1 355,24
$1 639,10

$493,11
$530,81
$570,76
$712,69

$706,83
$744,53
$784,48
$926,41

$920,55
$958,25
$998,20
$1 140,13

$213,72

Toc - Plan #9

Expanded Bronze

(EPO) Oscar Bronze Classic Next

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$0 $0 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $0 | Family: $0
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$335,72
$381,03
$429,04
$599,58
$911,12

$671,44
$762,06
$858,08
$1 199,16
$1 822,24

$928,26
$1 018,88
$1 114,90
$1 455,98

$1 185,08
$1 275,70
$1 371,72
$1 712,80

$1 441,90
$1 532,52
$1 628,54
$1 969,62

$592,54
$637,85
$685,86
$856,40

$849,36
$894,67
$942,68
$1 113,22

$1 106,18
$1 151,49
$1 199,50
$1 370,04

$256,82

Toc - Plan #10

Silver

(EPO) Oscar Silver Saver

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$4,200 $8,400 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $4,200 | Family: $8,400
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$367,31
$416,88
$469,41
$655,99
$996,85

$734,62
$833,76
$938,82
$1 311,98
$1 993,70

$1 015,60
$1 114,74
$1 219,80
$1 592,96

$1 296,58
$1 395,72
$1 500,78
$1 873,94

$1 577,56
$1 676,70
$1 781,76
$2 154,92

$648,29
$697,86
$750,39
$936,97

$929,27
$978,84
$1 031,37
$1 217,95

$1 210,25
$1 259,82
$1 312,35
$1 498,93

$280,98

Toc - Plan #11

Silver

(EPO) Oscar Silver Classic Next

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$6,000 $12,000 Annual Deductible

$8,000 $16,000 Maximum Out of Pocket Per Year

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $8,000 | Family: $16,000

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$378,23
$429,28
$483,37
$675,50
$1 026,49

$756,46
$858,56
$966,74
$1 351,00
$2 052,98

$1 045,80
$1 147,90
$1 256,08
$1 640,34

$1 335,14
$1 437,24
$1 545,42
$1 929,68

$1 624,48
$1 726,58
$1 834,76
$2 219,02

$667,57
$718,62
$772,71
$964,84

$956,91
$1 007,96
$1 062,05
$1 254,18

$1 246,25
$1 297,30
$1 351,39
$1 543,52

$289,34

Toc - Plan #12

Catastrophic

(EPO) Oscar Secure

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$8,550 $17,100 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $8,550 | Family: $17,100
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$233,56
$265,08
$298,48
$417,13
$633,86

$467,12
$530,16
$596,96
$834,26
$1 267,72

$645,79
$708,83
$775,63
$1 012,93

$824,46
$887,50
$954,30
$1 191,60

$1 003,13
$1 066,17
$1 132,97
$1 370,27

$412,23
$443,75
$477,15
$595,80

$590,90
$622,42
$655,82
$774,47

$769,57
$801,09
$834,49
$953,14

$178,67

Toc - Plan #13

Gold

(EPO) Oscar Gold Classic

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$2,500 $5,000 Annual Deductible

$6,000 $12,000 Maximum Out of Pocket Per Year

Deductible: Individual: $2,500 | Family: $5,000
Out of Pocket Maximum per year: Individual: $6,000 | Family: $12,000

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$384,53
$436,43
$491,41
$686,75
$1 043,58

$769,06
$872,86
$982,82
$1 373,50
$2 087,16

$1 063,22
$1 167,02
$1 276,98
$1 667,66

$1 357,38
$1 461,18
$1 571,14
$1 961,82

$1 651,54
$1 755,34
$1 865,30
$2 255,98

$678,69
$730,59
$785,57
$980,91

$972,85
$1 024,75
$1 079,73
$1 275,07

$1 267,01
$1 318,91
$1 373,89
$1 569,23

$294,16

Toc - Plan #14

Expanded Bronze

(EPO) Oscar Bronze HDHP

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$5,200 $10,400 Annual Deductible

$7,000 $14,000 Maximum Out of Pocket Per Year

Deductible: Individual: $5,200 | Family: $10,400
Out of Pocket Maximum per year: Individual: $7,000 | Family: $14,000

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$295,88
$335,82
$378,12
$528,43
$803,00

$591,76
$671,64
$756,24
$1 056,86
$1 606,00

$818,10
$897,98
$982,58
$1 283,20

$1 044,44
$1 124,32
$1 208,92
$1 509,54

$1 270,78
$1 350,66
$1 435,26
$1 735,88

$522,22
$562,16
$604,46
$754,77

$748,56
$788,50
$830,80
$981,11

$974,90
$1 014,84
$1 057,14
$1 207,45

$226,34

Toc - Plan #15

Silver

(EPO) Oscar Silver Saver 2

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$6,200 $12,400 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $6,200 | Family: $12,400
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$367,60
$417,21
$469,78
$656,51
$997,63

$735,20
$834,42
$939,56
$1 313,02
$1 995,26

$1 016,40
$1 115,62
$1 220,76
$1 594,22

$1 297,60
$1 396,82
$1 501,96
$1 875,42

$1 578,80
$1 678,02
$1 783,16
$2 156,62

$648,80
$698,41
$750,98
$937,71

$930,00
$979,61
$1 032,18
$1 218,91

$1 211,20
$1 260,81
$1 313,38
$1 500,11

$281,20

Toc - Plan #16

Silver

(EPO) Oscar Silver Classic Copay

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$7,000 $14,000 Annual Deductible

$8,200 $16,400 Maximum Out of Pocket Per Year

Deductible: Individual: $7,000 | Family: $14,000
Out of Pocket Maximum per year: Individual: $8,200 | Family: $16,400

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$385,95
$438,04
$493,23
$689,29
$1 047,44

$771,90
$876,08
$986,46
$1 378,58
$2 094,88

$1 067,14
$1 171,32
$1 281,70
$1 673,82

$1 362,38
$1 466,56
$1 576,94
$1 969,06

$1 657,62
$1 761,80
$1 872,18
$2 264,30

$681,19
$733,28
$788,47
$984,53

$976,43
$1 028,52
$1 083,71
$1 279,77

$1 271,67
$1 323,76
$1 378,95
$1 575,01

$295,24

Toc - Plan #17

Silver

(EPO) Oscar Silver Classic $0 Ded

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$0 $0 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $0 | Family: $0
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$395,51
$448,89
$505,45
$706,36
$1 073,39

$791,02
$897,78
$1 010,90
$1 412,72
$2 146,78

$1 093,58
$1 200,34
$1 313,46
$1 715,28

$1 396,14
$1 502,90
$1 616,02
$2 017,84

$1 698,70
$1 805,46
$1 918,58
$2 320,40

$698,07
$751,45
$808,01
$1 008,92

$1 000,63
$1 054,01
$1 110,57
$1 311,48

$1 303,19
$1 356,57
$1 413,13
$1 614,04

$302,56

Toc - Plan #18

Gold

(EPO) Oscar Gold Classic 2

Summary of Benefits and Coverage
Plan Brochure
Provider Directory for Oscar Insurance Company
Customer Service Phone:

Annual Out of Pocket Expenses

Individual Family

$1,000 $2,000 Annual Deductible

$7,400 $14,800 Maximum Out of Pocket Per Year

Deductible: Individual: $1,000 | Family: $2,000
Out of Pocket Maximum per year: Individual: $7,400 | Family: $14,800

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$401,65
$455,86
$513,30
$717,33
$1 090,05

$803,30
$911,72
$1 026,60
$1 434,66
$2 180,10

$1 110,55
$1 218,97
$1 333,85
$1 741,91

$1 417,80
$1 526,22
$1 641,10
$2 049,16

$1 725,05
$1 833,47
$1 948,35
$2 356,41

$708,90
$763,11
$820,55
$1 024,58

$1 016,15
$1 070,36
$1 127,80
$1 331,83

$1 323,40
$1 377,61
$1 435,05
$1 639,08

$307,25

Medica

Local: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-888-516-4692

Toc - Plan #19

Silver

(EPO) Medica Insure Silver Copay

Annual Out of Pocket Expenses

Individual Family

$4,800 $14,400 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $4,800 | Family: $14,400
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$459,55
$521,57
$587,29
$820,73
$1 247,18

$919,10
$1 043,14
$1 174,58
$1 641,46
$2 494,36

$1 270,65
$1 394,69
$1 526,13
$1 993,01

$1 622,20
$1 746,24
$1 877,68
$2 344,56

$1 973,75
$2 097,79
$2 229,23
$2 696,11

$811,10
$873,12
$938,84
$1 172,28

$1 162,65
$1 224,67
$1 290,39
$1 523,83

$1 514,20
$1 576,22
$1 641,94
$1 875,38

$351,55

Toc - Plan #20

Expanded Bronze

(EPO) Medica Insure Bronze Copay

Annual Out of Pocket Expenses

Individual Family

$7,000 $14,000 Annual Deductible

$8,300 $16,600 Maximum Out of Pocket Per Year

Deductible: Individual: $7,000 | Family: $14,000
Out of Pocket Maximum per year: Individual: $8,300 | Family: $16,600

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$345,42
$392,04
$441,43
$616,90
$937,44

$690,84
$784,08
$882,86
$1 233,80
$1 874,88

$955,08
$1 048,32
$1 147,10
$1 498,04

$1 219,32
$1 312,56
$1 411,34
$1 762,28

$1 483,56
$1 576,80
$1 675,58
$2 026,52

$609,66
$656,28
$705,67
$881,14

$873,90
$920,52
$969,91
$1 145,38

$1 138,14
$1 184,76
$1 234,15
$1 409,62

$264,24

Toc - Plan #21

Expanded Bronze

(EPO) Medica Insure Bronze HSA

Annual Out of Pocket Expenses

Individual Family

$6,700 $13,400 Annual Deductible

$7,000 $14,000 Maximum Out of Pocket Per Year

Deductible: Individual: $6,700 | Family: $13,400
Out of Pocket Maximum per year: Individual: $7,000 | Family: $14,000

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$387,48
$439,78
$495,19
$692,02
$1 051,60

$774,96
$879,56
$990,38
$1 384,04
$2 103,20

$1 071,38
$1 175,98
$1 286,80
$1 680,46

$1 367,80
$1 472,40
$1 583,22
$1 976,88

$1 664,22
$1 768,82
$1 879,64
$2 273,30

$683,90
$736,20
$791,61
$988,44

$980,32
$1 032,62
$1 088,03
$1 284,86

$1 276,74
$1 329,04
$1 384,45
$1 581,28

$296,42

Toc - Plan #22

Catastrophic

(EPO) Medica Insure Catastrophic

Annual Out of Pocket Expenses

Individual Family

$8,550 $17,100 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $8,550 | Family: $17,100
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$250,68
$284,51
$320,36
$447,70
$680,32

$501,36
$569,02
$640,72
$895,40
$1 360,64

$693,12
$760,78
$832,48
$1 087,16

$884,88
$952,54
$1 024,24
$1 278,92

$1 076,64
$1 144,30
$1 216,00
$1 470,68

$442,44
$476,27
$512,12
$639,46

$634,20
$668,03
$703,88
$831,22

$825,96
$859,79
$895,64
$1 022,98

$191,76

Toc - Plan #23

Silver

(EPO) Medica Insure Silver Share

Annual Out of Pocket Expenses

Individual Family

$1,400 $4,200 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $1,400 | Family: $4,200
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$473,77
$537,71
$605,46
$846,13
$1 285,77

$947,54
$1 075,42
$1 210,92
$1 692,26
$2 571,54

$1 309,96
$1 437,84
$1 573,34
$2 054,68

$1 672,38
$1 800,26
$1 935,76
$2 417,10

$2 034,80
$2 162,68
$2 298,18
$2 779,52

$836,19
$900,13
$967,88
$1 208,55

$1 198,61
$1 262,55
$1 330,30
$1 570,97

$1 561,03
$1 624,97
$1 692,72
$1 933,39

$362,42

Toc - Plan #24

Expanded Bronze

(EPO) Medica Insure Bronze Share Plus

Annual Out of Pocket Expenses

Individual Family

$2,300 $6,900 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $2,300 | Family: $6,900
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$366,45
$415,91
$468,31
$654,46
$994,52

$732,90
$831,82
$936,62
$1 308,92
$1 989,04

$1 013,23
$1 112,15
$1 216,95
$1 589,25

$1 293,56
$1 392,48
$1 497,28
$1 869,58

$1 573,89
$1 672,81
$1 777,61
$2 149,91

$646,78
$696,24
$748,64
$934,79

$927,11
$976,57
$1 028,97
$1 215,12

$1 207,44
$1 256,90
$1 309,30
$1 495,45

$280,33

Toc - Plan #25

Expanded Bronze

(EPO) Medica Insure Bronze Share

Annual Out of Pocket Expenses

Individual Family

$4,200 $12,600 Annual Deductible

$7,900 $15,800 Maximum Out of Pocket Per Year

Deductible: Individual: $4,200 | Family: $12,600
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$364,56
$413,76
$465,89
$651,08
$989,38

$729,12
$827,52
$931,78
$1 302,16
$1 978,76

$1 008,00
$1 106,40
$1 210,66
$1 581,04

$1 286,88
$1 385,28
$1 489,54
$1 859,92

$1 565,76
$1 664,16
$1 768,42
$2 138,80

$643,44
$692,64
$744,77
$929,96

$922,32
$971,52
$1 023,65
$1 208,84

$1 201,20
$1 250,40
$1 302,53
$1 487,72

$278,88

Toc - Plan #26

Gold

(EPO) Inspire by Medica Gold Copay

Annual Out of Pocket Expenses

Individual Family

$1,150 $3,450 Annual Deductible

$7,950 $15,900 Maximum Out of Pocket Per Year

Deductible: Individual: $1,150 | Family: $3,450
Out of Pocket Maximum per year: Individual: $7,950 | Family: $15,900

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$427,13
$484,79
$545,86
$762,84
$1 159,21

$854,26
$969,58
$1 091,72
$1 525,68
$2 318,42

$1 181,01
$1 296,33
$1 418,47
$1 852,43

$1 507,76
$1 623,08
$1 745,22
$2 179,18

$1 834,51
$1 949,83
$2 071,97
$2 505,93

$753,88
$811,54
$872,61
$1 089,59

$1 080,63
$1 138,29
$1 199,36
$1 416,34

$1 407,38
$1 465,04
$1 526,11
$1 743,09

$326,75

Toc - Plan #27

Silver

(EPO) Inspire by Medica Silver Copay

Annual Out of Pocket Expenses

Individual Family

$4,800 $14,400 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $4,800 | Family: $14,400
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$390,60
$443,32
$499,18
$697,60
$1 060,07

$781,20
$886,64
$998,36
$1 395,20
$2 120,14

$1 080,00
$1 185,44
$1 297,16
$1 694,00

$1 378,80
$1 484,24
$1 595,96
$1 992,80

$1 677,60
$1 783,04
$1 894,76
$2 291,60

$689,40
$742,12
$797,98
$996,40

$988,20
$1 040,92
$1 096,78
$1 295,20

$1 287,00
$1 339,72
$1 395,58
$1 594,00

$298,80

Toc - Plan #28

Expanded Bronze

(EPO) Inspire by Medica Bronze HSA

Annual Out of Pocket Expenses

Individual Family

$6,700 $13,400 Annual Deductible

$7,000 $14,000 Maximum Out of Pocket Per Year

Deductible: Individual: $6,700 | Family: $13,400
Out of Pocket Maximum per year: Individual: $7,000 | Family: $14,000

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$329,35
$373,80
$420,89
$588,20
$893,82

$658,70
$747,60
$841,78
$1 176,40
$1 787,64

$910,64
$999,54
$1 093,72
$1 428,34

$1 162,58
$1 251,48
$1 345,66
$1 680,28

$1 414,52
$1 503,42
$1 597,60
$1 932,22

$581,29
$625,74
$672,83
$840,14

$833,23
$877,68
$924,77
$1 092,08

$1 085,17
$1 129,62
$1 176,71
$1 344,02

$251,94

Toc - Plan #29

Catastrophic

(EPO) Inspire by Medica Catastrophic

Annual Out of Pocket Expenses

Individual Family

$8,550 $17,100 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $8,550 | Family: $17,100
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$213,07
$241,82
$272,29
$380,53
$578,25

$426,14
$483,64
$544,58
$761,06
$1 156,50

$589,13
$646,63
$707,57
$924,05

$752,12
$809,62
$870,56
$1 087,04

$915,11
$972,61
$1 033,55
$1 250,03

$376,06
$404,81
$435,28
$543,52

$539,05
$567,80
$598,27
$706,51

$702,04
$730,79
$761,26
$869,50

$162,99

Toc - Plan #30

Expanded Bronze

(EPO) Inspire by Medica Bronze Share Plus

Annual Out of Pocket Expenses

Individual Family

$2,300 $6,900 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $2,300 | Family: $6,900
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$311,47
$353,51
$398,05
$556,27
$845,31

$622,94
$707,02
$796,10
$1 112,54
$1 690,62

$861,21
$945,29
$1 034,37
$1 350,81

$1 099,48
$1 183,56
$1 272,64
$1 589,08

$1 337,75
$1 421,83
$1 510,91
$1 827,35

$549,74
$591,78
$636,32
$794,54

$788,01
$830,05
$874,59
$1 032,81

$1 026,28
$1 068,32
$1 112,86
$1 271,08

$238,27

Toc - Plan #31

Expanded Bronze

(EPO) Inspire by Medica Bronze Share

Annual Out of Pocket Expenses

Individual Family

$4,200 $12,600 Annual Deductible

$7,900 $15,800 Maximum Out of Pocket Per Year

Deductible: Individual: $4,200 | Family: $12,600
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$309,86
$351,68
$395,99
$553,40
$840,94

$619,72
$703,36
$791,98
$1 106,80
$1 681,88

$856,76
$940,40
$1 029,02
$1 343,84

$1 093,80
$1 177,44
$1 266,06
$1 580,88

$1 330,84
$1 414,48
$1 503,10
$1 817,92

$546,90
$588,72
$633,03
$790,44

$783,94
$825,76
$870,07
$1 027,48

$1 020,98
$1 062,80
$1 107,11
$1 264,52

$237,04

Toc - Plan #32

Expanded Bronze

(EPO) Inspire by Medica Bronze Copay Preferred Primary Care

Annual Out of Pocket Expenses

Individual Family

$7,500 $15,000 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $7,500 | Family: $15,000
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Age

Individual

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$304,63
$345,74
$389,30
$544,04
$826,73

$609,26
$691,48
$778,60
$1 088,08
$1 653,46

$842,29
$924,51
$1 011,63
$1 321,11

$1 075,32
$1 157,54
$1 244,66
$1 554,14

$1 308,35
$1 390,57
$1 477,69
$1 787,17

$537,66
$578,77
$622,33
$777,07

$770,69
$811,80
$855,36
$1 010,10

$1 003,72
$1 044,83
$1 088,39
$1 243,13

$233,03

‡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 Woodbury County here.

Woodbury County is in “Rating Area 3” of Iowa.

Currently, there are 32 plans offered in Rating Area 3.

Obamacare Rates and Providers for Other Years

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

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Obamacare Rates and Providers for Other Years

Obamacare Providers, Plans and 2021 Rates for Woodbury County, Iowa

Wellmark Health Plan of Iowa, Inc.

Oscar Insurance Company

Medica

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

2021 Obamacare Rates, Providers, and Plans for Woodbury County

Wellmark Health Plan of Iowa, Inc.

Expanded Bronze

(HMO) Wellmark Bronze Modified HMO

Annual Out of Pocket Expenses

Individual Family $8,150 $16,300 Annual Deductible $8,150 $16,300 Maximum Out of Pocket Per Year Deductible: Individual: $8,150 | Family: $16,300 Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Monthly Premiums:

Expanded Bronze

(HMO) Wellmark Bronze HDHP HMO

Annual Out of Pocket Expenses

Individual Family $6,900 $13,800 Annual Deductible $6,900 $13,800 Maximum Out of Pocket Per Year Deductible: Individual: $6,900 | Family: $13,800 Out of Pocket Maximum per year: Individual: $6,900 | Family: $13,800

Monthly Premiums:

Silver

(HMO) Wellmark Silver Modified HMO

Annual Out of Pocket Expenses

Individual Family $8,150 $16,300 Annual Deductible $8,150 $16,300 Maximum Out of Pocket Per Year Deductible: Individual: $8,150 | Family: $16,300 Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Monthly Premiums:

Gold

(HMO) Wellmark Gold Modified HMO

Annual Out of Pocket Expenses

Individual Family $5,250 $10,500 Annual Deductible $5,250 $10,500 Maximum Out of Pocket Per Year Deductible: Individual: $5,250 | Family: $10,500 Out of Pocket Maximum per year: Individual: $5,250 | Family: $10,500

Monthly Premiums:

Expanded Bronze

(HMO) Wellmark Bronze Traditional HMO

Annual Out of Pocket Expenses

Individual Family $7,200 $14,400 Annual Deductible $8,500 $17,000 Maximum Out of Pocket Per Year Deductible: Individual: $7,200 | Family: $14,400 Out of Pocket Maximum per year: Individual: $8,500 | Family: $17,000

Monthly Premiums:

Gold

(HMO) Wellmark Gold Traditional HMO

Annual Out of Pocket Expenses

Individual Family $1,500 $3,000 Annual Deductible $6,300 $12,600 Maximum Out of Pocket Per Year Deductible: Individual: $1,500 | Family: $3,000 Out of Pocket Maximum per year: Individual: $6,300 | Family: $12,600

Monthly Premiums:

Oscar Insurance Company

Expanded Bronze

(EPO) Oscar Bronze Classic PCP Copay

Annual Out of Pocket Expenses

Individual Family $6,000 $12,000 Annual Deductible $8,550 $17,100 Maximum Out of Pocket Per Year Deductible: Individual: $6,000 | Family: $12,000 Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Expanded Bronze

(EPO) Oscar Bronze Classic

Annual Out of Pocket Expenses

Individual Family $6,000 $12,000 Annual Deductible $8,550 $17,100 Maximum Out of Pocket Per Year Deductible: Individual: $6,000 | Family: $12,000 Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Expanded Bronze

(EPO) Oscar Bronze Classic Next

Annual Out of Pocket Expenses

Individual Family $0 $0 Annual Deductible $8,550 $17,100 Maximum Out of Pocket Per Year Deductible: Individual: $0 | Family: $0 Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Silver

(EPO) Oscar Silver Saver

Annual Out of Pocket Expenses

Individual Family $4,200 $8,400 Annual Deductible $8,550 $17,100 Maximum Out of Pocket Per Year Deductible: Individual: $4,200 | Family: $8,400 Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Silver

(EPO) Oscar Silver Classic Next

Annual Out of Pocket Expenses

Individual Family $6,000 $12,000 Annual Deductible $8,000 $16,000 Maximum Out of Pocket Per Year Deductible: Individual: $6,000 | Family: $12,000 Out of Pocket Maximum per year: Individual: $8,000 | Family: $16,000

Monthly Premiums:

Catastrophic

(EPO) Oscar Secure

Annual Out of Pocket Expenses

Individual Family $8,550 $17,100 Annual Deductible $8,550 $17,100 Maximum Out of Pocket Per Year Deductible: Individual: $8,550 | Family: $17,100 Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Monthly Premiums:

Gold

(EPO) Oscar Gold Classic

Annual Out of Pocket Expenses

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

Monthly Premiums:

Expanded Bronze

(EPO) Oscar Bronze HDHP

Annual Out of Pocket Expenses

Individual Family $5,200 $10,400 Annual Deductible $7,000 $14,000 Maximum Out of Pocket Per Year Deductible: Individual: $5,200 | Family: $10,400 Out of Pocket Maximum per year: Individual: $7,000 | Family: $14,000

Monthly Premiums:

Silver

Individual Family

$8,150 $16,300 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $8,150 | Family: $16,300
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Individual Family

$6,900 $13,800 Annual Deductible

$6,900 $13,800 Maximum Out of Pocket Per Year

Deductible: Individual: $6,900 | Family: $13,800
Out of Pocket Maximum per year: Individual: $6,900 | Family: $13,800

Individual Family

$8,150 $16,300 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $8,150 | Family: $16,300
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Individual Family

$5,250 $10,500 Annual Deductible

$5,250 $10,500 Maximum Out of Pocket Per Year

Deductible: Individual: $5,250 | Family: $10,500
Out of Pocket Maximum per year: Individual: $5,250 | Family: $10,500

Individual Family

$7,200 $14,400 Annual Deductible

$8,500 $17,000 Maximum Out of Pocket Per Year

Deductible: Individual: $7,200 | Family: $14,400
Out of Pocket Maximum per year: Individual: $8,500 | Family: $17,000

Individual Family

$1,500 $3,000 Annual Deductible

$6,300 $12,600 Maximum Out of Pocket Per Year

Deductible: Individual: $1,500 | Family: $3,000
Out of Pocket Maximum per year: Individual: $6,300 | Family: $12,600

Individual Family

$6,000 $12,000 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$6,000 $12,000 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$0 $0 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $0 | Family: $0
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$4,200 $8,400 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $4,200 | Family: $8,400
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$6,000 $12,000 Annual Deductible

$8,000 $16,000 Maximum Out of Pocket Per Year

Deductible: Individual: $6,000 | Family: $12,000
Out of Pocket Maximum per year: Individual: $8,000 | Family: $16,000

Individual Family

$8,550 $17,100 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $8,550 | Family: $17,100
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$2,500 $5,000 Annual Deductible

$6,000 $12,000 Maximum Out of Pocket Per Year

Deductible: Individual: $2,500 | Family: $5,000
Out of Pocket Maximum per year: Individual: $6,000 | Family: $12,000

Individual Family

$5,200 $10,400 Annual Deductible

$7,000 $14,000 Maximum Out of Pocket Per Year

Deductible: Individual: $5,200 | Family: $10,400
Out of Pocket Maximum per year: Individual: $7,000 | Family: $14,000

Individual Family

$6,200 $12,400 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $6,200 | Family: $12,400
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$7,000 $14,000 Annual Deductible

$8,200 $16,400 Maximum Out of Pocket Per Year

Deductible: Individual: $7,000 | Family: $14,000
Out of Pocket Maximum per year: Individual: $8,200 | Family: $16,400

Individual Family

$0 $0 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $0 | Family: $0
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$1,000 $2,000 Annual Deductible

$7,400 $14,800 Maximum Out of Pocket Per Year

Deductible: Individual: $1,000 | Family: $2,000
Out of Pocket Maximum per year: Individual: $7,400 | Family: $14,800

Individual Family

$4,800 $14,400 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $4,800 | Family: $14,400
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300

Individual Family

$7,000 $14,000 Annual Deductible

$8,300 $16,600 Maximum Out of Pocket Per Year

Deductible: Individual: $7,000 | Family: $14,000
Out of Pocket Maximum per year: Individual: $8,300 | Family: $16,600

Individual Family

$6,700 $13,400 Annual Deductible

$7,000 $14,000 Maximum Out of Pocket Per Year

Deductible: Individual: $6,700 | Family: $13,400
Out of Pocket Maximum per year: Individual: $7,000 | Family: $14,000

Individual Family

$8,550 $17,100 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $8,550 | Family: $17,100
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$1,400 $4,200 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $1,400 | Family: $4,200
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$2,300 $6,900 Annual Deductible

$8,550 $17,100 Maximum Out of Pocket Per Year

Deductible: Individual: $2,300 | Family: $6,900
Out of Pocket Maximum per year: Individual: $8,550 | Family: $17,100

Individual Family

$4,200 $12,600 Annual Deductible

$7,900 $15,800 Maximum Out of Pocket Per Year

Deductible: Individual: $4,200 | Family: $12,600
Out of Pocket Maximum per year: Individual: $7,900 | Family: $15,800

Individual Family

$1,150 $3,450 Annual Deductible

$7,950 $15,900 Maximum Out of Pocket Per Year

Deductible: Individual: $1,150 | Family: $3,450
Out of Pocket Maximum per year: Individual: $7,950 | Family: $15,900

Individual Family

$4,800 $14,400 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Deductible: Individual: $4,800 | Family: $14,400
Out of Pocket Maximum per year: Individual: $8,150 | Family: $16,300