Obamacare 2022 Rates and Health Insurance Providers for Saint Louis County , Missouri

Obamacare 2022 Rates and Health Insurance Providers for Saint Louis County , Missouri

Obamacare > Rates > Missouri > Saint Louis County

Obamacare Rates and Providers for Other Years

2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 |

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 Saint Louis County, MO.

The health insurance rates listed below are for calendar year 2022.

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 Ballwin, MO area accept this insurance coverage as within the plan's network.

Obamacare Providers, Plans and 2022 Rates for Saint Louis County, Missouri

Below, you’ll find a summary of the 55 plans for Saint Louis County, Missouri and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.

Obamacare Rates and Providers for Other Years

2014 | 2015 | 2016| 2017 | 2018 | 2019 2020 2021 2022

You may also be interested in:

How To Sign Up for Obamacare in Missouri

For 2022 health plans, Missouri open enrollment has ended. However, you may still be able to purchase health insurance for this year if you qualify for a special enrollment period. For example, if you’ve recently lost your job or income due to the COVID-19 crisis or for any other reason, you might qualify for a 60-day special enrollment period that will allow you to sign up for a new health insurance plan. (See What Happens If I Missed the Enrollment Deadline for 2022?)

To get covered, you can go directly to the online health insurance marketplace for Missouri. If you need personalized help, you can reach out to an enrollment assistant. Most enrollment helpers are working remotely during the COVID crisis.

Where's the Missouri Health Care Exchange?

You can find the health insurance exchange for Missouri at Healthcare.gov. This is where you can learn about the various health insurance options available to you under the Affordable Care Act. If you see a plan you like, you'll be guided through the enrollment process online.

more...  

Missouri Medicaid Expansion: Do I Qualify for Medicaid Under the ACA?

The Affordable Care Act (Obamacare) expanded Medicaid eligibility to include more people who couldn’t otherwise obtain health insurance. As written, the ACA would extend Medicaid to all adults with incomes at or below 138% of the federal poverty level. (For a single person in Missouri in 2021, that’s $17,609. For a family of four, it’s $36,156.)

However, the U.S. Supreme Court later ruled that it was up to individual states to decide whether to expand Medicaid. As of October 2021, 12 states have not expanded their programs.

Missouri Has Expanded Medicaid

In August 2020, Missouri voters approved a ballot measure to expand Medicaid by constitutional amendment. Missouri began accepting Medicaid applications on August 10, 2021, with coverage retroactive to July 1. Missouri's constitutional amendment prohibits burdens or restrictions on enrollment under the expansion, including work requirements or monthly premiums.

The Medicaid Coverage Gap

The Affordable Care Act assumed that Medicaid would be expanded to cover all Americans with incomes at or below 138% of the federal poverty level. And it created health plan subsidies for people with incomes between 100% - 400% of the poverty level.

That means, until Medicaid expansion takes effect, Missouri residents with incomes below the poverty level may fall into a coverage gap where they can get neither Medicaid nor ACA subsidies.

more...  

Get Help Finding a Health Insurance Plan in Missouri

Get Help From Missouri's Health Insurance Exchange

The following links and telephone numbers take you to the official help resources for Healthcare.gov, the health insurance marketplace for Missouri.

Help by phone: 800-318-2596 (TTY: 855-889-4325)

In-person help: Go to Find Local Help, where you can enter your city and state or zip code to find an application assister, insurance agent, or health insurance broker in your area.

Get Help From a Licensed Insurance Broker

To directly connect with a Missouri insurance broker who can help you evaluate insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)

More Information

For more detailed information, see How Do I Sign Up for Obamacare in Missouri?

  • Saint Louis County, MO Obamacare Rates
  • General Info
  • Rates

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Anthem Blue Cross and Blue Shield

Local: 1-855-738-6677 | Toll Free: 1-855-738-6677

Toc - Plan #1 Anthem Blue Cross and Blue Shield
Gold

(EPO) Anthem Gold Pathway X 1250

Annual Out of Pocket Expenses
Individual Family
$1,250 $2,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$524,11
$594,86
$669,81
$936,06
$1 422,43
$925,05
$995,80
$1 070,75
$1 337,00
$1 325,99
$1 396,74
$1 471,69
$1 737,94
$1 726,93
$1 797,68
$1 872,63
$2 138,88
$400,94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1 048,22
$1 189,72
$1 339,62
$1 872,12
$2 844,86
$1 449,16
$1 590,66
$1 740,56
$2 273,06
$1 850,10
$1 991,60
$2 141,50
$2 674,00
$2 251,04
$2 392,54
$2 542,44
$3 074,94
$400,94
Toc - Plan #2 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 1850 Online Plus

Annual Out of Pocket Expenses
Individual Family
$1,850 $3,700 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$422,63
$479,69
$540,12
$754,82
$1 147,02
$745,94
$803,00
$863,43
$1 078,13
$1 069,25
$1 126,31
$1 186,74
$1 401,44
$1 392,56
$1 449,62
$1 510,05
$1 724,75
$323,31
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$845,26
$959,38
$1 080,24
$1 509,64
$2 294,04
$1 168,57
$1 282,69
$1 403,55
$1 832,95
$1 491,88
$1 606,00
$1 726,86
$2 156,26
$1 815,19
$1 929,31
$2 050,17
$2 479,57
$323,31
Toc - Plan #3 Anthem Blue Cross and Blue Shield
Expanded Bronze

(EPO) Anthem Bronze Pathway X 6350

Annual Out of Pocket Expenses
Individual Family
$6,350 $12,700 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$296,73
$336,79
$379,22
$529,96
$805,33
$523,73
$563,79
$606,22
$756,96
$750,73
$790,79
$833,22
$983,96
$977,73
$1 017,79
$1 060,22
$1 210,96
$227,00
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$593,46
$673,58
$758,44
$1 059,92
$1 610,66
$820,46
$900,58
$985,44
$1 286,92
$1 047,46
$1 127,58
$1 212,44
$1 513,92
$1 274,46
$1 354,58
$1 439,44
$1 740,92
$227,00
Toc - Plan #4 Anthem Blue Cross and Blue Shield
Expanded Bronze

(EPO) Anthem Bronze Pathway X 0 for HSA

Annual Out of Pocket Expenses
Individual Family
$6,850 $13,700 Annual Deductible
$6,850 $13,700 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$290,07
$329,23
$370,71
$518,07
$787,25
$511,97
$551,13
$592,61
$739,97
$733,87
$773,03
$814,51
$961,87
$955,77
$994,93
$1 036,41
$1 183,77
$221,90
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$580,14
$658,46
$741,42
$1 036,14
$1 574,50
$802,04
$880,36
$963,32
$1 258,04
$1 023,94
$1 102,26
$1 185,22
$1 479,94
$1 245,84
$1 324,16
$1 407,12
$1 701,84
$221,90
Toc - Plan #5 Anthem Blue Cross and Blue Shield
Expanded Bronze

(EPO) Anthem Bronze Pathway X 20 for HSA

Annual Out of Pocket Expenses
Individual Family
$5,900 $11,800 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$289,52
$328,61
$370,01
$517,08
$785,76
$511,00
$550,09
$591,49
$738,56
$732,48
$771,57
$812,97
$960,04
$953,96
$993,05
$1 034,45
$1 181,52
$221,48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$579,04
$657,22
$740,02
$1 034,16
$1 571,52
$800,52
$878,70
$961,50
$1 255,64
$1 022,00
$1 100,18
$1 182,98
$1 477,12
$1 243,48
$1 321,66
$1 404,46
$1 698,60
$221,48
Toc - Plan #6 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 3950

Annual Out of Pocket Expenses
Individual Family
$3,950 $7,900 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$395,49
$448,88
$505,44
$706,35
$1 073,36
$698,04
$751,43
$807,99
$1 008,90
$1 000,59
$1 053,98
$1 110,54
$1 311,45
$1 303,14
$1 356,53
$1 413,09
$1 614,00
$302,55
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$790,98
$897,76
$1 010,88
$1 412,70
$2 146,72
$1 093,53
$1 200,31
$1 313,43
$1 715,25
$1 396,08
$1 502,86
$1 615,98
$2 017,80
$1 698,63
$1 805,41
$1 918,53
$2 320,35
$302,55
Toc - Plan #7 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 2950 for HSA

Annual Out of Pocket Expenses
Individual Family
$2,950 $5,900 Annual Deductible
$6,000 $12,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$406,96
$461,90
$520,09
$726,83
$1 104,49
$718,28
$773,22
$831,41
$1 038,15
$1 029,60
$1 084,54
$1 142,73
$1 349,47
$1 340,92
$1 395,86
$1 454,05
$1 660,79
$311,32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$813,92
$923,80
$1 040,18
$1 453,66
$2 208,98
$1 125,24
$1 235,12
$1 351,50
$1 764,98
$1 436,56
$1 546,44
$1 662,82
$2 076,30
$1 747,88
$1 857,76
$1 974,14
$2 387,62
$311,32
Toc - Plan #8 Anthem Blue Cross and Blue Shield
Expanded Bronze

(EPO) Anthem Bronze Pathway X 5950

Annual Out of Pocket Expenses
Individual Family
$5,950 $11,900 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$289,45
$328,53
$369,92
$516,96
$785,57
$510,88
$549,96
$591,35
$738,39
$732,31
$771,39
$812,78
$959,82
$953,74
$992,82
$1 034,21
$1 181,25
$221,43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$578,90
$657,06
$739,84
$1 033,92
$1 571,14
$800,33
$878,49
$961,27
$1 255,35
$1 021,76
$1 099,92
$1 182,70
$1 476,78
$1 243,19
$1 321,35
$1 404,13
$1 698,21
$221,43
Toc - Plan #9 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 2450

Annual Out of Pocket Expenses
Individual Family
$2,450 $4,900 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$403,21
$457,64
$515,30
$720,13
$1 094,31
$711,67
$766,10
$823,76
$1 028,59
$1 020,13
$1 074,56
$1 132,22
$1 337,05
$1 328,59
$1 383,02
$1 440,68
$1 645,51
$308,46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$806,42
$915,28
$1 030,60
$1 440,26
$2 188,62
$1 114,88
$1 223,74
$1 339,06
$1 748,72
$1 423,34
$1 532,20
$1 647,52
$2 057,18
$1 731,80
$1 840,66
$1 955,98
$2 365,64
$308,46
Toc - Plan #10 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 4500

Annual Out of Pocket Expenses
Individual Family
$4,500 $9,000 Annual Deductible
$6,800 $13,600 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$397,48
$451,14
$507,98
$709,90
$1 078,76
$701,55
$755,21
$812,05
$1 013,97
$1 005,62
$1 059,28
$1 116,12
$1 318,04
$1 309,69
$1 363,35
$1 420,19
$1 622,11
$304,07
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$794,96
$902,28
$1 015,96
$1 419,80
$2 157,52
$1 099,03
$1 206,35
$1 320,03
$1 723,87
$1 403,10
$1 510,42
$1 624,10
$2 027,94
$1 707,17
$1 814,49
$1 928,17
$2 332,01
$304,07
Toc - Plan #11 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 6000

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$381,63
$433,15
$487,72
$681,59
$1 035,74
$673,58
$725,10
$779,67
$973,54
$965,53
$1 017,05
$1 071,62
$1 265,49
$1 257,48
$1 309,00
$1 363,57
$1 557,44
$291,95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$763,26
$866,30
$975,44
$1 363,18
$2 071,48
$1 055,21
$1 158,25
$1 267,39
$1 655,13
$1 347,16
$1 450,20
$1 559,34
$1 947,08
$1 639,11
$1 742,15
$1 851,29
$2 239,03
$291,95
Toc - Plan #12 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 3250

Annual Out of Pocket Expenses
Individual Family
$3,250 $6,500 Annual Deductible
$6,450 $12,900 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$408,69
$463,86
$522,31
$729,92
$1 109,18
$721,34
$776,51
$834,96
$1 042,57
$1 033,99
$1 089,16
$1 147,61
$1 355,22
$1 346,64
$1 401,81
$1 460,26
$1 667,87
$312,65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$817,38
$927,72
$1 044,62
$1 459,84
$2 218,36
$1 130,03
$1 240,37
$1 357,27
$1 772,49
$1 442,68
$1 553,02
$1 669,92
$2 085,14
$1 755,33
$1 865,67
$1 982,57
$2 397,79
$312,65
Toc - Plan #13 Anthem Blue Cross and Blue Shield
Silver

(EPO) Anthem Silver Pathway X 6750

Annual Out of Pocket Expenses
Individual Family
$6,750 $13,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$367,03
$416,58
$469,06
$655,52
$996,12
$647,81
$697,36
$749,84
$936,30
$928,59
$978,14
$1 030,62
$1 217,08
$1 209,37
$1 258,92
$1 311,40
$1 497,86
$280,78
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$734,06
$833,16
$938,12
$1 311,04
$1 992,24
$1 014,84
$1 113,94
$1 218,90
$1 591,82
$1 295,62
$1 394,72
$1 499,68
$1 872,60
$1 576,40
$1 675,50
$1 780,46
$2 153,38
$280,78
Toc - Plan #14 Anthem Blue Cross and Blue Shield
Catastrophic

(EPO) Anthem Catastrophic Pathway X 8550

Annual Out of Pocket Expenses
Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$215,03
$244,06
$274,81
$384,04
$583,59
$379,53
$408,56
$439,31
$548,54
$544,03
$573,06
$603,81
$713,04
$708,53
$737,56
$768,31
$877,54
$164,50
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$430,06
$488,12
$549,62
$768,08
$1 167,18
$594,56
$652,62
$714,12
$932,58
$759,06
$817,12
$878,62
$1 097,08
$923,56
$981,62
$1 043,12
$1 261,58
$164,50
Toc - Plan #15 Anthem Blue Cross and Blue Shield
Expanded Bronze

(EPO) Anthem Bronze Pathway X 4400 Online Plus

Annual Out of Pocket Expenses
Individual Family
$4,400 $8,800 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$303,97
$345,01
$388,47
$542,89
$824,97
$536,51
$577,55
$621,01
$775,43
$769,05
$810,09
$853,55
$1 007,97
$1 001,59
$1 042,63
$1 086,09
$1 240,51
$232,54
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$607,94
$690,02
$776,94
$1 085,78
$1 649,94
$840,48
$922,56
$1 009,48
$1 318,32
$1 073,02
$1 155,10
$1 242,02
$1 550,86
$1 305,56
$1 387,64
$1 474,56
$1 783,40
$232,54

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WellFirst Health

Local: 1-866-514-4194 | Toll Free: 1-866-514-4194 | TTY: 1-866-514-4194

Toc - Plan #16 WellFirst Health
Gold

(EPO) WellFirst Gold Copay Plus 1500X

Annual Out of Pocket Expenses
Individual Family
$1,500 $3,000 Annual Deductible
$5,100 $10,200 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$362,94
$411,93
$463,83
$648,21
$985,01
$640,59
$689,58
$741,48
$925,86
$918,24
$967,23
$1 019,13
$1 203,51
$1 195,89
$1 244,88
$1 296,78
$1 481,16
$277,65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$725,88
$823,86
$927,66
$1 296,42
$1 970,02
$1 003,53
$1 101,51
$1 205,31
$1 574,07
$1 281,18
$1 379,16
$1 482,96
$1 851,72
$1 558,83
$1 656,81
$1 760,61
$2 129,37
$277,65
Toc - Plan #17 WellFirst Health
Silver

(EPO) WellFirst Silver Copay Plus 4800X

Annual Out of Pocket Expenses
Individual Family
$4,800 $9,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$367,73
$417,38
$469,97
$656,77
$998,03
$649,05
$698,70
$751,29
$938,09
$930,37
$980,02
$1 032,61
$1 219,41
$1 211,69
$1 261,34
$1 313,93
$1 500,73
$281,32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$735,46
$834,76
$939,94
$1 313,54
$1 996,06
$1 016,78
$1 116,08
$1 221,26
$1 594,86
$1 298,10
$1 397,40
$1 502,58
$1 876,18
$1 579,42
$1 678,72
$1 783,90
$2 157,50
$281,32
Toc - Plan #18 WellFirst Health
Expanded Bronze

(EPO) WellFirst Bronze Copay Plus 8500X

Annual Out of Pocket Expenses
Individual Family
$8,500 $17,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$236,96
$268,95
$302,84
$423,22
$643,12
$418,24
$450,23
$484,12
$604,50
$599,52
$631,51
$665,40
$785,78
$780,80
$812,79
$846,68
$967,06
$181,28
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$473,92
$537,90
$605,68
$846,44
$1 286,24
$655,20
$719,18
$786,96
$1 027,72
$836,48
$900,46
$968,24
$1 209,00
$1 017,76
$1 081,74
$1 149,52
$1 390,28
$181,28
Toc - Plan #19 WellFirst Health
Silver

(EPO) WellFirst Silver Classic 5000X

Annual Out of Pocket Expenses
Individual Family
$5,000 $10,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$357,86
$406,17
$457,34
$639,13
$971,23
$631,62
$679,93
$731,10
$912,89
$905,38
$953,69
$1 004,86
$1 186,65
$1 179,14
$1 227,45
$1 278,62
$1 460,41
$273,76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$715,72
$812,34
$914,68
$1 278,26
$1 942,46
$989,48
$1 086,10
$1 188,44
$1 552,02
$1 263,24
$1 359,86
$1 462,20
$1 825,78
$1 537,00
$1 633,62
$1 735,96
$2 099,54
$273,76
Toc - Plan #20 WellFirst Health
Gold

(EPO) WellFirst Gold Value Copay 3700X

Annual Out of Pocket Expenses
Individual Family
$3,700 $7,400 Annual Deductible
$3,700 $7,400 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$351,20
$398,61
$448,83
$627,24
$953,15
$619,87
$667,28
$717,50
$895,91
$888,54
$935,95
$986,17
$1 164,58
$1 157,21
$1 204,62
$1 254,84
$1 433,25
$268,67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$702,40
$797,22
$897,66
$1 254,48
$1 906,30
$971,07
$1 065,89
$1 166,33
$1 523,15
$1 239,74
$1 334,56
$1 435,00
$1 791,82
$1 508,41
$1 603,23
$1 703,67
$2 060,49
$268,67
Toc - Plan #21 WellFirst Health
Silver

(EPO) WellFirst Silver Value Copay 5000X

Annual Out of Pocket Expenses
Individual Family
$5,000 $10,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$364,35
$413,54
$465,64
$650,73
$988,84
$643,08
$692,27
$744,37
$929,46
$921,81
$971,00
$1 023,10
$1 208,19
$1 200,54
$1 249,73
$1 301,83
$1 486,92
$278,73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$728,70
$827,08
$931,28
$1 301,46
$1 977,68
$1 007,43
$1 105,81
$1 210,01
$1 580,19
$1 286,16
$1 384,54
$1 488,74
$1 858,92
$1 564,89
$1 663,27
$1 767,47
$2 137,65
$278,73
Toc - Plan #22 WellFirst Health
Bronze

(EPO) WellFirst Bronze Value Copay 8500X

Annual Out of Pocket Expenses
Individual Family
$8,500 $17,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$233,49
$265,01
$298,40
$417,02
$633,70
$412,11
$443,63
$477,02
$595,64
$590,73
$622,25
$655,64
$774,26
$769,35
$800,87
$834,26
$952,88
$178,62
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$466,98
$530,02
$596,80
$834,04
$1 267,40
$645,60
$708,64
$775,42
$1 012,66
$824,22
$887,26
$954,04
$1 191,28
$1 002,84
$1 065,88
$1 132,66
$1 369,90
$178,62
Toc - Plan #23 WellFirst Health
Silver

(EPO) WellFirst Silver HSA-E 4500X

Annual Out of Pocket Expenses
Individual Family
$4,500 $9,000 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$348,49
$395,53
$445,37
$622,40
$945,80
$615,08
$662,12
$711,96
$888,99
$881,67
$928,71
$978,55
$1 155,58
$1 148,26
$1 195,30
$1 245,14
$1 422,17
$266,59
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$696,98
$791,06
$890,74
$1 244,80
$1 891,60
$963,57
$1 057,65
$1 157,33
$1 511,39
$1 230,16
$1 324,24
$1 423,92
$1 777,98
$1 496,75
$1 590,83
$1 690,51
$2 044,57
$266,59
Toc - Plan #24 WellFirst Health
Expanded Bronze

(EPO) WellFirst Bronze HSA-E 6850X

Annual Out of Pocket Expenses
Individual Family
$6,850 $13,700 Annual Deductible
$6,850 $13,700 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$249,44
$283,11
$318,78
$445,49
$676,97
$440,26
$473,93
$509,60
$636,31
$631,08
$664,75
$700,42
$827,13
$821,90
$855,57
$891,24
$1 017,95
$190,82
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$498,88
$566,22
$637,56
$890,98
$1 353,94
$689,70
$757,04
$828,38
$1 081,80
$880,52
$947,86
$1 019,20
$1 272,62
$1 071,34
$1 138,68
$1 210,02
$1 463,44
$190,82
Toc - Plan #25 WellFirst Health
Catastrophic

(EPO) WellFirst Catastrophic Safety Net

Annual Out of Pocket Expenses
Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$204,88
$232,54
$261,83
$365,91
$556,04
$361,61
$389,27
$418,56
$522,64
$518,34
$546,00
$575,29
$679,37
$675,07
$702,73
$732,02
$836,10
$156,73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$409,76
$465,08
$523,66
$731,82
$1 112,08
$566,49
$621,81
$680,39
$888,55
$723,22
$778,54
$837,12
$1 045,28
$879,95
$935,27
$993,85
$1 202,01
$156,73

ADVERTISEMENT

Cigna Healthcare

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777

Toc - Plan #26 Cigna Healthcare
Expanded Bronze

(EPO) Cigna Connect 5900

Annual Out of Pocket Expenses
Individual Family
$5,900 $11,800 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$270,99
$307,57
$346,33
$483,99
$735,47
$478,30
$514,88
$553,64
$691,30
$685,61
$722,19
$760,95
$898,61
$892,92
$929,50
$968,26
$1 105,92
$207,31
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$541,98
$615,14
$692,66
$967,98
$1 470,94
$749,29
$822,45
$899,97
$1 175,29
$956,60
$1 029,76
$1 107,28
$1 382,60
$1 163,91
$1 237,07
$1 314,59
$1 589,91
$207,31
Toc - Plan #27 Cigna Healthcare
Silver

(EPO) Cigna Connect 5500

Annual Out of Pocket Expenses
Individual Family
$5,500 $11,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$323,50
$367,17
$413,43
$577,76
$877,97
$570,97
$614,64
$660,90
$825,23
$818,44
$862,11
$908,37
$1 072,70
$1 065,91
$1 109,58
$1 155,84
$1 320,17
$247,47
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$647,00
$734,34
$826,86
$1 155,52
$1 755,94
$894,47
$981,81
$1 074,33
$1 402,99
$1 141,94
$1 229,28
$1 321,80
$1 650,46
$1 389,41
$1 476,75
$1 569,27
$1 897,93
$247,47
Toc - Plan #28 Cigna Healthcare
Silver

(EPO) Cigna Connect 2900

Annual Out of Pocket Expenses
Individual Family
$2,900 $5,800 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$327,29
$371,48
$418,28
$584,54
$888,27
$577,67
$621,86
$668,66
$834,92
$828,05
$872,24
$919,04
$1 085,30
$1 078,43
$1 122,62
$1 169,42
$1 335,68
$250,38
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$654,58
$742,96
$836,56
$1 169,08
$1 776,54
$904,96
$993,34
$1 086,94
$1 419,46
$1 155,34
$1 243,72
$1 337,32
$1 669,84
$1 405,72
$1 494,10
$1 587,70
$1 920,22
$250,38
Toc - Plan #29 Cigna Healthcare
Gold

(EPO) Cigna Connect 1000

Annual Out of Pocket Expenses
Individual Family
$1,000 $2,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$408,84
$464,03
$522,50
$730,19
$1 109,59
$721,60
$776,79
$835,26
$1 042,95
$1 034,36
$1 089,55
$1 148,02
$1 355,71
$1 347,12
$1 402,31
$1 460,78
$1 668,47
$312,76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$817,68
$928,06
$1 045,00
$1 460,38
$2 219,18
$1 130,44
$1 240,82
$1 357,76
$1 773,14
$1 443,20
$1 553,58
$1 670,52
$2 085,90
$1 755,96
$1 866,34
$1 983,28
$2 398,66
$312,76
Toc - Plan #30 Cigna Healthcare
Expanded Bronze

(EPO) Cigna Connect 7000

Annual Out of Pocket Expenses
Individual Family
$7,000 $14,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$267,80
$303,96
$342,25
$478,29
$726,81
$472,67
$508,83
$547,12
$683,16
$677,54
$713,70
$751,99
$888,03
$882,41
$918,57
$956,86
$1 092,90
$204,87
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$535,60
$607,92
$684,50
$956,58
$1 453,62
$740,47
$812,79
$889,37
$1 161,45
$945,34
$1 017,66
$1 094,24
$1 366,32
$1 150,21
$1 222,53
$1 299,11
$1 571,19
$204,87
Toc - Plan #31 Cigna Healthcare
Bronze

(EPO) Cigna Connect 8550

Annual Out of Pocket Expenses
Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$259,49
$294,52
$331,63
$463,44
$704,25
$458,00
$493,03
$530,14
$661,95
$656,51
$691,54
$728,65
$860,46
$855,02
$890,05
$927,16
$1 058,97
$198,51
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$518,98
$589,04
$663,26
$926,88
$1 408,50
$717,49
$787,55
$861,77
$1 125,39
$916,00
$986,06
$1 060,28
$1 323,90
$1 114,51
$1 184,57
$1 258,79
$1 522,41
$198,51
Toc - Plan #32 Cigna Healthcare
Silver

(EPO) Cigna Connect 7300

Annual Out of Pocket Expenses
Individual Family
$7,300 $14,600 Annual Deductible
$7,300 $14,600 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$324,33
$368,12
$414,50
$579,26
$880,23
$572,44
$616,23
$662,61
$827,37
$820,55
$864,34
$910,72
$1 075,48
$1 068,66
$1 112,45
$1 158,83
$1 323,59
$248,11
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$648,66
$736,24
$829,00
$1 158,52
$1 760,46
$896,77
$984,35
$1 077,11
$1 406,63
$1 144,88
$1 232,46
$1 325,22
$1 654,74
$1 392,99
$1 480,57
$1 573,33
$1 902,85
$248,11
Toc - Plan #33 Cigna Healthcare
Silver

(EPO) Cigna Connect 4500

Annual Out of Pocket Expenses
Individual Family
$4,500 $9,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$324,56
$368,37
$414,79
$579,66
$880,85
$572,85
$616,66
$663,08
$827,95
$821,14
$864,95
$911,37
$1 076,24
$1 069,43
$1 113,24
$1 159,66
$1 324,53
$248,29
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$649,12
$736,74
$829,58
$1 159,32
$1 761,70
$897,41
$985,03
$1 077,87
$1 407,61
$1 145,70
$1 233,32
$1 326,16
$1 655,90
$1 393,99
$1 481,61
$1 574,45
$1 904,19
$248,29
Toc - Plan #34 Cigna Healthcare
Silver

(EPO) Cigna Connect 3500 Diabetes Care

Annual Out of Pocket Expenses
Individual Family
$3,500 $7,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$324,98
$368,85
$415,32
$580,41
$881,99
$573,59
$617,46
$663,93
$829,02
$822,20
$866,07
$912,54
$1 077,63
$1 070,81
$1 114,68
$1 161,15
$1 326,24
$248,61
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$649,96
$737,70
$830,64
$1 160,82
$1 763,98
$898,57
$986,31
$1 079,25
$1 409,43
$1 147,18
$1 234,92
$1 327,86
$1 658,04
$1 395,79
$1 483,53
$1 576,47
$1 906,65
$248,61

ADVERTISEMENT

Ambetter from Home State Health

Local: 1-855-650-3789 | Toll Free: 1-855-650-3789

Toc - Plan #35 Ambetter from Home State Health
Bronze

(EPO) Ambetter Essential Care 1 (2021)

Annual Out of Pocket Expenses
Individual Family
$8,300 $16,600 Annual Deductible
$8,300 $16,600 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$301,70
$342,42
$385,56
$538,82
$818,79
$532,49
$573,21
$616,35
$769,61
$763,28
$804,00
$847,14
$1 000,40
$994,07
$1 034,79
$1 077,93
$1 231,19
$230,79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$603,40
$684,84
$771,12
$1 077,64
$1 637,58
$834,19
$915,63
$1 001,91
$1 308,43
$1 064,98
$1 146,42
$1 232,70
$1 539,22
$1 295,77
$1 377,21
$1 463,49
$1 770,01
$230,79
Toc - Plan #36 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 4 (2021)

Annual Out of Pocket Expenses
Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$364,72
$413,95
$466,11
$651,38
$989,83
$643,73
$692,96
$745,12
$930,39
$922,74
$971,97
$1 024,13
$1 209,40
$1 201,75
$1 250,98
$1 303,14
$1 488,41
$279,01
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$729,44
$827,90
$932,22
$1 302,76
$1 979,66
$1 008,45
$1 106,91
$1 211,23
$1 581,77
$1 287,46
$1 385,92
$1 490,24
$1 860,78
$1 566,47
$1 664,93
$1 769,25
$2 139,79
$279,01
Toc - Plan #37 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 11 (2021)

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$353,31
$400,99
$451,52
$630,99
$958,85
$623,58
$671,26
$721,79
$901,26
$893,85
$941,53
$992,06
$1 171,53
$1 164,12
$1 211,80
$1 262,33
$1 441,80
$270,27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$706,62
$801,98
$903,04
$1 261,98
$1 917,70
$976,89
$1 072,25
$1 173,31
$1 532,25
$1 247,16
$1 342,52
$1 443,58
$1 802,52
$1 517,43
$1 612,79
$1 713,85
$2 072,79
$270,27
Toc - Plan #38 Ambetter from Home State Health
Gold

(EPO) Ambetter Secure Care 5 (2021)

Annual Out of Pocket Expenses
Individual Family
$1,450 $2,900 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$459,77
$521,83
$587,57
$821,13
$1 247,79
$811,49
$873,55
$939,29
$1 172,85
$1 163,21
$1 225,27
$1 291,01
$1 524,57
$1 514,93
$1 576,99
$1 642,73
$1 876,29
$351,72
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$919,54
$1 043,66
$1 175,14
$1 642,26
$2 495,58
$1 271,26
$1 395,38
$1 526,86
$1 993,98
$1 622,98
$1 747,10
$1 878,58
$2 345,70
$1 974,70
$2 098,82
$2 230,30
$2 697,42
$351,72
Toc - Plan #39 Ambetter from Home State Health
Expanded Bronze

(EPO) Ambetter Essential Care 5 (2021)

Annual Out of Pocket Expenses
Individual Family
$8,100 $16,200 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$325,30
$369,20
$415,72
$580,97
$882,83
$574,15
$618,05
$664,57
$829,82
$823,00
$866,90
$913,42
$1 078,67
$1 071,85
$1 115,75
$1 162,27
$1 327,52
$248,85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$650,60
$738,40
$831,44
$1 161,94
$1 765,66
$899,45
$987,25
$1 080,29
$1 410,79
$1 148,30
$1 236,10
$1 329,14
$1 659,64
$1 397,15
$1 484,95
$1 577,99
$1 908,49
$248,85
Toc - Plan #40 Ambetter from Home State Health
Expanded Bronze

(EPO) Ambetter Essential Care 2 HSA (2021)

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:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$326,72
$370,82
$417,54
$583,51
$886,69
$576,65
$620,75
$667,47
$833,44
$826,58
$870,68
$917,40
$1 083,37
$1 076,51
$1 120,61
$1 167,33
$1 333,30
$249,93
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$653,44
$741,64
$835,08
$1 167,02
$1 773,38
$903,37
$991,57
$1 085,01
$1 416,95
$1 153,30
$1 241,50
$1 334,94
$1 666,88
$1 403,23
$1 491,43
$1 584,87
$1 916,81
$249,93
Toc - Plan #41 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 126 (2021)

Annual Out of Pocket Expenses
Individual Family
$5,450 $10,900 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$362,75
$411,72
$463,59
$647,86
$984,49
$640,25
$689,22
$741,09
$925,36
$917,75
$966,72
$1 018,59
$1 202,86
$1 195,25
$1 244,22
$1 296,09
$1 480,36
$277,50
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$725,50
$823,44
$927,18
$1 295,72
$1 968,98
$1 003,00
$1 100,94
$1 204,68
$1 573,22
$1 280,50
$1 378,44
$1 482,18
$1 850,72
$1 558,00
$1 655,94
$1 759,68
$2 128,22
$277,50
Toc - Plan #42 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 124 (2021)

Annual Out of Pocket Expenses
Individual Family
$7,450 $14,900 Annual Deductible
$7,450 $14,900 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$358,93
$407,37
$458,69
$641,02
$974,10
$633,50
$681,94
$733,26
$915,59
$908,07
$956,51
$1 007,83
$1 190,16
$1 182,64
$1 231,08
$1 282,40
$1 464,73
$274,57
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$717,86
$814,74
$917,38
$1 282,04
$1 948,20
$992,43
$1 089,31
$1 191,95
$1 556,61
$1 267,00
$1 363,88
$1 466,52
$1 831,18
$1 541,57
$1 638,45
$1 741,09
$2 105,75
$274,57
Toc - Plan #43 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 127 (2021)

Annual Out of Pocket Expenses
Individual Family
$2,750 $5,500 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$376,65
$427,49
$481,35
$672,68
$1 022,20
$664,78
$715,62
$769,48
$960,81
$952,91
$1 003,75
$1 057,61
$1 248,94
$1 241,04
$1 291,88
$1 345,74
$1 537,07
$288,13
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$753,30
$854,98
$962,70
$1 345,36
$2 044,40
$1 041,43
$1 143,11
$1 250,83
$1 633,49
$1 329,56
$1 431,24
$1 538,96
$1 921,62
$1 617,69
$1 719,37
$1 827,09
$2 209,75
$288,13
Toc - Plan #44 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 128 (2021)

Annual Out of Pocket Expenses
Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$374,43
$424,96
$478,50
$668,71
$1 016,16
$660,86
$711,39
$764,93
$955,14
$947,29
$997,82
$1 051,36
$1 241,57
$1 233,72
$1 284,25
$1 337,79
$1 528,00
$286,43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$748,86
$849,92
$957,00
$1 337,42
$2 032,32
$1 035,29
$1 136,35
$1 243,43
$1 623,85
$1 321,72
$1 422,78
$1 529,86
$1 910,28
$1 608,15
$1 709,21
$1 816,29
$2 196,71
$286,43
Toc - Plan #45 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 129 (2021)

Annual Out of Pocket Expenses
Individual Family
$5,450 $10,900 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$341,53
$387,62
$436,46
$609,95
$926,88
$602,79
$648,88
$697,72
$871,21
$864,05
$910,14
$958,98
$1 132,47
$1 125,31
$1 171,40
$1 220,24
$1 393,73
$261,26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$683,06
$775,24
$872,92
$1 219,90
$1 853,76
$944,32
$1 036,50
$1 134,18
$1 481,16
$1 205,58
$1 297,76
$1 395,44
$1 742,42
$1 466,84
$1 559,02
$1 656,70
$2 003,68
$261,26
Toc - Plan #46 Ambetter from Home State Health
Bronze

(EPO) Ambetter Essential Care 1 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$8,300 $16,600 Annual Deductible
$8,300 $16,600 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$313,48
$355,79
$400,61
$559,85
$850,75
$553,28
$595,59
$640,41
$799,65
$793,08
$835,39
$880,21
$1 039,45
$1 032,88
$1 075,19
$1 120,01
$1 279,25
$239,80
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$626,96
$711,58
$801,22
$1 119,70
$1 701,50
$866,76
$951,38
$1 041,02
$1 359,50
$1 106,56
$1 191,18
$1 280,82
$1 599,30
$1 346,36
$1 430,98
$1 520,62
$1 839,10
$239,80
Toc - Plan #47 Ambetter from Home State Health
Expanded Bronze

(EPO) Ambetter Essential Care 5 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$8,100 $16,200 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$338,00
$383,61
$431,95
$603,64
$917,29
$596,56
$642,17
$690,51
$862,20
$855,12
$900,73
$949,07
$1 120,76
$1 113,68
$1 159,29
$1 207,63
$1 379,32
$258,56
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$676,00
$767,22
$863,90
$1 207,28
$1 834,58
$934,56
$1 025,78
$1 122,46
$1 465,84
$1 193,12
$1 284,34
$1 381,02
$1 724,40
$1 451,68
$1 542,90
$1 639,58
$1 982,96
$258,56
Toc - Plan #48 Ambetter from Home State Health
Gold

(EPO) Ambetter Secure Care 5 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$1,450 $2,900 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$477,71
$542,19
$610,51
$853,18
$1 296,49
$843,15
$907,63
$975,95
$1 218,62
$1 208,59
$1 273,07
$1 341,39
$1 584,06
$1 574,03
$1 638,51
$1 706,83
$1 949,50
$365,44
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$955,42
$1 084,38
$1 221,02
$1 706,36
$2 592,98
$1 320,86
$1 449,82
$1 586,46
$2 071,80
$1 686,30
$1 815,26
$1 951,90
$2 437,24
$2 051,74
$2 180,70
$2 317,34
$2 802,68
$365,44
Toc - Plan #49 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 11 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$367,10
$416,65
$469,14
$655,62
$996,28
$647,92
$697,47
$749,96
$936,44
$928,74
$978,29
$1 030,78
$1 217,26
$1 209,56
$1 259,11
$1 311,60
$1 498,08
$280,82
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$734,20
$833,30
$938,28
$1 311,24
$1 992,56
$1 015,02
$1 114,12
$1 219,10
$1 592,06
$1 295,84
$1 394,94
$1 499,92
$1 872,88
$1 576,66
$1 675,76
$1 780,74
$2 153,70
$280,82
Toc - Plan #50 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 4 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$378,96
$430,11
$484,30
$676,80
$1 028,47
$668,86
$720,01
$774,20
$966,70
$958,76
$1 009,91
$1 064,10
$1 256,60
$1 248,66
$1 299,81
$1 354,00
$1 546,50
$289,90
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$757,92
$860,22
$968,60
$1 353,60
$2 056,94
$1 047,82
$1 150,12
$1 258,50
$1 643,50
$1 337,72
$1 440,02
$1 548,40
$1 933,40
$1 627,62
$1 729,92
$1 838,30
$2 223,30
$289,90
Toc - Plan #51 Ambetter from Home State Health
Expanded Bronze

(EPO) Ambetter Essential Care 2 HSA (2021) + Vision + Adult Dental

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:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$339,47
$385,29
$433,83
$606,28
$921,30
$599,16
$644,98
$693,52
$865,97
$858,85
$904,67
$953,21
$1 125,66
$1 118,54
$1 164,36
$1 212,90
$1 385,35
$259,69
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$678,94
$770,58
$867,66
$1 212,56
$1 842,60
$938,63
$1 030,27
$1 127,35
$1 472,25
$1 198,32
$1 289,96
$1 387,04
$1 731,94
$1 458,01
$1 549,65
$1 646,73
$1 991,63
$259,69
Toc - Plan #52 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 126 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$5,450 $10,900 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$376,91
$427,79
$481,68
$673,15
$1 022,92
$665,24
$716,12
$770,01
$961,48
$953,57
$1 004,45
$1 058,34
$1 249,81
$1 241,90
$1 292,78
$1 346,67
$1 538,14
$288,33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$753,82
$855,58
$963,36
$1 346,30
$2 045,84
$1 042,15
$1 143,91
$1 251,69
$1 634,63
$1 330,48
$1 432,24
$1 540,02
$1 922,96
$1 618,81
$1 720,57
$1 828,35
$2 211,29
$288,33
Toc - Plan #53 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 124 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$7,450 $14,900 Annual Deductible
$7,450 $14,900 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$372,93
$423,27
$476,60
$666,04
$1 012,12
$658,22
$708,56
$761,89
$951,33
$943,51
$993,85
$1 047,18
$1 236,62
$1 228,80
$1 279,14
$1 332,47
$1 521,91
$285,29
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$745,86
$846,54
$953,20
$1 332,08
$2 024,24
$1 031,15
$1 131,83
$1 238,49
$1 617,37
$1 316,44
$1 417,12
$1 523,78
$1 902,66
$1 601,73
$1 702,41
$1 809,07
$2 187,95
$285,29
Toc - Plan #54 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 127 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$2,750 $5,500 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$391,35
$444,17
$500,13
$698,94
$1 062,10
$690,73
$743,55
$799,51
$998,32
$990,11
$1 042,93
$1 098,89
$1 297,70
$1 289,49
$1 342,31
$1 398,27
$1 597,08
$299,38
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$782,70
$888,34
$1 000,26
$1 397,88
$2 124,20
$1 082,08
$1 187,72
$1 299,64
$1 697,26
$1 381,46
$1 487,10
$1 599,02
$1 996,64
$1 680,84
$1 786,48
$1 898,40
$2 296,02
$299,38
Toc - Plan #55 Ambetter from Home State Health
Silver

(EPO) Ambetter Balanced Care 128 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year
Monthly Premiums:
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$389,04
$441,55
$497,18
$694,81
$1 055,83
$686,65
$739,16
$794,79
$992,42
$984,26
$1 036,77
$1 092,40
$1 290,03
$1 281,87
$1 334,38
$1 390,01
$1 587,64
$297,61
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$778,08
$883,10
$994,36
$1 389,62
$2 111,66
$1 075,69
$1 180,71
$1 291,97
$1 687,23
$1 373,30
$1 478,32
$1 589,58
$1 984,84
$1 670,91
$1 775,93
$1 887,19
$2 282,45
$297,61

‡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 Saint Louis County here.

Saint Louis County is in “Rating Area 6” of Missouri.

Currently, there are 55 plans offered in Rating Area 6.

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2022 Obamacare Rates for Saint Louis County

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