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|
Montana Health Cooperative
Local: 1-406-447-9510 | Toll Free: 1-855-488-0622
TTY: 1-855-488-0622
|
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$6,650
: Family:
$13,300
Out of Pocket Maximum per year: Individual:
$6,650
: Family:
$13,300
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$310.04
$351.89
$396.23
$553.73
$841.44 |
$620.08
$703.78
$792.46
$1,107.46
$1,682.88 |
$857.26
$940.96
$1,029.64
$1,344.64 |
$1,094.44
$1,178.14
$1,266.82
$1,581.82 |
$1,331.62
$1,415.32
$1,504.00
$1,819.00 |
$547.22
$589.07
$633.41
$790.91 |
$784.40
$826.25
$870.59
$1,028.09 |
$1,021.58
$1,063.43
$1,107.77
$1,265.27 |
$237.18 |
Expanded Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$5,000
: Family:
$10,000
Out of Pocket Maximum per year: Individual:
$6,800
: Family:
$13,600
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Expanded Bronze |
21
30
40
50
60 |
$314.29
$356.72
$401.66
$561.32
$852.97 |
$628.58
$713.44
$803.32
$1,122.64
$1,705.94 |
$869.01
$953.87
$1,043.75
$1,363.07 |
$1,109.44
$1,194.30
$1,284.18
$1,603.50 |
$1,349.87
$1,434.73
$1,524.61
$1,843.93 |
$554.72
$597.15
$642.09
$801.75 |
$795.15
$837.58
$882.52
$1,042.18 |
$1,035.58
$1,078.01
$1,122.95
$1,282.61 |
$240.43 |
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$750
: Family:
$1,500
Out of Pocket Maximum per year: Individual:
$5,000
: Family:
$10,000
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$438.59
$497.80
$560.52
$783.33
$1,190.35 |
$877.18
$995.60
$1,121.04
$1,566.66
$2,380.70 |
$1,212.70
$1,331.12
$1,456.56
$1,902.18 |
$1,548.22
$1,666.64
$1,792.08
$2,237.70 |
$1,883.74
$2,002.16
$2,127.60
$2,573.22 |
$774.11
$833.32
$896.04
$1,118.85 |
$1,109.63
$1,168.84
$1,231.56
$1,454.37 |
$1,445.15
$1,504.36
$1,567.08
$1,789.89 |
$335.52 |
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|
PacificSource Health Plans
Local: 1-406-442-6589 | Toll Free: 1-877-590-1596
TTY: 1-800-253-4091
|
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (PacificSource Health Plans)
Customer Service Phone: 1-877-590-1596
Deductible: Individual:
$6,550
: Family:
$13,100
Out of Pocket Maximum per year: Individual:
$6,550
: Family:
$13,100
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$292.00
$332.00
$374.00
$522.00
$793.00 |
$584.00
$664.00
$748.00
$1,044.00
$1,586.00 |
$808.00
$888.00
$972.00
$1,268.00 |
$1,032.00
$1,112.00
$1,196.00
$1,492.00 |
$1,256.00
$1,336.00
$1,420.00
$1,716.00 |
$516.00
$556.00
$598.00
$746.00 |
$740.00
$780.00
$822.00
$970.00 |
$964.00
$1,004.00
$1,046.00
$1,194.00 |
$224.00 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (PacificSource Health Plans)
Customer Service Phone: 1-877-590-1596
Deductible: Individual:
$3,000
: Family:
$6,000
Out of Pocket Maximum per year: Individual:
$5,000
: Family:
$10,000
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$395.00
$449.00
$505.00
$706.00
$1,073.00 |
$790.00
$898.00
$1,010.00
$1,412.00
$2,146.00 |
$1,092.00
$1,200.00
$1,312.00
$1,714.00 |
$1,394.00
$1,502.00
$1,614.00
$2,016.00 |
$1,696.00
$1,804.00
$1,916.00
$2,318.00 |
$697.00
$751.00
$807.00
$1,008.00 |
$999.00
$1,053.00
$1,109.00
$1,310.00 |
$1,301.00
$1,355.00
$1,411.00
$1,612.00 |
$302.00 |
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (PacificSource Health Plans)
Customer Service Phone: 1-877-590-1596
Deductible: Individual:
$1,500
: Family:
$3,000
Out of Pocket Maximum per year: Individual:
$5,000
: Family:
$10,000
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$446.00
$506.00
$570.00
$797.00
$1,211.00 |
$892.00
$1,012.00
$1,140.00
$1,594.00
$2,422.00 |
$1,233.00
$1,353.00
$1,481.00
$1,935.00 |
$1,574.00
$1,694.00
$1,822.00
$2,276.00 |
$1,915.00
$2,035.00
$2,163.00
$2,617.00 |
$787.00
$847.00
$911.00
$1,138.00 |
$1,128.00
$1,188.00
$1,252.00
$1,479.00 |
$1,469.00
$1,529.00
$1,593.00
$1,820.00 |
$341.00 |
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|
Blue Cross and Blue Shield of Montana
Local: 1-855-258-8471 | Toll Free: 1-855-258-8471
TTY: 1-406-444-4212
|
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$450
: Family:
$900
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$578.06
$656.10
$738.76
$1,032.41
$1,568.85 |
$1,156.12
$1,312.20
$1,477.52
$2,064.82
$3,137.70 |
$1,598.33
$1,754.41
$1,919.73
$2,507.03 |
$2,040.54
$2,196.62
$2,361.94
$2,949.24 |
$2,482.75
$2,638.83
$2,804.15
$3,391.45 |
$1,020.27
$1,098.31
$1,180.97
$1,474.62 |
$1,462.48
$1,540.52
$1,623.18
$1,916.83 |
$1,904.69
$1,982.73
$2,065.39
$2,359.04 |
$442.21 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$1,000
: Family:
$2,000
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$536.15
$608.53
$685.20
$957.56
$1,455.10 |
$1,072.30
$1,217.06
$1,370.40
$1,915.12
$2,910.20 |
$1,482.45
$1,627.21
$1,780.55
$2,325.27 |
$1,892.60
$2,037.36
$2,190.70
$2,735.42 |
$2,302.75
$2,447.51
$2,600.85
$3,145.57 |
$946.30
$1,018.68
$1,095.35
$1,367.71 |
$1,356.45
$1,428.83
$1,505.50
$1,777.86 |
$1,766.60
$1,838.98
$1,915.65
$2,188.01 |
$410.15 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$2,850
: Family:
$5,700
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$412.29
$467.95
$526.91
$736.35
$1,118.96 |
$824.58
$935.90
$1,053.82
$1,472.70
$2,237.92 |
$1,139.98
$1,251.30
$1,369.22
$1,788.10 |
$1,455.38
$1,566.70
$1,684.62
$2,103.50 |
$1,770.78
$1,882.10
$2,000.02
$2,418.90 |
$727.69
$783.35
$842.31
$1,051.75 |
$1,043.09
$1,098.75
$1,157.71
$1,367.15 |
$1,358.49
$1,414.15
$1,473.11
$1,682.55 |
$315.40 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$2,700
: Family:
$5,400
Out of Pocket Maximum per year: Individual:
$6,550
: Family:
$13,100
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$441.66
$501.29
$564.45
$788.81
$1,198.68 |
$883.32
$1,002.58
$1,128.90
$1,577.62
$2,397.36 |
$1,221.19
$1,340.45
$1,466.77
$1,915.49 |
$1,559.06
$1,678.32
$1,804.64
$2,253.36 |
$1,896.93
$2,016.19
$2,142.51
$2,591.23 |
$779.53
$839.16
$902.32
$1,126.68 |
$1,117.40
$1,177.03
$1,240.19
$1,464.55 |
$1,455.27
$1,514.90
$1,578.06
$1,802.42 |
$337.87 |
Catastrophic
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$7,350
: Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Catastrophic |
21
30
40
50
60 |
$354.29
$402.12
$452.79
$632.77
$961.55 |
$708.58
$804.24
$905.58
$1,265.54
$1,923.10 |
$979.61
$1,075.27
$1,176.61
$1,536.57 |
$1,250.64
$1,346.30
$1,447.64
$1,807.60 |
$1,521.67
$1,617.33
$1,718.67
$2,078.63 |
$625.32
$673.15
$723.82
$903.80 |
$896.35
$944.18
$994.85
$1,174.83 |
$1,167.38
$1,215.21
$1,265.88
$1,445.86 |
$271.03 |
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$0
: Family:
$0
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$515.22
$584.78
$658.46
$920.19
$1,398.32 |
$1,030.44
$1,169.56
$1,316.92
$1,840.38
$2,796.64 |
$1,424.59
$1,563.71
$1,711.07
$2,234.53 |
$1,818.74
$1,957.86
$2,105.22
$2,628.68 |
$2,212.89
$2,352.01
$2,499.37
$3,022.83 |
$909.37
$978.93
$1,052.61
$1,314.34 |
$1,303.52
$1,373.08
$1,446.76
$1,708.49 |
$1,697.67
$1,767.23
$1,840.91
$2,102.64 |
$394.15 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$3,500
: Family:
$7,000
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$448.87
$509.46
$573.65
$801.67
$1,218.22 |
$897.74
$1,018.92
$1,147.30
$1,603.34
$2,436.44 |
$1,241.12
$1,362.30
$1,490.68
$1,946.72 |
$1,584.50
$1,705.68
$1,834.06
$2,290.10 |
$1,927.88
$2,049.06
$2,177.44
$2,633.48 |
$792.25
$852.84
$917.03
$1,145.05 |
$1,135.63
$1,196.22
$1,260.41
$1,488.43 |
$1,479.01
$1,539.60
$1,603.79
$1,831.81 |
$343.38 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Montana)
Customer Service Phone: 1-855-258-8471
Deductible: Individual:
$4,000
: Family:
$8,000
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$342.25
$388.45
$437.39
$611.26
$928.86 |
$684.50
$776.90
$874.78
$1,222.52
$1,857.72 |
$946.32
$1,038.72
$1,136.60
$1,484.34 |
$1,208.14
$1,300.54
$1,398.42
$1,746.16 |
$1,469.96
$1,562.36
$1,660.24
$2,007.98 |
$604.07
$650.27
$699.21
$873.08 |
$865.89
$912.09
$961.03
$1,134.90 |
$1,127.71
$1,173.91
$1,222.85
$1,396.72 |
$261.82 |
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|
Montana Health Cooperative
Local: 1-406-447-9510 | Toll Free: 1-855-488-0622
TTY: 1-855-488-0622
|
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$800
: Family:
$1,600
Out of Pocket Maximum per year: Individual:
$5,750
: Family:
$11,500
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$481.16
$546.11
$614.92
$859.35
$1,305.86 |
$962.32
$1,092.22
$1,229.84
$1,718.70
$2,611.72 |
$1,330.40
$1,460.30
$1,597.92
$2,086.78 |
$1,698.48
$1,828.38
$1,966.00
$2,454.86 |
$2,066.56
$2,196.46
$2,334.08
$2,822.94 |
$849.24
$914.19
$983.00
$1,227.43 |
$1,217.32
$1,282.27
$1,351.08
$1,595.51 |
$1,585.40
$1,650.35
$1,719.16
$1,963.59 |
$368.08 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$2,450
: Family:
$4,900
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$442.27
$501.97
$565.22
$789.89
$1,200.31 |
$884.54
$1,003.94
$1,130.44
$1,579.78
$2,400.62 |
$1,222.87
$1,342.27
$1,468.77
$1,918.11 |
$1,561.20
$1,680.60
$1,807.10
$2,256.44 |
$1,899.53
$2,018.93
$2,145.43
$2,594.77 |
$780.60
$840.30
$903.55
$1,128.22 |
$1,118.93
$1,178.63
$1,241.88
$1,466.55 |
$1,457.26
$1,516.96
$1,580.21
$1,804.88 |
$338.33 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$7,200
: Family:
$14,400
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$295.58
$335.49
$377.76
$527.91
$802.22 |
$591.16
$670.98
$755.52
$1,055.82
$1,604.44 |
$817.28
$897.10
$981.64
$1,281.94 |
$1,043.40
$1,123.22
$1,207.76
$1,508.06 |
$1,269.52
$1,349.34
$1,433.88
$1,734.18 |
$521.70
$561.61
$603.88
$754.03 |
$747.82
$787.73
$830.00
$980.15 |
$973.94
$1,013.85
$1,056.12
$1,206.27 |
$226.12 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$2,450
: Family:
$4,900
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$395.80
$449.23
$505.83
$706.90
$1,074.20 |
$791.60
$898.46
$1,011.66
$1,413.80
$2,148.40 |
$1,094.39
$1,201.25
$1,314.45
$1,716.59 |
$1,397.18
$1,504.04
$1,617.24
$2,019.38 |
$1,699.97
$1,806.83
$1,920.03
$2,322.17 |
$698.59
$752.02
$808.62
$1,009.69 |
$1,001.38
$1,054.81
$1,111.41
$1,312.48 |
$1,304.17
$1,357.60
$1,414.20
$1,615.27 |
$302.79 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$7,200
: Family:
$14,400
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$261.34
$296.62
$333.99
$466.75
$709.27 |
$522.68
$593.24
$667.98
$933.50
$1,418.54 |
$722.60
$793.16
$867.90
$1,133.42 |
$922.52
$993.08
$1,067.82
$1,333.34 |
$1,122.44
$1,193.00
$1,267.74
$1,533.26 |
$461.26
$496.54
$533.91
$666.67 |
$661.18
$696.46
$733.83
$866.59 |
$861.10
$896.38
$933.75
$1,066.51 |
$199.92 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$6,650
: Family:
$13,300
Out of Pocket Maximum per year: Individual:
$6,650
: Family:
$13,300
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$274.83
$311.93
$351.24
$490.85
$745.89 |
$549.66
$623.86
$702.48
$981.70
$1,491.78 |
$759.91
$834.11
$912.73
$1,191.95 |
$970.16
$1,044.36
$1,122.98
$1,402.20 |
$1,180.41
$1,254.61
$1,333.23
$1,612.45 |
$485.08
$522.18
$561.49
$701.10 |
$695.33
$732.43
$771.74
$911.35 |
$905.58
$942.68
$981.99
$1,121.60 |
$210.25 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$5,700
: Family:
$11,400
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$372.56
$422.86
$476.14
$665.40
$1,011.14 |
$745.12
$845.72
$952.28
$1,330.80
$2,022.28 |
$1,030.13
$1,130.73
$1,237.29
$1,615.81 |
$1,315.14
$1,415.74
$1,522.30
$1,900.82 |
$1,600.15
$1,700.75
$1,807.31
$2,185.83 |
$657.57
$707.87
$761.15
$950.41 |
$942.58
$992.88
$1,046.16
$1,235.42 |
$1,227.59
$1,277.89
$1,331.17
$1,520.43 |
$285.01 |
Catastrophic
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$7,350
: Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Catastrophic |
21
30
40
50
60 |
$195.58
$221.98
$249.95
$349.30
$530.79 |
$391.16
$443.96
$499.90
$698.60
$1,061.58 |
$540.78
$593.58
$649.52
$848.22 |
$690.40
$743.20
$799.14
$997.84 |
$840.02
$892.82
$948.76
$1,147.46 |
$345.20
$371.60
$399.57
$498.92 |
$494.82
$521.22
$549.19
$648.54 |
$644.44
$670.84
$698.81
$798.16 |
$149.62 |
Expanded Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Montana Health Cooperative)
Customer Service Phone: 1-855-488-0622
Deductible: Individual:
$5,500
: Family:
$11,000
Out of Pocket Maximum per year: Individual:
$7,200
: Family:
$14,400
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Expanded Bronze |
21
30
40
50
60 |
$273.49
$310.41
$349.52
$488.45
$742.24 |
$546.98
$620.82
$699.04
$976.90
$1,484.48 |
$756.20
$830.04
$908.26
$1,186.12 |
$965.42
$1,039.26
$1,117.48
$1,395.34 |
$1,174.64
$1,248.48
$1,326.70
$1,604.56 |
$482.71
$519.63
$558.74
$697.67 |
$691.93
$728.85
$767.96
$906.89 |
$901.15
$938.07
$977.18
$1,116.11 |
$209.22 |
Under the Affordable Care Act (ACA) in Montana, you may be able to reduce your health insurance through tax credits or, if your income is very low, by qualifying for Medicaid.
Many people who apply for coverage at the Montana exchange will be eligible for some form of financial assistance. Read on to learn more about your options.
For 2018, in most states, open enrollment for health insurance under the Affordable Care Act ended on December 15. That means it’s too late for most people to use a health insurance exchange to get coverage for 2018.
If you let the ACA deadline pass you by this year, here are some things to know.
Certain life events make you eligible to sign up for health insurance outside of open enrolllment. The circumstances under which you may qualify for special enrollment include: