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Providers for Zip Code 45238

Obamacare 2017 Marketplace Rates For Hamilton County, Ohio

Saturday, December 10th, 2016

Click for Cincinnati, Ohio Forecast

Obamacare Providers, Plans and 2017 Rates for Hamilton County

The health insurance rates listed below are for calendar year 2017.

2017 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Hamilton County, Ohio.

Currently, there are 55 plans offered in Hamilton County.

Below, you’ll find a summary of plans and rates for each of these providers. This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

 

The table below shows premiums for the following scenarios:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

 

Note: If you are over 65, you qualify for Medicare. Click here to see listings of 2017 Medicare Advantage plans for Hamilton County

 

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Cincinnati, OH area accept this insurance coverage as within the plan's "network".

‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Hamilton County here.

CareSource

Local: 1-800-479-9502 | Toll Free: 1-800-479-9502

TTY: 1-800-750-0750

Plan: (HMO) CareSource Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

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
any age
Bronze 21
30
40
50
60
$184.85
$209.80
$236.23
$330.14
$501.67
$369.70
$419.60
$472.46
$660.28
$1003.34
$487.08
$536.98
$589.84
$777.66
$604.46
$654.36
$707.22
$895.04
$721.84
$771.74
$824.60
$1012.42
$302.23
$327.18
$353.61
$447.52
$419.61
$444.56
$470.99
$564.90
$536.99
$561.94
$588.37
$682.28
$117.38

Plan: (HMO) CareSource Gold Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000

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
any age
Gold 21
30
40
50
60
$273.60
$310.53
$349.66
$488.64
$742.54
$547.20
$621.06
$699.32
$977.28
$1485.08
$720.93
$794.79
$873.05
$1151.01
$894.66
$968.52
$1046.78
$1324.74
$1068.39
$1142.25
$1220.51
$1498.47
$447.33
$484.26
$523.39
$662.37
$621.06
$657.99
$697.12
$836.10
$794.79
$831.72
$870.85
$1009.83
$173.73

Community Insurance Company(Anthem BCBS)

Local: 1-855-748-1808 | Toll Free: 1-855-748-1808

Plan: (PPO) Anthem Catastrophic Pathway X PPO 7150

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Catastrophic 21
30
40
50
60
$216.42
$245.64
$276.58
$386.53
$587.36
$432.84
$491.28
$553.16
$773.06
$1174.72
$570.27
$628.71
$690.59
$910.49
$707.70
$766.14
$828.02
$1047.92
$845.13
$903.57
$965.45
$1185.35
$353.85
$383.07
$414.01
$523.96
$491.28
$520.50
$551.44
$661.39
$628.71
$657.93
$688.87
$798.82
$137.43

Plan: (PPO) Anthem Bronze Pathway X PPO 0 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

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
any age
Bronze 21
30
40
50
60
$269.74
$306.15
$344.73
$481.76
$732.07
$539.48
$612.30
$689.46
$963.52
$1464.14
$710.76
$783.58
$860.74
$1134.80
$882.04
$954.86
$1032.02
$1306.08
$1053.32
$1126.14
$1203.30
$1477.36
$441.02
$477.43
$516.01
$653.04
$612.30
$648.71
$687.29
$824.32
$783.58
$819.99
$858.57
$995.60
$171.28

Plan: (PPO) Anthem Bronze Pathway X PPO 5150

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $5,150 : Family: $10,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$269.36
$305.72
$344.24
$481.08
$731.04
$538.72
$611.44
$688.48
$962.16
$1462.08
$709.76
$782.48
$859.52
$1133.20
$880.80
$953.52
$1030.56
$1304.24
$1051.84
$1124.56
$1201.60
$1475.28
$440.40
$476.76
$515.28
$652.12
$611.44
$647.80
$686.32
$823.16
$782.48
$818.84
$857.36
$994.20
$171.04

Plan: (PPO) Anthem Bronze Pathway X PPO 6800

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$272.17
$308.91
$347.83
$486.10
$738.67
$544.34
$617.82
$695.66
$972.20
$1477.34
$717.17
$790.65
$868.49
$1145.03
$890.00
$963.48
$1041.32
$1317.86
$1062.83
$1136.31
$1214.15
$1490.69
$445.00
$481.74
$520.66
$658.93
$617.83
$654.57
$693.49
$831.76
$790.66
$827.40
$866.32
$1004.59
$172.83

Plan: (PPO) Anthem Silver Pathway X PPO 3000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

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
any age
Silver 21
30
40
50
60
$320.52
$363.79
$409.62
$572.45
$869.89
$641.04
$727.58
$819.24
$1144.90
$1739.78
$844.57
$931.11
$1022.77
$1348.43
$1048.10
$1134.64
$1226.30
$1551.96
$1251.63
$1338.17
$1429.83
$1755.49
$524.05
$567.32
$613.15
$775.98
$727.58
$770.85
$816.68
$979.51
$931.11
$974.38
$1020.21
$1183.04
$203.53

Plan: (PPO) Anthem Silver Pathway X PPO 10 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

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
any age
Silver 21
30
40
50
60
$324.06
$367.81
$414.15
$578.77
$879.50
$648.12
$735.62
$828.30
$1157.54
$1759.00
$853.90
$941.40
$1034.08
$1363.32
$1059.68
$1147.18
$1239.86
$1569.10
$1265.46
$1352.96
$1445.64
$1774.88
$529.84
$573.59
$619.93
$784.55
$735.62
$779.37
$825.71
$990.33
$941.40
$985.15
$1031.49
$1196.11
$205.78

Plan: (PPO) Anthem Silver Pathway X PPO 4050

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $4,050 : Family: $8,100
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$323.12
$366.74
$412.95
$577.09
$876.95
$646.24
$733.48
$825.90
$1154.18
$1753.90
$851.42
$938.66
$1031.08
$1359.36
$1056.60
$1143.84
$1236.26
$1564.54
$1261.78
$1349.02
$1441.44
$1769.72
$528.30
$571.92
$618.13
$782.27
$733.48
$777.10
$823.31
$987.45
$938.66
$982.28
$1028.49
$1192.63
$205.18

Plan: (PPO) Anthem Silver Pathway X PPO 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$332.22
$377.07
$424.58
$593.34
$901.65
$664.44
$754.14
$849.16
$1186.68
$1803.30
$875.40
$965.10
$1060.12
$1397.64
$1086.36
$1176.06
$1271.08
$1608.60
$1297.32
$1387.02
$1482.04
$1819.56
$543.18
$588.03
$635.54
$804.30
$754.14
$798.99
$846.50
$1015.26
$965.10
$1009.95
$1057.46
$1226.22
$210.96

Plan: (PPO) Anthem Silver Pathway X PPO 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$330.23
$374.81
$422.03
$589.79
$896.24
$660.46
$749.62
$844.06
$1179.58
$1792.48
$870.16
$959.32
$1053.76
$1389.28
$1079.86
$1169.02
$1263.46
$1598.98
$1289.56
$1378.72
$1473.16
$1808.68
$539.93
$584.51
$631.73
$799.49
$749.63
$794.21
$841.43
$1009.19
$959.33
$1003.91
$1051.13
$1218.89
$209.70

Plan: (PPO) Anthem Silver Pathway X PPO 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $5,700 : Family: $11,400

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
any age
Silver 21
30
40
50
60
$322.19
$365.69
$411.76
$575.43
$874.42
$644.38
$731.38
$823.52
$1150.86
$1748.84
$848.97
$935.97
$1028.11
$1355.45
$1053.56
$1140.56
$1232.70
$1560.04
$1258.15
$1345.15
$1437.29
$1764.63
$526.78
$570.28
$616.35
$780.02
$731.37
$774.87
$820.94
$984.61
$935.96
$979.46
$1025.53
$1189.20
$204.59

Plan: (PPO) Anthem Bronze Pathway X PPO 5850

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $5,850 : Family: $11,700
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$263.13
$298.65
$336.28
$469.95
$714.13
$526.26
$597.30
$672.56
$939.90
$1428.26
$693.35
$764.39
$839.65
$1106.99
$860.44
$931.48
$1006.74
$1274.08
$1027.53
$1098.57
$1173.83
$1441.17
$430.22
$465.74
$503.37
$637.04
$597.31
$632.83
$670.46
$804.13
$764.40
$799.92
$837.55
$971.22
$167.09

Plan: (HMO) Anthem Bronze Pathway X HMO 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$237.42
$269.47
$303.42
$424.03
$644.36
$474.84
$538.94
$606.84
$848.06
$1288.72
$625.60
$689.70
$757.60
$998.82
$776.36
$840.46
$908.36
$1149.58
$927.12
$991.22
$1059.12
$1300.34
$388.18
$420.23
$454.18
$574.79
$538.94
$570.99
$604.94
$725.55
$689.70
$721.75
$755.70
$876.31
$150.76

Plan: (HMO) Anthem Bronze Pathway X HMO 5200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $5,200 : Family: $10,400
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$240.49
$272.96
$307.35
$429.52
$652.69
$480.98
$545.92
$614.70
$859.04
$1305.38
$633.69
$698.63
$767.41
$1011.75
$786.40
$851.34
$920.12
$1164.46
$939.11
$1004.05
$1072.83
$1317.17
$393.20
$425.67
$460.06
$582.23
$545.91
$578.38
$612.77
$734.94
$698.62
$731.09
$765.48
$887.65
$152.71

Plan: (HMO) Anthem Bronze Pathway X HMO 7150

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$234.11
$265.71
$299.19
$418.12
$635.37
$468.22
$531.42
$598.38
$836.24
$1270.74
$616.88
$680.08
$747.04
$984.90
$765.54
$828.74
$895.70
$1133.56
$914.20
$977.40
$1044.36
$1282.22
$382.77
$414.37
$447.85
$566.78
$531.43
$563.03
$596.51
$715.44
$680.09
$711.69
$745.17
$864.10
$148.66

Plan: (HMO) Anthem Silver Pathway X HMO 4250

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $4,250 : Family: $8,500
Out of Pocket Maximum per year: Individual: $5,250 : Family: $10,500

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
any age
Silver 21
30
40
50
60
$281.41
$319.40
$359.64
$502.60
$763.75
$562.82
$638.80
$719.28
$1005.20
$1527.50
$741.52
$817.50
$897.98
$1183.90
$920.22
$996.20
$1076.68
$1362.60
$1098.92
$1174.90
$1255.38
$1541.30
$460.11
$498.10
$538.34
$681.30
$638.81
$676.80
$717.04
$860.00
$817.51
$855.50
$895.74
$1038.70
$178.70

Plan: (HMO) Anthem Silver Pathway X HMO 2850

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $2,850 : Family: $5,700
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$281.50
$319.50
$359.76
$502.76
$763.99
$563.00
$639.00
$719.52
$1005.52
$1527.98
$741.75
$817.75
$898.27
$1184.27
$920.50
$996.50
$1077.02
$1363.02
$1099.25
$1175.25
$1255.77
$1541.77
$460.25
$498.25
$538.51
$681.51
$639.00
$677.00
$717.26
$860.26
$817.75
$855.75
$896.01
$1039.01
$178.75

Plan: (HMO) Anthem Gold Pathway X HMO 1450

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $1,450 : Family: $4,350
Out of Pocket Maximum per year: Individual: $4,200 : Family: $8,400

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
any age
Gold 21
30
40
50
60
$359.77
$408.34
$459.79
$642.55
$976.42
$719.54
$816.68
$919.58
$1285.10
$1952.84
$947.99
$1045.13
$1148.03
$1513.55
$1176.44
$1273.58
$1376.48
$1742.00
$1404.89
$1502.03
$1604.93
$1970.45
$588.22
$636.79
$688.24
$871.00
$816.67
$865.24
$916.69
$1099.45
$1045.12
$1093.69
$1145.14
$1327.90
$228.45

Plan: (HMO) Anthem Silver Core Pathway X HMO 5300

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $5,300 : Family: $10,600
Out of Pocket Maximum per year: Individual: $6,750 : Family: $13,500

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
any age
Silver 21
30
40
50
60
$263.60
$299.19
$336.88
$470.79
$715.41
$527.20
$598.38
$673.76
$941.58
$1430.82
$694.59
$765.77
$841.15
$1108.97
$861.98
$933.16
$1008.54
$1276.36
$1029.37
$1100.55
$1175.93
$1443.75
$430.99
$466.58
$504.27
$638.18
$598.38
$633.97
$671.66
$805.57
$765.77
$801.36
$839.05
$972.96
$167.39

Plan: (HMO) Anthem Bronze Pathway X HMO 0 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

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
any age
Bronze 21
30
40
50
60
$242.16
$274.85
$309.48
$432.50
$657.22
$484.32
$549.70
$618.96
$865.00
$1314.44
$638.09
$703.47
$772.73
$1018.77
$791.86
$857.24
$926.50
$1172.54
$945.63
$1011.01
$1080.27
$1326.31
$395.93
$428.62
$463.25
$586.27
$549.70
$582.39
$617.02
$740.04
$703.47
$736.16
$770.79
$893.81
$153.77

CareSource

Local: 1-800-479-9502 | Toll Free: 1-800-479-9502

TTY: 1-800-750-0750

Plan: (HMO) CareSource Gold

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000

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
any age
Gold 21
30
40
50
60
$258.52
$293.42
$330.38
$461.71
$701.61
$517.04
$586.84
$660.76
$923.42
$1403.22
$681.20
$751.00
$824.92
$1087.58
$845.36
$915.16
$989.08
$1251.74
$1009.52
$1079.32
$1153.24
$1415.90
$422.68
$457.58
$494.54
$625.87
$586.84
$621.74
$658.70
$790.03
$751.00
$785.90
$822.86
$954.19
$164.16

Community Insurance Company(Anthem BCBS)

Local: 1-855-748-1808 | Toll Free: 1-855-748-1808

Plan: (HMO) Anthem Silver Pathway X HMO 10 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $3,200 : Family: $6,400
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
any age
Silver 21
30
40
50
60
$284.83
$323.28
$364.01
$508.71
$773.03
$569.66
$646.56
$728.02
$1017.42
$1546.06
$750.53
$827.43
$908.89
$1198.29
$931.40
$1008.30
$1089.76
$1379.16
$1112.27
$1189.17
$1270.63
$1560.03
$465.70
$504.15
$544.88
$689.58
$646.57
$685.02
$725.75
$870.45
$827.44
$865.89
$906.62
$1051.32
$180.87

Plan: (HMO) Anthem Silver Pathway X HMO 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $5,700 : Family: $11,400

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
any age
Silver 21
30
40
50
60
$287.76
$326.61
$367.76
$513.94
$780.98
$575.52
$653.22
$735.52
$1027.88
$1561.96
$758.25
$835.95
$918.25
$1210.61
$940.98
$1018.68
$1100.98
$1393.34
$1123.71
$1201.41
$1283.71
$1576.07
$470.49
$509.34
$550.49
$696.67
$653.22
$692.07
$733.22
$879.40
$835.95
$874.80
$915.95
$1062.13
$182.73
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Buckeye Community Health Plan

Local: 1-877-687-1189 | Toll Free: 1-877-687-1189

TTY: 1-877-941-9236

Plan: (HMO) Ambetter Secure Care 1 (2017) with 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
any age
Gold 21
30
40
50
60
$259.46
$294.48
$331.58
$463.39
$704.16
$518.92
$588.96
$663.16
$926.78
$1408.32
$683.67
$753.71
$827.91
$1091.53
$848.42
$918.46
$992.66
$1256.28
$1013.17
$1083.21
$1157.41
$1421.03
$424.21
$459.23
$496.33
$628.14
$588.96
$623.98
$661.08
$792.89
$753.71
$788.73
$825.83
$957.64
$164.75

Plan: (HMO) Ambetter Balanced Care 1 (2017)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$190.26
$215.94
$243.14
$339.79
$516.35
$380.52
$431.88
$486.28
$679.58
$1032.70
$501.33
$552.69
$607.09
$800.39
$622.14
$673.50
$727.90
$921.20
$742.95
$794.31
$848.71
$1042.01
$311.07
$336.75
$363.95
$460.60
$431.88
$457.56
$484.76
$581.41
$552.69
$578.37
$605.57
$702.22
$120.81

Plan: (HMO) Ambetter Balanced Care 2 (2017)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$186.53
$211.70
$238.38
$333.13
$506.23
$373.06
$423.40
$476.76
$666.26
$1012.46
$491.50
$541.84
$595.20
$784.70
$609.94
$660.28
$713.64
$903.14
$728.38
$778.72
$832.08
$1021.58
$304.97
$330.14
$356.82
$451.57
$423.41
$448.58
$475.26
$570.01
$541.85
$567.02
$593.70
$688.45
$118.44

Plan: (HMO) Ambetter Balanced Care 10 (2017)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$202.20
$229.49
$258.40
$361.11
$548.75
$404.40
$458.98
$516.80
$722.22
$1097.50
$532.79
$587.37
$645.19
$850.61
$661.18
$715.76
$773.58
$979.00
$789.57
$844.15
$901.97
$1107.39
$330.59
$357.88
$386.79
$489.50
$458.98
$486.27
$515.18
$617.89
$587.37
$614.66
$643.57
$746.28
$128.39

Plan: (HMO) Ambetter Balanced Care 12 (2017)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$205.00
$232.66
$261.98
$366.11
$556.34
$410.00
$465.32
$523.96
$732.22
$1112.68
$540.17
$595.49
$654.13
$862.39
$670.34
$725.66
$784.30
$992.56
$800.51
$855.83
$914.47
$1122.73
$335.17
$362.83
$392.15
$496.28
$465.34
$493.00
$522.32
$626.45
$595.51
$623.17
$652.49
$756.62
$130.17

Plan: (HMO) Ambetter Balanced Care 1 (2017) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$194.28
$220.49
$248.27
$346.96
$527.24
$388.56
$440.98
$496.54
$693.92
$1054.48
$511.92
$564.34
$619.90
$817.28
$635.28
$687.70
$743.26
$940.64
$758.64
$811.06
$866.62
$1064.00
$317.64
$343.85
$371.63
$470.32
$441.00
$467.21
$494.99
$593.68
$564.36
$590.57
$618.35
$717.04
$123.36

Plan: (HMO) Ambetter Balanced Care 2 (2017) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$190.47
$216.17
$243.41
$340.16
$516.91
$380.94
$432.34
$486.82
$680.32
$1033.82
$501.88
$553.28
$607.76
$801.26
$622.82
$674.22
$728.70
$922.20
$743.76
$795.16
$849.64
$1043.14
$311.41
$337.11
$364.35
$461.10
$432.35
$458.05
$485.29
$582.04
$553.29
$578.99
$606.23
$702.98
$120.94

Plan: (HMO) Ambetter Balanced Care 10 (2017) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$206.47
$234.33
$263.85
$368.73
$560.33
$412.94
$468.66
$527.70
$737.46
$1120.66
$544.04
$599.76
$658.80
$868.56
$675.14
$730.86
$789.90
$999.66
$806.24
$861.96
$921.00
$1130.76
$337.57
$365.43
$394.95
$499.83
$468.67
$496.53
$526.05
$630.93
$599.77
$627.63
$657.15
$762.03
$131.10

Plan: (HMO) Ambetter Balanced Care 1 (2017) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$202.20
$229.49
$258.40
$361.12
$548.75
$404.40
$458.98
$516.80
$722.24
$1097.50
$532.79
$587.37
$645.19
$850.63
$661.18
$715.76
$773.58
$979.02
$789.57
$844.15
$901.97
$1107.41
$330.59
$357.88
$386.79
$489.51
$458.98
$486.27
$515.18
$617.90
$587.37
$614.66
$643.57
$746.29
$128.39

Plan: (HMO) Ambetter Balanced Care 2 (2017) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$198.24
$224.99
$253.34
$354.04
$537.99
$396.48
$449.98
$506.68
$708.08
$1075.98
$522.35
$575.85
$632.55
$833.95
$648.22
$701.72
$758.42
$959.82
$774.09
$827.59
$884.29
$1085.69
$324.11
$350.86
$379.21
$479.91
$449.98
$476.73
$505.08
$605.78
$575.85
$602.60
$630.95
$731.65
$125.87

Plan: (HMO) Ambetter Balanced Care 10 (2017) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

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
any age
Silver 21
30
40
50
60
$214.89
$243.89
$274.62
$383.77
$583.18
$429.78
$487.78
$549.24
$767.54
$1166.36
$566.23
$624.23
$685.69
$903.99
$702.68
$760.68
$822.14
$1040.44
$839.13
$897.13
$958.59
$1176.89
$351.34
$380.34
$411.07
$520.22
$487.79
$516.79
$547.52
$656.67
$624.24
$653.24
$683.97
$793.12
$136.45
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Molina Healthcare of Ohio, Inc.

Local: 1-888-296-7677 | Toll Free: 1-888-296-7677

Plan: (HMO) Molina Marketplace Gold Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $1,025 : Family: $2,050
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Gold 21
30
40
50
60
$243.31
$276.16
$310.95
$434.55
$660.34
$486.62
$552.32
$621.90
$869.10
$1320.68
$641.12
$706.82
$776.40
$1023.60
$795.62
$861.32
$930.90
$1178.10
$950.12
$1015.82
$1085.40
$1332.60
$397.81
$430.66
$465.45
$589.05
$552.31
$585.16
$619.95
$743.55
$706.81
$739.66
$774.45
$898.05
$154.50

Plan: (HMO) Molina Marketplace Silver Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $2,400 : Family: $4,800
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$191.15
$216.96
$244.29
$341.40
$518.79
$382.30
$433.92
$488.58
$682.80
$1037.58
$503.68
$555.30
$609.96
$804.18
$625.06
$676.68
$731.34
$925.56
$746.44
$798.06
$852.72
$1046.94
$312.53
$338.34
$365.67
$462.78
$433.91
$459.72
$487.05
$584.16
$555.29
$581.10
$608.43
$705.54
$121.38

Plan: (HMO) Molina Marketplace Bronze Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$164.46
$186.66
$210.18
$293.73
$446.34
$328.92
$373.32
$420.36
$587.46
$892.68
$433.35
$477.75
$524.79
$691.89
$537.78
$582.18
$629.22
$796.32
$642.21
$686.61
$733.65
$900.75
$268.89
$291.09
$314.61
$398.16
$373.32
$395.52
$419.04
$502.59
$477.75
$499.95
$523.47
$607.02
$104.43
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CareSource

Local: 1-800-479-9502 | Toll Free: 1-800-479-9502

TTY: 1-800-750-0750

Plan: (HMO) CareSource Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,300 : Family: $6,600
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

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
any age
Silver 21
30
40
50
60
$213.90
$242.77
$273.36
$382.02
$580.52
$427.80
$485.54
$546.72
$764.04
$1161.04
$563.62
$621.36
$682.54
$899.86
$699.44
$757.18
$818.36
$1035.68
$835.26
$893.00
$954.18
$1171.50
$349.72
$378.59
$409.18
$517.84
$485.54
$514.41
$545.00
$653.66
$621.36
$650.23
$680.82
$789.48
$135.82
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Molina Healthcare of Ohio, Inc.

Local: 1-888-296-7677 | Toll Free: 1-888-296-7677

Plan: (HMO) Molina Marketplace Options Silver Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$192.91
$218.96
$246.54
$344.54
$523.57
$385.82
$437.92
$493.08
$689.08
$1047.14
$508.32
$560.42
$615.58
$811.58
$630.82
$682.92
$738.08
$934.08
$753.32
$805.42
$860.58
$1056.58
$315.41
$341.46
$369.04
$467.04
$437.91
$463.96
$491.54
$589.54
$560.41
$586.46
$614.04
$712.04
$122.50

Plan: (HMO) Molina Marketplace Options Bronze Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$169.20
$192.05
$216.24
$302.20
$459.22
$338.40
$384.10
$432.48
$604.40
$918.44
$445.84
$491.54
$539.92
$711.84
$553.28
$598.98
$647.36
$819.28
$660.72
$706.42
$754.80
$926.72
$276.64
$299.49
$323.68
$409.64
$384.08
$406.93
$431.12
$517.08
$491.52
$514.37
$538.56
$624.52
$107.44
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Humana Health Plan of Ohio, Inc.

Local: 1-877-720-4854 | Toll Free: 1-877-720-4854

TTY: 1-800-325-2028

Plan: (HMO) Humana Basic 7150/Cincinnati/Northern KY HMOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Health Plan of Ohio, Inc.)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Catastrophic 21
30
40
50
60
$206.17
$234.00
$263.49
$368.22
$559.55
$412.34
$468.00
$526.98
$736.44
$1119.10
$543.26
$598.92
$657.90
$867.36
$674.18
$729.84
$788.82
$998.28
$805.10
$860.76
$919.74
$1129.20
$337.09
$364.92
$394.41
$499.14
$468.01
$495.84
$525.33
$630.06
$598.93
$626.76
$656.25
$760.98
$130.92

Plan: (HMO) Humana Bronze 6550/Cincinnati/Northern KY HMOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Health Plan of Ohio, Inc.)

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
any age
Bronze 21
30
40
50
60
$267.94
$304.11
$342.43
$478.54
$727.19
$535.88
$608.22
$684.86
$957.08
$1454.38
$706.02
$778.36
$855.00
$1127.22
$876.16
$948.50
$1025.14
$1297.36
$1046.30
$1118.64
$1195.28
$1467.50
$438.08
$474.25
$512.57
$648.68
$608.22
$644.39
$682.71
$818.82
$778.36
$814.53
$852.85
$988.96
$170.14

Plan: (HMO) Humana Silver 4150/Cincinnati/Northern KY HMOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Health Plan of Ohio, Inc.)

Deductible: Individual: $4,150 : Family: $8,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$342.80
$389.08
$438.10
$612.24
$930.36
$685.60
$778.16
$876.20
$1224.48
$1860.72
$903.28
$995.84
$1093.88
$1442.16
$1120.96
$1213.52
$1311.56
$1659.84
$1338.64
$1431.20
$1529.24
$1877.52
$560.48
$606.76
$655.78
$829.92
$778.16
$824.44
$873.46
$1047.60
$995.84
$1042.12
$1091.14
$1265.28
$217.68

CareSource

Local: 1-800-479-9502 | Toll Free: 1-800-479-9502

TTY: 1-800-750-0750

Plan: (HMO) CareSource Silver Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,300 : Family: $6,600
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

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
any age
Silver 21
30
40
50
60
$229.29
$260.24
$293.03
$409.51
$622.29
$458.58
$520.48
$586.06
$819.02
$1244.58
$604.18
$666.08
$731.66
$964.62
$749.78
$811.68
$877.26
$1110.22
$895.38
$957.28
$1022.86
$1255.82
$374.89
$405.84
$438.63
$555.11
$520.49
$551.44
$584.23
$700.71
$666.09
$697.04
$729.83
$846.31
$145.60

Plan: (HMO) CareSource Bronze Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

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
any age
Bronze 21
30
40
50
60
$200.33
$227.37
$256.01
$357.78
$543.68
$400.66
$454.74
$512.02
$715.56
$1087.36
$527.87
$581.95
$639.23
$842.77
$655.08
$709.16
$766.44
$969.98
$782.29
$836.37
$893.65
$1097.19
$327.54
$354.58
$383.22
$484.99
$454.75
$481.79
$510.43
$612.20
$581.96
$609.00
$637.64
$739.41
$127.21

Plan: (HMO) CareSource Federal Simple Choice Gold

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $1,250 : Family: $2,500
Out of Pocket Maximum per year: Individual: $4,750 : Family: $9,500

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
any age
Gold 21
30
40
50
60
$236.38
$268.29
$302.09
$422.17
$641.53
$472.76
$536.58
$604.18
$844.34
$1283.06
$622.86
$686.68
$754.28
$994.44
$772.96
$836.78
$904.38
$1144.54
$923.06
$986.88
$1054.48
$1294.64
$386.48
$418.39
$452.19
$572.27
$536.58
$568.49
$602.29
$722.37
$686.68
$718.59
$752.39
$872.47
$150.10

Plan: (HMO) CareSource Federal Simple Choice Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$195.01
$221.34
$249.22
$348.29
$529.26
$390.02
$442.68
$498.44
$696.58
$1058.52
$513.85
$566.51
$622.27
$820.41
$637.68
$690.34
$746.10
$944.24
$761.51
$814.17
$869.93
$1068.07
$318.84
$345.17
$373.05
$472.12
$442.67
$469.00
$496.88
$595.95
$566.50
$592.83
$620.71
$719.78
$123.83

Plan: (HMO) CareSource Federal Simple Choice Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$171.55
$194.71
$219.24
$306.39
$465.59
$343.10
$389.42
$438.48
$612.78
$931.18
$452.03
$498.35
$547.41
$721.71
$560.96
$607.28
$656.34
$830.64
$669.89
$716.21
$765.27
$939.57
$280.48
$303.64
$328.17
$415.32
$389.41
$412.57
$437.10
$524.25
$498.34
$521.50
$546.03
$633.18
$108.93

Plan: (HMO) CareSource Low Premium Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,150 : Family: $12,300
Out of Pocket Maximum per year: Individual: $7,000 : Family: $14,000

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
any age
Silver 21
30
40
50
60
$183.24
$207.98
$234.18
$327.26
$497.31
$366.48
$415.96
$468.36
$654.52
$994.62
$482.84
$532.32
$584.72
$770.88
$599.20
$648.68
$701.08
$887.24
$715.56
$765.04
$817.44
$1003.60
$299.60
$324.34
$350.54
$443.62
$415.96
$440.70
$466.90
$559.98
$532.32
$557.06
$583.26
$676.34
$116.36
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Medical Health Insuring Corp. of Ohio

Local: 1-888-308-0357 | Toll Free: 1-888-308-0357

Plan: (HMO) Market HMO 1200 - Mercy

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: Individual: $6,750 : Family: $13,500

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
any age
Gold 21
30
40
50
60
$297.65
$337.83
$380.39
$531.60
$807.82
$595.30
$675.66
$760.78
$1063.20
$1615.64
$784.31
$864.67
$949.79
$1252.21
$973.32
$1053.68
$1138.80
$1441.22
$1162.33
$1242.69
$1327.81
$1630.23
$486.66
$526.84
$569.40
$720.61
$675.67
$715.85
$758.41
$909.62
$864.68
$904.86
$947.42
$1098.63
$189.01

Plan: (HMO) Market HMO 1750 - Mercy

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)

Deductible: Individual: $1,750 : Family: $3,500
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Silver 21
30
40
50
60
$244.79
$277.84
$312.84
$437.19
$664.36
$489.58
$555.68
$625.68
$874.38
$1328.72
$645.02
$711.12
$781.12
$1029.82
$800.46
$866.56
$936.56
$1185.26
$955.90
$1022.00
$1092.00
$1340.70
$400.23
$433.28
$468.28
$592.63
$555.67
$588.72
$623.72
$748.07
$711.11
$744.16
$779.16
$903.51
$155.44

Plan: (HMO) Market HMO 4000 HSA - Mercy

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000

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
any age
Silver 21
30
40
50
60
$240.68
$273.18
$307.59
$429.86
$653.22
$481.36
$546.36
$615.18
$859.72
$1306.44
$634.19
$699.19
$768.01
$1012.55
$787.02
$852.02
$920.84
$1165.38
$939.85
$1004.85
$1073.67
$1318.21
$393.51
$426.01
$460.42
$582.69
$546.34
$578.84
$613.25
$735.52
$699.17
$731.67
$766.08
$888.35
$152.83

Plan: (HMO) Market HMO 6400 HSA - Mercy

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

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
any age
Bronze 21
30
40
50
60
$184.75
$209.69
$236.11
$329.96
$501.40
$369.50
$419.38
$472.22
$659.92
$1002.80
$486.81
$536.69
$589.53
$777.23
$604.12
$654.00
$706.84
$894.54
$721.43
$771.31
$824.15
$1011.85
$302.06
$327.00
$353.42
$447.27
$419.37
$444.31
$470.73
$564.58
$536.68
$561.62
$588.04
$681.89
$117.31

Plan: (HMO) Market HMO 7150 - Mercy

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

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
any age
Bronze 21
30
40
50
60
$180.64
$205.03
$230.86
$322.63
$490.26
$361.28
$410.06
$461.72
$645.26
$980.52
$475.99
$524.77
$576.43
$759.97
$590.70
$639.48
$691.14
$874.68
$705.41
$754.19
$805.85
$989.39
$295.35
$319.74
$345.57
$437.34
$410.06
$434.45
$460.28
$552.05
$524.77
$549.16
$574.99
$666.76
$114.71