Obamacare 2022 Rates and Health Insurance Providers for Williamsburg County , South Carolina
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Obamacare 2022 Rates and Health Insurance Providers for Williamsburg County , South Carolina

Obamacare > Rates > South Carolina > Williamsburg 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 Williamsburg County, SC.

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 Kingstree, SC area accept this insurance coverage as within the plan's network.

Obamacare Providers, Plans and 2022 Rates for Williamsburg County, South Carolina

Below, you’ll find a summary of the 52 plans for Williamsburg County, South Carolina 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 South Carolina

For 2022 health plans, South Carolina 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 South Carolina. 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 South Carolina Health Care Exchange?

You can find the health insurance exchange for South Carolina 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...  

South Carolina 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 South Carolina 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.

South Carolina Has Not Expanded Medicaid

Because South Carolina has not yet expanded Medicaid eligibility, you may have fewer options for health coverage than people in states where Medicaid is more inclusive.

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 South Carolina 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 South Carolina

Get Help From South Carolina'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 South Carolina.

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 South Carolina 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 South Carolina?

  • Williamsburg County, SC Obamacare Rates
  • General Info
  • Rates
Williamsburg County, SC Obamacare Guide
Obamacare Basics for South Carolina - (Basics)
Obamacare Rates for Williamsburg County - (Rates)
Obamacare Enrollment - (How to Enroll)
Obamacare Financial Assistance - (Financial Help)
Obamacare for Different Life Situations - (Life Situations)
Using Your Obamacare Health Insurance Plan - (Using Your Plan)
Obamacare News - (News)

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BlueCross BlueShield of South Carolina

Local: 1-855-404-6752 | Toll Free: 1-855-404-6752 | TTY: 1-855-889-4325
Toc - Plan #1 BlueCross BlueShield of South Carolina
Gold

(EPO) BlueEssentials Gold 1

Annual Out of Pocket Expenses
Individual Family
$2,000 $4,000 Annual Deductible
$4,500 $9,000 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 		$428,65
$486,51
$547,81
$765,56
$1 163,35 		$756,56
$814,42
$875,72
$1 093,47 		$1 084,47
$1 142,33
$1 203,63
$1 421,38 		$1 412,38
$1 470,24
$1 531,54
$1 749,29 		$327,91
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$857,30
$973,02
$1 095,62
$1 531,12
$2 326,70 		$1 185,21
$1 300,93
$1 423,53
$1 859,03 		$1 513,12
$1 628,84
$1 751,44
$2 186,94 		$1 841,03
$1 956,75
$2 079,35
$2 514,85 		$327,91
Toc - Plan #2 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 1

Annual Out of Pocket Expenses
Individual Family
$1,200 $2,400 Annual Deductible
$8,150 $16,300 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 		$446,97
$507,31
$571,23
$798,29
$1 213,07 		$788,90
$849,24
$913,16
$1 140,22 		$1 130,83
$1 191,17
$1 255,09
$1 482,15 		$1 472,76
$1 533,10
$1 597,02
$1 824,08 		$341,93
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$893,94
$1 014,62
$1 142,46
$1 596,58
$2 426,14 		$1 235,87
$1 356,55
$1 484,39
$1 938,51 		$1 577,80
$1 698,48
$1 826,32
$2 280,44 		$1 919,73
$2 040,41
$2 168,25
$2 622,37 		$341,93
Toc - Plan #3 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 2

Annual Out of Pocket Expenses
Individual Family
$3,400 $6,800 Annual Deductible
$6,600 $13,200 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 		$425,84
$483,33
$544,22
$760,55
$1 155,73 		$751,61
$809,10
$869,99
$1 086,32 		$1 077,38
$1 134,87
$1 195,76
$1 412,09 		$1 403,15
$1 460,64
$1 521,53
$1 737,86 		$325,77
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$851,68
$966,66
$1 088,44
$1 521,10
$2 311,46 		$1 177,45
$1 292,43
$1 414,21
$1 846,87 		$1 503,22
$1 618,20
$1 739,98
$2 172,64 		$1 828,99
$1 943,97
$2 065,75
$2 498,41 		$325,77
Toc - Plan #4 BlueCross BlueShield of South Carolina
Expanded Bronze

(EPO) BlueEssentials Bronze 1

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 		$269,05
$305,37
$343,84
$480,52
$730,19 		$474,87
$511,19
$549,66
$686,34 		$680,69
$717,01
$755,48
$892,16 		$886,51
$922,83
$961,30
$1 097,98 		$205,82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$538,10
$610,74
$687,68
$961,04
$1 460,38 		$743,92
$816,56
$893,50
$1 166,86 		$949,74
$1 022,38
$1 099,32
$1 372,68 		$1 155,56
$1 228,20
$1 305,14
$1 578,50 		$205,82
Toc - Plan #5 BlueCross BlueShield of South Carolina
Bronze

(EPO) BlueEssentials Bronze 2

Annual Out of Pocket Expenses
Individual Family
$8,250 $16,500 Annual Deductible
$8,250 $16,500 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 		$268,48
$304,72
$343,11
$479,50
$728,65 		$473,86
$510,10
$548,49
$684,88 		$679,24
$715,48
$753,87
$890,26 		$884,62
$920,86
$959,25
$1 095,64 		$205,38
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$536,96
$609,44
$686,22
$959,00
$1 457,30 		$742,34
$814,82
$891,60
$1 164,38 		$947,72
$1 020,20
$1 096,98
$1 369,76 		$1 153,10
$1 225,58
$1 302,36
$1 575,14 		$205,38
Toc - Plan #6 BlueCross BlueShield of South Carolina
Gold

(EPO) BlueEssentials Gold 2

Annual Out of Pocket Expenses
Individual Family
$2,000 $4,000 Annual Deductible
$5,600 $11,200 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 		$418,51
$475,01
$534,86
$747,46
$1 135,84 		$738,67
$795,17
$855,02
$1 067,62 		$1 058,83
$1 115,33
$1 175,18
$1 387,78 		$1 378,99
$1 435,49
$1 495,34
$1 707,94 		$320,16
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$837,02
$950,02
$1 069,72
$1 494,92
$2 271,68 		$1 157,18
$1 270,18
$1 389,88
$1 815,08 		$1 477,34
$1 590,34
$1 710,04
$2 135,24 		$1 797,50
$1 910,50
$2 030,20
$2 455,40 		$320,16
Toc - Plan #7 BlueCross BlueShield of South Carolina
Gold

(EPO) BlueEssentials HD Gold 3

Annual Out of Pocket Expenses
Individual Family
$3,000 $6,000 Annual Deductible
$3,000 $6,000 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 		$426,62
$484,21
$545,22
$761,94
$1 157,84 		$752,98
$810,57
$871,58
$1 088,30 		$1 079,34
$1 136,93
$1 197,94
$1 414,66 		$1 405,70
$1 463,29
$1 524,30
$1 741,02 		$326,36
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$853,24
$968,42
$1 090,44
$1 523,88
$2 315,68 		$1 179,60
$1 294,78
$1 416,80
$1 850,24 		$1 505,96
$1 621,14
$1 743,16
$2 176,60 		$1 832,32
$1 947,50
$2 069,52
$2 502,96 		$326,36
Toc - Plan #8 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials HD Silver 6

Annual Out of Pocket Expenses
Individual Family
$4,300 $8,600 Annual Deductible
$4,300 $8,600 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 		$450,05
$510,81
$575,17
$803,80
$1 221,45 		$794,34
$855,10
$919,46
$1 148,09 		$1 138,63
$1 199,39
$1 263,75
$1 492,38 		$1 482,92
$1 543,68
$1 608,04
$1 836,67 		$344,29
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$900,10
$1 021,62
$1 150,34
$1 607,60
$2 442,90 		$1 244,39
$1 365,91
$1 494,63
$1 951,89 		$1 588,68
$1 710,20
$1 838,92
$2 296,18 		$1 932,97
$2 054,49
$2 183,21
$2 640,47 		$344,29
Toc - Plan #9 BlueCross BlueShield of South Carolina
Expanded Bronze

(EPO) BlueEssentials HD Bronze 3

Annual Out of Pocket Expenses
Individual Family
$6,300 $12,600 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 		$280,69
$318,58
$358,72
$501,31
$761,79 		$495,42
$533,31
$573,45
$716,04 		$710,15
$748,04
$788,18
$930,77 		$924,88
$962,77
$1 002,91
$1 145,50 		$214,73
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$561,38
$637,16
$717,44
$1 002,62
$1 523,58 		$776,11
$851,89
$932,17
$1 217,35 		$990,84
$1 066,62
$1 146,90
$1 432,08 		$1 205,57
$1 281,35
$1 361,63
$1 646,81 		$214,73
Toc - Plan #10 BlueCross BlueShield of South Carolina
Expanded Bronze

(EPO) BlueEssentials Bronze 4

Annual Out of Pocket Expenses
Individual Family
$7,700 $15,400 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 		$271,14
$307,75
$346,52
$484,26
$735,88 		$478,56
$515,17
$553,94
$691,68 		$685,98
$722,59
$761,36
$899,10 		$893,40
$930,01
$968,78
$1 106,52 		$207,42
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$542,28
$615,50
$693,04
$968,52
$1 471,76 		$749,70
$822,92
$900,46
$1 175,94 		$957,12
$1 030,34
$1 107,88
$1 383,36 		$1 164,54
$1 237,76
$1 315,30
$1 590,78 		$207,42
Toc - Plan #11 BlueCross BlueShield of South Carolina
Expanded Bronze

(EPO) BlueEssentials HD Bronze 5

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 		$280,82
$318,73
$358,89
$501,54
$762,14 		$495,65
$533,56
$573,72
$716,37 		$710,48
$748,39
$788,55
$931,20 		$925,31
$963,22
$1 003,38
$1 146,03 		$214,83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$561,64
$637,46
$717,78
$1 003,08
$1 524,28 		$776,47
$852,29
$932,61
$1 217,91 		$991,30
$1 067,12
$1 147,44
$1 432,74 		$1 206,13
$1 281,95
$1 362,27
$1 647,57 		$214,83
Toc - Plan #12 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 7

Annual Out of Pocket Expenses
Individual Family
$7,400 $14,800 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 		$412,22
$467,87
$526,82
$736,23
$1 118,77 		$727,57
$783,22
$842,17
$1 051,58 		$1 042,92
$1 098,57
$1 157,52
$1 366,93 		$1 358,27
$1 413,92
$1 472,87
$1 682,28 		$315,35
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$824,44
$935,74
$1 053,64
$1 472,46
$2 237,54 		$1 139,79
$1 251,09
$1 368,99
$1 787,81 		$1 455,14
$1 566,44
$1 684,34
$2 103,16 		$1 770,49
$1 881,79
$1 999,69
$2 418,51 		$315,35
Toc - Plan #13 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 8

Annual Out of Pocket Expenses
Individual Family
$5,250 $10,500 Annual Deductible
$7,900 $15,800 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 		$434,70
$493,38
$555,54
$776,37
$1 179,77 		$767,24
$825,92
$888,08
$1 108,91 		$1 099,78
$1 158,46
$1 220,62
$1 441,45 		$1 432,32
$1 491,00
$1 553,16
$1 773,99 		$332,54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$869,40
$986,76
$1 111,08
$1 552,74
$2 359,54 		$1 201,94
$1 319,30
$1 443,62
$1 885,28 		$1 534,48
$1 651,84
$1 776,16
$2 217,82 		$1 867,02
$1 984,38
$2 108,70
$2 550,36 		$332,54
Toc - Plan #14 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 9

Annual Out of Pocket Expenses
Individual Family
$6,000 $12,000 Annual Deductible
$7,850 $15,700 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 		$431,23
$489,45
$551,11
$770,18
$1 170,36 		$761,12
$819,34
$881,00
$1 100,07 		$1 091,01
$1 149,23
$1 210,89
$1 429,96 		$1 420,90
$1 479,12
$1 540,78
$1 759,85 		$329,89
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$862,46
$978,90
$1 102,22
$1 540,36
$2 340,72 		$1 192,35
$1 308,79
$1 432,11
$1 870,25 		$1 522,24
$1 638,68
$1 762,00
$2 200,14 		$1 852,13
$1 968,57
$2 091,89
$2 530,03 		$329,89
Toc - Plan #15 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 11

Annual Out of Pocket Expenses
Individual Family
$5,500 $11,000 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 		$432,86
$491,30
$553,19
$773,09
$1 174,78 		$764,00
$822,44
$884,33
$1 104,23 		$1 095,14
$1 153,58
$1 215,47
$1 435,37 		$1 426,28
$1 484,72
$1 546,61
$1 766,51 		$331,14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$865,72
$982,60
$1 106,38
$1 546,18
$2 349,56 		$1 196,86
$1 313,74
$1 437,52
$1 877,32 		$1 528,00
$1 644,88
$1 768,66
$2 208,46 		$1 859,14
$1 976,02
$2 099,80
$2 539,60 		$331,14
Toc - Plan #16 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 12

Annual Out of Pocket Expenses
Individual Family
$4,800 $9,600 Annual Deductible
$7,350 $14,700 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 		$439,60
$498,95
$561,81
$785,12
$1 193,07 		$775,89
$835,24
$898,10
$1 121,41 		$1 112,18
$1 171,53
$1 234,39
$1 457,70 		$1 448,47
$1 507,82
$1 570,68
$1 793,99 		$336,29
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$879,20
$997,90
$1 123,62
$1 570,24
$2 386,14 		$1 215,49
$1 334,19
$1 459,91
$1 906,53 		$1 551,78
$1 670,48
$1 796,20
$2 242,82 		$1 888,07
$2 006,77
$2 132,49
$2 579,11 		$336,29
Toc - Plan #17 BlueCross BlueShield of South Carolina
Gold

(EPO) BlueEssentials Gold 4

Annual Out of Pocket Expenses
Individual Family
$2,500 $5,000 Annual Deductible
$5,500 $11,000 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 		$418,58
$475,09
$534,95
$747,59
$1 136,03 		$738,79
$795,30
$855,16
$1 067,80 		$1 059,00
$1 115,51
$1 175,37
$1 388,01 		$1 379,21
$1 435,72
$1 495,58
$1 708,22 		$320,21
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$837,16
$950,18
$1 069,90
$1 495,18
$2 272,06 		$1 157,37
$1 270,39
$1 390,11
$1 815,39 		$1 477,58
$1 590,60
$1 710,32
$2 135,60 		$1 797,79
$1 910,81
$2 030,53
$2 455,81 		$320,21
Toc - Plan #18 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials HD Silver 13

Annual Out of Pocket Expenses
Individual Family
$5,750 $11,500 Annual Deductible
$5,750 $11,500 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 		$424,45
$481,75
$542,45
$758,07
$1 151,96 		$749,16
$806,46
$867,16
$1 082,78 		$1 073,87
$1 131,17
$1 191,87
$1 407,49 		$1 398,58
$1 455,88
$1 516,58
$1 732,20 		$324,71
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$848,90
$963,50
$1 084,90
$1 516,14
$2 303,92 		$1 173,61
$1 288,21
$1 409,61
$1 840,85 		$1 498,32
$1 612,92
$1 734,32
$2 165,56 		$1 823,03
$1 937,63
$2 059,03
$2 490,27 		$324,71
Toc - Plan #19 BlueCross BlueShield of South Carolina
Silver

(EPO) BlueEssentials Silver 14

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 		$410,47
$465,89
$524,58
$733,11
$1 114,02 		$724,48
$779,90
$838,59
$1 047,12 		$1 038,49
$1 093,91
$1 152,60
$1 361,13 		$1 352,50
$1 407,92
$1 466,61
$1 675,14 		$314,01
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$820,94
$931,78
$1 049,16
$1 466,22
$2 228,04 		$1 134,95
$1 245,79
$1 363,17
$1 780,23 		$1 448,96
$1 559,80
$1 677,18
$2 094,24 		$1 762,97
$1 873,81
$1 991,19
$2 408,25 		$314,01
Toc - Plan #20 BlueCross BlueShield of South Carolina
Catastrophic

(EPO) BlueEssentials Catastrophic 1

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 		$178,38
$202,46
$227,97
$318,59
$484,13 		$314,84
$338,92
$364,43
$455,05 		$451,30
$475,38
$500,89
$591,51 		$587,76
$611,84
$637,35
$727,97 		$136,46
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$356,76
$404,92
$455,94
$637,18
$968,26 		$493,22
$541,38
$592,40
$773,64 		$629,68
$677,84
$728,86
$910,10 		$766,14
$814,30
$865,32
$1 046,56 		$136,46

ADVERTISEMENT

Molina Healthcare

Local: 1-855-885-3176 | Toll Free: 1-800-659-8331 | TTY: 1-800-659-8331
Toc - Plan #21 Molina Healthcare
Gold

(HMO) Confident Care Gold 1

Annual Out of Pocket Expenses
Individual Family
$2,925 $5,850 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 		$367,37
$416,97
$469,51
$656,13
$997,06 		$648,41
$698,01
$750,55
$937,17 		$929,45
$979,05
$1 031,59
$1 218,21 		$1 210,49
$1 260,09
$1 312,63
$1 499,25 		$281,04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$734,74
$833,94
$939,02
$1 312,26
$1 994,12 		$1 015,78
$1 114,98
$1 220,06
$1 593,30 		$1 296,82
$1 396,02
$1 501,10
$1 874,34 		$1 577,86
$1 677,06
$1 782,14
$2 155,38 		$281,04
Toc - Plan #22 Molina Healthcare
Silver

(HMO) Constant Care Silver 1

Annual Out of Pocket Expenses
Individual Family
$0 $0 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 		$331,61
$376,37
$423,79
$592,25
$899,98 		$585,29
$630,05
$677,47
$845,93 		$838,97
$883,73
$931,15
$1 099,61 		$1 092,65
$1 137,41
$1 184,83
$1 353,29 		$253,68
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$663,22
$752,74
$847,58
$1 184,50
$1 799,96 		$916,90
$1 006,42
$1 101,26
$1 438,18 		$1 170,58
$1 260,10
$1 354,94
$1 691,86 		$1 424,26
$1 513,78
$1 608,62
$1 945,54 		$253,68
Toc - Plan #23 Molina Healthcare
Bronze

(HMO) Core Care Bronze 1

Annual Out of Pocket Expenses
Individual Family
$6,100 $12,200 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 		$239,70
$272,06
$306,34
$428,11
$650,55 		$423,07
$455,43
$489,71
$611,48 		$606,44
$638,80
$673,08
$794,85 		$789,81
$822,17
$856,45
$978,22 		$183,37
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$479,40
$544,12
$612,68
$856,22
$1 301,10 		$662,77
$727,49
$796,05
$1 039,59 		$846,14
$910,86
$979,42
$1 222,96 		$1 029,51
$1 094,23
$1 162,79
$1 406,33 		$183,37
Toc - Plan #24 Molina Healthcare
Silver

(HMO) Constant Care Silver 4

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 		$327,84
$372,10
$418,98
$585,52
$889,76 		$578,64
$622,90
$669,78
$836,32 		$829,44
$873,70
$920,58
$1 087,12 		$1 080,24
$1 124,50
$1 171,38
$1 337,92 		$250,80
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$655,68
$744,20
$837,96
$1 171,04
$1 779,52 		$906,48
$995,00
$1 088,76
$1 421,84 		$1 157,28
$1 245,80
$1 339,56
$1 672,64 		$1 408,08
$1 496,60
$1 590,36
$1 923,44 		$250,80
Toc - Plan #25 Molina Healthcare
Expanded Bronze

(HMO) Core Care Bronze 4

Annual Out of Pocket Expenses
Individual Family
$0 $0 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 		$250,61
$284,44
$320,28
$447,59
$680,15 		$442,33
$476,16
$512,00
$639,31 		$634,05
$667,88
$703,72
$831,03 		$825,77
$859,60
$895,44
$1 022,75 		$191,72
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$501,22
$568,88
$640,56
$895,18
$1 360,30 		$692,94
$760,60
$832,28
$1 086,90 		$884,66
$952,32
$1 024,00
$1 278,62 		$1 076,38
$1 144,04
$1 215,72
$1 470,34 		$191,72
Toc - Plan #26 Molina Healthcare
Expanded Bronze

(HMO) Core Care Bronze 5

Annual Out of Pocket Expenses
Individual Family
$0 $0 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 		$243,79
$276,71
$311,57
$435,42
$661,66 		$430,29
$463,21
$498,07
$621,92 		$616,79
$649,71
$684,57
$808,42 		$803,29
$836,21
$871,07
$994,92 		$186,50
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$487,58
$553,42
$623,14
$870,84
$1 323,32 		$674,08
$739,92
$809,64
$1 057,34 		$860,58
$926,42
$996,14
$1 243,84 		$1 047,08
$1 112,92
$1 182,64
$1 430,34 		$186,50
Toc - Plan #27 Molina Healthcare
Gold

(HMO) Confident Care Gold 1 + Vision

Annual Out of Pocket Expenses
Individual Family
$2,925 $5,850 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 		$370,47
$420,48
$473,46
$661,66
$1 005,46 		$653,88
$703,89
$756,87
$945,07 		$937,29
$987,30
$1 040,28
$1 228,48 		$1 220,70
$1 270,71
$1 323,69
$1 511,89 		$283,41
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$740,94
$840,96
$946,92
$1 323,32
$2 010,92 		$1 024,35
$1 124,37
$1 230,33
$1 606,73 		$1 307,76
$1 407,78
$1 513,74
$1 890,14 		$1 591,17
$1 691,19
$1 797,15
$2 173,55 		$283,41
Toc - Plan #28 Molina Healthcare
Silver

(HMO) Constant Care Silver 1 + Vision

Annual Out of Pocket Expenses
Individual Family
$0 $0 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 		$334,73
$379,92
$427,79
$597,83
$908,46 		$590,80
$635,99
$683,86
$853,90 		$846,87
$892,06
$939,93
$1 109,97 		$1 102,94
$1 148,13
$1 196,00
$1 366,04 		$256,07
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$669,46
$759,84
$855,58
$1 195,66
$1 816,92 		$925,53
$1 015,91
$1 111,65
$1 451,73 		$1 181,60
$1 271,98
$1 367,72
$1 707,80 		$1 437,67
$1 528,05
$1 623,79
$1 963,87 		$256,07
Toc - Plan #29 Molina Healthcare
Bronze

(HMO) Core Care Bronze 1 + Vision

Annual Out of Pocket Expenses
Individual Family
$6,100 $12,200 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 		$242,59
$275,34
$310,04
$433,27
$658,40 		$428,17
$460,92
$495,62
$618,85 		$613,75
$646,50
$681,20
$804,43 		$799,33
$832,08
$866,78
$990,01 		$185,58
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$485,18
$550,68
$620,08
$866,54
$1 316,80 		$670,76
$736,26
$805,66
$1 052,12 		$856,34
$921,84
$991,24
$1 237,70 		$1 041,92
$1 107,42
$1 176,82
$1 423,28 		$185,58
Toc - Plan #30 Molina Healthcare
Silver

(HMO) Constant Care Silver 2

Annual Out of Pocket Expenses
Individual Family
$5,200 $10,400 Annual Deductible
$8,150 $16,300 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 		$331,41
$376,15
$423,54
$591,90
$899,45 		$584,94
$629,68
$677,07
$845,43 		$838,47
$883,21
$930,60
$1 098,96 		$1 092,00
$1 136,74
$1 184,13
$1 352,49 		$253,53
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$662,82
$752,30
$847,08
$1 183,80
$1 798,90 		$916,35
$1 005,83
$1 100,61
$1 437,33 		$1 169,88
$1 259,36
$1 354,14
$1 690,86 		$1 423,41
$1 512,89
$1 607,67
$1 944,39 		$253,53
Toc - Plan #31 Molina Healthcare
Bronze

(HMO) Core Care Bronze 2

Annual Out of Pocket Expenses
Individual Family
$8,000 $16,000 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 		$237,39
$269,43
$303,38
$423,97
$644,27 		$418,99
$451,03
$484,98
$605,57 		$600,59
$632,63
$666,58
$787,17 		$782,19
$814,23
$848,18
$968,77 		$181,60
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$474,78
$538,86
$606,76
$847,94
$1 288,54 		$656,38
$720,46
$788,36
$1 029,54 		$837,98
$902,06
$969,96
$1 211,14 		$1 019,58
$1 083,66
$1 151,56
$1 392,74 		$181,60

ADVERTISEMENT

Ambetter from Absolute Total Care

Local: 1-833-270-5443 | Toll Free: 1-833-270-5443

Toc - Plan #32 Ambetter from Absolute Total Care
Bronze

(HMO) 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 		$267,76
$303,90
$342,19
$478,20
$726,68 		$472,59
$508,73
$547,02
$683,03 		$677,42
$713,56
$751,85
$887,86 		$882,25
$918,39
$956,68
$1 092,69 		$204,83
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$535,52
$607,80
$684,38
$956,40
$1 453,36 		$740,35
$812,63
$889,21
$1 161,23 		$945,18
$1 017,46
$1 094,04
$1 366,06 		$1 150,01
$1 222,29
$1 298,87
$1 570,89 		$204,83
Toc - Plan #33 Ambetter from Absolute Total Care
Silver

(HMO) 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 		$365,14
$414,42
$466,64
$652,12
$990,97 		$644,47
$693,75
$745,97
$931,45 		$923,80
$973,08
$1 025,30
$1 210,78 		$1 203,13
$1 252,41
$1 304,63
$1 490,11 		$279,33
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$730,28
$828,84
$933,28
$1 304,24
$1 981,94 		$1 009,61
$1 108,17
$1 212,61
$1 583,57 		$1 288,94
$1 387,50
$1 491,94
$1 862,90 		$1 568,27
$1 666,83
$1 771,27
$2 142,23 		$279,33
Toc - Plan #34 Ambetter from Absolute Total Care
Gold

(HMO) Ambetter Secure Care 5 (2021)

Annual Out of Pocket Expenses
Individual Family
$1,450 $2,900 Annual Deductible
$6,300 $12,600 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 		$426,81
$484,42
$545,45
$762,27
$1 158,34 		$753,31
$810,92
$871,95
$1 088,77 		$1 079,81
$1 137,42
$1 198,45
$1 415,27 		$1 406,31
$1 463,92
$1 524,95
$1 741,77 		$326,50
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$853,62
$968,84
$1 090,90
$1 524,54
$2 316,68 		$1 180,12
$1 295,34
$1 417,40
$1 851,04 		$1 506,62
$1 621,84
$1 743,90
$2 177,54 		$1 833,12
$1 948,34
$2 070,40
$2 504,04 		$326,50
Toc - Plan #35 Ambetter from Absolute Total Care
Expanded Bronze

(HMO) 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 		$288,87
$327,85
$369,16
$515,90
$783,95 		$509,84
$548,82
$590,13
$736,87 		$730,81
$769,79
$811,10
$957,84 		$951,78
$990,76
$1 032,07
$1 178,81 		$220,97
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$577,74
$655,70
$738,32
$1 031,80
$1 567,90 		$798,71
$876,67
$959,29
$1 252,77 		$1 019,68
$1 097,64
$1 180,26
$1 473,74 		$1 240,65
$1 318,61
$1 401,23
$1 694,71 		$220,97
Toc - Plan #36 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 12 (2021)

Annual Out of Pocket Expenses
Individual Family
$6,500 $13,000 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 		$357,84
$406,14
$457,31
$639,08
$971,15 		$631,58
$679,88
$731,05
$912,82 		$905,32
$953,62
$1 004,79
$1 186,56 		$1 179,06
$1 227,36
$1 278,53
$1 460,30 		$273,74
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$715,68
$812,28
$914,62
$1 278,16
$1 942,30 		$989,42
$1 086,02
$1 188,36
$1 551,90 		$1 263,16
$1 359,76
$1 462,10
$1 825,64 		$1 536,90
$1 633,50
$1 735,84
$2 099,38 		$273,74
Toc - Plan #37 Ambetter from Absolute Total Care
Expanded Bronze

(HMO) 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 		$290,98
$330,25
$371,86
$519,68
$789,70 		$513,57
$552,84
$594,45
$742,27 		$736,16
$775,43
$817,04
$964,86 		$958,75
$998,02
$1 039,63
$1 187,45 		$222,59
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$581,96
$660,50
$743,72
$1 039,36
$1 579,40 		$804,55
$883,09
$966,31
$1 261,95 		$1 027,14
$1 105,68
$1 188,90
$1 484,54 		$1 249,73
$1 328,27
$1 411,49
$1 707,13 		$222,59
Toc - Plan #38 Ambetter from Absolute Total Care
Expanded Bronze

(HMO) Ambetter Essential Care 10 (2021)

Annual Out of Pocket Expenses
Individual Family
$7,200 $14,400 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 		$276,63
$313,97
$353,52
$494,05
$750,76 		$488,25
$525,59
$565,14
$705,67 		$699,87
$737,21
$776,76
$917,29 		$911,49
$948,83
$988,38
$1 128,91 		$211,62
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$553,26
$627,94
$707,04
$988,10
$1 501,52 		$764,88
$839,56
$918,66
$1 199,72 		$976,50
$1 051,18
$1 130,28
$1 411,34 		$1 188,12
$1 262,80
$1 341,90
$1 622,96 		$211,62
Toc - Plan #39 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 29 (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 		$354,48
$402,32
$453,01
$633,08
$962,03 		$625,65
$673,49
$724,18
$904,25 		$896,82
$944,66
$995,35
$1 175,42 		$1 167,99
$1 215,83
$1 266,52
$1 446,59 		$271,17
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$708,96
$804,64
$906,02
$1 266,16
$1 924,06 		$980,13
$1 075,81
$1 177,19
$1 537,33 		$1 251,30
$1 346,98
$1 448,36
$1 808,50 		$1 522,47
$1 618,15
$1 719,53
$2 079,67 		$271,17
Toc - Plan #40 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 25 HSA (2021)

Annual Out of Pocket Expenses
Individual Family
$4,800 $9,600 Annual Deductible
$4,800 $9,600 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 		$371,39
$421,51
$474,62
$663,28
$1 007,91 		$655,49
$705,61
$758,72
$947,38 		$939,59
$989,71
$1 042,82
$1 231,48 		$1 223,69
$1 273,81
$1 326,92
$1 515,58 		$284,10
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$742,78
$843,02
$949,24
$1 326,56
$2 015,82 		$1 026,88
$1 127,12
$1 233,34
$1 610,66 		$1 310,98
$1 411,22
$1 517,44
$1 894,76 		$1 595,08
$1 695,32
$1 801,54
$2 178,86 		$284,10
Toc - Plan #41 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 27 (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 		$392,20
$445,13
$501,22
$700,45
$1 064,40 		$692,22
$745,15
$801,24
$1 000,47 		$992,24
$1 045,17
$1 101,26
$1 300,49 		$1 292,26
$1 345,19
$1 401,28
$1 600,51 		$300,02
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$784,40
$890,26
$1 002,44
$1 400,90
$2 128,80 		$1 084,42
$1 190,28
$1 302,46
$1 700,92 		$1 384,44
$1 490,30
$1 602,48
$2 000,94 		$1 684,46
$1 790,32
$1 902,50
$2 300,96 		$300,02
Toc - Plan #42 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 28 (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 		$396,07
$449,53
$506,16
$707,36
$1 074,90 		$699,05
$752,51
$809,14
$1 010,34 		$1 002,03
$1 055,49
$1 112,12
$1 313,32 		$1 305,01
$1 358,47
$1 415,10
$1 616,30 		$302,98
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$792,14
$899,06
$1 012,32
$1 414,72
$2 149,80 		$1 095,12
$1 202,04
$1 315,30
$1 717,70 		$1 398,10
$1 505,02
$1 618,28
$2 020,68 		$1 701,08
$1 808,00
$1 921,26
$2 323,66 		$302,98
Toc - Plan #43 Ambetter from Absolute Total Care
Gold

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

Annual Out of Pocket Expenses
Individual Family
$1,450 $2,900 Annual Deductible
$6,300 $12,600 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 		$445,16
$505,25
$568,90
$795,04
$1 208,14 		$785,70
$845,79
$909,44
$1 135,58 		$1 126,24
$1 186,33
$1 249,98
$1 476,12 		$1 466,78
$1 526,87
$1 590,52
$1 816,66 		$340,54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$890,32
$1 010,50
$1 137,80
$1 590,08
$2 416,28 		$1 230,86
$1 351,04
$1 478,34
$1 930,62 		$1 571,40
$1 691,58
$1 818,88
$2 271,16 		$1 911,94
$2 032,12
$2 159,42
$2 611,70 		$340,54
Toc - Plan #44 Ambetter from Absolute Total Care
Bronze

(HMO) 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 		$279,27
$316,96
$356,90
$498,76
$757,92 		$492,91
$530,60
$570,54
$712,40 		$706,55
$744,24
$784,18
$926,04 		$920,19
$957,88
$997,82
$1 139,68 		$213,64
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$558,54
$633,92
$713,80
$997,52
$1 515,84 		$772,18
$847,56
$927,44
$1 211,16 		$985,82
$1 061,20
$1 141,08
$1 424,80 		$1 199,46
$1 274,84
$1 354,72
$1 638,44 		$213,64
Toc - Plan #45 Ambetter from Absolute Total Care
Silver

(HMO) 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 		$380,84
$432,24
$486,70
$680,16
$1 033,57 		$672,17
$723,57
$778,03
$971,49 		$963,50
$1 014,90
$1 069,36
$1 262,82 		$1 254,83
$1 306,23
$1 360,69
$1 554,15 		$291,33
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$761,68
$864,48
$973,40
$1 360,32
$2 067,14 		$1 053,01
$1 155,81
$1 264,73
$1 651,65 		$1 344,34
$1 447,14
$1 556,06
$1 942,98 		$1 635,67
$1 738,47
$1 847,39
$2 234,31 		$291,33
Toc - Plan #46 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 12 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$6,500 $13,000 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 		$373,22
$423,60
$476,97
$666,56
$1 012,90 		$658,73
$709,11
$762,48
$952,07 		$944,24
$994,62
$1 047,99
$1 237,58 		$1 229,75
$1 280,13
$1 333,50
$1 523,09 		$285,51
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$746,44
$847,20
$953,94
$1 333,12
$2 025,80 		$1 031,95
$1 132,71
$1 239,45
$1 618,63 		$1 317,46
$1 418,22
$1 524,96
$1 904,14 		$1 602,97
$1 703,73
$1 810,47
$2 189,65 		$285,51
Toc - Plan #47 Ambetter from Absolute Total Care
Expanded Bronze

(HMO) 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 		$301,28
$341,95
$385,03
$538,07
$817,66 		$531,75
$572,42
$615,50
$768,54 		$762,22
$802,89
$845,97
$999,01 		$992,69
$1 033,36
$1 076,44
$1 229,48 		$230,47
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$602,56
$683,90
$770,06
$1 076,14
$1 635,32 		$833,03
$914,37
$1 000,53
$1 306,61 		$1 063,50
$1 144,84
$1 231,00
$1 537,08 		$1 293,97
$1 375,31
$1 461,47
$1 767,55 		$230,47
Toc - Plan #48 Ambetter from Absolute Total Care
Expanded Bronze

(HMO) 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 		$303,49
$344,45
$387,85
$542,02
$823,65 		$535,65
$576,61
$620,01
$774,18 		$767,81
$808,77
$852,17
$1 006,34 		$999,97
$1 040,93
$1 084,33
$1 238,50 		$232,16
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$606,98
$688,90
$775,70
$1 084,04
$1 647,30 		$839,14
$921,06
$1 007,86
$1 316,20 		$1 071,30
$1 153,22
$1 240,02
$1 548,36 		$1 303,46
$1 385,38
$1 472,18
$1 780,52 		$232,16
Toc - Plan #49 Ambetter from Absolute Total Care
Expanded Bronze

(HMO) Ambetter Essential Care 10 (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$7,200 $14,400 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 		$288,53
$327,47
$368,72
$515,29
$783,03 		$509,24
$548,18
$589,43
$736,00 		$729,95
$768,89
$810,14
$956,71 		$950,66
$989,60
$1 030,85
$1 177,42 		$220,71
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$577,06
$654,94
$737,44
$1 030,58
$1 566,06 		$797,77
$875,65
$958,15
$1 251,29 		$1 018,48
$1 096,36
$1 178,86
$1 472,00 		$1 239,19
$1 317,07
$1 399,57
$1 692,71 		$220,71
Toc - Plan #50 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 25 HSA (2021) + Vision + Adult Dental

Annual Out of Pocket Expenses
Individual Family
$4,800 $9,600 Annual Deductible
$4,800 $9,600 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 		$387,35
$439,63
$495,02
$691,79
$1 051,24 		$683,67
$735,95
$791,34
$988,11 		$979,99
$1 032,27
$1 087,66
$1 284,43 		$1 276,31
$1 328,59
$1 383,98
$1 580,75 		$296,32
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$774,70
$879,26
$990,04
$1 383,58
$2 102,48 		$1 071,02
$1 175,58
$1 286,36
$1 679,90 		$1 367,34
$1 471,90
$1 582,68
$1 976,22 		$1 663,66
$1 768,22
$1 879,00
$2 272,54 		$296,32
Toc - Plan #51 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 27 (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 		$409,06
$464,27
$522,76
$730,56
$1 110,16 		$721,98
$777,19
$835,68
$1 043,48 		$1 034,90
$1 090,11
$1 148,60
$1 356,40 		$1 347,82
$1 403,03
$1 461,52
$1 669,32 		$312,92
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$818,12
$928,54
$1 045,52
$1 461,12
$2 220,32 		$1 131,04
$1 241,46
$1 358,44
$1 774,04 		$1 443,96
$1 554,38
$1 671,36
$2 086,96 		$1 756,88
$1 867,30
$1 984,28
$2 399,88 		$312,92
Toc - Plan #52 Ambetter from Absolute Total Care
Silver

(HMO) Ambetter Balanced Care 28 (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 		$413,10
$468,85
$527,92
$737,77
$1 121,11 		$729,11
$784,86
$843,93
$1 053,78 		$1 045,12
$1 100,87
$1 159,94
$1 369,79 		$1 361,13
$1 416,88
$1 475,95
$1 685,80 		$316,01
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$826,20
$937,70
$1 055,84
$1 475,54
$2 242,22 		$1 142,21
$1 253,71
$1 371,85
$1 791,55 		$1 458,22
$1 569,72
$1 687,86
$2 107,56 		$1 774,23
$1 885,73
$2 003,87
$2 423,57 		$316,01

‡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 Williamsburg County here.

Williamsburg County is in “Rating Area 45” of South Carolina.

Currently, there are 52 plans offered in Rating Area 45.

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2022 Obamacare Rates for Williamsburg County

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