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|
Community Health Choice, Inc.
Local: 1-713-295-6704 | Toll Free: 1-855-315-5386
TTY: 1-800-518-1655
|
Expanded Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$6,000
: Family:
$12,000
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Expanded Bronze |
21
30
40
50
60 |
$266.82
$302.84
$341.00
$476.54
$724.15 |
$533.64
$605.68
$682.00
$953.08
$1,448.30 |
$737.76
$809.80
$886.12
$1,157.20 |
$941.88
$1,013.92
$1,090.24
$1,361.32 |
$1,146.00
$1,218.04
$1,294.36
$1,565.44 |
$470.94
$506.96
$545.12
$680.66 |
$675.06
$711.08
$749.24
$884.78 |
$879.18
$915.20
$953.36
$1,088.90 |
$204.12 |
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|
Celtic Insurance Company
Local: 1-877-687-1196 | Toll Free: 1-877-687-1196
TTY: 1-800-735-2989
|
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
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
0-14 |
Gold |
21
30
40
50
60 |
$353.43
$401.13
$451.67
$631.21
$959.18 |
$706.86
$802.26
$903.34
$1,262.42
$1,918.36 |
$977.23
$1,072.63
$1,173.71
$1,532.79 |
$1,247.60
$1,343.00
$1,444.08
$1,803.16 |
$1,517.97
$1,613.37
$1,714.45
$2,073.53 |
$623.80
$671.50
$722.04
$901.58 |
$894.17
$941.87
$992.41
$1,171.95 |
$1,164.54
$1,212.24
$1,262.78
$1,442.32 |
$270.37 |
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|
Community Health Choice, Inc.
Local: 1-713-295-6704 | Toll Free: 1-855-315-5386
TTY: 1-800-518-1655
|
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$0
: Family:
$0
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$413.40
$469.21
$528.33
$738.33
$1,121.97 |
$826.80
$938.42
$1,056.66
$1,476.66
$2,243.94 |
$1,143.05
$1,254.67
$1,372.91
$1,792.91 |
$1,459.30
$1,570.92
$1,689.16
$2,109.16 |
$1,775.55
$1,887.17
$2,005.41
$2,425.41 |
$729.65
$785.46
$844.58
$1,054.58 |
$1,045.90
$1,101.71
$1,160.83
$1,370.83 |
$1,362.15
$1,417.96
$1,477.08
$1,687.08 |
$316.25 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$0
: Family:
$0
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$374.57
$425.14
$478.70
$668.98
$1,016.58 |
$749.14
$850.28
$957.40
$1,337.96
$2,033.16 |
$1,035.69
$1,136.83
$1,243.95
$1,624.51 |
$1,322.24
$1,423.38
$1,530.50
$1,911.06 |
$1,608.79
$1,709.93
$1,817.05
$2,197.61 |
$661.12
$711.69
$765.25
$955.53 |
$947.67
$998.24
$1,051.80
$1,242.08 |
$1,234.22
$1,284.79
$1,338.35
$1,528.63 |
$286.55 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$2,500
: Family:
$5,000
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$359.57
$408.11
$459.53
$642.19
$975.87 |
$719.14
$816.22
$919.06
$1,284.38
$1,951.74 |
$994.21
$1,091.29
$1,194.13
$1,559.45 |
$1,269.28
$1,366.36
$1,469.20
$1,834.52 |
$1,544.35
$1,641.43
$1,744.27
$2,109.59 |
$634.64
$683.18
$734.60
$917.26 |
$909.71
$958.25
$1,009.67
$1,192.33 |
$1,184.78
$1,233.32
$1,284.74
$1,467.40 |
$275.07 |
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$500
: Family:
$1,000
Out of Pocket Maximum per year: Individual:
$5,000
: Family:
$10,000
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$393.40
$446.51
$502.77
$702.61
$1,067.69 |
$786.80
$893.02
$1,005.54
$1,405.22
$2,135.38 |
$1,087.75
$1,193.97
$1,306.49
$1,706.17 |
$1,388.70
$1,494.92
$1,607.44
$2,007.12 |
$1,689.65
$1,795.87
$1,908.39
$2,308.07 |
$694.35
$747.46
$803.72
$1,003.56 |
$995.30
$1,048.41
$1,104.67
$1,304.51 |
$1,296.25
$1,349.36
$1,405.62
$1,605.46 |
$300.95 |
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$0
: Family:
$0
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$470.27
$533.76
$601.01
$839.90
$1,276.31 |
$940.54
$1,067.52
$1,202.02
$1,679.80
$2,552.62 |
$1,300.30
$1,427.28
$1,561.78
$2,039.56 |
$1,660.06
$1,787.04
$1,921.54
$2,399.32 |
$2,019.82
$2,146.80
$2,281.30
$2,759.08 |
$830.03
$893.52
$960.77
$1,199.66 |
$1,189.79
$1,253.28
$1,320.53
$1,559.42 |
$1,549.55
$1,613.04
$1,680.29
$1,919.18 |
$359.76 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$0
: Family:
$0
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$427.69
$485.43
$546.59
$763.85
$1,160.75 |
$855.38
$970.86
$1,093.18
$1,527.70
$2,321.50 |
$1,182.56
$1,298.04
$1,420.36
$1,854.88 |
$1,509.74
$1,625.22
$1,747.54
$2,182.06 |
$1,836.92
$1,952.40
$2,074.72
$2,509.24 |
$754.87
$812.61
$873.77
$1,091.03 |
$1,082.05
$1,139.79
$1,200.95
$1,418.21 |
$1,409.23
$1,466.97
$1,528.13
$1,745.39 |
$327.18 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Community Health Choice, Inc.)
Customer Service Phone: 1-855-315-5386
Deductible: Individual:
$6,000
: Family:
$12,000
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
0-14 |
Bronze |
21
30
40
50
60 |
$247.06
$280.41
$315.74
$441.25
$670.52 |
$494.12
$560.82
$631.48
$882.50
$1,341.04 |
$683.12
$749.82
$820.48
$1,071.50 |
$872.12
$938.82
$1,009.48
$1,260.50 |
$1,061.12
$1,127.82
$1,198.48
$1,449.50 |
$436.06
$469.41
$504.74
$630.25 |
$625.06
$658.41
$693.74
$819.25 |
$814.06
$847.41
$882.74
$1,008.25 |
$189.00 |
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|
Celtic Insurance Company
Local: 1-877-687-1196 | Toll Free: 1-877-687-1196
TTY: 1-800-735-2989
|
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
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
0-14 |
Silver |
21
30
40
50
60 |
$327.06
$371.20
$417.97
$584.11
$887.61 |
$654.12
$742.40
$835.94
$1,168.22
$1,775.22 |
$904.31
$992.59
$1,086.13
$1,418.41 |
$1,154.50
$1,242.78
$1,336.32
$1,668.60 |
$1,404.69
$1,492.97
$1,586.51
$1,918.79 |
$577.25
$621.39
$668.16
$834.30 |
$827.44
$871.58
$918.35
$1,084.49 |
$1,077.63
$1,121.77
$1,168.54
$1,334.68 |
$250.19 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
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
0-14 |
Silver |
21
30
40
50
60 |
$321.59
$365.00
$410.98
$574.35
$872.78 |
$643.18
$730.00
$821.96
$1,148.70
$1,745.56 |
$889.19
$976.01
$1,067.97
$1,394.71 |
$1,135.20
$1,222.02
$1,313.98
$1,640.72 |
$1,381.21
$1,468.03
$1,559.99
$1,886.73 |
$567.60
$611.01
$656.99
$820.36 |
$813.61
$857.02
$903.00
$1,066.37 |
$1,059.62
$1,103.03
$1,149.01
$1,312.38 |
$246.01 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$5,000
: Family:
$10,000
Out of Pocket Maximum per year: Individual:
$6,700
: Family:
$13,400
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$341.21
$387.26
$436.05
$609.38
$926.02 |
$682.42
$774.52
$872.10
$1,218.76
$1,852.04 |
$943.44
$1,035.54
$1,133.12
$1,479.78 |
$1,204.46
$1,296.56
$1,394.14
$1,740.80 |
$1,465.48
$1,557.58
$1,655.16
$2,001.82 |
$602.23
$648.28
$697.07
$870.40 |
$863.25
$909.30
$958.09
$1,131.42 |
$1,124.27
$1,170.32
$1,219.11
$1,392.44 |
$261.02 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$6,800
: Family:
$13,600
Out of Pocket Maximum per year: Individual:
$6,800
: Family:
$13,600
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$280.11
$317.91
$357.97
$500.26
$760.19 |
$560.22
$635.82
$715.94
$1,000.52
$1,520.38 |
$774.50
$850.10
$930.22
$1,214.80 |
$988.78
$1,064.38
$1,144.50
$1,429.08 |
$1,203.06
$1,278.66
$1,358.78
$1,643.36 |
$494.39
$532.19
$572.25
$714.54 |
$708.67
$746.47
$786.53
$928.82 |
$922.95
$960.75
$1,000.81
$1,143.10 |
$214.28 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$3,000
: Family:
$6,000
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
0-14 |
Silver |
21
30
40
50
60 |
$342.50
$388.72
$437.70
$611.68
$929.51 |
$685.00
$777.44
$875.40
$1,223.36
$1,859.02 |
$947.00
$1,039.44
$1,137.40
$1,485.36 |
$1,209.00
$1,301.44
$1,399.40
$1,747.36 |
$1,471.00
$1,563.44
$1,661.40
$2,009.36 |
$604.50
$650.72
$699.70
$873.68 |
$866.50
$912.72
$961.70
$1,135.68 |
$1,128.50
$1,174.72
$1,223.70
$1,397.68 |
$262.00 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$7,050
: Family:
$14,100
Out of Pocket Maximum per year: Individual:
$7,050
: Family:
$14,100
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$314.20
$356.60
$401.53
$561.14
$852.70 |
$628.40
$713.20
$803.06
$1,122.28
$1,705.40 |
$868.75
$953.55
$1,043.41
$1,362.63 |
$1,109.10
$1,193.90
$1,283.76
$1,602.98 |
$1,349.45
$1,434.25
$1,524.11
$1,843.33 |
$554.55
$596.95
$641.88
$801.49 |
$794.90
$837.30
$882.23
$1,041.84 |
$1,035.25
$1,077.65
$1,122.58
$1,282.19 |
$240.35 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$3,500
: Family:
$7,000
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$349.25
$396.39
$446.33
$623.74
$947.84 |
$698.50
$792.78
$892.66
$1,247.48
$1,895.68 |
$965.67
$1,059.95
$1,159.83
$1,514.65 |
$1,232.84
$1,327.12
$1,427.00
$1,781.82 |
$1,500.01
$1,594.29
$1,694.17
$2,048.99 |
$616.42
$663.56
$713.50
$890.91 |
$883.59
$930.73
$980.67
$1,158.08 |
$1,150.76
$1,197.90
$1,247.84
$1,425.25 |
$267.17 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$7,350
: Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$304.87
$346.02
$389.61
$544.48
$827.39 |
$609.74
$692.04
$779.22
$1,088.96
$1,654.78 |
$842.96
$925.26
$1,012.44
$1,322.18 |
$1,076.18
$1,158.48
$1,245.66
$1,555.40 |
$1,309.40
$1,391.70
$1,478.88
$1,788.62 |
$538.09
$579.24
$622.83
$777.70 |
$771.31
$812.46
$856.05
$1,010.92 |
$1,004.53
$1,045.68
$1,089.27
$1,244.14 |
$233.22 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
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
0-14 |
Silver |
21
30
40
50
60 |
$331.42
$376.15
$423.54
$591.89
$899.43 |
$662.84
$752.30
$847.08
$1,183.78
$1,798.86 |
$916.37
$1,005.83
$1,100.61
$1,437.31 |
$1,169.90
$1,259.36
$1,354.14
$1,690.84 |
$1,423.43
$1,512.89
$1,607.67
$1,944.37 |
$584.95
$629.68
$677.07
$845.42 |
$838.48
$883.21
$930.60
$1,098.95 |
$1,092.01
$1,136.74
$1,184.13
$1,352.48 |
$253.53 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
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
0-14 |
Silver |
21
30
40
50
60 |
$325.88
$369.86
$416.46
$582.00
$884.40 |
$651.76
$739.72
$832.92
$1,164.00
$1,768.80 |
$901.05
$989.01
$1,082.21
$1,413.29 |
$1,150.34
$1,238.30
$1,331.50
$1,662.58 |
$1,399.63
$1,487.59
$1,580.79
$1,911.87 |
$575.17
$619.15
$665.75
$831.29 |
$824.46
$868.44
$915.04
$1,080.58 |
$1,073.75
$1,117.73
$1,164.33
$1,329.87 |
$249.29 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$5,000
: Family:
$10,000
Out of Pocket Maximum per year: Individual:
$6,700
: Family:
$13,400
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$345.75
$392.42
$441.86
$617.50
$938.35 |
$691.50
$784.84
$883.72
$1,235.00
$1,876.70 |
$955.99
$1,049.33
$1,148.21
$1,499.49 |
$1,220.48
$1,313.82
$1,412.70
$1,763.98 |
$1,484.97
$1,578.31
$1,677.19
$2,028.47 |
$610.24
$656.91
$706.35
$881.99 |
$874.73
$921.40
$970.84
$1,146.48 |
$1,139.22
$1,185.89
$1,235.33
$1,410.97 |
$264.49 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$6,800
: Family:
$13,600
Out of Pocket Maximum per year: Individual:
$6,800
: Family:
$13,600
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$283.84
$322.15
$362.73
$506.92
$770.31 |
$567.68
$644.30
$725.46
$1,013.84
$1,540.62 |
$784.81
$861.43
$942.59
$1,230.97 |
$1,001.94
$1,078.56
$1,159.72
$1,448.10 |
$1,219.07
$1,295.69
$1,376.85
$1,665.23 |
$500.97
$539.28
$579.86
$724.05 |
$718.10
$756.41
$796.99
$941.18 |
$935.23
$973.54
$1,014.12
$1,158.31 |
$217.13 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Celtic Insurance Company)
Customer Service Phone: 1-877-687-1196
Deductible: Individual:
$3,000
: Family:
$6,000
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
0-14 |
Silver |
21
30
40
50
60 |
$347.06
$393.90
$443.53
$619.83
$941.89 |
$694.12
$787.80
$887.06
$1,239.66
$1,883.78 |
$959.61
$1,053.29
$1,152.55
$1,505.15 |
$1,225.10
$1,318.78
$1,418.04
$1,770.64 |
$1,490.59
$1,584.27
$1,683.53
$2,036.13 |
$612.55
$659.39
$709.02
$885.32 |
$878.04
$924.88
$974.51
$1,150.81 |
$1,143.53
$1,190.37
$1,240.00
$1,416.30 |
$265.49 |
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|
Blue Cross Blue Shield of Texas
Local: 1-888-697-0683 | Toll Free: 1-888-697-0683
TTY: 1-800-735-2989
|
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$350
: Family:
$1,050
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$417.70
$474.09
$533.82
$746.01
$1,133.63 |
$835.40
$948.18
$1,067.64
$1,492.02
$2,267.26 |
$1,154.94
$1,267.72
$1,387.18
$1,811.56 |
$1,474.48
$1,587.26
$1,706.72
$2,131.10 |
$1,794.02
$1,906.80
$2,026.26
$2,450.64 |
$737.24
$793.63
$853.36
$1,065.55 |
$1,056.78
$1,113.17
$1,172.90
$1,385.09 |
$1,376.32
$1,432.71
$1,492.44
$1,704.63 |
$319.54 |
Catastrophic
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$7,350
: Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Catastrophic |
21
30
40
50
60 |
$289.27
$328.32
$369.69
$516.63
$785.08 |
$578.54
$656.64
$739.38
$1,033.26
$1,570.16 |
$799.83
$877.93
$960.67
$1,254.55 |
$1,021.12
$1,099.22
$1,181.96
$1,475.84 |
$1,242.41
$1,320.51
$1,403.25
$1,697.13 |
$510.56
$549.61
$590.98
$737.92 |
$731.85
$770.90
$812.27
$959.21 |
$953.14
$992.19
$1,033.56
$1,180.50 |
$221.29 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$1,700
: Family:
$5,100
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$426.05
$483.57
$544.50
$760.93
$1,156.31 |
$852.10
$967.14
$1,089.00
$1,521.86
$2,312.62 |
$1,178.03
$1,293.07
$1,414.93
$1,847.79 |
$1,503.96
$1,619.00
$1,740.86
$2,173.72 |
$1,829.89
$1,944.93
$2,066.79
$2,499.65 |
$751.98
$809.50
$870.43
$1,086.86 |
$1,077.91
$1,135.43
$1,196.36
$1,412.79 |
$1,403.84
$1,461.36
$1,522.29
$1,738.72 |
$325.93 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$5,600
: Family:
$14,700
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$306.64
$348.03
$391.88
$547.65
$832.21 |
$613.28
$696.06
$783.76
$1,095.30
$1,664.42 |
$847.86
$930.64
$1,018.34
$1,329.88 |
$1,082.44
$1,165.22
$1,252.92
$1,564.46 |
$1,317.02
$1,399.80
$1,487.50
$1,799.04 |
$541.22
$582.61
$626.46
$782.23 |
$775.80
$817.19
$861.04
$1,016.81 |
$1,010.38
$1,051.77
$1,095.62
$1,251.39 |
$234.58 |
Bronze
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$2,850
: Family:
$8,550
Out of Pocket Maximum per year: Individual:
$6,550
: Family:
$13,100
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Bronze |
21
30
40
50
60 |
$372.80
$423.13
$476.44
$665.82
$1,011.78 |
$745.60
$846.26
$952.88
$1,331.64
$2,023.56 |
$1,030.79
$1,131.45
$1,238.07
$1,616.83 |
$1,315.98
$1,416.64
$1,523.26
$1,902.02 |
$1,601.17
$1,701.83
$1,808.45
$2,187.21 |
$657.99
$708.32
$761.63
$951.01 |
$943.18
$993.51
$1,046.82
$1,236.20 |
$1,228.37
$1,278.70
$1,332.01
$1,521.39 |
$285.19 |
Gold
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$750
: Family:
$2,250
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Gold |
21
30
40
50
60 |
$468.27
$531.48
$598.44
$836.32
$1,270.87 |
$936.54
$1,062.96
$1,196.88
$1,672.64
$2,541.74 |
$1,294.76
$1,421.18
$1,555.10
$2,030.86 |
$1,652.98
$1,779.40
$1,913.32
$2,389.08 |
$2,011.20
$2,137.62
$2,271.54
$2,747.30 |
$826.49
$889.70
$956.66
$1,194.54 |
$1,184.71
$1,247.92
$1,314.88
$1,552.76 |
$1,542.93
$1,606.14
$1,673.10
$1,910.98 |
$358.22 |
Silver
Summary of Benefits and Coverage -
Plan Brochure
Provider Directory for This Plan: (Blue Cross Blue Shield of Texas)
Customer Service Phone: 1-888-697-0683
Deductible: Individual:
$1,450
: Family:
$4,350
Out of Pocket Maximum per year: Individual:
$7,350
: Family:
$14,700
Monthly Premiums: |
Metal level |
Age |
Individual
|
Couple
|
Couple
w
1 Kid
|
Couple
w 2 Kids
|
Couple
w3+Kids
|
Single
w
1 Kid
|
Single
w 2 Kids
|
Single
w3+Kids
|
Child
0-14 |
Silver |
21
30
40
50
60 |
$492.13
$558.57
$628.95
$878.95
$1,335.65 |
$984.26
$1,117.14
$1,257.90
$1,757.90
$2,671.30 |
$1,360.74
$1,493.62
$1,634.38
$2,134.38 |
$1,737.22
$1,870.10
$2,010.86
$2,510.86 |
$2,113.70
$2,246.58
$2,387.34
$2,887.34 |
$868.61
$935.05
$1,005.43
$1,255.43 |
$1,245.09
$1,311.53
$1,381.91
$1,631.91 |
$1,621.57
$1,688.01
$1,758.39
$2,008.39 |
$376.48 |
Under the Affordable Care Act (ACA) in Texas, you may be able to reduce your health insurance through tax credits or, if your income is very low, by qualifying for Medicaid.
Many people who apply for coverage at the Texas exchange will be eligible for some form of financial assistance. Read on to learn more about your options.
For 2018, in most states, open enrollment for health insurance under the Affordable Care Act ended on December 15. That means it’s too late for most people to use a health insurance exchange to get coverage for 2018.
If you let the ACA deadline pass you by this year, here are some things to know.
Certain life events make you eligible to sign up for health insurance outside of open enrolllment. The circumstances under which you may qualify for special enrollment include: