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Obamacare 2021 Rates and Health Insurance Providers for Fort Bend County , Texas

Obamacare > Rates > Texas > Fort Bend County

Obamacare Rates and Providers for Other Years

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

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 Fort Bend County, TX.

The health insurance rates listed below are for calendar year 2021.

Obamacare Providers, Plans and 2021 Rates for Fort Bend County, Texas

Below, you’ll find a summary of the 78 plans for Fort Bend County, Texas and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

  • Oscar Insurance Company

    Local: 1-855-672-2755 | Toll Free: 1-855-672-2755

  • Community Health Choice

    Local: 1-713-295-6704 | Toll Free: 1-855-315-5386 | TTY: 1-855-315-5386

  • Ambetter from Superior HealthPlan

    Local: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989

  • Blue Cross and Blue Shield of Texas

    Local: 1-888-697-0683 | Toll Free: 1-888-697-0683 | TTY: 1-800-735-2989

  • Molina Healthcare

    Local: 1-888-560-2025 | Toll Free: 1-888-560-2025

    • For detailed information on available subsidies to make your coverage affordable, you must take one of the following actions:

    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 Richmond, TX area accept this insurance coverage as within the plan's network.

    2021 Obamacare Rates, Providers, and Plans for Fort Bend County

    ADVERTISEMENT

    Oscar Insurance Company

    Local: 1-855-672-2755 | Toll Free: 1-855-672-2755

    Toc - Plan #1

    Expanded Bronze

    (EPO) Oscar Bronze Simple

    Annual Out of Pocket Expenses
    Individual Family
    $7,300 $14,600 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$264,81
    $300,55
    $338,41
    $472,93
    $718,66     		$529,62
    $601,10
    $676,82
    $945,86
    $1 437,32     		$732,19
    $803,67
    $879,39
    $1 148,43     		$934,76
    $1 006,24
    $1 081,96
    $1 351,00     		$1 137,33
    $1 208,81
    $1 284,53
    $1 553,57     		$467,38
    $503,12
    $540,98
    $675,50     		$669,95
    $705,69
    $743,55
    $878,07     		$872,52
    $908,26
    $946,12
    $1 080,64     		$202,57
    Toc - Plan #2

    Expanded Bronze

    (EPO) Oscar Bronze Classic PCP Copay

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$273,46
    $310,37
    $349,47
    $488,39
    $742,15     		$546,92
    $620,74
    $698,94
    $976,78
    $1 484,30     		$756,11
    $829,93
    $908,13
    $1 185,97     		$965,30
    $1 039,12
    $1 117,32
    $1 395,16     		$1 174,49
    $1 248,31
    $1 326,51
    $1 604,35     		$482,65
    $519,56
    $558,66
    $697,58     		$691,84
    $728,75
    $767,85
    $906,77     		$901,03
    $937,94
    $977,04
    $1 115,96     		$209,19
    Toc - Plan #3

    Expanded Bronze

    (EPO) Oscar Bronze Classic

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$266,42
    $302,38
    $340,47
    $475,81
    $723,04     		$532,84
    $604,76
    $680,94
    $951,62
    $1 446,08     		$736,64
    $808,56
    $884,74
    $1 155,42     		$940,44
    $1 012,36
    $1 088,54
    $1 359,22     		$1 144,24
    $1 216,16
    $1 292,34
    $1 563,02     		$470,22
    $506,18
    $544,27
    $679,61     		$674,02
    $709,98
    $748,07
    $883,41     		$877,82
    $913,78
    $951,87
    $1 087,21     		$203,80
    Toc - Plan #4

    Expanded Bronze

    (EPO) Oscar Bronze Classic Next

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$323,88
    $367,59
    $413,90
    $578,42
    $878,97     		$647,76
    $735,18
    $827,80
    $1 156,84
    $1 757,94     		$895,52
    $982,94
    $1 075,56
    $1 404,60     		$1 143,28
    $1 230,70
    $1 323,32
    $1 652,36     		$1 391,04
    $1 478,46
    $1 571,08
    $1 900,12     		$571,64
    $615,35
    $661,66
    $826,18     		$819,40
    $863,11
    $909,42
    $1 073,94     		$1 067,16
    $1 110,87
    $1 157,18
    $1 321,70     		$247,76
    Toc - Plan #5

    Silver

    (EPO) Oscar Silver Classic

    Annual Out of Pocket Expenses
    Individual Family
    $5,000 $10,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$365,31
    $414,61
    $466,85
    $652,42
    $991,42     		$730,62
    $829,22
    $933,70
    $1 304,84
    $1 982,84     		$1 010,07
    $1 108,67
    $1 213,15
    $1 584,29     		$1 289,52
    $1 388,12
    $1 492,60
    $1 863,74     		$1 568,97
    $1 667,57
    $1 772,05
    $2 143,19     		$644,76
    $694,06
    $746,30
    $931,87     		$924,21
    $973,51
    $1 025,75
    $1 211,32     		$1 203,66
    $1 252,96
    $1 305,20
    $1 490,77     		$279,45
    Toc - Plan #6

    Silver

    (EPO) Oscar Silver Saver 2

    Annual Out of Pocket Expenses
    Individual Family
    $6,200 $12,400 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$358,62
    $407,03
    $458,31
    $640,48
    $973,28     		$717,24
    $814,06
    $916,62
    $1 280,96
    $1 946,56     		$991,58
    $1 088,40
    $1 190,96
    $1 555,30     		$1 265,92
    $1 362,74
    $1 465,30
    $1 829,64     		$1 540,26
    $1 637,08
    $1 739,64
    $2 103,98     		$632,96
    $681,37
    $732,65
    $914,82     		$907,30
    $955,71
    $1 006,99
    $1 189,16     		$1 181,64
    $1 230,05
    $1 281,33
    $1 463,50     		$274,34
    Toc - Plan #7

    Silver

    (EPO) Oscar Silver Classic Next

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,000 $16,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$367,23
    $416,79
    $469,30
    $655,85
    $996,62     		$734,46
    $833,58
    $938,60
    $1 311,70
    $1 993,24     		$1 015,38
    $1 114,50
    $1 219,52
    $1 592,62     		$1 296,30
    $1 395,42
    $1 500,44
    $1 873,54     		$1 577,22
    $1 676,34
    $1 781,36
    $2 154,46     		$648,15
    $697,71
    $750,22
    $936,77     		$929,07
    $978,63
    $1 031,14
    $1 217,69     		$1 209,99
    $1 259,55
    $1 312,06
    $1 498,61     		$280,92
    Toc - Plan #8

    Catastrophic

    (EPO) Oscar Secure

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$218,99
    $248,54
    $279,85
    $391,10
    $594,31     		$437,98
    $497,08
    $559,70
    $782,20
    $1 188,62     		$605,50
    $664,60
    $727,22
    $949,72     		$773,02
    $832,12
    $894,74
    $1 117,24     		$940,54
    $999,64
    $1 062,26
    $1 284,76     		$386,51
    $416,06
    $447,37
    $558,62     		$554,03
    $583,58
    $614,89
    $726,14     		$721,55
    $751,10
    $782,41
    $893,66     		$167,52
    Toc - Plan #9

    Expanded Bronze

    (EPO) Oscar Bronze Classic Next 2

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$323,58
    $367,25
    $413,52
    $577,89
    $878,16     		$647,16
    $734,50
    $827,04
    $1 155,78
    $1 756,32     		$894,69
    $982,03
    $1 074,57
    $1 403,31     		$1 142,22
    $1 229,56
    $1 322,10
    $1 650,84     		$1 389,75
    $1 477,09
    $1 569,63
    $1 898,37     		$571,11
    $614,78
    $661,05
    $825,42     		$818,64
    $862,31
    $908,58
    $1 072,95     		$1 066,17
    $1 109,84
    $1 156,11
    $1 320,48     		$247,53
    Toc - Plan #10

    Gold

    (EPO) Oscar Gold Classic

    Annual Out of Pocket Expenses
    Individual Family
    $2,500 $5,000 Annual Deductible
    $6,000 $12,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$387,87
    $440,22
    $495,69
    $692,72
    $1 052,65     		$775,74
    $880,44
    $991,38
    $1 385,44
    $2 105,30     		$1 072,45
    $1 177,15
    $1 288,09
    $1 682,15     		$1 369,16
    $1 473,86
    $1 584,80
    $1 978,86     		$1 665,87
    $1 770,57
    $1 881,51
    $2 275,57     		$684,58
    $736,93
    $792,40
    $989,43     		$981,29
    $1 033,64
    $1 089,11
    $1 286,14     		$1 278,00
    $1 330,35
    $1 385,82
    $1 582,85     		$296,71
    Toc - Plan #11

    Expanded Bronze

    (EPO) Oscar Bronze HDHP

    Annual Out of Pocket Expenses
    Individual Family
    $5,200 $10,400 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$284,63
    $323,04
    $363,74
    $508,33
    $772,46     		$569,26
    $646,08
    $727,48
    $1 016,66
    $1 544,92     		$786,99
    $863,81
    $945,21
    $1 234,39     		$1 004,72
    $1 081,54
    $1 162,94
    $1 452,12     		$1 222,45
    $1 299,27
    $1 380,67
    $1 669,85     		$502,36
    $540,77
    $581,47
    $726,06     		$720,09
    $758,50
    $799,20
    $943,79     		$937,82
    $976,23
    $1 016,93
    $1 161,52     		$217,73
    Toc - Plan #12

    Silver

    (EPO) Oscar Silver Classic Copay

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $8,200 $16,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$373,72
    $424,17
    $477,61
    $667,45
    $1 014,26     		$747,44
    $848,34
    $955,22
    $1 334,90
    $2 028,52     		$1 033,33
    $1 134,23
    $1 241,11
    $1 620,79     		$1 319,22
    $1 420,12
    $1 527,00
    $1 906,68     		$1 605,11
    $1 706,01
    $1 812,89
    $2 192,57     		$659,61
    $710,06
    $763,50
    $953,34     		$945,50
    $995,95
    $1 049,39
    $1 239,23     		$1 231,39
    $1 281,84
    $1 335,28
    $1 525,12     		$285,89
    Toc - Plan #13

    Silver

    (EPO) Oscar Silver Classic $0 Ded

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$387,01
    $439,24
    $494,58
    $691,18
    $1 050,31     		$774,02
    $878,48
    $989,16
    $1 382,36
    $2 100,62     		$1 070,07
    $1 174,53
    $1 285,21
    $1 678,41     		$1 366,12
    $1 470,58
    $1 581,26
    $1 974,46     		$1 662,17
    $1 766,63
    $1 877,31
    $2 270,51     		$683,06
    $735,29
    $790,63
    $987,23     		$979,11
    $1 031,34
    $1 086,68
    $1 283,28     		$1 275,16
    $1 327,39
    $1 382,73
    $1 579,33     		$296,05
    ADVERTISEMENT

    Community Health Choice

    Local: 1-713-295-6704 | Toll Free: 1-855-315-5386 | TTY: 1-855-315-5386
    Toc - Plan #14

    Expanded Bronze

    (HMO) Community Vital Bronze 003 (No Deductible for PCP, Free Preventive Care, 24/7 Telehealth)

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$301,94
    $342,71
    $385,88
    $539,27
    $819,48     		$603,88
    $685,42
    $771,76
    $1 078,54
    $1 638,96     		$834,87
    $916,41
    $1 002,75
    $1 309,53     		$1 065,86
    $1 147,40
    $1 233,74
    $1 540,52     		$1 296,85
    $1 378,39
    $1 464,73
    $1 771,51     		$532,93
    $573,70
    $616,87
    $770,26     		$763,92
    $804,69
    $847,86
    $1 001,25     		$994,91
    $1 035,68
    $1 078,85
    $1 232,24     		$230,99
    Toc - Plan #15

    Silver

    (HMO) Community Advance Preferred Silver 004 (No deductible PCP, Specialists, Urgent Care and Generics, Free 24/7 Telehealth)

    Annual Out of Pocket Expenses
    Individual Family
    $3,000 $6,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$401,98
    $456,25
    $513,73
    $717,94
    $1 090,97     		$803,96
    $912,50
    $1 027,46
    $1 435,88
    $2 181,94     		$1 111,47
    $1 220,01
    $1 334,97
    $1 743,39     		$1 418,98
    $1 527,52
    $1 642,48
    $2 050,90     		$1 726,49
    $1 835,03
    $1 949,99
    $2 358,41     		$709,49
    $763,76
    $821,24
    $1 025,45     		$1 017,00
    $1 071,27
    $1 128,75
    $1 332,96     		$1 324,51
    $1 378,78
    $1 436,26
    $1 640,47     		$307,51
    Toc - Plan #16

    Gold

    (HMO) Community Enhanced Gold 005 (No Deductible PCP, Specialists & Generics, Free 24/7 Telehealth)

    Annual Out of Pocket Expenses
    Individual Family
    $2,000 $4,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$383,95
    $435,78
    $490,68
    $685,73
    $1 042,03     		$767,90
    $871,56
    $981,36
    $1 371,46
    $2 084,06     		$1 061,62
    $1 165,28
    $1 275,08
    $1 665,18     		$1 355,34
    $1 459,00
    $1 568,80
    $1 958,90     		$1 649,06
    $1 752,72
    $1 862,52
    $2 252,62     		$677,67
    $729,50
    $784,40
    $979,45     		$971,39
    $1 023,22
    $1 078,12
    $1 273,17     		$1 265,11
    $1 316,94
    $1 371,84
    $1 566,89     		$293,72
    Toc - Plan #17

    Expanded Bronze

    (HMO) Community Essential Bronze 008 HSA(No cost after deductible, No referrals for Specialists)

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$310,05
    $351,90
    $396,24
    $553,75
    $841,47     		$620,10
    $703,80
    $792,48
    $1 107,50
    $1 682,94     		$857,29
    $940,99
    $1 029,67
    $1 344,69     		$1 094,48
    $1 178,18
    $1 266,86
    $1 581,88     		$1 331,67
    $1 415,37
    $1 504,05
    $1 819,07     		$547,24
    $589,09
    $633,43
    $790,94     		$784,43
    $826,28
    $870,62
    $1 028,13     		$1 021,62
    $1 063,47
    $1 107,81
    $1 265,32     		$237,19
    Toc - Plan #18

    Silver

    (HMO) Community Standard Preferred Silver 009 (No deductible PCP, Urgent Care & Generics, Free 24/7 Telehealth)

    Annual Out of Pocket Expenses
    Individual Family
    $5,000 $10,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$393,56
    $446,69
    $502,97
    $702,90
    $1 068,13     		$787,12
    $893,38
    $1 005,94
    $1 405,80
    $2 136,26     		$1 088,20
    $1 194,46
    $1 307,02
    $1 706,88     		$1 389,28
    $1 495,54
    $1 608,10
    $2 007,96     		$1 690,36
    $1 796,62
    $1 909,18
    $2 309,04     		$694,64
    $747,77
    $804,05
    $1 003,98     		$995,72
    $1 048,85
    $1 105,13
    $1 305,06     		$1 296,80
    $1 349,93
    $1 406,21
    $1 606,14     		$301,08
    Toc - Plan #19

    Bronze

    (HMO) Community Value Bronze 10 (Free Preventive Care, Free 24/7 Telehealth)

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$297,91
    $338,13
    $380,73
    $532,07
    $808,54     		$595,82
    $676,26
    $761,46
    $1 064,14
    $1 617,08     		$823,72
    $904,16
    $989,36
    $1 292,04     		$1 051,62
    $1 132,06
    $1 217,26
    $1 519,94     		$1 279,52
    $1 359,96
    $1 445,16
    $1 747,84     		$525,81
    $566,03
    $608,63
    $759,97     		$753,71
    $793,93
    $836,53
    $987,87     		$981,61
    $1 021,83
    $1 064,43
    $1 215,77     		$227,90
    Toc - Plan #20

    Expanded Bronze

    (HMO) Community Virtual Now Bronze 11 (Unlimited Free 24/7 Virtual Visits)

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$297,31
    $337,45
    $379,96
    $530,99
    $806,90     		$594,62
    $674,90
    $759,92
    $1 061,98
    $1 613,80     		$822,06
    $902,34
    $987,36
    $1 289,42     		$1 049,50
    $1 129,78
    $1 214,80
    $1 516,86     		$1 276,94
    $1 357,22
    $1 442,24
    $1 744,30     		$524,75
    $564,89
    $607,40
    $758,43     		$752,19
    $792,33
    $834,84
    $985,87     		$979,63
    $1 019,77
    $1 062,28
    $1 213,31     		$227,44
    Toc - Plan #21

    Silver

    (HMO) Community Standard Silver 12 (No deductible PCP, Urgent Care & Generics, Free 24/7 Telehealth)

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$384,75
    $436,70
    $491,71
    $687,17
    $1 044,22     		$769,50
    $873,40
    $983,42
    $1 374,34
    $2 088,44     		$1 063,84
    $1 167,74
    $1 277,76
    $1 668,68     		$1 358,18
    $1 462,08
    $1 572,10
    $1 963,02     		$1 652,52
    $1 756,42
    $1 866,44
    $2 257,36     		$679,09
    $731,04
    $786,05
    $981,51     		$973,43
    $1 025,38
    $1 080,39
    $1 275,85     		$1 267,77
    $1 319,72
    $1 374,73
    $1 570,19     		$294,34
    Toc - Plan #22

    Silver

    (HMO) Community Advance Silver 13 (No Deductible PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth)

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$388,98
    $441,49
    $497,12
    $694,72
    $1 055,70     		$777,96
    $882,98
    $994,24
    $1 389,44
    $2 111,40     		$1 075,53
    $1 180,55
    $1 291,81
    $1 687,01     		$1 373,10
    $1 478,12
    $1 589,38
    $1 984,58     		$1 670,67
    $1 775,69
    $1 886,95
    $2 282,15     		$686,55
    $739,06
    $794,69
    $992,29     		$984,12
    $1 036,63
    $1 092,26
    $1 289,86     		$1 281,69
    $1 334,20
    $1 389,83
    $1 587,43     		$297,57
    ADVERTISEMENT

    Ambetter from Superior HealthPlan

    Local: 1-877-687-1196 | Toll Free: 1-877-687-1196 | TTY: 1-800-735-2989
    Toc - Plan #23

    Silver

    (EPO) Ambetter Balanced Care 11 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$332,52
    $377,40
    $424,95
    $593,87
    $902,44     		$665,04
    $754,80
    $849,90
    $1 187,74
    $1 804,88     		$919,41
    $1 009,17
    $1 104,27
    $1 442,11     		$1 173,78
    $1 263,54
    $1 358,64
    $1 696,48     		$1 428,15
    $1 517,91
    $1 613,01
    $1 950,85     		$586,89
    $631,77
    $679,32
    $848,24     		$841,26
    $886,14
    $933,69
    $1 102,61     		$1 095,63
    $1 140,51
    $1 188,06
    $1 356,98     		$254,37
    Toc - Plan #24

    Bronze

    (EPO) Ambetter Essential Care 1 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $8,300 $16,600 Annual Deductible
    $8,300 $16,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$279,95
    $317,73
    $357,77
    $499,98
    $759,76     		$559,90
    $635,46
    $715,54
    $999,96
    $1 519,52     		$774,06
    $849,62
    $929,70
    $1 214,12     		$988,22
    $1 063,78
    $1 143,86
    $1 428,28     		$1 202,38
    $1 277,94
    $1 358,02
    $1 642,44     		$494,11
    $531,89
    $571,93
    $714,14     		$708,27
    $746,05
    $786,09
    $928,30     		$922,43
    $960,21
    $1 000,25
    $1 142,46     		$214,16
    Toc - Plan #25

    Expanded Bronze

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$290,16
    $329,32
    $370,81
    $518,21
    $787,47     		$580,32
    $658,64
    $741,62
    $1 036,42
    $1 574,94     		$802,28
    $880,60
    $963,58
    $1 258,38     		$1 024,24
    $1 102,56
    $1 185,54
    $1 480,34     		$1 246,20
    $1 324,52
    $1 407,50
    $1 702,30     		$512,12
    $551,28
    $592,77
    $740,17     		$734,08
    $773,24
    $814,73
    $962,13     		$956,04
    $995,20
    $1 036,69
    $1 184,09     		$221,96
    Toc - Plan #26

    Gold

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$442,75
    $502,51
    $565,82
    $790,73
    $1 201,59     		$885,50
    $1 005,02
    $1 131,64
    $1 581,46
    $2 403,18     		$1 224,20
    $1 343,72
    $1 470,34
    $1 920,16     		$1 562,90
    $1 682,42
    $1 809,04
    $2 258,86     		$1 901,60
    $2 021,12
    $2 147,74
    $2 597,56     		$781,45
    $841,21
    $904,52
    $1 129,43     		$1 120,15
    $1 179,91
    $1 243,22
    $1 468,13     		$1 458,85
    $1 518,61
    $1 581,92
    $1 806,83     		$338,70
    Toc - Plan #27

    Expanded Bronze

    (EPO) Ambetter Essential Care 2 HSA (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $6,900 $13,800 Annual Deductible
    $6,900 $13,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$302,60
    $343,43
    $386,70
    $540,42
    $821,22     		$605,20
    $686,86
    $773,40
    $1 080,84
    $1 642,44     		$836,68
    $918,34
    $1 004,88
    $1 312,32     		$1 068,16
    $1 149,82
    $1 236,36
    $1 543,80     		$1 299,64
    $1 381,30
    $1 467,84
    $1 775,28     		$534,08
    $574,91
    $618,18
    $771,90     		$765,56
    $806,39
    $849,66
    $1 003,38     		$997,04
    $1 037,87
    $1 081,14
    $1 234,86     		$231,48
    Toc - Plan #28

    Silver

    (EPO) Ambetter Balanced Care 5 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $7,350 $14,700 Annual Deductible
    $7,350 $14,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$331,62
    $376,38
    $423,80
    $592,26
    $900,00     		$663,24
    $752,76
    $847,60
    $1 184,52
    $1 800,00     		$916,92
    $1 006,44
    $1 101,28
    $1 438,20     		$1 170,60
    $1 260,12
    $1 354,96
    $1 691,88     		$1 424,28
    $1 513,80
    $1 608,64
    $1 945,56     		$585,30
    $630,06
    $677,48
    $845,94     		$838,98
    $883,74
    $931,16
    $1 099,62     		$1 092,66
    $1 137,42
    $1 184,84
    $1 353,30     		$253,68
    Toc - Plan #29

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$325,67
    $369,63
    $416,20
    $581,63
    $883,85     		$651,34
    $739,26
    $832,40
    $1 163,26
    $1 767,70     		$900,47
    $988,39
    $1 081,53
    $1 412,39     		$1 149,60
    $1 237,52
    $1 330,66
    $1 661,52     		$1 398,73
    $1 486,65
    $1 579,79
    $1 910,65     		$574,80
    $618,76
    $665,33
    $830,76     		$823,93
    $867,89
    $914,46
    $1 079,89     		$1 073,06
    $1 117,02
    $1 163,59
    $1 329,02     		$249,13
    Toc - Plan #30

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$322,81
    $366,38
    $412,54
    $576,52
    $876,09     		$645,62
    $732,76
    $825,08
    $1 153,04
    $1 752,18     		$892,56
    $979,70
    $1 072,02
    $1 399,98     		$1 139,50
    $1 226,64
    $1 318,96
    $1 646,92     		$1 386,44
    $1 473,58
    $1 565,90
    $1 893,86     		$569,75
    $613,32
    $659,48
    $823,46     		$816,69
    $860,26
    $906,42
    $1 070,40     		$1 063,63
    $1 107,20
    $1 153,36
    $1 317,34     		$246,94
    Toc - Plan #31

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$336,28
    $381,67
    $429,75
    $600,58
    $912,63     		$672,56
    $763,34
    $859,50
    $1 201,16
    $1 825,26     		$929,81
    $1 020,59
    $1 116,75
    $1 458,41     		$1 187,06
    $1 277,84
    $1 374,00
    $1 715,66     		$1 444,31
    $1 535,09
    $1 631,25
    $1 972,91     		$593,53
    $638,92
    $687,00
    $857,83     		$850,78
    $896,17
    $944,25
    $1 115,08     		$1 108,03
    $1 153,42
    $1 201,50
    $1 372,33     		$257,25
    Toc - Plan #32

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$355,43
    $403,40
    $454,23
    $634,78
    $964,61     		$710,86
    $806,80
    $908,46
    $1 269,56
    $1 929,22     		$982,76
    $1 078,70
    $1 180,36
    $1 541,46     		$1 254,66
    $1 350,60
    $1 452,26
    $1 813,36     		$1 526,56
    $1 622,50
    $1 724,16
    $2 085,26     		$627,33
    $675,30
    $726,13
    $906,68     		$899,23
    $947,20
    $998,03
    $1 178,58     		$1 171,13
    $1 219,10
    $1 269,93
    $1 450,48     		$271,90
    Toc - Plan #33

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$358,32
    $406,69
    $457,93
    $639,95
    $972,47     		$716,64
    $813,38
    $915,86
    $1 279,90
    $1 944,94     		$990,75
    $1 087,49
    $1 189,97
    $1 554,01     		$1 264,86
    $1 361,60
    $1 464,08
    $1 828,12     		$1 538,97
    $1 635,71
    $1 738,19
    $2 102,23     		$632,43
    $680,80
    $732,04
    $914,06     		$906,54
    $954,91
    $1 006,15
    $1 188,17     		$1 180,65
    $1 229,02
    $1 280,26
    $1 462,28     		$274,11
    Toc - Plan #34

    Gold

    (EPO) Ambetter Secure Care 15 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $1,150 $2,300 Annual Deductible
    $4,450 $8,900 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$452,23
    $513,26
    $577,93
    $807,66
    $1 227,31     		$904,46
    $1 026,52
    $1 155,86
    $1 615,32
    $2 454,62     		$1 250,41
    $1 372,47
    $1 501,81
    $1 961,27     		$1 596,36
    $1 718,42
    $1 847,76
    $2 307,22     		$1 942,31
    $2 064,37
    $2 193,71
    $2 653,17     		$798,18
    $859,21
    $923,88
    $1 153,61     		$1 144,13
    $1 205,16
    $1 269,83
    $1 499,56     		$1 490,08
    $1 551,11
    $1 615,78
    $1 845,51     		$345,95
    Toc - Plan #35

    Gold

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

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$447,83
    $508,28
    $572,32
    $799,81
    $1 215,39     		$895,66
    $1 016,56
    $1 144,64
    $1 599,62
    $2 430,78     		$1 238,24
    $1 359,14
    $1 487,22
    $1 942,20     		$1 580,82
    $1 701,72
    $1 829,80
    $2 284,78     		$1 923,40
    $2 044,30
    $2 172,38
    $2 627,36     		$790,41
    $850,86
    $914,90
    $1 142,39     		$1 132,99
    $1 193,44
    $1 257,48
    $1 484,97     		$1 475,57
    $1 536,02
    $1 600,06
    $1 827,55     		$342,58
    Toc - Plan #36

    Bronze

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

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$283,17
    $321,38
    $361,87
    $505,72
    $768,48     		$566,34
    $642,76
    $723,74
    $1 011,44
    $1 536,96     		$782,95
    $859,37
    $940,35
    $1 228,05     		$999,56
    $1 075,98
    $1 156,96
    $1 444,66     		$1 216,17
    $1 292,59
    $1 373,57
    $1 661,27     		$499,78
    $537,99
    $578,48
    $722,33     		$716,39
    $754,60
    $795,09
    $938,94     		$933,00
    $971,21
    $1 011,70
    $1 155,55     		$216,61
    Toc - Plan #37

    Expanded Bronze

    (EPO) Ambetter Essential Care 10 (2021) + Vision

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$293,49
    $333,10
    $375,07
    $524,16
    $796,51     		$586,98
    $666,20
    $750,14
    $1 048,32
    $1 593,02     		$811,49
    $890,71
    $974,65
    $1 272,83     		$1 036,00
    $1 115,22
    $1 199,16
    $1 497,34     		$1 260,51
    $1 339,73
    $1 423,67
    $1 721,85     		$518,00
    $557,61
    $599,58
    $748,67     		$742,51
    $782,12
    $824,09
    $973,18     		$967,02
    $1 006,63
    $1 048,60
    $1 197,69     		$224,51
    Toc - Plan #38

    Silver

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

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$336,34
    $381,73
    $429,83
    $600,68
    $912,80     		$672,68
    $763,46
    $859,66
    $1 201,36
    $1 825,60     		$929,97
    $1 020,75
    $1 116,95
    $1 458,65     		$1 187,26
    $1 278,04
    $1 374,24
    $1 715,94     		$1 444,55
    $1 535,33
    $1 631,53
    $1 973,23     		$593,63
    $639,02
    $687,12
    $857,97     		$850,92
    $896,31
    $944,41
    $1 115,26     		$1 108,21
    $1 153,60
    $1 201,70
    $1 372,55     		$257,29
    Toc - Plan #39

    Expanded Bronze

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

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$306,07
    $347,38
    $391,14
    $546,62
    $830,65     		$612,14
    $694,76
    $782,28
    $1 093,24
    $1 661,30     		$846,28
    $928,90
    $1 016,42
    $1 327,38     		$1 080,42
    $1 163,04
    $1 250,56
    $1 561,52     		$1 314,56
    $1 397,18
    $1 484,70
    $1 795,66     		$540,21
    $581,52
    $625,28
    $780,76     		$774,35
    $815,66
    $859,42
    $1 014,90     		$1 008,49
    $1 049,80
    $1 093,56
    $1 249,04     		$234,14
    Toc - Plan #40

    Silver

    (EPO) Ambetter Balanced Care 5 (2021) + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $7,350 $14,700 Annual Deductible
    $7,350 $14,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$335,43
    $380,70
    $428,67
    $599,06
    $910,33     		$670,86
    $761,40
    $857,34
    $1 198,12
    $1 820,66     		$927,46
    $1 018,00
    $1 113,94
    $1 454,72     		$1 184,06
    $1 274,60
    $1 370,54
    $1 711,32     		$1 440,66
    $1 531,20
    $1 627,14
    $1 967,92     		$592,03
    $637,30
    $685,27
    $855,66     		$848,63
    $893,90
    $941,87
    $1 112,26     		$1 105,23
    $1 150,50
    $1 198,47
    $1 368,86     		$256,60
    Toc - Plan #41

    Silver

    (EPO) Ambetter Balanced Care 12 (2021) + Vision

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$329,41
    $373,87
    $420,97
    $588,31
    $893,99     		$658,82
    $747,74
    $841,94
    $1 176,62
    $1 787,98     		$910,81
    $999,73
    $1 093,93
    $1 428,61     		$1 162,80
    $1 251,72
    $1 345,92
    $1 680,60     		$1 414,79
    $1 503,71
    $1 597,91
    $1 932,59     		$581,40
    $625,86
    $672,96
    $840,30     		$833,39
    $877,85
    $924,95
    $1 092,29     		$1 085,38
    $1 129,84
    $1 176,94
    $1 344,28     		$251,99
    Toc - Plan #42

    Silver

    (EPO) Ambetter Balanced Care 25 HSA (2021) + Vision

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$340,14
    $386,05
    $434,69
    $607,47
    $923,11     		$680,28
    $772,10
    $869,38
    $1 214,94
    $1 846,22     		$940,48
    $1 032,30
    $1 129,58
    $1 475,14     		$1 200,68
    $1 292,50
    $1 389,78
    $1 735,34     		$1 460,88
    $1 552,70
    $1 649,98
    $1 995,54     		$600,34
    $646,25
    $694,89
    $867,67     		$860,54
    $906,45
    $955,09
    $1 127,87     		$1 120,74
    $1 166,65
    $1 215,29
    $1 388,07     		$260,20
    Toc - Plan #43

    Silver

    (EPO) Ambetter Balanced Care 27 (2021) + Vision

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$359,51
    $408,03
    $459,44
    $642,07
    $975,69     		$719,02
    $816,06
    $918,88
    $1 284,14
    $1 951,38     		$994,04
    $1 091,08
    $1 193,90
    $1 559,16     		$1 269,06
    $1 366,10
    $1 468,92
    $1 834,18     		$1 544,08
    $1 641,12
    $1 743,94
    $2 109,20     		$634,53
    $683,05
    $734,46
    $917,09     		$909,55
    $958,07
    $1 009,48
    $1 192,11     		$1 184,57
    $1 233,09
    $1 284,50
    $1 467,13     		$275,02
    Toc - Plan #44

    Silver

    (EPO) Ambetter Balanced Care 28 (2021) + Vision

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$362,44
    $411,36
    $463,18
    $647,30
    $983,63     		$724,88
    $822,72
    $926,36
    $1 294,60
    $1 967,26     		$1 002,14
    $1 099,98
    $1 203,62
    $1 571,86     		$1 279,40
    $1 377,24
    $1 480,88
    $1 849,12     		$1 556,66
    $1 654,50
    $1 758,14
    $2 126,38     		$639,70
    $688,62
    $740,44
    $924,56     		$916,96
    $965,88
    $1 017,70
    $1 201,82     		$1 194,22
    $1 243,14
    $1 294,96
    $1 479,08     		$277,26
    Toc - Plan #45

    Gold

    (EPO) Ambetter Secure Care 15 (2021) + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $1,150 $2,300 Annual Deductible
    $4,450 $8,900 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$457,42
    $519,16
    $584,57
    $816,93
    $1 241,40     		$914,84
    $1 038,32
    $1 169,14
    $1 633,86
    $2 482,80     		$1 264,76
    $1 388,24
    $1 519,06
    $1 983,78     		$1 614,68
    $1 738,16
    $1 868,98
    $2 333,70     		$1 964,60
    $2 088,08
    $2 218,90
    $2 683,62     		$807,34
    $869,08
    $934,49
    $1 166,85     		$1 157,26
    $1 219,00
    $1 284,41
    $1 516,77     		$1 507,18
    $1 568,92
    $1 634,33
    $1 866,69     		$349,92
    Toc - Plan #46

    Gold

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$463,88
    $526,50
    $592,83
    $828,48
    $1 258,96     		$927,76
    $1 053,00
    $1 185,66
    $1 656,96
    $2 517,92     		$1 282,62
    $1 407,86
    $1 540,52
    $2 011,82     		$1 637,48
    $1 762,72
    $1 895,38
    $2 366,68     		$1 992,34
    $2 117,58
    $2 250,24
    $2 721,54     		$818,74
    $881,36
    $947,69
    $1 183,34     		$1 173,60
    $1 236,22
    $1 302,55
    $1 538,20     		$1 528,46
    $1 591,08
    $1 657,41
    $1 893,06     		$354,86
    Toc - Plan #47

    Bronze

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

    Annual Out of Pocket Expenses
    Individual Family
    $8,300 $16,600 Annual Deductible
    $8,300 $16,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$293,32
    $332,90
    $374,84
    $523,84
    $796,03     		$586,64
    $665,80
    $749,68
    $1 047,68
    $1 592,06     		$811,02
    $890,18
    $974,06
    $1 272,06     		$1 035,40
    $1 114,56
    $1 198,44
    $1 496,44     		$1 259,78
    $1 338,94
    $1 422,82
    $1 720,82     		$517,70
    $557,28
    $599,22
    $748,22     		$742,08
    $781,66
    $823,60
    $972,60     		$966,46
    $1 006,04
    $1 047,98
    $1 196,98     		$224,38
    Toc - Plan #48

    Expanded Bronze

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$304,01
    $345,04
    $388,51
    $542,95
    $825,06     		$608,02
    $690,08
    $777,02
    $1 085,90
    $1 650,12     		$840,58
    $922,64
    $1 009,58
    $1 318,46     		$1 073,14
    $1 155,20
    $1 242,14
    $1 551,02     		$1 305,70
    $1 387,76
    $1 474,70
    $1 783,58     		$536,57
    $577,60
    $621,07
    $775,51     		$769,13
    $810,16
    $853,63
    $1 008,07     		$1 001,69
    $1 042,72
    $1 086,19
    $1 240,63     		$232,56
    Toc - Plan #49

    Silver

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

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$348,39
    $395,42
    $445,24
    $622,22
    $945,52     		$696,78
    $790,84
    $890,48
    $1 244,44
    $1 891,04     		$963,29
    $1 057,35
    $1 156,99
    $1 510,95     		$1 229,80
    $1 323,86
    $1 423,50
    $1 777,46     		$1 496,31
    $1 590,37
    $1 690,01
    $2 043,97     		$614,90
    $661,93
    $711,75
    $888,73     		$881,41
    $928,44
    $978,26
    $1 155,24     		$1 147,92
    $1 194,95
    $1 244,77
    $1 421,75     		$266,51
    Toc - Plan #50

    Expanded Bronze

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

    Annual Out of Pocket Expenses
    Individual Family
    $6,900 $13,800 Annual Deductible
    $6,900 $13,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$317,04
    $359,83
    $405,16
    $566,22
    $860,42     		$634,08
    $719,66
    $810,32
    $1 132,44
    $1 720,84     		$876,61
    $962,19
    $1 052,85
    $1 374,97     		$1 119,14
    $1 204,72
    $1 295,38
    $1 617,50     		$1 361,67
    $1 447,25
    $1 537,91
    $1 860,03     		$559,57
    $602,36
    $647,69
    $808,75     		$802,10
    $844,89
    $890,22
    $1 051,28     		$1 044,63
    $1 087,42
    $1 132,75
    $1 293,81     		$242,53
    Toc - Plan #51

    Silver

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

    Annual Out of Pocket Expenses
    Individual Family
    $7,350 $14,700 Annual Deductible
    $7,350 $14,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$347,45
    $394,35
    $444,03
    $620,54
    $942,96     		$694,90
    $788,70
    $888,06
    $1 241,08
    $1 885,92     		$960,69
    $1 054,49
    $1 153,85
    $1 506,87     		$1 226,48
    $1 320,28
    $1 419,64
    $1 772,66     		$1 492,27
    $1 586,07
    $1 685,43
    $2 038,45     		$613,24
    $660,14
    $709,82
    $886,33     		$879,03
    $925,93
    $975,61
    $1 152,12     		$1 144,82
    $1 191,72
    $1 241,40
    $1 417,91     		$265,79
    Toc - Plan #52

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$341,22
    $387,27
    $436,06
    $609,40
    $926,04     		$682,44
    $774,54
    $872,12
    $1 218,80
    $1 852,08     		$943,46
    $1 035,56
    $1 133,14
    $1 479,82     		$1 204,48
    $1 296,58
    $1 394,16
    $1 740,84     		$1 465,50
    $1 557,60
    $1 655,18
    $2 001,86     		$602,24
    $648,29
    $697,08
    $870,42     		$863,26
    $909,31
    $958,10
    $1 131,44     		$1 124,28
    $1 170,33
    $1 219,12
    $1 392,46     		$261,02
    Toc - Plan #53

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$352,33
    $399,89
    $450,27
    $629,25
    $956,20     		$704,66
    $799,78
    $900,54
    $1 258,50
    $1 912,40     		$974,19
    $1 069,31
    $1 170,07
    $1 528,03     		$1 243,72
    $1 338,84
    $1 439,60
    $1 797,56     		$1 513,25
    $1 608,37
    $1 709,13
    $2 067,09     		$621,86
    $669,42
    $719,80
    $898,78     		$891,39
    $938,95
    $989,33
    $1 168,31     		$1 160,92
    $1 208,48
    $1 258,86
    $1 437,84     		$269,53
    Toc - Plan #54

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$372,40
    $422,66
    $475,91
    $665,09
    $1 010,66     		$744,80
    $845,32
    $951,82
    $1 330,18
    $2 021,32     		$1 029,68
    $1 130,20
    $1 236,70
    $1 615,06     		$1 314,56
    $1 415,08
    $1 521,58
    $1 899,94     		$1 599,44
    $1 699,96
    $1 806,46
    $2 184,82     		$657,28
    $707,54
    $760,79
    $949,97     		$942,16
    $992,42
    $1 045,67
    $1 234,85     		$1 227,04
    $1 277,30
    $1 330,55
    $1 519,73     		$284,88
    Toc - Plan #55

    Silver

    (EPO) 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$375,43
    $426,10
    $479,79
    $670,50
    $1 018,89     		$750,86
    $852,20
    $959,58
    $1 341,00
    $2 037,78     		$1 038,06
    $1 139,40
    $1 246,78
    $1 628,20     		$1 325,26
    $1 426,60
    $1 533,98
    $1 915,40     		$1 612,46
    $1 713,80
    $1 821,18
    $2 202,60     		$662,63
    $713,30
    $766,99
    $957,70     		$949,83
    $1 000,50
    $1 054,19
    $1 244,90     		$1 237,03
    $1 287,70
    $1 341,39
    $1 532,10     		$287,20
    Toc - Plan #56

    Gold

    (EPO) Ambetter Secure Care 15 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $1,150 $2,300 Annual Deductible
    $4,450 $8,900 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$473,81
    $537,77
    $605,52
    $846,21
    $1 285,90     		$947,62
    $1 075,54
    $1 211,04
    $1 692,42
    $2 571,80     		$1 310,08
    $1 438,00
    $1 573,50
    $2 054,88     		$1 672,54
    $1 800,46
    $1 935,96
    $2 417,34     		$2 035,00
    $2 162,92
    $2 298,42
    $2 779,80     		$836,27
    $900,23
    $967,98
    $1 208,67     		$1 198,73
    $1 262,69
    $1 330,44
    $1 571,13     		$1 561,19
    $1 625,15
    $1 692,90
    $1 933,59     		$362,46
    ADVERTISEMENT

    Blue Cross and Blue Shield of Texas

    Local: 1-888-697-0683 | Toll Free: 1-888-697-0683 | TTY: 1-800-735-2989
    Toc - Plan #57

    Gold

    (HMO) Blue Advantage Gold HMO_ 206

    Annual Out of Pocket Expenses
    Individual Family
    $750 $2,250 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$387,37
    $439,67
    $495,06
    $691,85
    $1 051,33     		$774,74
    $879,34
    $990,12
    $1 383,70
    $2 102,66     		$1 071,08
    $1 175,68
    $1 286,46
    $1 680,04     		$1 367,42
    $1 472,02
    $1 582,80
    $1 976,38     		$1 663,76
    $1 768,36
    $1 879,14
    $2 272,72     		$683,71
    $736,01
    $791,40
    $988,19     		$980,05
    $1 032,35
    $1 087,74
    $1 284,53     		$1 276,39
    $1 328,69
    $1 384,08
    $1 580,87     		$296,34
    Toc - Plan #58

    Catastrophic

    (HMO) Blue Advantage Security HMO_ 200

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$264,18
    $299,84
    $337,62
    $471,83
    $716,99     		$528,36
    $599,68
    $675,24
    $943,66
    $1 433,98     		$730,46
    $801,78
    $877,34
    $1 145,76     		$932,56
    $1 003,88
    $1 079,44
    $1 347,86     		$1 134,66
    $1 205,98
    $1 281,54
    $1 549,96     		$466,28
    $501,94
    $539,72
    $673,93     		$668,38
    $704,04
    $741,82
    $876,03     		$870,48
    $906,14
    $943,92
    $1 078,13     		$202,10
    Toc - Plan #59

    Silver

    (HMO) Blue Advantage Silver HMO_ 205

    Annual Out of Pocket Expenses
    Individual Family
    $1,900 $5,700 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$386,49
    $438,67
    $493,94
    $690,28
    $1 048,94     		$772,98
    $877,34
    $987,88
    $1 380,56
    $2 097,88     		$1 068,65
    $1 173,01
    $1 283,55
    $1 676,23     		$1 364,32
    $1 468,68
    $1 579,22
    $1 971,90     		$1 659,99
    $1 764,35
    $1 874,89
    $2 267,57     		$682,16
    $734,34
    $789,61
    $985,95     		$977,83
    $1 030,01
    $1 085,28
    $1 281,62     		$1 273,50
    $1 325,68
    $1 380,95
    $1 577,29     		$295,67
    Toc - Plan #60

    Expanded Bronze

    (HMO) Blue Advantage Bronze HMO_ 204

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$290,70
    $329,95
    $371,52
    $519,19
    $788,96     		$581,40
    $659,90
    $743,04
    $1 038,38
    $1 577,92     		$803,79
    $882,29
    $965,43
    $1 260,77     		$1 026,18
    $1 104,68
    $1 187,82
    $1 483,16     		$1 248,57
    $1 327,07
    $1 410,21
    $1 705,55     		$513,09
    $552,34
    $593,91
    $741,58     		$735,48
    $774,73
    $816,30
    $963,97     		$957,87
    $997,12
    $1 038,69
    $1 186,36     		$222,39
    Toc - Plan #61

    Bronze

    (HMO) Blue Advantage Bronze HMO_ 301

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$288,28
    $327,20
    $368,43
    $514,87
    $782,40     		$576,56
    $654,40
    $736,86
    $1 029,74
    $1 564,80     		$797,10
    $874,94
    $957,40
    $1 250,28     		$1 017,64
    $1 095,48
    $1 177,94
    $1 470,82     		$1 238,18
    $1 316,02
    $1 398,48
    $1 691,36     		$508,82
    $547,74
    $588,97
    $735,41     		$729,36
    $768,28
    $809,51
    $955,95     		$949,90
    $988,82
    $1 030,05
    $1 176,49     		$220,54
    Toc - Plan #62

    Gold

    (HMO) Blue Advantage Plus Gold_ 203

    Annual Out of Pocket Expenses
    Individual Family
    $750 $2,250 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$457,69
    $519,48
    $584,93
    $817,43
    $1 242,17     		$915,38
    $1 038,96
    $1 169,86
    $1 634,86
    $2 484,34     		$1 265,51
    $1 389,09
    $1 519,99
    $1 984,99     		$1 615,64
    $1 739,22
    $1 870,12
    $2 335,12     		$1 965,77
    $2 089,35
    $2 220,25
    $2 685,25     		$807,82
    $869,61
    $935,06
    $1 167,56     		$1 157,95
    $1 219,74
    $1 285,19
    $1 517,69     		$1 508,08
    $1 569,87
    $1 635,32
    $1 867,82     		$350,13
    Toc - Plan #63

    Silver

    (HMO) Blue Advantage Plus Silver_ 202

    Annual Out of Pocket Expenses
    Individual Family
    $1,250 $3,750 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$454,07
    $515,37
    $580,30
    $810,96
    $1 232,34     		$908,14
    $1 030,74
    $1 160,60
    $1 621,92
    $2 464,68     		$1 255,50
    $1 378,10
    $1 507,96
    $1 969,28     		$1 602,86
    $1 725,46
    $1 855,32
    $2 316,64     		$1 950,22
    $2 072,82
    $2 202,68
    $2 664,00     		$801,43
    $862,73
    $927,66
    $1 158,32     		$1 148,79
    $1 210,09
    $1 275,02
    $1 505,68     		$1 496,15
    $1 557,45
    $1 622,38
    $1 853,04     		$347,36
    Toc - Plan #64

    Expanded Bronze

    (HMO) Blue Advantage Plus Bronze_ 303

    Annual Out of Pocket Expenses
    Individual Family
    $4,900 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$343,77
    $390,18
    $439,34
    $613,98
    $933,00     		$687,54
    $780,36
    $878,68
    $1 227,96
    $1 866,00     		$950,53
    $1 043,35
    $1 141,67
    $1 490,95     		$1 213,52
    $1 306,34
    $1 404,66
    $1 753,94     		$1 476,51
    $1 569,33
    $1 667,65
    $2 016,93     		$606,76
    $653,17
    $702,33
    $876,97     		$869,75
    $916,16
    $965,32
    $1 139,96     		$1 132,74
    $1 179,15
    $1 228,31
    $1 402,95     		$262,99
    Toc - Plan #65

    Bronze

    (HMO) Blue Advantage Plus Bronze_ 305

    Annual Out of Pocket Expenses
    Individual Family
    $5,000 $15,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$320,94
    $364,27
    $410,16
    $573,20
    $871,03     		$641,88
    $728,54
    $820,32
    $1 146,40
    $1 742,06     		$887,40
    $974,06
    $1 065,84
    $1 391,92     		$1 132,92
    $1 219,58
    $1 311,36
    $1 637,44     		$1 378,44
    $1 465,10
    $1 556,88
    $1 882,96     		$566,46
    $609,79
    $655,68
    $818,72     		$811,98
    $855,31
    $901,20
    $1 064,24     		$1 057,50
    $1 100,83
    $1 146,72
    $1 309,76     		$245,52
    ADVERTISEMENT

    Molina Healthcare

    Local: 1-888-560-2025 | Toll Free: 1-888-560-2025

    Toc - Plan #66

    Gold

    (HMO) Molina Gold 3

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$343,64
    $390,03
    $439,17
    $613,73
    $932,63     		$687,28
    $780,06
    $878,34
    $1 227,46
    $1 865,26     		$950,16
    $1 042,94
    $1 141,22
    $1 490,34     		$1 213,04
    $1 305,82
    $1 404,10
    $1 753,22     		$1 475,92
    $1 568,70
    $1 666,98
    $2 016,10     		$606,52
    $652,91
    $702,05
    $876,61     		$869,40
    $915,79
    $964,93
    $1 139,49     		$1 132,28
    $1 178,67
    $1 227,81
    $1 402,37     		$262,88
    Toc - Plan #67

    Silver

    (HMO) Molina Silver 3 250

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$323,30
    $366,95
    $413,18
    $577,42
    $877,45     		$646,60
    $733,90
    $826,36
    $1 154,84
    $1 754,90     		$893,93
    $981,23
    $1 073,69
    $1 402,17     		$1 141,26
    $1 228,56
    $1 321,02
    $1 649,50     		$1 388,59
    $1 475,89
    $1 568,35
    $1 896,83     		$570,63
    $614,28
    $660,51
    $824,75     		$817,96
    $861,61
    $907,84
    $1 072,08     		$1 065,29
    $1 108,94
    $1 155,17
    $1 319,41     		$247,33
    Toc - Plan #68

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$345,88
    $392,57
    $442,03
    $617,74
    $938,71     		$691,76
    $785,14
    $884,06
    $1 235,48
    $1 877,42     		$956,36
    $1 049,74
    $1 148,66
    $1 500,08     		$1 220,96
    $1 314,34
    $1 413,26
    $1 764,68     		$1 485,56
    $1 578,94
    $1 677,86
    $2 029,28     		$610,48
    $657,17
    $706,63
    $882,34     		$875,08
    $921,77
    $971,23
    $1 146,94     		$1 139,68
    $1 186,37
    $1 235,83
    $1 411,54     		$264,60
    Toc - Plan #69

    Silver

    (HMO) Constant Care Silver 1 250

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$322,46
    $365,99
    $412,10
    $575,91
    $875,15     		$644,92
    $731,98
    $824,20
    $1 151,82
    $1 750,30     		$891,60
    $978,66
    $1 070,88
    $1 398,50     		$1 138,28
    $1 225,34
    $1 317,56
    $1 645,18     		$1 384,96
    $1 472,02
    $1 564,24
    $1 891,86     		$569,14
    $612,67
    $658,78
    $822,59     		$815,82
    $859,35
    $905,46
    $1 069,27     		$1 062,50
    $1 106,03
    $1 152,14
    $1 315,95     		$246,68
    Toc - Plan #70

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$228,27
    $259,09
    $291,73
    $407,69
    $619,52     		$456,54
    $518,18
    $583,46
    $815,38
    $1 239,04     		$631,17
    $692,81
    $758,09
    $990,01     		$805,80
    $867,44
    $932,72
    $1 164,64     		$980,43
    $1 042,07
    $1 107,35
    $1 339,27     		$402,90
    $433,72
    $466,36
    $582,32     		$577,53
    $608,35
    $640,99
    $756,95     		$752,16
    $782,98
    $815,62
    $931,58     		$174,63
    Toc - Plan #71

    Silver

    (HMO) Constant Care Silver 2 250

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$322,16
    $365,65
    $411,72
    $575,38
    $874,35     		$644,32
    $731,30
    $823,44
    $1 150,76
    $1 748,70     		$890,77
    $977,75
    $1 069,89
    $1 397,21     		$1 137,22
    $1 224,20
    $1 316,34
    $1 643,66     		$1 383,67
    $1 470,65
    $1 562,79
    $1 890,11     		$568,61
    $612,10
    $658,17
    $821,83     		$815,06
    $858,55
    $904,62
    $1 068,28     		$1 061,51
    $1 105,00
    $1 151,07
    $1 314,73     		$246,45
    Toc - Plan #72

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$226,30
    $256,85
    $289,21
    $404,17
    $614,17     		$452,60
    $513,70
    $578,42
    $808,34
    $1 228,34     		$625,72
    $686,82
    $751,54
    $981,46     		$798,84
    $859,94
    $924,66
    $1 154,58     		$971,96
    $1 033,06
    $1 097,78
    $1 327,70     		$399,42
    $429,97
    $462,33
    $577,29     		$572,54
    $603,09
    $635,45
    $750,41     		$745,66
    $776,21
    $808,57
    $923,53     		$173,12
    Toc - Plan #73

    Silver

    (HMO) Constant Care Silver 4 250

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$318,83
    $361,88
    $407,47
    $569,44
    $865,32     		$637,66
    $723,76
    $814,94
    $1 138,88
    $1 730,64     		$881,57
    $967,67
    $1 058,85
    $1 382,79     		$1 125,48
    $1 211,58
    $1 302,76
    $1 626,70     		$1 369,39
    $1 455,49
    $1 546,67
    $1 870,61     		$562,74
    $605,79
    $651,38
    $813,35     		$806,65
    $849,70
    $895,29
    $1 057,26     		$1 050,56
    $1 093,61
    $1 139,20
    $1 301,17     		$243,91
    Toc - Plan #74

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$238,86
    $271,11
    $305,26
    $426,61
    $648,27     		$477,72
    $542,22
    $610,52
    $853,22
    $1 296,54     		$660,45
    $724,95
    $793,25
    $1 035,95     		$843,18
    $907,68
    $975,98
    $1 218,68     		$1 025,91
    $1 090,41
    $1 158,71
    $1 401,41     		$421,59
    $453,84
    $487,99
    $609,34     		$604,32
    $636,57
    $670,72
    $792,07     		$787,05
    $819,30
    $853,45
    $974,80     		$182,73
    Toc - Plan #75

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$232,39
    $263,76
    $296,99
    $415,04
    $630,70     		$464,78
    $527,52
    $593,98
    $830,08
    $1 261,40     		$642,56
    $705,30
    $771,76
    $1 007,86     		$820,34
    $883,08
    $949,54
    $1 185,64     		$998,12
    $1 060,86
    $1 127,32
    $1 363,42     		$410,17
    $441,54
    $474,77
    $592,82     		$587,95
    $619,32
    $652,55
    $770,60     		$765,73
    $797,10
    $830,33
    $948,38     		$177,78
    Toc - Plan #76

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$349,24
    $396,39
    $446,33
    $623,74
    $947,84     		$698,48
    $792,78
    $892,66
    $1 247,48
    $1 895,68     		$965,65
    $1 059,95
    $1 159,83
    $1 514,65     		$1 232,82
    $1 327,12
    $1 427,00
    $1 781,82     		$1 499,99
    $1 594,29
    $1 694,17
    $2 048,99     		$616,41
    $663,56
    $713,50
    $890,91     		$883,58
    $930,73
    $980,67
    $1 158,08     		$1 150,75
    $1 197,90
    $1 247,84
    $1 425,25     		$267,17
    Toc - Plan #77

    Silver

    (HMO) Constant Care Silver 1 250 + 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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$325,82
    $369,80
    $416,40
    $581,91
    $884,27     		$651,64
    $739,60
    $832,80
    $1 163,82
    $1 768,54     		$900,89
    $988,85
    $1 082,05
    $1 413,07     		$1 150,14
    $1 238,10
    $1 331,30
    $1 662,32     		$1 399,39
    $1 487,35
    $1 580,55
    $1 911,57     		$575,07
    $619,05
    $665,65
    $831,16     		$824,32
    $868,30
    $914,90
    $1 080,41     		$1 073,57
    $1 117,55
    $1 164,15
    $1 329,66     		$249,25
    Toc - Plan #78

    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
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$231,63
    $262,90
    $296,02
    $413,69
    $628,65     		$463,26
    $525,80
    $592,04
    $827,38
    $1 257,30     		$640,46
    $703,00
    $769,24
    $1 004,58     		$817,66
    $880,20
    $946,44
    $1 181,78     		$994,86
    $1 057,40
    $1 123,64
    $1 358,98     		$408,83
    $440,10
    $473,22
    $590,89     		$586,03
    $617,30
    $650,42
    $768,09     		$763,23
    $794,50
    $827,62
    $945,29     		$177,20

    ‡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 Fort Bend County here.

    Fort Bend County is in “Rating Area 10” of Texas.

    Currently, there are 78 plans offered in Rating Area 10.

    Obamacare Rates and Providers for Other Years

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