Texas

Obamacare 2018 Rates

Texas Obamacare 2018 Rates

 
Richmond, TX

Obamacare 2018 Rates and Health Insurance Providers for Fort Bend County,Richmond,TX


The health insurance rates listed below are for calendar year 2018.

2018 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

(click here for 2017)

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

Obamacare Providers, Plans and 2018 Rates for Fort Bend County

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

Currently, there are 29 plans offered in Rating Area 10.

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must either

  • contact a licensed health insurance agent (by contacting one of the advertisers you see on this website)
  • complete an application at HealthCare.gov, or
  • contact the provider directly.

The table below shows premiums for the following scenarios for:

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

Each scenario is covered for age

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

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

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

2018 Obamacare Rates Providers, Plans for Fort Bend County

Community Health Choice, Inc.

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

TTY: 1-800-518-1655

Expanded Bronze

Plan: (HMO) Community Health Choice HMO Bronze 003

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

Celtic Insurance Company

Local: 1-877-687-1196 | Toll Free: 1-877-687-1196

TTY: 1-800-735-2989

Gold

Plan: (EPO) Ambetter Secure Care 1 (2018) with 3 Free PCP Visits

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

Community Health Choice, Inc.

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

TTY: 1-800-518-1655

Gold

Plan: (HMO) Community Health Choice HMO Gold 001

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

Plan: (HMO) Community Health Choice HMO Silver 002

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

Plan: (HMO) Community Health Choice HMO Silver 004

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

Plan: (HMO) Community Health Choice HMO Gold 005

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

Plan: (HMO) Community Health Choice- Gold Limited Network Plan 006

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

Plan: (HMO) Community Health Choice- Silver Limited Network Plan 007

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

Plan: (HMO) Community Health Choice HMO Bronze 008 High Deductible Health Plan- HSA Compatible

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

Plan: (EPO) Ambetter Balanced Care 1 (2018)

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

Plan: (EPO) Ambetter Balanced Care 2 (2018)

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

Plan: (EPO) Ambetter Balanced Care 10 (2018)

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

Plan: (EPO) Ambetter Essential Care 1 (2018)

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

Plan: (EPO) Ambetter Balanced Care 3 (2018)

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

Plan: (EPO) Ambetter Balanced Care 4 (2018)

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

Plan: (EPO) Ambetter Balanced Care 12 (2018)

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

Plan: (EPO) Ambetter Balanced Care 5 (2018)

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

Plan: (EPO) Ambetter Balanced Care 1 (2018) + Vision

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

Plan: (EPO) Ambetter Balanced Care 2 (2018) + Vision

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

Plan: (EPO) Ambetter Balanced Care 10 (2018) + Vision

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

Plan: (EPO) Ambetter Essential Care 1 (2018) + Vision

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

Plan: (EPO) Ambetter Balanced Care 3 (2018) + Vision

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

Blue Cross Blue Shield of Texas

Local: 1-888-697-0683 | Toll Free: 1-888-697-0683

TTY: 1-800-735-2989

Gold

Plan: (HMO) Blue Advantage Gold HMO? 206 - Three $30 PCP Visits

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

Plan: (HMO) Blue Advantage Security HMO? 200

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

Plan: (HMO) Blue Advantage Silver HMO? 205 - Two $25 PCP Visits

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

Plan: (HMO) Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits

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

Plan: (HMO) Blue Advantage Plus Bronze? 201

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

Plan: (HMO) Blue Advantage Plus Gold? 203

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

Plan: (HMO) Blue Advantage Plus Silver? 202

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

‡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.

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