ADVERTISEMENT
|
CareFirst BlueChoice, Inc.
Local: 1-855-444-3119 | Toll Free: 1-855-444-3119 | TTY: 1-202-479-3546
|
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$3,000 |
$6,000 |
Maximum Out of Pocket Per Year |
$6,650 |
$13,300 |
Deductible: Individual:
$3,000
| Family:
$6,000
Out of Pocket Maximum per year: Individual:
$6,650
| Family:
$13,300
Monthly Premiums:
|
21
30
40
50
60
|
$525.13
$596.02
$671.12
$937.88
$1,425.20 |
$1,050.26
$1,192.04
$1,342.24
$1,875.76
$2,850.40 |
$1,451.98
$1,593.76
$1,743.96
$2,277.48 |
$1,853.70
$1,995.48
$2,145.68
$2,679.20 |
$2,255.42
$2,397.20
$2,547.40
$3,080.92 |
$926.85
$997.74
$1,072.84
$1,339.60 |
$1,328.57
$1,399.46
$1,474.56
$1,741.32 |
$1,730.29
$1,801.18
$1,876.28
$2,143.04 |
$401.72 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,750 |
$3,500 |
Maximum Out of Pocket Per Year |
$6,650 |
$13,300 |
Deductible: Individual:
$1,750
| Family:
$3,500
Out of Pocket Maximum per year: Individual:
$6,650
| Family:
$13,300
Monthly Premiums:
|
21
30
40
50
60
|
$506.09
$574.41
$646.78
$903.88
$1,373.53 |
$1,012.18
$1,148.82
$1,293.56
$1,807.76
$2,747.06 |
$1,399.34
$1,535.98
$1,680.72
$2,194.92 |
$1,786.50
$1,923.14
$2,067.88
$2,582.08 |
$2,173.66
$2,310.30
$2,455.04
$2,969.24 |
$893.25
$961.57
$1,033.94
$1,291.04 |
$1,280.41
$1,348.73
$1,421.10
$1,678.20 |
$1,667.57
$1,735.89
$1,808.26
$2,065.36 |
$387.16 |
|
Catastrophic
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$184.66
$209.59
$236.00
$329.80
$501.17 |
$369.32
$419.18
$472.00
$659.60
$1,002.34 |
$510.58
$560.44
$613.26
$800.86 |
$651.84
$701.70
$754.52
$942.12 |
$793.10
$842.96
$895.78
$1,083.38 |
$325.92
$350.85
$377.26
$471.06 |
$467.18
$492.11
$518.52
$612.32 |
$608.44
$633.37
$659.78
$753.58 |
$141.26 |
ADVERTISEMENT
|
Group Hospitalization and Medical Services Inc.
Local: 1-855-444-3119 | Toll Free: 1-855-444-3119 | TTY: 1-202-479-3546
|
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,750 |
$3,500 |
Maximum Out of Pocket Per Year |
$6,650 |
$13,300 |
Deductible: Individual:
$1,750
| Family:
$3,500
Out of Pocket Maximum per year: Individual:
$6,650
| Family:
$13,300
Monthly Premiums:
|
21
30
40
50
60
|
$1,003.26
$1,138.70
$1,282.17
$1,791.82
$2,722.85 |
$2,006.52
$2,277.40
$2,564.34
$3,583.64
$5,445.70 |
$2,774.01
$3,044.89
$3,331.83
$4,351.13 |
$3,541.50
$3,812.38
$4,099.32
$5,118.62 |
$4,308.99
$4,579.87
$4,866.81
$5,886.11 |
$1,770.75
$1,906.19
$2,049.66
$2,559.31 |
$2,538.24
$2,673.68
$2,817.15
$3,326.80 |
$3,305.73
$3,441.17
$3,584.64
$4,094.29 |
$767.49 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$3,000 |
$6,000 |
Maximum Out of Pocket Per Year |
$6,650 |
$13,300 |
Deductible: Individual:
$3,000
| Family:
$6,000
Out of Pocket Maximum per year: Individual:
$6,650
| Family:
$13,300
Monthly Premiums:
|
21
30
40
50
60
|
$1,018.20
$1,155.66
$1,301.26
$1,818.51
$2,763.39 |
$2,036.40
$2,311.32
$2,602.52
$3,637.02
$5,526.78 |
$2,815.32
$3,090.24
$3,381.44
$4,415.94 |
$3,594.24
$3,869.16
$4,160.36
$5,194.86 |
$4,373.16
$4,648.08
$4,939.28
$5,973.78 |
$1,797.12
$1,934.58
$2,080.18
$2,597.43 |
$2,576.04
$2,713.50
$2,859.10
$3,376.35 |
$3,354.96
$3,492.42
$3,638.02
$4,155.27 |
$778.92 |
ADVERTISEMENT
|
Cigna Health and Life Insurance Company
Local: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777
|
|
Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,000 |
$14,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$7,000
| Family:
$14,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$315.42
$358.01
$403.11
$563.35
$856.06 |
$630.84
$716.02
$806.22
$1,126.70
$1,712.12 |
$872.14
$957.32
$1,047.52
$1,368.00 |
$1,113.44
$1,198.62
$1,288.82
$1,609.30 |
$1,354.74
$1,439.92
$1,530.12
$1,850.60 |
$556.72
$599.31
$644.41
$804.65 |
$798.02
$840.61
$885.71
$1,045.95 |
$1,039.32
$1,081.91
$1,127.01
$1,287.25 |
$241.30 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,750 |
$13,500 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,750
| Family:
$13,500
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$329.19
$373.63
$420.70
$587.93
$893.41 |
$658.38
$747.26
$841.40
$1,175.86
$1,786.82 |
$910.21
$999.09
$1,093.23
$1,427.69 |
$1,162.04
$1,250.92
$1,345.06
$1,679.52 |
$1,413.87
$1,502.75
$1,596.89
$1,931.35 |
$581.02
$625.46
$672.53
$839.76 |
$832.85
$877.29
$924.36
$1,091.59 |
$1,084.68
$1,129.12
$1,176.19
$1,343.42 |
$251.83 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,500 |
$9,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$4,500
| Family:
$9,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$417.28
$473.61
$533.28
$745.26
$1,132.50 |
$834.56
$947.22
$1,066.56
$1,490.52
$2,265.00 |
$1,153.78
$1,266.44
$1,385.78
$1,809.74 |
$1,473.00
$1,585.66
$1,705.00
$2,128.96 |
$1,792.22
$1,904.88
$2,024.22
$2,448.18 |
$736.50
$792.83
$852.50
$1,064.48 |
$1,055.72
$1,112.05
$1,171.72
$1,383.70 |
$1,374.94
$1,431.27
$1,490.94
$1,702.92 |
$319.22 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,500 |
$3,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$1,500
| Family:
$3,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$406.30
$461.15
$519.25
$725.65
$1,102.69 |
$812.60
$922.30
$1,038.50
$1,451.30
$2,205.38 |
$1,123.42
$1,233.12
$1,349.32
$1,762.12 |
$1,434.24
$1,543.94
$1,660.14
$2,072.94 |
$1,745.06
$1,854.76
$1,970.96
$2,383.76 |
$717.12
$771.97
$830.07
$1,036.47 |
$1,027.94
$1,082.79
$1,140.89
$1,347.29 |
$1,338.76
$1,393.61
$1,451.71
$1,658.11 |
$310.82 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,500 |
$13,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,500
| Family:
$13,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$412.28
$467.94
$526.90
$736.34
$1,118.94 |
$824.56
$935.88
$1,053.80
$1,472.68
$2,237.88 |
$1,139.96
$1,251.28
$1,369.20
$1,788.08 |
$1,455.36
$1,566.68
$1,684.60
$2,103.48 |
$1,770.76
$1,882.08
$2,000.00
$2,418.88 |
$727.68
$783.34
$842.30
$1,051.74 |
$1,043.08
$1,098.74
$1,157.70
$1,367.14 |
$1,358.48
$1,414.14
$1,473.10
$1,682.54 |
$315.40 |
ADVERTISEMENT
|
HealthKeepers, Inc.
Local: 1-855-748-1810 | Toll Free: 1-855-748-1810
|
|
Catastrophic
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$240.98
$273.51
$307.97
$430.39
$654.02 |
$481.96
$547.02
$615.94
$860.78
$1,308.04 |
$666.31
$731.37
$800.29
$1,045.13 |
$850.66
$915.72
$984.64
$1,229.48 |
$1,035.01
$1,100.07
$1,168.99
$1,413.83 |
$425.33
$457.86
$492.32
$614.74 |
$609.68
$642.21
$676.67
$799.09 |
$794.03
$826.56
$861.02
$983.44 |
$184.35 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,300 |
$12,600 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,300
| Family:
$12,600
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$318.88
$361.93
$407.53
$569.52
$865.44 |
$637.76
$723.86
$815.06
$1,139.04
$1,730.88 |
$881.70
$967.80
$1,059.00
$1,382.98 |
$1,125.64
$1,211.74
$1,302.94
$1,626.92 |
$1,369.58
$1,455.68
$1,546.88
$1,870.86 |
$562.82
$605.87
$651.47
$813.46 |
$806.76
$849.81
$895.41
$1,057.40 |
$1,050.70
$1,093.75
$1,139.35
$1,301.34 |
$243.94 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,250 |
$10,500 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,250
| Family:
$10,500
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$313.52
$355.85
$400.68
$559.95
$850.89 |
$627.04
$711.70
$801.36
$1,119.90
$1,701.78 |
$866.88
$951.54
$1,041.20
$1,359.74 |
$1,106.72
$1,191.38
$1,281.04
$1,599.58 |
$1,346.56
$1,431.22
$1,520.88
$1,839.42 |
$553.36
$595.69
$640.52
$799.79 |
$793.20
$835.53
$880.36
$1,039.63 |
$1,033.04
$1,075.37
$1,120.20
$1,279.47 |
$239.84 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$4,900 |
$9,800 |
Maximum Out of Pocket Per Year |
$6,850 |
$13,700 |
Deductible: Individual:
$4,900
| Family:
$9,800
Out of Pocket Maximum per year: Individual:
$6,850
| Family:
$13,700
Monthly Premiums:
|
21
30
40
50
60
|
$320.06
$363.27
$409.04
$571.63
$868.64 |
$640.12
$726.54
$818.08
$1,143.26
$1,737.28 |
$884.97
$971.39
$1,062.93
$1,388.11 |
$1,129.82
$1,216.24
$1,307.78
$1,632.96 |
$1,374.67
$1,461.09
$1,552.63
$1,877.81 |
$564.91
$608.12
$653.89
$816.48 |
$809.76
$852.97
$898.74
$1,061.33 |
$1,054.61
$1,097.82
$1,143.59
$1,306.18 |
$244.85 |
|
Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$7,500 |
$15,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$7,500
| Family:
$15,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$300.29
$340.83
$383.77
$536.32
$814.99 |
$600.58
$681.66
$767.54
$1,072.64
$1,629.98 |
$830.30
$911.38
$997.26
$1,302.36 |
$1,060.02
$1,141.10
$1,226.98
$1,532.08 |
$1,289.74
$1,370.82
$1,456.70
$1,761.80 |
$530.01
$570.55
$613.49
$766.04 |
$759.73
$800.27
$843.21
$995.76 |
$989.45
$1,029.99
$1,072.93
$1,225.48 |
$229.72 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,600 |
$4,800 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$1,600
| Family:
$4,800
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$404.54
$459.15
$517.00
$722.51
$1,097.92 |
$809.08
$918.30
$1,034.00
$1,445.02
$2,195.84 |
$1,118.55
$1,227.77
$1,343.47
$1,754.49 |
$1,428.02
$1,537.24
$1,652.94
$2,063.96 |
$1,737.49
$1,846.71
$1,962.41
$2,373.43 |
$714.01
$768.62
$826.47
$1,031.98 |
$1,023.48
$1,078.09
$1,135.94
$1,341.45 |
$1,332.95
$1,387.56
$1,445.41
$1,650.92 |
$309.47 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,000 |
$4,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$2,000
| Family:
$4,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$435.83
$494.67
$556.99
$778.39
$1,182.84 |
$871.66
$989.34
$1,113.98
$1,556.78
$2,365.68 |
$1,205.07
$1,322.75
$1,447.39
$1,890.19 |
$1,538.48
$1,656.16
$1,780.80
$2,223.60 |
$1,871.89
$1,989.57
$2,114.21
$2,557.01 |
$769.24
$828.08
$890.40
$1,111.80 |
$1,102.65
$1,161.49
$1,223.81
$1,445.21 |
$1,436.06
$1,494.90
$1,557.22
$1,778.62 |
$333.41 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,250 |
$12,500 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,250
| Family:
$12,500
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$402.15
$456.44
$513.95
$718.24
$1,091.44 |
$804.30
$912.88
$1,027.90
$1,436.48
$2,182.88 |
$1,111.94
$1,220.52
$1,335.54
$1,744.12 |
$1,419.58
$1,528.16
$1,643.18
$2,051.76 |
$1,727.22
$1,835.80
$1,950.82
$2,359.40 |
$709.79
$764.08
$821.59
$1,025.88 |
$1,017.43
$1,071.72
$1,129.23
$1,333.52 |
$1,325.07
$1,379.36
$1,436.87
$1,641.16 |
$307.64 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,700 |
$11,400 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,700
| Family:
$11,400
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$322.65
$366.21
$412.35
$576.25
$875.67 |
$645.30
$732.42
$824.70
$1,152.50
$1,751.34 |
$892.13
$979.25
$1,071.53
$1,399.33 |
$1,138.96
$1,226.08
$1,318.36
$1,646.16 |
$1,385.79
$1,472.91
$1,565.19
$1,892.99 |
$569.48
$613.04
$659.18
$823.08 |
$816.31
$859.87
$906.01
$1,069.91 |
$1,063.14
$1,106.70
$1,152.84
$1,316.74 |
$246.83 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,000 |
$10,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,000
| Family:
$10,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$410.47
$465.88
$524.58
$733.10
$1,114.02 |
$820.94
$931.76
$1,049.16
$1,466.20
$2,228.04 |
$1,134.95
$1,245.77
$1,363.17
$1,780.21 |
$1,448.96
$1,559.78
$1,677.18
$2,094.22 |
$1,762.97
$1,873.79
$1,991.19
$2,408.23 |
$724.48
$779.89
$838.59
$1,047.11 |
$1,038.49
$1,093.90
$1,152.60
$1,361.12 |
$1,352.50
$1,407.91
$1,466.61
$1,675.13 |
$314.01 |
ADVERTISEMENT
|
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
Local: 1-800-807-1140 | Toll Free: 1-800-807-1140 | TTY: 1-703-359-7616
|
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$0 |
$0 |
Maximum Out of Pocket Per Year |
$6,850 |
$13,700 |
Deductible: Individual:
$0
| Family:
$0
Out of Pocket Maximum per year: Individual:
$6,850
| Family:
$13,700
Monthly Premiums:
|
21
30
40
50
60
|
$477.82
$542.32
$610.65
$853.38
$1,296.79 |
$955.64
$1,084.64
$1,221.30
$1,706.76
$2,593.58 |
$1,321.17
$1,450.17
$1,586.83
$2,072.29 |
$1,686.70
$1,815.70
$1,952.36
$2,437.82 |
$2,052.23
$2,181.23
$2,317.89
$2,803.35 |
$843.35
$907.85
$976.18
$1,218.91 |
$1,208.88
$1,273.38
$1,341.71
$1,584.44 |
$1,574.41
$1,638.91
$1,707.24
$1,949.97 |
$365.53 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,000 |
$2,000 |
Maximum Out of Pocket Per Year |
$6,950 |
$13,900 |
Deductible: Individual:
$1,000
| Family:
$2,000
Out of Pocket Maximum per year: Individual:
$6,950
| Family:
$13,900
Monthly Premiums:
|
21
30
40
50
60
|
$468.66
$531.93
$598.95
$837.03
$1,271.94 |
$937.32
$1,063.86
$1,197.90
$1,674.06
$2,543.88 |
$1,295.84
$1,422.38
$1,556.42
$2,032.58 |
$1,654.36
$1,780.90
$1,914.94
$2,391.10 |
$2,012.88
$2,139.42
$2,273.46
$2,749.62 |
$827.18
$890.45
$957.47
$1,195.55 |
$1,185.70
$1,248.97
$1,315.99
$1,554.07 |
$1,544.22
$1,607.49
$1,674.51
$1,912.59 |
$358.52 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$2,500 |
$5,000 |
Maximum Out of Pocket Per Year |
$7,750 |
$15,500 |
Deductible: Individual:
$2,500
| Family:
$5,000
Out of Pocket Maximum per year: Individual:
$7,750
| Family:
$15,500
Monthly Premiums:
|
21
30
40
50
60
|
$494.95
$561.76
$632.54
$883.97
$1,343.28 |
$989.90
$1,123.52
$1,265.08
$1,767.94
$2,686.56 |
$1,368.53
$1,502.15
$1,643.71
$2,146.57 |
$1,747.16
$1,880.78
$2,022.34
$2,525.20 |
$2,125.79
$2,259.41
$2,400.97
$2,903.83 |
$873.58
$940.39
$1,011.17
$1,262.60 |
$1,252.21
$1,319.02
$1,389.80
$1,641.23 |
$1,630.84
$1,697.65
$1,768.43
$2,019.86 |
$378.63 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$3,200 |
$6,400 |
Maximum Out of Pocket Per Year |
$6,650 |
$13,300 |
Deductible: Individual:
$3,200
| Family:
$6,400
Out of Pocket Maximum per year: Individual:
$6,650
| Family:
$13,300
Monthly Premiums:
|
21
30
40
50
60
|
$463.07
$525.59
$591.80
$827.04
$1,256.77 |
$926.14
$1,051.18
$1,183.60
$1,654.08
$2,513.54 |
$1,280.39
$1,405.43
$1,537.85
$2,008.33 |
$1,634.64
$1,759.68
$1,892.10
$2,362.58 |
$1,988.89
$2,113.93
$2,246.35
$2,716.83 |
$817.32
$879.84
$946.05
$1,181.29 |
$1,171.57
$1,234.09
$1,300.30
$1,535.54 |
$1,525.82
$1,588.34
$1,654.55
$1,889.79 |
$354.25 |
|
Expanded Bronze
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$5,500 |
$11,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$5,500
| Family:
$11,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$386.92
$439.15
$494.48
$691.04
$1,050.10 |
$773.84
$878.30
$988.96
$1,382.08
$2,100.20 |
$1,069.83
$1,174.29
$1,284.95
$1,678.07 |
$1,365.82
$1,470.28
$1,580.94
$1,974.06 |
$1,661.81
$1,766.27
$1,876.93
$2,270.05 |
$682.91
$735.14
$790.47
$987.03 |
$978.90
$1,031.13
$1,086.46
$1,283.02 |
$1,274.89
$1,327.12
$1,382.45
$1,579.01 |
$295.99 |
|
Catastrophic
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$8,150 |
$16,300 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$8,150
| Family:
$16,300
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$281.12
$319.07
$359.27
$502.08
$762.97 |
$562.24
$638.14
$718.54
$1,004.16
$1,525.94 |
$777.30
$853.20
$933.60
$1,219.22 |
$992.36
$1,068.26
$1,148.66
$1,434.28 |
$1,207.42
$1,283.32
$1,363.72
$1,649.34 |
$496.18
$534.13
$574.33
$717.14 |
$711.24
$749.19
$789.39
$932.20 |
$926.30
$964.25
$1,004.45
$1,147.26 |
$215.06 |
|
Platinum
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$0 |
$0 |
Maximum Out of Pocket Per Year |
$4,000 |
$8,000 |
Deductible: Individual:
$0
| Family:
$0
Out of Pocket Maximum per year: Individual:
$4,000
| Family:
$8,000
Monthly Premiums:
|
21
30
40
50
60
|
$555.34
$630.32
$709.73
$991.84
$1,507.20 |
$1,110.68
$1,260.64
$1,419.46
$1,983.68
$3,014.40 |
$1,535.52
$1,685.48
$1,844.30
$2,408.52 |
$1,960.36
$2,110.32
$2,269.14
$2,833.36 |
$2,385.20
$2,535.16
$2,693.98
$3,258.20 |
$980.18
$1,055.16
$1,134.57
$1,416.68 |
$1,405.02
$1,480.00
$1,559.41
$1,841.52 |
$1,829.86
$1,904.84
$1,984.25
$2,266.36 |
$424.84 |
|
Silver
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$6,000 |
$12,000 |
Maximum Out of Pocket Per Year |
$8,150 |
$16,300 |
Deductible: Individual:
$6,000
| Family:
$12,000
Out of Pocket Maximum per year: Individual:
$8,150
| Family:
$16,300
Monthly Premiums:
|
21
30
40
50
60
|
$465.39
$528.22
$594.77
$831.19
$1,263.07 |
$930.78
$1,056.44
$1,189.54
$1,662.38
$2,526.14 |
$1,286.80
$1,412.46
$1,545.56
$2,018.40 |
$1,642.82
$1,768.48
$1,901.58
$2,374.42 |
$1,998.84
$2,124.50
$2,257.60
$2,730.44 |
$821.41
$884.24
$950.79
$1,187.21 |
$1,177.43
$1,240.26
$1,306.81
$1,543.23 |
$1,533.45
$1,596.28
$1,662.83
$1,899.25 |
$356.02 |
|
Gold
|
Annual Out of Pocket Expenses
|
Individual |
Family |
Annual Deductible |
$1,500 |
$3,000 |
Maximum Out of Pocket Per Year |
$6,850 |
$13,700 |
Deductible: Individual:
$1,500
| Family:
$3,000
Out of Pocket Maximum per year: Individual:
$6,850
| Family:
$13,700
Monthly Premiums:
|
21
30
40
50
60
|
$456.68
$518.33
$583.64
$815.63
$1,239.43 |
$913.36
$1,036.66
$1,167.28
$1,631.26
$2,478.86 |
$1,262.72
$1,386.02
$1,516.64
$1,980.62 |
$1,612.08
$1,735.38
$1,866.00
$2,329.98 |
$1,961.44
$2,084.74
$2,215.36
$2,679.34 |
$806.04
$867.69
$933.00
$1,164.99 |
$1,155.40
$1,217.05
$1,282.36
$1,514.35 |
$1,504.76
$1,566.41
$1,631.72
$1,863.71 |
$349.36 |
Prince William County is in “Rating Area 10” of Virginia.
Currently, there are 29 plans offered in Rating Area 10.