Fremont County, Wyoming Obamacare 2024 Rates

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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 Fremont County, WY.

The health insurance rates listed below are for calendar year 2024.

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

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 24 Plans and 2024 Rates for Fremont County, Wyoming

Below, you’ll find a summary of the 24 plans for Fremont County, Wyoming and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.


Obamacare Rates and Providers for Other Years

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Blue Cross Blue Shield of Wyoming

Local: 1-307-634-1393x2949 | Toll Free: 1-800-851-2227 | TTY: 1-800-696-4710

Toc - Plan #1 Blue Cross Blue Shield of Wyoming
Expanded Bronze

(PPO) BlueSelect Bronze Core

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$7,150 $14,300 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$482.01
$547.08
$616.00
$860.86
$1,308.16
$850.75
$915.82
$984.74
$1,229.60
$1,219.49
$1,284.56
$1,353.48
$1,598.34
$1,588.23
$1,653.30
$1,722.22
$1,967.08
$368.74
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$964.02
$1,094.16
$1,232.00
$1,721.72
$2,616.32
$1,332.76
$1,462.90
$1,600.74
$2,090.46
$1,701.50
$1,831.64
$1,969.48
$2,459.20
$2,070.24
$2,200.38
$2,338.22
$2,827.94
$368.74
Toc - Plan #2 Blue Cross Blue Shield of Wyoming
Gold

(PPO) BlueSelect Gold Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$800 $1,600 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$580.58
$658.96
$741.98
$1,036.92
$1,575.69
$1,024.73
$1,103.11
$1,186.13
$1,481.07
$1,468.88
$1,547.26
$1,630.28
$1,925.22
$1,913.03
$1,991.41
$2,074.43
$2,369.37
$444.15
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,161.16
$1,317.92
$1,483.96
$2,073.84
$3,151.38
$1,605.31
$1,762.07
$1,928.11
$2,517.99
$2,049.46
$2,206.22
$2,372.26
$2,962.14
$2,493.61
$2,650.37
$2,816.41
$3,406.29
$444.15
Toc - Plan #3 Blue Cross Blue Shield of Wyoming
Gold

(PPO) BlueSelect Gold HealthPlus

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$580.47
$658.83
$741.83
$1,036.71
$1,575.37
$1,024.53
$1,102.89
$1,185.89
$1,480.77
$1,468.59
$1,546.95
$1,629.95
$1,924.83
$1,912.65
$1,991.01
$2,074.01
$2,368.89
$444.06
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,160.94
$1,317.66
$1,483.66
$2,073.42
$3,150.74
$1,605.00
$1,761.72
$1,927.72
$2,517.48
$2,049.06
$2,205.78
$2,371.78
$2,961.54
$2,493.12
$2,649.84
$2,815.84
$3,405.60
$444.06
Toc - Plan #4 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$2,750 $5,500 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$657.74
$746.54
$840.59
$1,174.73
$1,785.11
$1,160.92
$1,249.72
$1,343.77
$1,677.91
$1,664.10
$1,752.90
$1,846.95
$2,181.09
$2,167.28
$2,256.08
$2,350.13
$2,684.27
$503.18
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,315.48
$1,493.08
$1,681.18
$2,349.46
$3,570.22
$1,818.66
$1,996.26
$2,184.36
$2,852.64
$2,321.84
$2,499.44
$2,687.54
$3,355.82
$2,825.02
$3,002.62
$3,190.72
$3,859.00
$503.18
Toc - Plan #5 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver HealthPlus

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$4,250 $8,500 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$656.66
$745.31
$839.21
$1,172.79
$1,782.16
$1,159.00
$1,247.65
$1,341.55
$1,675.13
$1,661.34
$1,749.99
$1,843.89
$2,177.47
$2,163.68
$2,252.33
$2,346.23
$2,679.81
$502.34
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,313.32
$1,490.62
$1,678.42
$2,345.58
$3,564.32
$1,815.66
$1,992.96
$2,180.76
$2,847.92
$2,318.00
$2,495.30
$2,683.10
$3,350.26
$2,820.34
$2,997.64
$3,185.44
$3,852.60
$502.34
Toc - Plan #6 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver Value

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$659.15
$748.14
$842.40
$1,177.24
$1,788.93
$1,163.40
$1,252.39
$1,346.65
$1,681.49
$1,667.65
$1,756.64
$1,850.90
$2,185.74
$2,171.90
$2,260.89
$2,355.15
$2,689.99
$504.25
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,318.30
$1,496.28
$1,684.80
$2,354.48
$3,577.86
$1,822.55
$2,000.53
$2,189.05
$2,858.73
$2,326.80
$2,504.78
$2,693.30
$3,362.98
$2,831.05
$3,009.03
$3,197.55
$3,867.23
$504.25
Toc - Plan #7 Blue Cross Blue Shield of Wyoming
Bronze

(PPO) BlueSelect Bronze Value

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$494.00
$560.69
$631.33
$882.28
$1,340.71
$871.91
$938.60
$1,009.24
$1,260.19
$1,249.82
$1,316.51
$1,387.15
$1,638.10
$1,627.73
$1,694.42
$1,765.06
$2,016.01
$377.91
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$988.00
$1,121.38
$1,262.66
$1,764.56
$2,681.42
$1,365.91
$1,499.29
$1,640.57
$2,142.47
$1,743.82
$1,877.20
$2,018.48
$2,520.38
$2,121.73
$2,255.11
$2,396.39
$2,898.29
$377.91
Toc - Plan #8 Blue Cross Blue Shield of Wyoming
Bronze

(PPO) BlueSelect Bronze Balance

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$9,100 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$496.77
$563.84
$634.88
$887.24
$1,348.24
$876.80
$943.87
$1,014.91
$1,267.27
$1,256.83
$1,323.90
$1,394.94
$1,647.30
$1,636.86
$1,703.93
$1,774.97
$2,027.33
$380.03
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$993.54
$1,127.68
$1,269.76
$1,774.48
$2,696.48
$1,373.57
$1,507.71
$1,649.79
$2,154.51
$1,753.60
$1,887.74
$2,029.82
$2,534.54
$2,133.63
$2,267.77
$2,409.85
$2,914.57
$380.03
Toc - Plan #9 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver Balance

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$652.19
$740.23
$833.49
$1,164.80
$1,770.03
$1,151.11
$1,239.15
$1,332.41
$1,663.72
$1,650.03
$1,738.07
$1,831.33
$2,162.64
$2,148.95
$2,236.99
$2,330.25
$2,661.56
$498.92
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,304.38
$1,480.46
$1,666.98
$2,329.60
$3,540.06
$1,803.30
$1,979.38
$2,165.90
$2,828.52
$2,302.22
$2,478.30
$2,664.82
$3,327.44
$2,801.14
$2,977.22
$3,163.74
$3,826.36
$498.92
Toc - Plan #10 Blue Cross Blue Shield of Wyoming
Gold

(PPO) BlueSelect Gold Balance

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$565.67
$642.04
$722.93
$1,010.29
$1,535.23
$998.41
$1,074.78
$1,155.67
$1,443.03
$1,431.15
$1,507.52
$1,588.41
$1,875.77
$1,863.89
$1,940.26
$2,021.15
$2,308.51
$432.74
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,131.34
$1,284.08
$1,445.86
$2,020.58
$3,070.46
$1,564.08
$1,716.82
$1,878.60
$2,453.32
$1,996.82
$2,149.56
$2,311.34
$2,886.06
$2,429.56
$2,582.30
$2,744.08
$3,318.80
$432.74
Toc - Plan #11 Blue Cross Blue Shield of Wyoming
Gold

(PPO) BlueSelect Gold Core

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$1,600 $3,200 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$556.95
$632.14
$711.78
$994.71
$1,511.56
$983.02
$1,058.21
$1,137.85
$1,420.78
$1,409.09
$1,484.28
$1,563.92
$1,846.85
$1,835.16
$1,910.35
$1,989.99
$2,272.92
$426.07
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,113.90
$1,264.28
$1,423.56
$1,989.42
$3,023.12
$1,539.97
$1,690.35
$1,849.63
$2,415.49
$1,966.04
$2,116.42
$2,275.70
$2,841.56
$2,392.11
$2,542.49
$2,701.77
$3,267.63
$426.07
Toc - Plan #12 Blue Cross Blue Shield of Wyoming
Bronze

(PPO) BlueSelect Bronze Basic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$9,100 $18,200 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$463.57
$526.15
$592.44
$827.93
$1,258.12
$818.20
$880.78
$947.07
$1,182.56
$1,172.83
$1,235.41
$1,301.70
$1,537.19
$1,527.46
$1,590.04
$1,656.33
$1,891.82
$354.63
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$927.14
$1,052.30
$1,184.88
$1,655.86
$2,516.24
$1,281.77
$1,406.93
$1,539.51
$2,010.49
$1,636.40
$1,761.56
$1,894.14
$2,365.12
$1,991.03
$2,116.19
$2,248.77
$2,719.75
$354.63
Toc - Plan #13 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver Balance without Kid's Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$649.26
$736.91
$829.75
$1,159.57
$1,762.08
$1,145.94
$1,233.59
$1,326.43
$1,656.25
$1,642.62
$1,730.27
$1,823.11
$2,152.93
$2,139.30
$2,226.95
$2,319.79
$2,649.61
$496.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,298.52
$1,473.82
$1,659.50
$2,319.14
$3,524.16
$1,795.20
$1,970.50
$2,156.18
$2,815.82
$2,291.88
$2,467.18
$2,652.86
$3,312.50
$2,788.56
$2,963.86
$3,149.54
$3,809.18
$496.68
Toc - Plan #14 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver Classic without Kid's Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$2,750 $5,500 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$654.78
$743.18
$836.81
$1,169.44
$1,777.07
$1,155.69
$1,244.09
$1,337.72
$1,670.35
$1,656.60
$1,745.00
$1,838.63
$2,171.26
$2,157.51
$2,245.91
$2,339.54
$2,672.17
$500.91
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,309.56
$1,486.36
$1,673.62
$2,338.88
$3,554.14
$1,810.47
$1,987.27
$2,174.53
$2,839.79
$2,311.38
$2,488.18
$2,675.44
$3,340.70
$2,812.29
$2,989.09
$3,176.35
$3,841.61
$500.91
Toc - Plan #15 Blue Cross Blue Shield of Wyoming
Gold

(PPO) BlueSelect Gold Standard without Kid's Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$578.46
$656.55
$739.27
$1,033.13
$1,569.93
$1,020.98
$1,099.07
$1,181.79
$1,475.65
$1,463.50
$1,541.59
$1,624.31
$1,918.17
$1,906.02
$1,984.11
$2,066.83
$2,360.69
$442.52
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,156.92
$1,313.10
$1,478.54
$2,066.26
$3,139.86
$1,599.44
$1,755.62
$1,921.06
$2,508.78
$2,041.96
$2,198.14
$2,363.58
$2,951.30
$2,484.48
$2,640.66
$2,806.10
$3,393.82
$442.52
Toc - Plan #16 Blue Cross Blue Shield of Wyoming
Silver

(PPO) BlueSelect Silver Standard without Kid's Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$650.28
$738.06
$831.05
$1,161.39
$1,764.84
$1,147.74
$1,235.52
$1,328.51
$1,658.85
$1,645.20
$1,732.98
$1,825.97
$2,156.31
$2,142.66
$2,230.44
$2,323.43
$2,653.77
$497.46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,300.56
$1,476.12
$1,662.10
$2,322.78
$3,529.68
$1,798.02
$1,973.58
$2,159.56
$2,820.24
$2,295.48
$2,471.04
$2,657.02
$3,317.70
$2,792.94
$2,968.50
$3,154.48
$3,815.16
$497.46
Toc - Plan #17 Blue Cross Blue Shield of Wyoming
Expanded Bronze

(PPO) BlueSelect Expanded Bronze Standard without Kid's Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-851-2227

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$522.03
$592.51
$667.16
$932.35
$1,416.79
$921.39
$991.87
$1,066.52
$1,331.71
$1,320.75
$1,391.23
$1,465.88
$1,731.07
$1,720.11
$1,790.59
$1,865.24
$2,130.43
$399.36
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,044.06
$1,185.02
$1,334.32
$1,864.70
$2,833.58
$1,443.42
$1,584.38
$1,733.68
$2,264.06
$1,842.78
$1,983.74
$2,133.04
$2,663.42
$2,242.14
$2,383.10
$2,532.40
$3,062.78
$399.36

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Mountain Health CO-OP

Local: 1-406-447-9510 | Toll Free: 1-855-447-2900 | TTY: 1-855-447-2900

Toc - Plan #18 Mountain Health CO-OP
Gold

(PPO) High Plains Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$608.73
$690.91
$777.96
$1,087.20
$1,652.10
$1,074.41
$1,156.59
$1,243.64
$1,552.88
$1,540.09
$1,622.27
$1,709.32
$2,018.56
$2,005.77
$2,087.95
$2,175.00
$2,484.24
$465.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,217.46
$1,381.82
$1,555.92
$2,174.40
$3,304.20
$1,683.14
$1,847.50
$2,021.60
$2,640.08
$2,148.82
$2,313.18
$2,487.28
$3,105.76
$2,614.50
$2,778.86
$2,952.96
$3,571.44
$465.68
Toc - Plan #19 Mountain Health CO-OP
Silver

(PPO) High Plains Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$675.72
$766.95
$863.58
$1,206.84
$1,833.92
$1,192.65
$1,283.88
$1,380.51
$1,723.77
$1,709.58
$1,800.81
$1,897.44
$2,240.70
$2,226.51
$2,317.74
$2,414.37
$2,757.63
$516.93
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,351.44
$1,533.90
$1,727.16
$2,413.68
$3,667.84
$1,868.37
$2,050.83
$2,244.09
$2,930.61
$2,385.30
$2,567.76
$2,761.02
$3,447.54
$2,902.23
$3,084.69
$3,277.95
$3,964.47
$516.93
Toc - Plan #20 Mountain Health CO-OP
Expanded Bronze

(PPO) High Plains Bronze HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$497.12
$564.23
$635.32
$887.86
$1,349.18
$877.42
$944.53
$1,015.62
$1,268.16
$1,257.72
$1,324.83
$1,395.92
$1,648.46
$1,638.02
$1,705.13
$1,776.22
$2,028.76
$380.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$994.24
$1,128.46
$1,270.64
$1,775.72
$2,698.36
$1,374.54
$1,508.76
$1,650.94
$2,156.02
$1,754.84
$1,889.06
$2,031.24
$2,536.32
$2,135.14
$2,269.36
$2,411.54
$2,916.62
$380.30
Toc - Plan #21 Mountain Health CO-OP
Gold

(PPO) High Plains Gold Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$599.96
$680.95
$766.74
$1,071.52
$1,628.28
$1,058.93
$1,139.92
$1,225.71
$1,530.49
$1,517.90
$1,598.89
$1,684.68
$1,989.46
$1,976.87
$2,057.86
$2,143.65
$2,448.43
$458.97
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,199.92
$1,361.90
$1,533.48
$2,143.04
$3,256.56
$1,658.89
$1,820.87
$1,992.45
$2,602.01
$2,117.86
$2,279.84
$2,451.42
$3,060.98
$2,576.83
$2,738.81
$2,910.39
$3,519.95
$458.97
Toc - Plan #22 Mountain Health CO-OP
Silver

(PPO) High Plains Silver Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$661.66
$750.98
$845.60
$1,181.72
$1,795.75
$1,167.83
$1,257.15
$1,351.77
$1,687.89
$1,674.00
$1,763.32
$1,857.94
$2,194.06
$2,180.17
$2,269.49
$2,364.11
$2,700.23
$506.17
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,323.32
$1,501.96
$1,691.20
$2,363.44
$3,591.50
$1,829.49
$2,008.13
$2,197.37
$2,869.61
$2,335.66
$2,514.30
$2,703.54
$3,375.78
$2,841.83
$3,020.47
$3,209.71
$3,881.95
$506.17
Toc - Plan #23 Mountain Health CO-OP
Expanded Bronze

(PPO) High Plains Bronze Standard Expanded

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$488.65
$554.62
$624.49
$872.73
$1,326.19
$862.47
$928.44
$998.31
$1,246.55
$1,236.29
$1,302.26
$1,372.13
$1,620.37
$1,610.11
$1,676.08
$1,745.95
$1,994.19
$373.82
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$977.30
$1,109.24
$1,248.98
$1,745.46
$2,652.38
$1,351.12
$1,483.06
$1,622.80
$2,119.28
$1,724.94
$1,856.88
$1,996.62
$2,493.10
$2,098.76
$2,230.70
$2,370.44
$2,866.92
$373.82
Toc - Plan #24 Mountain Health CO-OP
Gold

(PPO) High Plains Gold HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-447-2900

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$3,500 $7,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$610.08
$692.45
$779.69
$1,089.61
$1,655.77
$1,076.79
$1,159.16
$1,246.40
$1,556.32
$1,543.50
$1,625.87
$1,713.11
$2,023.03
$2,010.21
$2,092.58
$2,179.82
$2,489.74
$466.71
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,220.16
$1,384.90
$1,559.38
$2,179.22
$3,311.54
$1,686.87
$1,851.61
$2,026.09
$2,645.93
$2,153.58
$2,318.32
$2,492.80
$3,112.64
$2,620.29
$2,785.03
$2,959.51
$3,579.35
$466.71

‡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 Fremont County here.

Fremont County is in “Rating Area 3” of Wyoming.

Currently, there are 24 plans offered in Rating Area 3.


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