Shelby County, Illinois 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 Shelby County, IL.

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, 47 Plans and 2024 Rates for Shelby County, Illinois

Below, you’ll find a summary of the 47 plans for Shelby County, Illinois 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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Health Alliance

Local: 1-866-247-3296 | Toll Free: 1-866-247-3296 | TTY: 1-800-526-0844

Toc - Plan #1 Health Alliance
Catastrophic

(HMO) 2024 HMO 9450 Elite Catastrophic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$9,450 $18,900 Annual Deductible
$9,450 $18,900 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
$325.54
$369.49
$416.04
$581.42
$883.52
$574.58
$618.53
$665.08
$830.46
$823.62
$867.57
$914.12
$1,079.50
$1,072.66
$1,116.61
$1,163.16
$1,328.54
$249.04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$651.08
$738.98
$832.08
$1,162.84
$1,767.04
$900.12
$988.02
$1,081.12
$1,411.88
$1,149.16
$1,237.06
$1,330.16
$1,660.92
$1,398.20
$1,486.10
$1,579.20
$1,909.96
$249.04
Toc - Plan #2 Health Alliance
Expanded Bronze

(POS) 2024 POS 6500 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 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
$433.52
$492.05
$554.04
$774.27
$1,176.58
$765.16
$823.69
$885.68
$1,105.91
$1,096.80
$1,155.33
$1,217.32
$1,437.55
$1,428.44
$1,486.97
$1,548.96
$1,769.19
$331.64
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$867.04
$984.10
$1,108.08
$1,548.54
$2,353.16
$1,198.68
$1,315.74
$1,439.72
$1,880.18
$1,530.32
$1,647.38
$1,771.36
$2,211.82
$1,861.96
$1,979.02
$2,103.00
$2,543.46
$331.64
Toc - Plan #3 Health Alliance
Silver

(POS) 2024 POS 7250 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$7,250 $14,500 Annual Deductible
$8,600 $17,200 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
$569.97
$646.92
$728.42
$1,017.97
$1,546.91
$1,005.99
$1,082.94
$1,164.44
$1,453.99
$1,442.01
$1,518.96
$1,600.46
$1,890.01
$1,878.03
$1,954.98
$2,036.48
$2,326.03
$436.02
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,139.94
$1,293.84
$1,456.84
$2,035.94
$3,093.82
$1,575.96
$1,729.86
$1,892.86
$2,471.96
$2,011.98
$2,165.88
$2,328.88
$2,907.98
$2,448.00
$2,601.90
$2,764.90
$3,344.00
$436.02
Toc - Plan #4 Health Alliance
Expanded Bronze

(POS) 2024 POS HSA 7100 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$7,100 $14,200 Annual Deductible
$7,100 $14,200 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
$418.35
$474.82
$534.65
$747.17
$1,135.40
$738.39
$794.86
$854.69
$1,067.21
$1,058.43
$1,114.90
$1,174.73
$1,387.25
$1,378.47
$1,434.94
$1,494.77
$1,707.29
$320.04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$836.70
$949.64
$1,069.30
$1,494.34
$2,270.80
$1,156.74
$1,269.68
$1,389.34
$1,814.38
$1,476.78
$1,589.72
$1,709.38
$2,134.42
$1,796.82
$1,909.76
$2,029.42
$2,454.46
$320.04
Toc - Plan #5 Health Alliance
Gold

(POS) 2024 POS 1000 Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$6,000 $12,000 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
$635.58
$721.39
$812.28
$1,135.15
$1,724.97
$1,121.80
$1,207.61
$1,298.50
$1,621.37
$1,608.02
$1,693.83
$1,784.72
$2,107.59
$2,094.24
$2,180.05
$2,270.94
$2,593.81
$486.22
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,271.16
$1,442.78
$1,624.56
$2,270.30
$3,449.94
$1,757.38
$1,929.00
$2,110.78
$2,756.52
$2,243.60
$2,415.22
$2,597.00
$3,242.74
$2,729.82
$2,901.44
$3,083.22
$3,728.96
$486.22
Toc - Plan #6 Health Alliance
Gold

(POS) 2024 POS 2500 Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

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:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$614.86
$697.87
$785.80
$1,098.15
$1,668.74
$1,085.23
$1,168.24
$1,256.17
$1,568.52
$1,555.60
$1,638.61
$1,726.54
$2,038.89
$2,025.97
$2,108.98
$2,196.91
$2,509.26
$470.37
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,229.72
$1,395.74
$1,571.60
$2,196.30
$3,337.48
$1,700.09
$1,866.11
$2,041.97
$2,666.67
$2,170.46
$2,336.48
$2,512.34
$3,137.04
$2,640.83
$2,806.85
$2,982.71
$3,607.41
$470.37
Toc - Plan #7 Health Alliance
Silver

(POS) 2024 POS 4200 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$4,200 $8,400 Annual Deductible
$8,750 $17,500 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
$596.67
$677.22
$762.54
$1,065.64
$1,619.36
$1,053.12
$1,133.67
$1,218.99
$1,522.09
$1,509.57
$1,590.12
$1,675.44
$1,978.54
$1,966.02
$2,046.57
$2,131.89
$2,434.99
$456.45
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,193.34
$1,354.44
$1,525.08
$2,131.28
$3,238.72
$1,649.79
$1,810.89
$1,981.53
$2,587.73
$2,106.24
$2,267.34
$2,437.98
$3,044.18
$2,562.69
$2,723.79
$2,894.43
$3,500.63
$456.45
Toc - Plan #8 Health Alliance
Platinum

(POS) 2024 POS 0 Elite Platinum

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$3,200 $6,400 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
$732.74
$831.66
$936.44
$1,308.67
$1,988.66
$1,293.28
$1,392.20
$1,496.98
$1,869.21
$1,853.82
$1,952.74
$2,057.52
$2,429.75
$2,414.36
$2,513.28
$2,618.06
$2,990.29
$560.54
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,465.48
$1,663.32
$1,872.88
$2,617.34
$3,977.32
$2,026.02
$2,223.86
$2,433.42
$3,177.88
$2,586.56
$2,784.40
$2,993.96
$3,738.42
$3,147.10
$3,344.94
$3,554.50
$4,298.96
$560.54
Toc - Plan #9 Health Alliance
Gold

(POS) 2024 POS 1500 Elite Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

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
$591.95
$671.87
$756.51
$1,057.22
$1,606.56
$1,044.79
$1,124.71
$1,209.35
$1,510.06
$1,497.63
$1,577.55
$1,662.19
$1,962.90
$1,950.47
$2,030.39
$2,115.03
$2,415.74
$452.84
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,183.90
$1,343.74
$1,513.02
$2,114.44
$3,213.12
$1,636.74
$1,796.58
$1,965.86
$2,567.28
$2,089.58
$2,249.42
$2,418.70
$3,020.12
$2,542.42
$2,702.26
$2,871.54
$3,472.96
$452.84
Toc - Plan #10 Health Alliance
Silver

(POS) 2024 POS 5900 Elite Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

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
$541.51
$614.62
$692.06
$967.14
$1,469.67
$955.77
$1,028.88
$1,106.32
$1,381.40
$1,370.03
$1,443.14
$1,520.58
$1,795.66
$1,784.29
$1,857.40
$1,934.84
$2,209.92
$414.26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,083.02
$1,229.24
$1,384.12
$1,934.28
$2,939.34
$1,497.28
$1,643.50
$1,798.38
$2,348.54
$1,911.54
$2,057.76
$2,212.64
$2,762.80
$2,325.80
$2,472.02
$2,626.90
$3,177.06
$414.26
Toc - Plan #11 Health Alliance
Expanded Bronze

(POS) 2024 POS 7500 Elite Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-247-3296

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
$424.52
$481.83
$542.54
$758.19
$1,152.15
$749.28
$806.59
$867.30
$1,082.95
$1,074.04
$1,131.35
$1,192.06
$1,407.71
$1,398.80
$1,456.11
$1,516.82
$1,732.47
$324.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$849.04
$963.66
$1,085.08
$1,516.38
$2,304.30
$1,173.80
$1,288.42
$1,409.84
$1,841.14
$1,498.56
$1,613.18
$1,734.60
$2,165.90
$1,823.32
$1,937.94
$2,059.36
$2,490.66
$324.76

ADVERTISEMENT

Blue Cross and Blue Shield of Illinois

Local: 1-800-538-8833 | Toll Free: 1-800-538-8833 | TTY: 1-800-526-0844

Toc - Plan #12 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 204 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 Annual Deductible
$9,450 $18,900 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
$609.99
$692.34
$779.57
$1,089.45
$1,655.52
$1,076.63
$1,158.98
$1,246.21
$1,556.09
$1,543.27
$1,625.62
$1,712.85
$2,022.73
$2,009.91
$2,092.26
$2,179.49
$2,489.37
$466.64
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,219.98
$1,384.68
$1,559.14
$2,178.90
$3,311.04
$1,686.62
$1,851.32
$2,025.78
$2,645.54
$2,153.26
$2,317.96
$2,492.42
$3,112.18
$2,619.90
$2,784.60
$2,959.06
$3,578.82
$466.64
Toc - Plan #13 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 203

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$2,250 $4,500 Annual Deductible
$9,450 $18,900 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
$525.85
$596.84
$672.04
$939.17
$1,427.16
$928.13
$999.12
$1,074.32
$1,341.45
$1,330.41
$1,401.40
$1,476.60
$1,743.73
$1,732.69
$1,803.68
$1,878.88
$2,146.01
$402.28
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,051.70
$1,193.68
$1,344.08
$1,878.34
$2,854.32
$1,453.98
$1,595.96
$1,746.36
$2,280.62
$1,856.26
$1,998.24
$2,148.64
$2,682.90
$2,258.54
$2,400.52
$2,550.92
$3,085.18
$402.28
Toc - Plan #14 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 202

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 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
$461.42
$523.71
$589.70
$824.10
$1,252.30
$814.41
$876.70
$942.69
$1,177.09
$1,167.40
$1,229.69
$1,295.68
$1,530.08
$1,520.39
$1,582.68
$1,648.67
$1,883.07
$352.99
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$922.84
$1,047.42
$1,179.40
$1,648.20
$2,504.60
$1,275.83
$1,400.41
$1,532.39
$2,001.19
$1,628.82
$1,753.40
$1,885.38
$2,354.18
$1,981.81
$2,106.39
$2,238.37
$2,707.17
$352.99
Toc - Plan #15 Blue Cross and Blue Shield of Illinois
Catastrophic

(PPO) Blue Choice Preferred Security PPO? 200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$9,450 $18,900 Annual Deductible
$9,450 $18,900 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
$383.25
$434.99
$489.80
$684.49
$1,040.15
$676.44
$728.18
$782.99
$977.68
$969.63
$1,021.37
$1,076.18
$1,270.87
$1,262.82
$1,314.56
$1,369.37
$1,564.06
$293.19
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$766.50
$869.98
$979.60
$1,368.98
$2,080.30
$1,059.69
$1,163.17
$1,272.79
$1,662.17
$1,352.88
$1,456.36
$1,565.98
$1,955.36
$1,646.07
$1,749.55
$1,859.17
$2,248.55
$293.19
Toc - Plan #16 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 201

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$9,450 $18,900 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
$415.93
$472.08
$531.56
$742.86
$1,128.84
$734.12
$790.27
$849.75
$1,061.05
$1,052.31
$1,108.46
$1,167.94
$1,379.24
$1,370.50
$1,426.65
$1,486.13
$1,697.43
$318.19
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$831.86
$944.16
$1,063.12
$1,485.72
$2,257.68
$1,150.05
$1,262.35
$1,381.31
$1,803.91
$1,468.24
$1,580.54
$1,699.50
$2,122.10
$1,786.43
$1,898.73
$2,017.69
$2,440.29
$318.19
Toc - Plan #17 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 601 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,450 $18,900 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
$406.75
$461.67
$519.83
$726.46
$1,103.93
$717.92
$772.84
$831.00
$1,037.63
$1,029.09
$1,084.01
$1,142.17
$1,348.80
$1,340.26
$1,395.18
$1,453.34
$1,659.97
$311.17
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$813.50
$923.34
$1,039.66
$1,452.92
$2,207.86
$1,124.67
$1,234.51
$1,350.83
$1,764.09
$1,435.84
$1,545.68
$1,662.00
$2,075.26
$1,747.01
$1,856.85
$1,973.17
$2,386.43
$311.17
Toc - Plan #18 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 701 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$9,000 $18,000 Annual Deductible
$9,450 $18,900 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
$385.99
$438.10
$493.30
$689.38
$1,047.59
$681.27
$733.38
$788.58
$984.66
$976.55
$1,028.66
$1,083.86
$1,279.94
$1,271.83
$1,323.94
$1,379.14
$1,575.22
$295.28
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$771.98
$876.20
$986.60
$1,378.76
$2,095.18
$1,067.26
$1,171.48
$1,281.88
$1,674.04
$1,362.54
$1,466.76
$1,577.16
$1,969.32
$1,657.82
$1,762.04
$1,872.44
$2,264.60
$295.28
Toc - Plan #19 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 707

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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
$601.48
$682.68
$768.69
$1,074.24
$1,632.41
$1,061.61
$1,142.81
$1,228.82
$1,534.37
$1,521.74
$1,602.94
$1,688.95
$1,994.50
$1,981.87
$2,063.07
$2,149.08
$2,454.63
$460.13
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,202.96
$1,365.36
$1,537.38
$2,148.48
$3,264.82
$1,663.09
$1,825.49
$1,997.51
$2,608.61
$2,123.22
$2,285.62
$2,457.64
$3,068.74
$2,583.35
$2,745.75
$2,917.77
$3,528.87
$460.13
Toc - Plan #20 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 708

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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
$459.02
$520.99
$586.62
$819.81
$1,245.77
$810.17
$872.14
$937.77
$1,170.96
$1,161.32
$1,223.29
$1,288.92
$1,522.11
$1,512.47
$1,574.44
$1,640.07
$1,873.26
$351.15
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$918.04
$1,041.98
$1,173.24
$1,639.62
$2,491.54
$1,269.19
$1,393.13
$1,524.39
$1,990.77
$1,620.34
$1,744.28
$1,875.54
$2,341.92
$1,971.49
$2,095.43
$2,226.69
$2,693.07
$351.15
Toc - Plan #21 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 706

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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
$529.53
$601.02
$676.74
$945.75
$1,437.15
$934.62
$1,006.11
$1,081.83
$1,350.84
$1,339.71
$1,411.20
$1,486.92
$1,755.93
$1,744.80
$1,816.29
$1,892.01
$2,161.02
$405.09
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,059.06
$1,202.04
$1,353.48
$1,891.50
$2,874.30
$1,464.15
$1,607.13
$1,758.57
$2,296.59
$1,869.24
$2,012.22
$2,163.66
$2,701.68
$2,274.33
$2,417.31
$2,568.75
$3,106.77
$405.09
Toc - Plan #22 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 801 - Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$6,200 $12,400 Annual Deductible
$9,450 $18,900 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
$518.54
$588.54
$662.69
$926.11
$1,407.31
$915.22
$985.22
$1,059.37
$1,322.79
$1,311.90
$1,381.90
$1,456.05
$1,719.47
$1,708.58
$1,778.58
$1,852.73
$2,116.15
$396.68
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,037.08
$1,177.08
$1,325.38
$1,852.22
$2,814.62
$1,433.76
$1,573.76
$1,722.06
$2,248.90
$1,830.44
$1,970.44
$2,118.74
$2,645.58
$2,227.12
$2,367.12
$2,515.42
$3,042.26
$396.68

ADVERTISEMENT

UnitedHealthcare

Local: 1-888-200-0325 | Toll Free: 1-888-200-0325 | TTY: 1-888-200-0325

Toc - Plan #23 UnitedHealthcare
Silver

(HMO) UHC Silver Value (Virtual Urgent Care)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$9,450 $18,900 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
$468.11
$531.30
$598.24
$836.04
$1,270.45
$826.21
$889.40
$956.34
$1,194.14
$1,184.31
$1,247.50
$1,314.44
$1,552.24
$1,542.41
$1,605.60
$1,672.54
$1,910.34
$358.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$936.22
$1,062.60
$1,196.48
$1,672.08
$2,540.90
$1,294.32
$1,420.70
$1,554.58
$2,030.18
$1,652.42
$1,778.80
$1,912.68
$2,388.28
$2,010.52
$2,136.90
$2,270.78
$2,746.38
$358.10
Toc - Plan #24 UnitedHealthcare
Silver

(HMO) UHC Silver Virtual First (Unlimited App-based Care) (Disponible en espanol)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$3,800 $7,600 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
$461.26
$523.53
$589.49
$823.81
$1,251.86
$814.12
$876.39
$942.35
$1,176.67
$1,166.98
$1,229.25
$1,295.21
$1,529.53
$1,519.84
$1,582.11
$1,648.07
$1,882.39
$352.86
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$922.52
$1,047.06
$1,178.98
$1,647.62
$2,503.72
$1,275.38
$1,399.92
$1,531.84
$2,000.48
$1,628.24
$1,752.78
$1,884.70
$2,353.34
$1,981.10
$2,105.64
$2,237.56
$2,706.20
$352.86
Toc - Plan #25 UnitedHealthcare
Gold

(HMO) UHC Gold Standard (Rx Copay)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

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
$547.29
$621.17
$699.43
$977.45
$1,485.34
$965.96
$1,039.84
$1,118.10
$1,396.12
$1,384.63
$1,458.51
$1,536.77
$1,814.79
$1,803.30
$1,877.18
$1,955.44
$2,233.46
$418.67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,094.58
$1,242.34
$1,398.86
$1,954.90
$2,970.68
$1,513.25
$1,661.01
$1,817.53
$2,373.57
$1,931.92
$2,079.68
$2,236.20
$2,792.24
$2,350.59
$2,498.35
$2,654.87
$3,210.91
$418.67
Toc - Plan #26 UnitedHealthcare
Silver

(HMO) UHC Silver Copay Focus (Virtual Urgent Care + PCP Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,450 $18,900 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
$480.53
$545.40
$614.12
$858.23
$1,304.17
$848.14
$913.01
$981.73
$1,225.84
$1,215.75
$1,280.62
$1,349.34
$1,593.45
$1,583.36
$1,648.23
$1,716.95
$1,961.06
$367.61
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$961.06
$1,090.80
$1,228.24
$1,716.46
$2,608.34
$1,328.67
$1,458.41
$1,595.85
$2,084.07
$1,696.28
$1,826.02
$1,963.46
$2,451.68
$2,063.89
$2,193.63
$2,331.07
$2,819.29
$367.61
Toc - Plan #27 UnitedHealthcare
Silver

(HMO) UHC Silver Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

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
$470.01
$533.47
$600.68
$839.45
$1,275.62
$829.57
$893.03
$960.24
$1,199.01
$1,189.13
$1,252.59
$1,319.80
$1,558.57
$1,548.69
$1,612.15
$1,679.36
$1,918.13
$359.56
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$940.02
$1,066.94
$1,201.36
$1,678.90
$2,551.24
$1,299.58
$1,426.50
$1,560.92
$2,038.46
$1,659.14
$1,786.06
$1,920.48
$2,398.02
$2,018.70
$2,145.62
$2,280.04
$2,757.58
$359.56
Toc - Plan #28 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value (Virtual Urgent Care + PCP Visits, Rx Copay)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$7,850 $15,700 Annual Deductible
$9,450 $18,900 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
$386.87
$439.09
$494.42
$690.94
$1,049.96
$682.82
$735.04
$790.37
$986.89
$978.77
$1,030.99
$1,086.32
$1,282.84
$1,274.72
$1,326.94
$1,382.27
$1,578.79
$295.95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$773.74
$878.18
$988.84
$1,381.88
$2,099.92
$1,069.69
$1,174.13
$1,284.79
$1,677.83
$1,365.64
$1,470.08
$1,580.74
$1,973.78
$1,661.59
$1,766.03
$1,876.69
$2,269.73
$295.95
Toc - Plan #29 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$6,700 $13,400 Annual Deductible
$8,050 $16,100 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
$372.96
$423.31
$476.65
$666.11
$1,012.22
$658.28
$708.63
$761.97
$951.43
$943.60
$993.95
$1,047.29
$1,236.75
$1,228.92
$1,279.27
$1,332.61
$1,522.07
$285.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$745.92
$846.62
$953.30
$1,332.22
$2,024.44
$1,031.24
$1,131.94
$1,238.62
$1,617.54
$1,316.56
$1,417.26
$1,523.94
$1,902.86
$1,601.88
$1,702.58
$1,809.26
$2,188.18
$285.32
Toc - Plan #30 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

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
$389.25
$441.80
$497.47
$695.21
$1,056.43
$687.03
$739.58
$795.25
$992.99
$984.81
$1,037.36
$1,093.03
$1,290.77
$1,282.59
$1,335.14
$1,390.81
$1,588.55
$297.78
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$778.50
$883.60
$994.94
$1,390.42
$2,112.86
$1,076.28
$1,181.38
$1,292.72
$1,688.20
$1,374.06
$1,479.16
$1,590.50
$1,985.98
$1,671.84
$1,776.94
$1,888.28
$2,283.76
$297.78
Toc - Plan #31 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Copay Focus (Virtual Urgent Care)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,450 $18,900 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
$412.16
$467.80
$526.74
$736.11
$1,118.60
$727.46
$783.10
$842.04
$1,051.41
$1,042.76
$1,098.40
$1,157.34
$1,366.71
$1,358.06
$1,413.70
$1,472.64
$1,682.01
$315.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$824.32
$935.60
$1,053.48
$1,472.22
$2,237.20
$1,139.62
$1,250.90
$1,368.78
$1,787.52
$1,454.92
$1,566.20
$1,684.08
$2,102.82
$1,770.22
$1,881.50
$1,999.38
$2,418.12
$315.30
Toc - Plan #32 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Virtual First (Unlimited App-based Care, Rx Copay) (Disponible en espanol)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$7,250 $14,500 Annual Deductible
$9,450 $18,900 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
$381.75
$433.29
$487.88
$681.81
$1,036.07
$673.79
$725.33
$779.92
$973.85
$965.83
$1,017.37
$1,071.96
$1,265.89
$1,257.87
$1,309.41
$1,364.00
$1,557.93
$292.04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$763.50
$866.58
$975.76
$1,363.62
$2,072.14
$1,055.54
$1,158.62
$1,267.80
$1,655.66
$1,347.58
$1,450.66
$1,559.84
$1,947.70
$1,639.62
$1,742.70
$1,851.88
$2,239.74
$292.04
Toc - Plan #33 UnitedHealthcare
Silver

(HMO) UHC Silver Advantage (Virtual Urgent Care + PCP Visits, Rx Copay)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$9,450 $18,900 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
$469.47
$532.84
$599.98
$838.46
$1,274.13
$828.61
$891.98
$959.12
$1,197.60
$1,187.75
$1,251.12
$1,318.26
$1,556.74
$1,546.89
$1,610.26
$1,677.40
$1,915.88
$359.14
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$938.94
$1,065.68
$1,199.96
$1,676.92
$2,548.26
$1,298.08
$1,424.82
$1,559.10
$2,036.06
$1,657.22
$1,783.96
$1,918.24
$2,395.20
$2,016.36
$2,143.10
$2,277.38
$2,754.34
$359.14
Toc - Plan #34 UnitedHealthcare
Gold

(HMO) UHC Gold Advantage (Virtual Urgent Care + PCP Visits, Rx Copay)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 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
$554.51
$629.37
$708.66
$990.35
$1,504.94
$978.71
$1,053.57
$1,132.86
$1,414.55
$1,402.91
$1,477.77
$1,557.06
$1,838.75
$1,827.11
$1,901.97
$1,981.26
$2,262.95
$424.20
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,109.02
$1,258.74
$1,417.32
$1,980.70
$3,009.88
$1,533.22
$1,682.94
$1,841.52
$2,404.90
$1,957.42
$2,107.14
$2,265.72
$2,829.10
$2,381.62
$2,531.34
$2,689.92
$3,253.30
$424.20
Toc - Plan #35 UnitedHealthcare
Gold

(HMO) UHC Gold Copay Focus (Virtual Urgent Care + PCP Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$556.02
$631.08
$710.60
$993.05
$1,509.04
$981.38
$1,056.44
$1,135.96
$1,418.41
$1,406.74
$1,481.80
$1,561.32
$1,843.77
$1,832.10
$1,907.16
$1,986.68
$2,269.13
$425.36
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,112.04
$1,262.16
$1,421.20
$1,986.10
$3,018.08
$1,537.40
$1,687.52
$1,846.56
$2,411.46
$1,962.76
$2,112.88
$2,271.92
$2,836.82
$2,388.12
$2,538.24
$2,697.28
$3,262.18
$425.36
Toc - Plan #36 UnitedHealthcare
Gold

(HMO) UHC Gold Virtual First (Unlimited App-based Care) (Disponible en espanol)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$8,400 $16,800 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
$521.37
$591.75
$666.31
$931.16
$1,414.99
$920.22
$990.60
$1,065.16
$1,330.01
$1,319.07
$1,389.45
$1,464.01
$1,728.86
$1,717.92
$1,788.30
$1,862.86
$2,127.71
$398.85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,042.74
$1,183.50
$1,332.62
$1,862.32
$2,829.98
$1,441.59
$1,582.35
$1,731.47
$2,261.17
$1,840.44
$1,981.20
$2,130.32
$2,660.02
$2,239.29
$2,380.05
$2,529.17
$3,058.87
$398.85
Toc - Plan #37 UnitedHealthcare
Silver

(HMO) UHC Silver Advantage+ (Virtual Urgent Care + PCP Visits, Rx Copay, Dental + Vision)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$9,450 $18,900 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
$491.31
$557.64
$627.89
$877.48
$1,333.42
$867.16
$933.49
$1,003.74
$1,253.33
$1,243.01
$1,309.34
$1,379.59
$1,629.18
$1,618.86
$1,685.19
$1,755.44
$2,005.03
$375.85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$982.62
$1,115.28
$1,255.78
$1,754.96
$2,666.84
$1,358.47
$1,491.13
$1,631.63
$2,130.81
$1,734.32
$1,866.98
$2,007.48
$2,506.66
$2,110.17
$2,242.83
$2,383.33
$2,882.51
$375.85
Toc - Plan #38 UnitedHealthcare
Gold

(HMO) UHC Gold Advantage+ (Virtual Urgent Care + PCP Visits, Rx Copay, Dental + Vision)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-200-0325

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 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
$576.35
$654.16
$736.58
$1,029.37
$1,564.23
$1,017.26
$1,095.07
$1,177.49
$1,470.28
$1,458.17
$1,535.98
$1,618.40
$1,911.19
$1,899.08
$1,976.89
$2,059.31
$2,352.10
$440.91
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,152.70
$1,308.32
$1,473.16
$2,058.74
$3,128.46
$1,593.61
$1,749.23
$1,914.07
$2,499.65
$2,034.52
$2,190.14
$2,354.98
$2,940.56
$2,475.43
$2,631.05
$2,795.89
$3,381.47
$440.91

ADVERTISEMENT

Aetna CVS Health

Local: 1-844-365-7373 | Toll Free: 1-844-365-7373

Toc - Plan #39 Aetna CVS Health
Expanded Bronze

(HMO) Bronze 1: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$8,995 $17,990 Annual Deductible
$9,395 $18,790 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
$409.56
$464.85
$523.42
$731.48
$1,111.55
$722.88
$778.17
$836.74
$1,044.80
$1,036.20
$1,091.49
$1,150.06
$1,358.12
$1,349.52
$1,404.81
$1,463.38
$1,671.44
$313.32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$819.12
$929.70
$1,046.84
$1,462.96
$2,223.10
$1,132.44
$1,243.02
$1,360.16
$1,776.28
$1,445.76
$1,556.34
$1,673.48
$2,089.60
$1,759.08
$1,869.66
$1,986.80
$2,402.92
$313.32
Toc - Plan #40 Aetna CVS Health
Expanded Bronze

(HMO) Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$446.09
$506.31
$570.10
$796.71
$1,210.67
$787.35
$847.57
$911.36
$1,137.97
$1,128.61
$1,188.83
$1,252.62
$1,479.23
$1,469.87
$1,530.09
$1,593.88
$1,820.49
$341.26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$892.18
$1,012.62
$1,140.20
$1,593.42
$2,421.34
$1,233.44
$1,353.88
$1,481.46
$1,934.68
$1,574.70
$1,695.14
$1,822.72
$2,275.94
$1,915.96
$2,036.40
$2,163.98
$2,617.20
$341.26
Toc - Plan #41 Aetna CVS Health
Expanded Bronze

(HMO) Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

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
$404.56
$459.17
$517.02
$722.53
$1,097.96
$714.05
$768.66
$826.51
$1,032.02
$1,023.54
$1,078.15
$1,136.00
$1,341.51
$1,333.03
$1,387.64
$1,445.49
$1,651.00
$309.49
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$809.12
$918.34
$1,034.04
$1,445.06
$2,195.92
$1,118.61
$1,227.83
$1,343.53
$1,754.55
$1,428.10
$1,537.32
$1,653.02
$2,064.04
$1,737.59
$1,846.81
$1,962.51
$2,373.53
$309.49
Toc - Plan #42 Aetna CVS Health
Gold

(HMO) Gold 3: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$795 $1,590 Annual Deductible
$9,195 $18,390 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
$527.55
$598.77
$674.21
$942.21
$1,431.77
$931.13
$1,002.35
$1,077.79
$1,345.79
$1,334.71
$1,405.93
$1,481.37
$1,749.37
$1,738.29
$1,809.51
$1,884.95
$2,152.95
$403.58
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,055.10
$1,197.54
$1,348.42
$1,884.42
$2,863.54
$1,458.68
$1,601.12
$1,752.00
$2,288.00
$1,862.26
$2,004.70
$2,155.58
$2,691.58
$2,265.84
$2,408.28
$2,559.16
$3,095.16
$403.58
Toc - Plan #43 Aetna CVS Health
Gold

(HMO) Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

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
$525.88
$596.87
$672.07
$939.22
$1,427.23
$928.18
$999.17
$1,074.37
$1,341.52
$1,330.48
$1,401.47
$1,476.67
$1,743.82
$1,732.78
$1,803.77
$1,878.97
$2,146.12
$402.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,051.76
$1,193.74
$1,344.14
$1,878.44
$2,854.46
$1,454.06
$1,596.04
$1,746.44
$2,280.74
$1,856.36
$1,998.34
$2,148.74
$2,683.04
$2,258.66
$2,400.64
$2,551.04
$3,085.34
$402.30
Toc - Plan #44 Aetna CVS Health
Silver

(HMO) Silver 5: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$8,395 $16,790 Annual Deductible
$8,885 $17,770 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
$484.16
$549.52
$618.76
$864.71
$1,314.01
$854.54
$919.90
$989.14
$1,235.09
$1,224.92
$1,290.28
$1,359.52
$1,605.47
$1,595.30
$1,660.66
$1,729.90
$1,975.85
$370.38
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$968.32
$1,099.04
$1,237.52
$1,729.42
$2,628.02
$1,338.70
$1,469.42
$1,607.90
$2,099.80
$1,709.08
$1,839.80
$1,978.28
$2,470.18
$2,079.46
$2,210.18
$2,348.66
$2,840.56
$370.38
Toc - Plan #45 Aetna CVS Health
Silver

(HMO) Silver 6: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,445 $16,890 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
$495.35
$562.22
$633.05
$884.69
$1,344.37
$874.29
$941.16
$1,011.99
$1,263.63
$1,253.23
$1,320.10
$1,390.93
$1,642.57
$1,632.17
$1,699.04
$1,769.87
$2,021.51
$378.94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$990.70
$1,124.44
$1,266.10
$1,769.38
$2,688.74
$1,369.64
$1,503.38
$1,645.04
$2,148.32
$1,748.58
$1,882.32
$2,023.98
$2,527.26
$2,127.52
$2,261.26
$2,402.92
$2,906.20
$378.94
Toc - Plan #46 Aetna CVS Health
Silver

(HMO) Silver 7: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,845 $17,690 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
$495.76
$562.68
$633.58
$885.42
$1,345.48
$875.02
$941.94
$1,012.84
$1,264.68
$1,254.28
$1,321.20
$1,392.10
$1,643.94
$1,633.54
$1,700.46
$1,771.36
$2,023.20
$379.26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$991.52
$1,125.36
$1,267.16
$1,770.84
$2,690.96
$1,370.78
$1,504.62
$1,646.42
$2,150.10
$1,750.04
$1,883.88
$2,025.68
$2,529.36
$2,129.30
$2,263.14
$2,404.94
$2,908.62
$379.26
Toc - Plan #47 Aetna CVS Health
Silver

(HMO) Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

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
$483.55
$548.83
$617.97
$863.61
$1,312.34
$853.47
$918.75
$987.89
$1,233.53
$1,223.39
$1,288.67
$1,357.81
$1,603.45
$1,593.31
$1,658.59
$1,727.73
$1,973.37
$369.92
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$967.10
$1,097.66
$1,235.94
$1,727.22
$2,624.68
$1,337.02
$1,467.58
$1,605.86
$2,097.14
$1,706.94
$1,837.50
$1,975.78
$2,467.06
$2,076.86
$2,207.42
$2,345.70
$2,836.98
$369.92

‡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 Shelby County here.

Shelby County is in “Rating Area 10” of Illinois.

Currently, there are 47 plans offered in Rating Area 10.

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2024 Obamacare Plans for Shelby County, IL

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