Obamacare 2024 Rates for Flagler County, Florida

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 Palm Coast, FL.

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, 110 Plans and 2024 Rates for Flagler County, Florida

Below, you’ll find a summary of the 110 plans for Flagler County, Florida 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

2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |

Florida Blue (BlueCross BlueShield FL)

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

Toc - Plan #1 Florida Blue (BlueCross BlueShield FL)

Silver

(PPO) BlueOptions Silver 24J01-03 ($0 Virtual Visits / $0 Labs / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$6,000 $12,000 Annual Deductible

$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]

Age

Individual

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$873.08
$990.95
$1,115.80
$1,559.32
$2,369.54

$1,540.99
$1,658.86
$1,783.71
$2,227.23

$2,208.90
$2,326.77
$2,451.62
$2,895.14

$2,876.81
$2,994.68
$3,119.53
$3,563.05

$667.91

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,746.16
$1,981.90
$2,231.60
$3,118.64
$4,739.08

$2,414.07
$2,649.81
$2,899.51
$3,786.55

$3,081.98
$3,317.72
$3,567.42
$4,454.46

$3,749.89
$3,985.63
$4,235.33
$5,122.37

$667.91

Toc - Plan #2 Florida Blue (BlueCross BlueShield FL)

Expanded Bronze

(PPO) BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$6,500 $13,000 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

$624.03
$708.27
$797.51
$1,114.52
$1,693.62

$1,101.41
$1,185.65
$1,274.89
$1,591.90

$1,578.79
$1,663.03
$1,752.27
$2,069.28

$2,056.17
$2,140.41
$2,229.65
$2,546.66

$477.38

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,248.06
$1,416.54
$1,595.02
$2,229.04
$3,387.24

$1,725.44
$1,893.92
$2,072.40
$2,706.42

$2,202.82
$2,371.30
$2,549.78
$3,183.80

$2,680.20
$2,848.68
$3,027.16
$3,661.18

$477.38

Toc - Plan #3 Florida Blue (BlueCross BlueShield FL)

Platinum

(PPO) BlueOptions Platinum 24J01-05 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$1,000 $2,000 Annual Deductible

$4,000 $8,000 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

$1,178.08
$1,337.12
$1,505.59
$2,104.05
$3,197.31

$2,079.31
$2,238.35
$2,406.82
$3,005.28

$2,980.54
$3,139.58
$3,308.05
$3,906.51

$3,881.77
$4,040.81
$4,209.28
$4,807.74

$901.23

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$2,356.16
$2,674.24
$3,011.18
$4,208.10
$6,394.62

$3,257.39
$3,575.47
$3,912.41
$5,109.33

$4,158.62
$4,476.70
$4,813.64
$6,010.56

$5,059.85
$5,377.93
$5,714.87
$6,911.79

$901.23

Toc - Plan #4 Florida Blue (BlueCross BlueShield FL)

Bronze

(PPO) BlueOptions Bronze 24J01-06 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$6,150 $12,300 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

$583.84
$662.66
$746.15
$1,042.74
$1,584.54

$1,030.48
$1,109.30
$1,192.79
$1,489.38

$1,477.12
$1,555.94
$1,639.43
$1,936.02

$1,923.76
$2,002.58
$2,086.07
$2,382.66

$446.64

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,167.68
$1,325.32
$1,492.30
$2,085.48
$3,169.08

$1,614.32
$1,771.96
$1,938.94
$2,532.12

$2,060.96
$2,218.60
$2,385.58
$2,978.76

$2,507.60
$2,665.24
$2,832.22
$3,425.40

$446.64

Toc - Plan #5 Florida Blue (BlueCross BlueShield FL)

Silver

(PPO) BlueOptions Silver 24J01-07 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$2,800 $5,600 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

$933.96
$1,060.04
$1,193.60
$1,668.05
$2,534.77

$1,648.44
$1,774.52
$1,908.08
$2,382.53

$2,362.92
$2,489.00
$2,622.56
$3,097.01

$3,077.40
$3,203.48
$3,337.04
$3,811.49

$714.48

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,867.92
$2,120.08
$2,387.20
$3,336.10
$5,069.54

$2,582.40
$2,834.56
$3,101.68
$4,050.58

$3,296.88
$3,549.04
$3,816.16
$4,765.06

$4,011.36
$4,263.52
$4,530.64
$5,479.54

$714.48

Toc - Plan #6 Florida Blue (BlueCross BlueShield FL)

Platinum

(PPO) BlueOptions Platinum 24J01-08 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$2,000 $4,000 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

$1,225.33
$1,390.75
$1,565.97
$2,188.44
$3,325.55

$2,162.71
$2,328.13
$2,503.35
$3,125.82

$3,100.09
$3,265.51
$3,440.73
$4,063.20

$4,037.47
$4,202.89
$4,378.11
$5,000.58

$937.38

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$2,450.66
$2,781.50
$3,131.94
$4,376.88
$6,651.10

$3,388.04
$3,718.88
$4,069.32
$5,314.26

$4,325.42
$4,656.26
$5,006.70
$6,251.64

$5,262.80
$5,593.64
$5,944.08
$7,189.02

$937.38

Toc - Plan #7 Florida Blue (BlueCross BlueShield FL)

Gold

(PPO) BlueOptions Gold 24J01-09 ($0 Virtual Visits / $20 PCP Visits / $15 Generic Meds / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$6,250 $12,500 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

$1,005.39
$1,141.12
$1,284.89
$1,795.63
$2,728.63

$1,774.51
$1,910.24
$2,054.01
$2,564.75

$2,543.63
$2,679.36
$2,823.13
$3,333.87

$3,312.75
$3,448.48
$3,592.25
$4,102.99

$769.12

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$2,010.78
$2,282.24
$2,569.78
$3,591.26
$5,457.26

$2,779.90
$3,051.36
$3,338.90
$4,360.38

$3,549.02
$3,820.48
$4,108.02
$5,129.50

$4,318.14
$4,589.60
$4,877.14
$5,898.62

$769.12

Toc - Plan #8 Florida Blue (BlueCross BlueShield FL)

Expanded Bronze

(PPO) BlueOptions Bronze (HSA) 24J01-10 (Rewards $$$ / $4 Condition Care Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$7,050 $14,100 Annual Deductible

$7,050 $14,100 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

$607.00
$688.95
$775.75
$1,084.10
$1,647.40

$1,071.36
$1,153.31
$1,240.11
$1,548.46

$1,535.72
$1,617.67
$1,704.47
$2,012.82

$2,000.08
$2,082.03
$2,168.83
$2,477.18

$464.36

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,214.00
$1,377.90
$1,551.50
$2,168.20
$3,294.80

$1,678.36
$1,842.26
$2,015.86
$2,632.56

$2,142.72
$2,306.62
$2,480.22
$3,096.92

$2,607.08
$2,770.98
$2,944.58
$3,561.28

$464.36

Toc - Plan #9 Florida Blue (BlueCross BlueShield FL)

Gold

(PPO) BlueOptions Gold 24J01-12 ($0 Virtual Visits / $20 Labs / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$1,500 $3,000 Annual Deductible

$5,900 $11,800 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

$975.68
$1,107.40
$1,246.92
$1,742.56
$2,648.00

$1,722.08
$1,853.80
$1,993.32
$2,488.96

$2,468.48
$2,600.20
$2,739.72
$3,235.36

$3,214.88
$3,346.60
$3,486.12
$3,981.76

$746.40

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,951.36
$2,214.80
$2,493.84
$3,485.12
$5,296.00

$2,697.76
$2,961.20
$3,240.24
$4,231.52

$3,444.16
$3,707.60
$3,986.64
$4,977.92

$4,190.56
$4,454.00
$4,733.04
$5,724.32

$746.40

Toc - Plan #10 Florida Blue (BlueCross BlueShield FL)

Expanded Bronze

(PPO) BlueOptions Bronze 24J01-17 ($0 Virtual Visits / $50 PCP Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$653.40
$741.61
$835.05
$1,166.97
$1,773.33

$1,153.25
$1,241.46
$1,334.90
$1,666.82

$1,653.10
$1,741.31
$1,834.75
$2,166.67

$2,152.95
$2,241.16
$2,334.60
$2,666.52

$499.85

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,306.80
$1,483.22
$1,670.10
$2,333.94
$3,546.66

$1,806.65
$1,983.07
$2,169.95
$2,833.79

$2,306.50
$2,482.92
$2,669.80
$3,333.64

$2,806.35
$2,982.77
$3,169.65
$3,833.49

$499.85

Toc - Plan #11 Florida Blue (BlueCross BlueShield FL)

Expanded Bronze

(PPO) BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$611.68
$694.26
$781.73
$1,092.46
$1,660.10

$1,079.62
$1,162.20
$1,249.67
$1,560.40

$1,547.56
$1,630.14
$1,717.61
$2,028.34

$2,015.50
$2,098.08
$2,185.55
$2,496.28

$467.94

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,223.36
$1,388.52
$1,563.46
$2,184.92
$3,320.20

$1,691.30
$1,856.46
$2,031.40
$2,652.86

$2,159.24
$2,324.40
$2,499.34
$3,120.80

$2,627.18
$2,792.34
$2,967.28
$3,588.74

$467.94

Toc - Plan #12 Florida Blue (BlueCross BlueShield FL)

Silver

(PPO) BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$907.39
$1,029.89
$1,159.64
$1,620.60
$2,462.66

$1,601.54
$1,724.04
$1,853.79
$2,314.75

$2,295.69
$2,418.19
$2,547.94
$3,008.90

$2,989.84
$3,112.34
$3,242.09
$3,703.05

$694.15

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,814.78
$2,059.78
$2,319.28
$3,241.20
$4,925.32

$2,508.93
$2,753.93
$3,013.43
$3,935.35

$3,203.08
$3,448.08
$3,707.58
$4,629.50

$3,897.23
$4,142.23
$4,401.73
$5,323.65

$694.15

Toc - Plan #13 Florida Blue (BlueCross BlueShield FL)

Gold

(PPO) BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$951.58
$1,080.04
$1,216.12
$1,699.52
$2,582.59

$1,679.54
$1,808.00
$1,944.08
$2,427.48

$2,407.50
$2,535.96
$2,672.04
$3,155.44

$3,135.46
$3,263.92
$3,400.00
$3,883.40

$727.96

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,903.16
$2,160.08
$2,432.24
$3,399.04
$5,165.18

$2,631.12
$2,888.04
$3,160.20
$4,127.00

$3,359.08
$3,616.00
$3,888.16
$4,854.96

$4,087.04
$4,343.96
$4,616.12
$5,582.92

$727.96

Toc - Plan #14 Florida Blue (BlueCross BlueShield FL)

Platinum

(PPO) BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$1,217.67
$1,382.06
$1,556.18
$2,174.76
$3,304.76

$2,149.19
$2,313.58
$2,487.70
$3,106.28

$3,080.71
$3,245.10
$3,419.22
$4,037.80

$4,012.23
$4,176.62
$4,350.74
$4,969.32

$931.52

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$2,435.34
$2,764.12
$3,112.36
$4,349.52
$6,609.52

$3,366.86
$3,695.64
$4,043.88
$5,281.04

$4,298.38
$4,627.16
$4,975.40
$6,212.56

$5,229.90
$5,558.68
$5,906.92
$7,144.08

$931.52

Florida Blue HMO (a BlueCross BlueShield FL company)

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

Toc - Plan #15 Florida Blue HMO (a BlueCross BlueShield FL company)

Silver

(POS) BlueCare Silver 24K01-02 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$6,000 $12,000 Annual Deductible

$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]

Age

Individual

Individual
1 Child

Individual
2 Children

Individual
3+ Children

Child
0-14

21
30
40
50
60

$629.13
$714.06
$804.03
$1,123.63
$1,707.46

$1,110.41
$1,195.34
$1,285.31
$1,604.91

$1,591.69
$1,676.62
$1,766.59
$2,086.19

$2,072.97
$2,157.90
$2,247.87
$2,567.47

$481.28

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,258.26
$1,428.12
$1,608.06
$2,247.26
$3,414.92

$1,739.54
$1,909.40
$2,089.34
$2,728.54

$2,220.82
$2,390.68
$2,570.62
$3,209.82

$2,702.10
$2,871.96
$3,051.90
$3,691.10

$481.28

Toc - Plan #16 Florida Blue HMO (a BlueCross BlueShield FL company)

Expanded Bronze

(POS) BlueCare Bronze 24K01-03 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$6,500 $13,000 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

$530.84
$602.50
$678.41
$948.08
$1,440.70

$936.93
$1,008.59
$1,084.50
$1,354.17

$1,343.02
$1,414.68
$1,490.59
$1,760.26

$1,749.11
$1,820.77
$1,896.68
$2,166.35

$406.09

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,061.68
$1,205.00
$1,356.82
$1,896.16
$2,881.40

$1,467.77
$1,611.09
$1,762.91
$2,302.25

$1,873.86
$2,017.18
$2,169.00
$2,708.34

$2,279.95
$2,423.27
$2,575.09
$3,114.43

$406.09

Toc - Plan #17 Florida Blue HMO (a BlueCross BlueShield FL company)

Platinum

(POS) BlueCare Platinum 24K01-04 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$1,000 $2,000 Annual Deductible

$4,000 $8,000 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

$859.84
$975.92
$1,098.88
$1,535.67
$2,333.61

$1,517.62
$1,633.70
$1,756.66
$2,193.45

$2,175.40
$2,291.48
$2,414.44
$2,851.23

$2,833.18
$2,949.26
$3,072.22
$3,509.01

$657.78

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,719.68
$1,951.84
$2,197.76
$3,071.34
$4,667.22

$2,377.46
$2,609.62
$2,855.54
$3,729.12

$3,035.24
$3,267.40
$3,513.32
$4,386.90

$3,693.02
$3,925.18
$4,171.10
$5,044.68

$657.78

Toc - Plan #18 Florida Blue HMO (a BlueCross BlueShield FL company)

Bronze

(POS) BlueCare Bronze 24K01-05 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$6,150 $12,300 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

$483.67
$548.97
$618.13
$863.83
$1,312.68

$853.68
$918.98
$988.14
$1,233.84

$1,223.69
$1,288.99
$1,358.15
$1,603.85

$1,593.70
$1,659.00
$1,728.16
$1,973.86

$370.01

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$967.34
$1,097.94
$1,236.26
$1,727.66
$2,625.36

$1,337.35
$1,467.95
$1,606.27
$2,097.67

$1,707.36
$1,837.96
$1,976.28
$2,467.68

$2,077.37
$2,207.97
$2,346.29
$2,837.69

$370.01

Toc - Plan #19 Florida Blue HMO (a BlueCross BlueShield FL company)

Silver

(POS) BlueCare Silver 24K01-06 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$2,800 $5,600 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

$692.43
$785.91
$884.93
$1,236.68
$1,879.26

$1,222.14
$1,315.62
$1,414.64
$1,766.39

$1,751.85
$1,845.33
$1,944.35
$2,296.10

$2,281.56
$2,375.04
$2,474.06
$2,825.81

$529.71

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,384.86
$1,571.82
$1,769.86
$2,473.36
$3,758.52

$1,914.57
$2,101.53
$2,299.57
$3,003.07

$2,444.28
$2,631.24
$2,829.28
$3,532.78

$2,973.99
$3,160.95
$3,358.99
$4,062.49

$529.71

Toc - Plan #20 Florida Blue HMO (a BlueCross BlueShield FL company)

Platinum

(POS) BlueCare Platinum 24K01-07 ($0 Virtual Visits / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$2,000 $4,000 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

$904.21
$1,026.28
$1,155.58
$1,614.92
$2,454.03

$1,595.93
$1,718.00
$1,847.30
$2,306.64

$2,287.65
$2,409.72
$2,539.02
$2,998.36

$2,979.37
$3,101.44
$3,230.74
$3,690.08

$691.72

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,808.42
$2,052.56
$2,311.16
$3,229.84
$4,908.06

$2,500.14
$2,744.28
$3,002.88
$3,921.56

$3,191.86
$3,436.00
$3,694.60
$4,613.28

$3,883.58
$4,127.72
$4,386.32
$5,305.00

$691.72

Toc - Plan #21 Florida Blue HMO (a BlueCross BlueShield FL company)

Gold

(POS) BlueCare Gold 24K01-08 ($0 Virtual Visits / $20 PCP Visit / $15 Generic Meds / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$6,250 $12,500 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

$782.22
$887.82
$999.68
$1,397.04
$2,122.95

$1,380.62
$1,486.22
$1,598.08
$1,995.44

$1,979.02
$2,084.62
$2,196.48
$2,593.84

$2,577.42
$2,683.02
$2,794.88
$3,192.24

$598.40

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,564.44
$1,775.64
$1,999.36
$2,794.08
$4,245.90

$2,162.84
$2,374.04
$2,597.76
$3,392.48

$2,761.24
$2,972.44
$3,196.16
$3,990.88

$3,359.64
$3,570.84
$3,794.56
$4,589.28

$598.40

Toc - Plan #22 Florida Blue HMO (a BlueCross BlueShield FL company)

Expanded Bronze

(POS) BlueCare Bronze (HSA) 24K01-09 (Rewards $$$ / $4 Condition Care Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$7,050 $14,100 Annual Deductible

$7,050 $14,100 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

$508.33
$576.95
$649.65
$907.88
$1,379.61

$897.20
$965.82
$1,038.52
$1,296.75

$1,286.07
$1,354.69
$1,427.39
$1,685.62

$1,674.94
$1,743.56
$1,816.26
$2,074.49

$388.87

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,016.66
$1,153.90
$1,299.30
$1,815.76
$2,759.22

$1,405.53
$1,542.77
$1,688.17
$2,204.63

$1,794.40
$1,931.64
$2,077.04
$2,593.50

$2,183.27
$2,320.51
$2,465.91
$2,982.37

$388.87

Toc - Plan #23 Florida Blue HMO (a BlueCross BlueShield FL company)

Gold

(POS) BlueCare Gold 24K01-10 ($0 Virtual Visits / $20 Labs / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

Annual Out of Pocket Expenses:

Individual Family

$1,500 $3,000 Annual Deductible

$5,900 $11,800 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

$750.41
$851.72
$959.02
$1,340.23
$2,036.61

$1,324.47
$1,425.78
$1,533.08
$1,914.29

$1,898.53
$1,999.84
$2,107.14
$2,488.35

$2,472.59
$2,573.90
$2,681.20
$3,062.41

$574.06

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,500.82
$1,703.44
$1,918.04
$2,680.46
$4,073.22

$2,074.88
$2,277.50
$2,492.10
$3,254.52

$2,648.94
$2,851.56
$3,066.16
$3,828.58

$3,223.00
$3,425.62
$3,640.22
$4,402.64

$574.06

Toc - Plan #24 Florida Blue HMO (a BlueCross BlueShield FL company)

Expanded Bronze

(POS) BlueCare Bronze 24K01-25 ($0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$566.38
$642.84
$723.83
$1,011.55
$1,537.16

$999.66
$1,076.12
$1,157.11
$1,444.83

$1,432.94
$1,509.40
$1,590.39
$1,878.11

$1,866.22
$1,942.68
$2,023.67
$2,311.39

$433.28

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,132.76
$1,285.68
$1,447.66
$2,023.10
$3,074.32

$1,566.04
$1,718.96
$1,880.94
$2,456.38

$1,999.32
$2,152.24
$2,314.22
$2,889.66

$2,432.60
$2,585.52
$2,747.50
$3,322.94

$433.28

Toc - Plan #25 Florida Blue HMO (a BlueCross BlueShield FL company)

Expanded Bronze

(POS) BlueCare Bronze 24K01-31S (Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$517.16
$586.98
$660.93
$923.65
$1,403.57

$912.79
$982.61
$1,056.56
$1,319.28

$1,308.42
$1,378.24
$1,452.19
$1,714.91

$1,704.05
$1,773.87
$1,847.82
$2,110.54

$395.63

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,034.32
$1,173.96
$1,321.86
$1,847.30
$2,807.14

$1,429.95
$1,569.59
$1,717.49
$2,242.93

$1,825.58
$1,965.22
$2,113.12
$2,638.56

$2,221.21
$2,360.85
$2,508.75
$3,034.19

$395.63

Toc - Plan #26 Florida Blue HMO (a BlueCross BlueShield FL company)

Silver

(POS) BlueCare Silver 24K01-32S ($40 PCP Visits / Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$666.26
$756.21
$851.48
$1,189.94
$1,808.23

$1,175.95
$1,265.90
$1,361.17
$1,699.63

$1,685.64
$1,775.59
$1,870.86
$2,209.32

$2,195.33
$2,285.28
$2,380.55
$2,719.01

$509.69

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,332.52
$1,512.42
$1,702.96
$2,379.88
$3,616.46

$1,842.21
$2,022.11
$2,212.65
$2,889.57

$2,351.90
$2,531.80
$2,722.34
$3,399.26

$2,861.59
$3,041.49
$3,232.03
$3,908.95

$509.69

Toc - Plan #27 Florida Blue HMO (a BlueCross BlueShield FL company)

Gold

(POS) BlueCare Gold 24K01-33S ($30 PCP Visit / Multilingual Available/ Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$727.27
$825.45
$929.45
$1,298.90
$1,973.81

$1,283.63
$1,381.81
$1,485.81
$1,855.26

$1,839.99
$1,938.17
$2,042.17
$2,411.62

$2,396.35
$2,494.53
$2,598.53
$2,967.98

$556.36

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,454.54
$1,650.90
$1,858.90
$2,597.80
$3,947.62

$2,010.90
$2,207.26
$2,415.26
$3,154.16

$2,567.26
$2,763.62
$2,971.62
$3,710.52

$3,123.62
$3,319.98
$3,527.98
$4,266.88

$556.36

Toc - Plan #28 Florida Blue HMO (a BlueCross BlueShield FL company)

Platinum

(POS) BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-352-2583

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

$901.35
$1,023.03
$1,151.93
$1,609.81
$2,446.26

$1,590.88
$1,712.56
$1,841.46
$2,299.34

$2,280.41
$2,402.09
$2,530.99
$2,988.87

$2,969.94
$3,091.62
$3,220.52
$3,678.40

$689.53

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,802.70
$2,046.06
$2,303.86
$3,219.62
$4,892.52

$2,492.23
$2,735.59
$2,993.39
$3,909.15

$3,181.76
$3,425.12
$3,682.92
$4,598.68

$3,871.29
$4,114.65
$4,372.45
$5,288.21

$689.53

Health First Commercial Plans, Inc.

Local: 1-855-443-4735 | Toll Free: 1-855-443-4735 | TTY: 1-800-955-8771

Toc - Plan #29 Health First Commercial Plans, Inc.

Silver

(HMO) Silver Gym Access 1664 (Primary Care & Specialist Copays, Open Access, Fitness Center Included)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$5,750 $11,500 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

$429.28
$487.23
$548.62
$766.69
$1,165.06

$757.68
$815.63
$877.02
$1,095.09

$1,086.08
$1,144.03
$1,205.42
$1,423.49

$1,414.48
$1,472.43
$1,533.82
$1,751.89

$328.40

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$858.56
$974.46
$1,097.24
$1,533.38
$2,330.12

$1,186.96
$1,302.86
$1,425.64
$1,861.78

$1,515.36
$1,631.26
$1,754.04
$2,190.18

$1,843.76
$1,959.66
$2,082.44
$2,518.58

$328.40

Toc - Plan #30 Health First Commercial Plans, Inc.

Silver

(HMO) Silver Gym Access 1688 (Open Access, Fitness Center Included)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$3,850 $7,700 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

$422.81
$479.88
$540.35
$755.13
$1,147.49

$746.26
$803.33
$863.80
$1,078.58

$1,069.71
$1,126.78
$1,187.25
$1,402.03

$1,393.16
$1,450.23
$1,510.70
$1,725.48

$323.45

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$845.62
$959.76
$1,080.70
$1,510.26
$2,294.98

$1,169.07
$1,283.21
$1,404.15
$1,833.71

$1,492.52
$1,606.66
$1,727.60
$2,157.16

$1,815.97
$1,930.11
$2,051.05
$2,480.61

$323.45

Toc - Plan #31 Health First Commercial Plans, Inc.

Gold

(HMO) Gold Gym Access 1736 (Primary Care & Urgent Care Copay, 0% Coinsurance, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$2,650 $5,300 Annual Deductible

$8,150 $16,300 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

$447.24
$507.62
$571.58
$798.78
$1,213.82

$789.38
$849.76
$913.72
$1,140.92

$1,131.52
$1,191.90
$1,255.86
$1,483.06

$1,473.66
$1,534.04
$1,598.00
$1,825.20

$342.14

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$894.48
$1,015.24
$1,143.16
$1,597.56
$2,427.64

$1,236.62
$1,357.38
$1,485.30
$1,939.70

$1,578.76
$1,699.52
$1,827.44
$2,281.84

$1,920.90
$2,041.66
$2,169.58
$2,623.98

$342.14

Toc - Plan #32 Health First Commercial Plans, Inc.

Gold

(HMO) Gold Gym Access 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$1,500 $3,000 Annual Deductible

$7,750 $15,500 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

$455.45
$516.94
$582.07
$813.44
$1,236.10

$803.87
$865.36
$930.49
$1,161.86

$1,152.29
$1,213.78
$1,278.91
$1,510.28

$1,500.71
$1,562.20
$1,627.33
$1,858.70

$348.42

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$910.90
$1,033.88
$1,164.14
$1,626.88
$2,472.20

$1,259.32
$1,382.30
$1,512.56
$1,975.30

$1,607.74
$1,730.72
$1,860.98
$2,323.72

$1,956.16
$2,079.14
$2,209.40
$2,672.14

$348.42

Toc - Plan #33 Health First Commercial Plans, Inc.

Catastrophic

(HMO) Catastrophic Gym Access 1746 (Primary Care Copay Visits 1-3, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

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

$200.21
$227.24
$255.87
$357.58
$543.38

$353.37
$380.40
$409.03
$510.74

$506.53
$533.56
$562.19
$663.90

$659.69
$686.72
$715.35
$817.06

$153.16

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$400.42
$454.48
$511.74
$715.16
$1,086.76

$553.58
$607.64
$664.90
$868.32

$706.74
$760.80
$818.06
$1,021.48

$859.90
$913.96
$971.22
$1,174.64

$153.16

Toc - Plan #34 Health First Commercial Plans, Inc.

Expanded Bronze

(HMO) Bronze 1750 (Unlimited Primary Care, Specialist & Urgent Care Copay Visits, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$8,500 $17,000 Annual Deductible

$9,350 $18,700 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

$350.45
$397.76
$447.88
$625.91
$951.13

$618.55
$665.86
$715.98
$894.01

$886.65
$933.96
$984.08
$1,162.11

$1,154.75
$1,202.06
$1,252.18
$1,430.21

$268.10

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$700.90
$795.52
$895.76
$1,251.82
$1,902.26

$969.00
$1,063.62
$1,163.86
$1,519.92

$1,237.10
$1,331.72
$1,431.96
$1,788.02

$1,505.20
$1,599.82
$1,700.06
$2,056.12

$268.10

Toc - Plan #35 Health First Commercial Plans, Inc.

Gold

(HMO) Gold 1770 (Low Primary Care, Specialist & Urgent Care Copay, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$1,600 $3,200 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

$433.25
$491.74
$553.70
$773.79
$1,175.85

$764.69
$823.18
$885.14
$1,105.23

$1,096.13
$1,154.62
$1,216.58
$1,436.67

$1,427.57
$1,486.06
$1,548.02
$1,768.11

$331.44

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$866.50
$983.48
$1,107.40
$1,547.58
$2,351.70

$1,197.94
$1,314.92
$1,438.84
$1,879.02

$1,529.38
$1,646.36
$1,770.28
$2,210.46

$1,860.82
$1,977.80
$2,101.72
$2,541.90

$331.44

Toc - Plan #36 Health First Commercial Plans, Inc.

Expanded Bronze

(HMO) Bronze HSA 1794 (HSA Qualified, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$7,050 $14,100 Annual Deductible

$7,050 $14,100 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

$359.41
$407.93
$459.32
$641.90
$975.44

$634.36
$682.88
$734.27
$916.85

$909.31
$957.83
$1,009.22
$1,191.80

$1,184.26
$1,232.78
$1,284.17
$1,466.75

$274.95

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$718.82
$815.86
$918.64
$1,283.80
$1,950.88

$993.77
$1,090.81
$1,193.59
$1,558.75

$1,268.72
$1,365.76
$1,468.54
$1,833.70

$1,543.67
$1,640.71
$1,743.49
$2,108.65

$274.95

Toc - Plan #37 Health First Commercial Plans, Inc.

Silver

(HMO) Silver 1806 ($2,100 Deductible, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$2,100 $4,200 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

$412.25
$467.91
$526.86
$736.28
$1,118.85

$727.62
$783.28
$842.23
$1,051.65

$1,042.99
$1,098.65
$1,157.60
$1,367.02

$1,358.36
$1,414.02
$1,472.97
$1,682.39

$315.37

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$824.50
$935.82
$1,053.72
$1,472.56
$2,237.70

$1,139.87
$1,251.19
$1,369.09
$1,787.93

$1,455.24
$1,566.56
$1,684.46
$2,103.30

$1,770.61
$1,881.93
$1,999.83
$2,418.67

$315.37

Toc - Plan #38 Health First Commercial Plans, Inc.

Expanded Bronze

(HMO) Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

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

$386.83
$439.06
$494.37
$690.88
$1,049.87

$682.76
$734.99
$790.30
$986.81

$978.69
$1,030.92
$1,086.23
$1,282.74

$1,274.62
$1,326.85
$1,382.16
$1,578.67

$295.93

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$773.66
$878.12
$988.74
$1,381.76
$2,099.74

$1,069.59
$1,174.05
$1,284.67
$1,677.69

$1,365.52
$1,469.98
$1,580.60
$1,973.62

$1,661.45
$1,765.91
$1,876.53
$2,269.55

$295.93

Toc - Plan #39 Health First Commercial Plans, Inc.

Expanded Bronze

(HMO) Bronze Standard 1828

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

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

$350.05
$397.30
$447.36
$625.18
$950.03

$617.84
$665.09
$715.15
$892.97

$885.63
$932.88
$982.94
$1,160.76

$1,153.42
$1,200.67
$1,250.73
$1,428.55

$267.79

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$700.10
$794.60
$894.72
$1,250.36
$1,900.06

$967.89
$1,062.39
$1,162.51
$1,518.15

$1,235.68
$1,330.18
$1,430.30
$1,785.94

$1,503.47
$1,597.97
$1,698.09
$2,053.73

$267.79

Toc - Plan #40 Health First Commercial Plans, Inc.

Silver

(HMO) Silver Standard 1829

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

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

$410.83
$466.29
$525.04
$733.74
$1,114.99

$725.11
$780.57
$839.32
$1,048.02

$1,039.39
$1,094.85
$1,153.60
$1,362.30

$1,353.67
$1,409.13
$1,467.88
$1,676.58

$314.28

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$821.66
$932.58
$1,050.08
$1,467.48
$2,229.98

$1,135.94
$1,246.86
$1,364.36
$1,781.76

$1,450.22
$1,561.14
$1,678.64
$2,096.04

$1,764.50
$1,875.42
$1,992.92
$2,410.32

$314.28

Toc - Plan #41 Health First Commercial Plans, Inc.

Gold

(HMO) Gold Standard 1833

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

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

$430.96
$489.14
$550.77
$769.70
$1,169.63

$760.64
$818.82
$880.45
$1,099.38

$1,090.32
$1,148.50
$1,210.13
$1,429.06

$1,420.00
$1,478.18
$1,539.81
$1,758.74

$329.68

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$861.92
$978.28
$1,101.54
$1,539.40
$2,339.26

$1,191.60
$1,307.96
$1,431.22
$1,869.08

$1,521.28
$1,637.64
$1,760.90
$2,198.76

$1,850.96
$1,967.32
$2,090.58
$2,528.44

$329.68

Toc - Plan #42 Health First Commercial Plans, Inc.

Expanded Bronze

(HMO) Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$8,300 $16,600 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

$326.85
$370.98
$417.72
$583.76
$887.08

$576.89
$621.02
$667.76
$833.80

$826.93
$871.06
$917.80
$1,083.84

$1,076.97
$1,121.10
$1,167.84
$1,333.88

$250.04

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$653.70
$741.96
$835.44
$1,167.52
$1,774.16

$903.74
$992.00
$1,085.48
$1,417.56

$1,153.78
$1,242.04
$1,335.52
$1,667.60

$1,403.82
$1,492.08
$1,585.56
$1,917.64

$250.04

Toc - Plan #43 Health First Commercial Plans, Inc.

Silver

(HMO) Silver Savings 1821 (Primary Care Copay, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$4,500 $9,000 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

$400.06
$454.06
$511.27
$714.50
$1,085.75

$706.10
$760.10
$817.31
$1,020.54

$1,012.14
$1,066.14
$1,123.35
$1,326.58

$1,318.18
$1,372.18
$1,429.39
$1,632.62

$306.04

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$800.12
$908.12
$1,022.54
$1,429.00
$2,171.50

$1,106.16
$1,214.16
$1,328.58
$1,735.04

$1,412.20
$1,520.20
$1,634.62
$2,041.08

$1,718.24
$1,826.24
$1,940.66
$2,347.12

$306.04

Toc - Plan #44 Health First Commercial Plans, Inc.

Gold

(HMO) Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-443-4735

Annual Out of Pocket Expenses:

Individual Family

$2,400 $4,800 Annual Deductible

$7,700 $15,400 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

$403.63
$458.12
$515.84
$720.89
$1,095.45

$712.41
$766.90
$824.62
$1,029.67

$1,021.19
$1,075.68
$1,133.40
$1,338.45

$1,329.97
$1,384.46
$1,442.18
$1,647.23

$308.78

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$807.26
$916.24
$1,031.68
$1,441.78
$2,190.90

$1,116.04
$1,225.02
$1,340.46
$1,750.56

$1,424.82
$1,533.80
$1,649.24
$2,059.34

$1,733.60
$1,842.58
$1,958.02
$2,368.12

$308.78

Oscar Insurance Company of Florida

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

Toc - Plan #45 Oscar Insurance Company of Florida

Expanded Bronze

(EPO) Bronze Elite + PCP Saver Plus

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$375.24
$425.89
$479.54
$670.16
$1,018.38

$662.29
$712.94
$766.59
$957.21

$949.34
$999.99
$1,053.64
$1,244.26

$1,236.39
$1,287.04
$1,340.69
$1,531.31

$287.05

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$750.48
$851.78
$959.08
$1,340.32
$2,036.76

$1,037.53
$1,138.83
$1,246.13
$1,627.37

$1,324.58
$1,425.88
$1,533.18
$1,914.42

$1,611.63
$1,712.93
$1,820.23
$2,201.47

$287.05

Toc - Plan #46 Oscar Insurance Company of Florida

Silver

(EPO) Silver Classic

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$5,400 $10,800 Annual Deductible

$8,650 $17,300 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

$413.51
$469.33
$528.46
$738.52
$1,122.25

$729.84
$785.66
$844.79
$1,054.85

$1,046.17
$1,101.99
$1,161.12
$1,371.18

$1,362.50
$1,418.32
$1,477.45
$1,687.51

$316.33

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$827.02
$938.66
$1,056.92
$1,477.04
$2,244.50

$1,143.35
$1,254.99
$1,373.25
$1,793.37

$1,459.68
$1,571.32
$1,689.58
$2,109.70

$1,776.01
$1,887.65
$2,005.91
$2,426.03

$316.33

Toc - Plan #47 Oscar Insurance Company of Florida

Catastrophic

(EPO) Secure

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$250.03
$283.77
$319.53
$446.54
$678.56

$441.30
$475.04
$510.80
$637.81

$632.57
$666.31
$702.07
$829.08

$823.84
$857.58
$893.34
$1,020.35

$191.27

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$500.06
$567.54
$639.06
$893.08
$1,357.12

$691.33
$758.81
$830.33
$1,084.35

$882.60
$950.08
$1,021.60
$1,275.62

$1,073.87
$1,141.35
$1,212.87
$1,466.89

$191.27

Toc - Plan #48 Oscar Insurance Company of Florida

Expanded Bronze

(EPO) Bronze Elite + Specialist Saver Plus

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$377.51
$428.47
$482.45
$674.22
$1,024.54

$666.30
$717.26
$771.24
$963.01

$955.09
$1,006.05
$1,060.03
$1,251.80

$1,243.88
$1,294.84
$1,348.82
$1,540.59

$288.79

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$755.02
$856.94
$964.90
$1,348.44
$2,049.08

$1,043.81
$1,145.73
$1,253.69
$1,637.23

$1,332.60
$1,434.52
$1,542.48
$1,926.02

$1,621.39
$1,723.31
$1,831.27
$2,214.81

$288.79

Toc - Plan #49 Oscar Insurance Company of Florida

Gold

(EPO) Gold Classic

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$3,500 $7,000 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

$438.90
$498.14
$560.90
$783.86
$1,191.15

$774.65
$833.89
$896.65
$1,119.61

$1,110.40
$1,169.64
$1,232.40
$1,455.36

$1,446.15
$1,505.39
$1,568.15
$1,791.11

$335.75

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$877.80
$996.28
$1,121.80
$1,567.72
$2,382.30

$1,213.55
$1,332.03
$1,457.55
$1,903.47

$1,549.30
$1,667.78
$1,793.30
$2,239.22

$1,885.05
$2,003.53
$2,129.05
$2,574.97

$335.75

Toc - Plan #50 Oscar Insurance Company of Florida

Silver

(EPO) Silver Simple

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$4,500 $9,000 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

$412.45
$468.12
$527.10
$736.62
$1,119.36

$727.97
$783.64
$842.62
$1,052.14

$1,043.49
$1,099.16
$1,158.14
$1,367.66

$1,359.01
$1,414.68
$1,473.66
$1,683.18

$315.52

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$824.90
$936.24
$1,054.20
$1,473.24
$2,238.72

$1,140.42
$1,251.76
$1,369.72
$1,788.76

$1,455.94
$1,567.28
$1,685.24
$2,104.28

$1,771.46
$1,882.80
$2,000.76
$2,419.80

$315.52

Toc - Plan #51 Oscar Insurance Company of Florida

Silver

(EPO) Silver Elite

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$5,000 $10,000 Annual Deductible

$8,000 $16,000 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

$420.92
$477.73
$537.92
$751.75
$1,142.35

$742.92
$799.73
$859.92
$1,073.75

$1,064.92
$1,121.73
$1,181.92
$1,395.75

$1,386.92
$1,443.73
$1,503.92
$1,717.75

$322.00

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$841.84
$955.46
$1,075.84
$1,503.50
$2,284.70

$1,163.84
$1,277.46
$1,397.84
$1,825.50

$1,485.84
$1,599.46
$1,719.84
$2,147.50

$1,807.84
$1,921.46
$2,041.84
$2,469.50

$322.00

Toc - Plan #52 Oscar Insurance Company of Florida

Expanded Bronze

(EPO) Bronze Classic 4700

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$4,700 $9,400 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

$339.68
$385.52
$434.09
$606.64
$921.85

$599.52
$645.36
$693.93
$866.48

$859.36
$905.20
$953.77
$1,126.32

$1,119.20
$1,165.04
$1,213.61
$1,386.16

$259.84

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$679.36
$771.04
$868.18
$1,213.28
$1,843.70

$939.20
$1,030.88
$1,128.02
$1,473.12

$1,199.04
$1,290.72
$1,387.86
$1,732.96

$1,458.88
$1,550.56
$1,647.70
$1,992.80

$259.84

Toc - Plan #53 Oscar Insurance Company of Florida

Silver

(EPO) Silver Simple PCP Saver

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$5,500 $11,000 Annual Deductible

$8,900 $17,800 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

$409.44
$464.71
$523.26
$731.25
$1,111.20

$722.66
$777.93
$836.48
$1,044.47

$1,035.88
$1,091.15
$1,149.70
$1,357.69

$1,349.10
$1,404.37
$1,462.92
$1,670.91

$313.22

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$818.88
$929.42
$1,046.52
$1,462.50
$2,222.40

$1,132.10
$1,242.64
$1,359.74
$1,775.72

$1,445.32
$1,555.86
$1,672.96
$2,088.94

$1,758.54
$1,869.08
$1,986.18
$2,402.16

$313.22

Toc - Plan #54 Oscar Insurance Company of Florida

Gold

(EPO) Gold Elite Saver Plus

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$0 $0 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

$479.22
$543.90
$612.43
$855.87
$1,300.57

$845.81
$910.49
$979.02
$1,222.46

$1,212.40
$1,277.08
$1,345.61
$1,589.05

$1,578.99
$1,643.67
$1,712.20
$1,955.64

$366.59

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$958.44
$1,087.80
$1,224.86
$1,711.74
$2,601.14

$1,325.03
$1,454.39
$1,591.45
$2,078.33

$1,691.62
$1,820.98
$1,958.04
$2,444.92

$2,058.21
$2,187.57
$2,324.63
$2,811.51

$366.59

Toc - Plan #55 Oscar Insurance Company of Florida

Gold

(EPO) Gold Elite

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family

$500 $1,000 Annual Deductible

$5,500 $11,000 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

$455.04
$516.46
$581.52
$812.68
$1,234.94

$803.14
$864.56
$929.62
$1,160.78

$1,151.24
$1,212.66
$1,277.72
$1,508.88

$1,499.34
$1,560.76
$1,625.82
$1,856.98

$348.10

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$910.08
$1,032.92
$1,163.04
$1,625.36
$2,469.88

$1,258.18
$1,381.02
$1,511.14
$1,973.46

$1,606.28
$1,729.12
$1,859.24
$2,321.56

$1,954.38
$2,077.22
$2,207.34
$2,669.66

$348.10

Toc - Plan #56 Oscar Insurance Company of Florida

Expanded Bronze

(EPO) Bronze Elite Saver Plus

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$368.53
$418.27
$470.97
$658.17
$1,000.16

$650.45
$700.19
$752.89
$940.09

$932.37
$982.11
$1,034.81
$1,222.01

$1,214.29
$1,264.03
$1,316.73
$1,503.93

$281.92

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$737.06
$836.54
$941.94
$1,316.34
$2,000.32

$1,018.98
$1,118.46
$1,223.86
$1,598.26

$1,300.90
$1,400.38
$1,505.78
$1,880.18

$1,582.82
$1,682.30
$1,787.70
$2,162.10

$281.92

Toc - Plan #57 Oscar Insurance Company of Florida

Expanded Bronze

(EPO) Bronze Classic Standard

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$336.67
$382.11
$430.25
$601.27
$913.69

$594.21
$639.65
$687.79
$858.81

$851.75
$897.19
$945.33
$1,116.35

$1,109.29
$1,154.73
$1,202.87
$1,373.89

$257.54

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$673.34
$764.22
$860.50
$1,202.54
$1,827.38

$930.88
$1,021.76
$1,118.04
$1,460.08

$1,188.42
$1,279.30
$1,375.58
$1,717.62

$1,445.96
$1,536.84
$1,633.12
$1,975.16

$257.54

Toc - Plan #58 Oscar Insurance Company of Florida

Silver

(EPO) Silver Classic Standard

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$410.29
$465.67
$524.34
$732.76
$1,113.49

$724.15
$779.53
$838.20
$1,046.62

$1,038.01
$1,093.39
$1,152.06
$1,360.48

$1,351.87
$1,407.25
$1,465.92
$1,674.34

$313.86

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$820.58
$931.34
$1,048.68
$1,465.52
$2,226.98

$1,134.44
$1,245.20
$1,362.54
$1,779.38

$1,448.30
$1,559.06
$1,676.40
$2,093.24

$1,762.16
$1,872.92
$1,990.26
$2,407.10

$313.86

Toc - Plan #59 Oscar Insurance Company of Florida

Gold

(EPO) Gold Classic Standard

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-855-672-2755

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

$424.22
$481.48
$542.14
$757.64
$1,151.31

$748.74
$806.00
$866.66
$1,082.16

$1,073.26
$1,130.52
$1,191.18
$1,406.68

$1,397.78
$1,455.04
$1,515.70
$1,731.20

$324.52

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$848.44
$962.96
$1,084.28
$1,515.28
$2,302.62

$1,172.96
$1,287.48
$1,408.80
$1,839.80

$1,497.48
$1,612.00
$1,733.32
$2,164.32

$1,822.00
$1,936.52
$2,057.84
$2,488.84

$324.52

Florida Health Care Plans

Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 | TTY: 1-800-955-8771

Toc - Plan #60 Florida Health Care Plans

Catastrophic

(HMO) Gym Access IND Essential Plus Catastrophic HMO 36

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$256.57
$291.21
$327.90
$458.23
$696.33

$452.85
$487.49
$524.18
$654.51

$649.13
$683.77
$720.46
$850.79

$845.41
$880.05
$916.74
$1,047.07

$196.28

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$513.14
$582.42
$655.80
$916.46
$1,392.66

$709.42
$778.70
$852.08
$1,112.74

$905.70
$974.98
$1,048.36
$1,309.02

$1,101.98
$1,171.26
$1,244.64
$1,505.30

$196.28

Toc - Plan #61 Florida Health Care Plans

Catastrophic

(POS) Gym Access IND Essential Plus Catastrophic POS 37

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$277.09
$314.50
$354.12
$494.88
$752.02

$489.06
$526.47
$566.09
$706.85

$701.03
$738.44
$778.06
$918.82

$913.00
$950.41
$990.03
$1,130.79

$211.97

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$554.18
$629.00
$708.24
$989.76
$1,504.04

$766.15
$840.97
$920.21
$1,201.73

$978.12
$1,052.94
$1,132.18
$1,413.70

$1,190.09
$1,264.91
$1,344.15
$1,625.67

$211.97

Toc - Plan #62 Florida Health Care Plans

Silver

(HMO) Gym Access IND Essential Plus Silver HMO 53

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$4,000 $8,000 Annual Deductible

$8,900 $17,800 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

$435.26
$494.02
$556.26
$777.37
$1,181.30

$768.23
$826.99
$889.23
$1,110.34

$1,101.20
$1,159.96
$1,222.20
$1,443.31

$1,434.17
$1,492.93
$1,555.17
$1,776.28

$332.97

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$870.52
$988.04
$1,112.52
$1,554.74
$2,362.60

$1,203.49
$1,321.01
$1,445.49
$1,887.71

$1,536.46
$1,653.98
$1,778.46
$2,220.68

$1,869.43
$1,986.95
$2,111.43
$2,553.65

$332.97

Toc - Plan #63 Florida Health Care Plans

Silver

(POS) Gym Access IND Essential Plus Silver POS 54

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$4,000 $8,000 Annual Deductible

$8,900 $17,800 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

$461.05
$523.29
$589.22
$823.44
$1,251.29

$813.75
$875.99
$941.92
$1,176.14

$1,166.45
$1,228.69
$1,294.62
$1,528.84

$1,519.15
$1,581.39
$1,647.32
$1,881.54

$352.70

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$922.10
$1,046.58
$1,178.44
$1,646.88
$2,502.58

$1,274.80
$1,399.28
$1,531.14
$1,999.58

$1,627.50
$1,751.98
$1,883.84
$2,352.28

$1,980.20
$2,104.68
$2,236.54
$2,704.98

$352.70

Toc - Plan #64 Florida Health Care Plans

Platinum

(POS) Gym Access IND Platinum POS 4000

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$4,000 $8,000 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

$633.33
$718.83
$809.40
$1,131.13
$1,718.86

$1,117.83
$1,203.33
$1,293.90
$1,615.63

$1,602.33
$1,687.83
$1,778.40
$2,100.13

$2,086.83
$2,172.33
$2,262.90
$2,584.63

$484.50

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,266.66
$1,437.66
$1,618.80
$2,262.26
$3,437.72

$1,751.16
$1,922.16
$2,103.30
$2,746.76

$2,235.66
$2,406.66
$2,587.80
$3,231.26

$2,720.16
$2,891.16
$3,072.30
$3,715.76

$484.50

Toc - Plan #65 Florida Health Care Plans

Gold

(HMO) Gym Access IND Gold HMO 55001

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$2,800 $5,600 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

$451.54
$512.50
$577.07
$806.45
$1,225.48

$796.97
$857.93
$922.50
$1,151.88

$1,142.40
$1,203.36
$1,267.93
$1,497.31

$1,487.83
$1,548.79
$1,613.36
$1,842.74

$345.43

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$903.08
$1,025.00
$1,154.14
$1,612.90
$2,450.96

$1,248.51
$1,370.43
$1,499.57
$1,958.33

$1,593.94
$1,715.86
$1,845.00
$2,303.76

$1,939.37
$2,061.29
$2,190.43
$2,649.19

$345.43

Toc - Plan #66 Florida Health Care Plans

Gold

(POS) Gym Access IND Gold POS 55001

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$2,800 $5,600 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

$488.40
$554.33
$624.18
$872.28
$1,325.52

$862.03
$927.96
$997.81
$1,245.91

$1,235.66
$1,301.59
$1,371.44
$1,619.54

$1,609.29
$1,675.22
$1,745.07
$1,993.17

$373.63

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$976.80
$1,108.66
$1,248.36
$1,744.56
$2,651.04

$1,350.43
$1,482.29
$1,621.99
$2,118.19

$1,724.06
$1,855.92
$1,995.62
$2,491.82

$2,097.69
$2,229.55
$2,369.25
$2,865.45

$373.63

Toc - Plan #67 Florida Health Care Plans

Gold

(HMO) Gym Access IND Gold HMO 4500

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$2,550 $5,100 Annual Deductible

$5,000 $10,000 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

$450.19
$510.97
$575.34
$804.04
$1,221.82

$794.59
$855.37
$919.74
$1,148.44

$1,138.99
$1,199.77
$1,264.14
$1,492.84

$1,483.39
$1,544.17
$1,608.54
$1,837.24

$344.40

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$900.38
$1,021.94
$1,150.68
$1,608.08
$2,443.64

$1,244.78
$1,366.34
$1,495.08
$1,952.48

$1,589.18
$1,710.74
$1,839.48
$2,296.88

$1,933.58
$2,055.14
$2,183.88
$2,641.28

$344.40

Toc - Plan #68 Florida Health Care Plans

Expanded Bronze

(HMO) Gym Access IND Bronze HMO HSA 5065

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$6,300 $12,600 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

$354.18
$401.99
$452.64
$632.57
$961.24

$625.13
$672.94
$723.59
$903.52

$896.08
$943.89
$994.54
$1,174.47

$1,167.03
$1,214.84
$1,265.49
$1,445.42

$270.95

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$708.36
$803.98
$905.28
$1,265.14
$1,922.48

$979.31
$1,074.93
$1,176.23
$1,536.09

$1,250.26
$1,345.88
$1,447.18
$1,807.04

$1,521.21
$1,616.83
$1,718.13
$2,077.99

$270.95

Toc - Plan #69 Florida Health Care Plans

Expanded Bronze

(POS) Gym Access IND Bronze POS BC 3841

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$8,000 $16,000 Annual Deductible

$9,300 $18,600 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

$389.98
$442.63
$498.39
$696.50
$1,058.41

$688.31
$740.96
$796.72
$994.83

$986.64
$1,039.29
$1,095.05
$1,293.16

$1,284.97
$1,337.62
$1,393.38
$1,591.49

$298.33

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$779.96
$885.26
$996.78
$1,393.00
$2,116.82

$1,078.29
$1,183.59
$1,295.11
$1,691.33

$1,376.62
$1,481.92
$1,593.44
$1,989.66

$1,674.95
$1,780.25
$1,891.77
$2,287.99

$298.33

Toc - Plan #70 Florida Health Care Plans

Silver

(HMO) Gym Access IND Silver HMO BC 0941

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$5,000 $10,000 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

$432.54
$490.93
$552.79
$772.52
$1,173.91

$763.43
$821.82
$883.68
$1,103.41

$1,094.32
$1,152.71
$1,214.57
$1,434.30

$1,425.21
$1,483.60
$1,545.46
$1,765.19

$330.89

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$865.08
$981.86
$1,105.58
$1,545.04
$2,347.82

$1,195.97
$1,312.75
$1,436.47
$1,875.93

$1,526.86
$1,643.64
$1,767.36
$2,206.82

$1,857.75
$1,974.53
$2,098.25
$2,537.71

$330.89

Toc - Plan #71 Florida Health Care Plans

Silver

(POS) Gym Access IND Silver POS BC 0941

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$5,000 $10,000 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

$467.14
$530.20
$597.00
$834.31
$1,267.82

$824.50
$887.56
$954.36
$1,191.67

$1,181.86
$1,244.92
$1,311.72
$1,549.03

$1,539.22
$1,602.28
$1,669.08
$1,906.39

$357.36

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$934.28
$1,060.40
$1,194.00
$1,668.62
$2,535.64

$1,291.64
$1,417.76
$1,551.36
$2,025.98

$1,649.00
$1,775.12
$1,908.72
$2,383.34

$2,006.36
$2,132.48
$2,266.08
$2,740.70

$357.36

Toc - Plan #72 Florida Health Care Plans

Silver

(HMO) Gym Access IND Silver HMO BC 7741

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$6,000 $12,000 Annual Deductible

$8,450 $16,900 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

$427.15
$484.82
$545.90
$762.89
$1,159.29

$753.92
$811.59
$872.67
$1,089.66

$1,080.69
$1,138.36
$1,199.44
$1,416.43

$1,407.46
$1,465.13
$1,526.21
$1,743.20

$326.77

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$854.30
$969.64
$1,091.80
$1,525.78
$2,318.58

$1,181.07
$1,296.41
$1,418.57
$1,852.55

$1,507.84
$1,623.18
$1,745.34
$2,179.32

$1,834.61
$1,949.95
$2,072.11
$2,506.09

$326.77

Toc - Plan #73 Florida Health Care Plans

Silver

(POS) Gym Access IND Silver POS BC 7741

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$6,000 $12,000 Annual Deductible

$8,450 $16,900 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

$461.32
$523.60
$589.57
$823.92
$1,252.02

$814.23
$876.51
$942.48
$1,176.83

$1,167.14
$1,229.42
$1,295.39
$1,529.74

$1,520.05
$1,582.33
$1,648.30
$1,882.65

$352.91

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$922.64
$1,047.20
$1,179.14
$1,647.84
$2,504.04

$1,275.55
$1,400.11
$1,532.05
$2,000.75

$1,628.46
$1,753.02
$1,884.96
$2,353.66

$1,981.37
$2,105.93
$2,237.87
$2,706.57

$352.91

Toc - Plan #74 Florida Health Care Plans

Gold

(HMO) Gym Access IND Gold HMO BC 5651

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$6,800 $13,600 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

$476.11
$540.38
$608.47
$850.33
$1,292.16

$840.33
$904.60
$972.69
$1,214.55

$1,204.55
$1,268.82
$1,336.91
$1,578.77

$1,568.77
$1,633.04
$1,701.13
$1,942.99

$364.22

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$952.22
$1,080.76
$1,216.94
$1,700.66
$2,584.32

$1,316.44
$1,444.98
$1,581.16
$2,064.88

$1,680.66
$1,809.20
$1,945.38
$2,429.10

$2,044.88
$2,173.42
$2,309.60
$2,793.32

$364.22

Toc - Plan #75 Florida Health Care Plans

Gold

(POS) Gym Access IND Gold POS BC 5651

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$6,800 $13,600 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

$514.80
$584.30
$657.91
$919.43
$1,397.17

$908.62
$978.12
$1,051.73
$1,313.25

$1,302.44
$1,371.94
$1,445.55
$1,707.07

$1,696.26
$1,765.76
$1,839.37
$2,100.89

$393.82

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,029.60
$1,168.60
$1,315.82
$1,838.86
$2,794.34

$1,423.42
$1,562.42
$1,709.64
$2,232.68

$1,817.24
$1,956.24
$2,103.46
$2,626.50

$2,211.06
$2,350.06
$2,497.28
$3,020.32

$393.82

Toc - Plan #76 Florida Health Care Plans

Platinum

(POS) Gym Access IND Platinum POS BC 5841

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$800 $1,600 Annual Deductible

$2,500 $5,000 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

$617.99
$701.42
$789.79
$1,103.73
$1,677.22

$1,090.75
$1,174.18
$1,262.55
$1,576.49

$1,563.51
$1,646.94
$1,735.31
$2,049.25

$2,036.27
$2,119.70
$2,208.07
$2,522.01

$472.76

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,235.98
$1,402.84
$1,579.58
$2,207.46
$3,354.44

$1,708.74
$1,875.60
$2,052.34
$2,680.22

$2,181.50
$2,348.36
$2,525.10
$3,152.98

$2,654.26
$2,821.12
$2,997.86
$3,625.74

$472.76

Toc - Plan #77 Florida Health Care Plans

Platinum

(POS) Gym Access IND Platinum POS BC 1941

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$2,100 $4,200 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

$641.98
$728.65
$820.45
$1,146.58
$1,742.33

$1,133.09
$1,219.76
$1,311.56
$1,637.69

$1,624.20
$1,710.87
$1,802.67
$2,128.80

$2,115.31
$2,201.98
$2,293.78
$2,619.91

$491.11

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,283.96
$1,457.30
$1,640.90
$2,293.16
$3,484.66

$1,775.07
$1,948.41
$2,132.01
$2,784.27

$2,266.18
$2,439.52
$2,623.12
$3,275.38

$2,757.29
$2,930.63
$3,114.23
$3,766.49

$491.11

Toc - Plan #78 Florida Health Care Plans

Expanded Bronze

(HMO) Gym Access IND Bronze Standardized HMO

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$7,150 $14,300 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

$357.36
$405.60
$456.71
$638.24
$969.88

$630.74
$678.98
$730.09
$911.62

$904.12
$952.36
$1,003.47
$1,185.00

$1,177.50
$1,225.74
$1,276.85
$1,458.38

$273.38

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$714.72
$811.20
$913.42
$1,276.48
$1,939.76

$988.10
$1,084.58
$1,186.80
$1,549.86

$1,261.48
$1,357.96
$1,460.18
$1,823.24

$1,534.86
$1,631.34
$1,733.56
$2,096.62

$273.38

Toc - Plan #79 Florida Health Care Plans

Expanded Bronze

(HMO) Gym Access IND Bronze HMO 1340

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$9,400 $18,800 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

$345.41
$392.04
$441.43
$616.90
$937.44

$609.65
$656.28
$705.67
$881.14

$873.89
$920.52
$969.91
$1,145.38

$1,138.13
$1,184.76
$1,234.15
$1,409.62

$264.24

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$690.82
$784.08
$882.86
$1,233.80
$1,874.88

$955.06
$1,048.32
$1,147.10
$1,498.04

$1,219.30
$1,312.56
$1,411.34
$1,762.28

$1,483.54
$1,576.80
$1,675.58
$2,026.52

$264.24

Toc - Plan #80 Florida Health Care Plans

Expanded Bronze

(POS) Gym Access IND Bronze POS 1042

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$5,500 $11,000 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

$389.77
$442.39
$498.13
$696.13
$1,057.84

$687.94
$740.56
$796.30
$994.30

$986.11
$1,038.73
$1,094.47
$1,292.47

$1,284.28
$1,336.90
$1,392.64
$1,590.64

$298.17

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$779.54
$884.78
$996.26
$1,392.26
$2,115.68

$1,077.71
$1,182.95
$1,294.43
$1,690.43

$1,375.88
$1,481.12
$1,592.60
$1,988.60

$1,674.05
$1,779.29
$1,890.77
$2,286.77

$298.17

Toc - Plan #81 Florida Health Care Plans

Gold

(HMO) Gym Access IND Gold HMO H.S.A 9010

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$1,750 $3,500 Annual Deductible

$4,900 $9,800 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

$418.83
$475.37
$535.26
$748.03
$1,136.70

$739.23
$795.77
$855.66
$1,068.43

$1,059.63
$1,116.17
$1,176.06
$1,388.83

$1,380.03
$1,436.57
$1,496.46
$1,709.23

$320.40

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$837.66
$950.74
$1,070.52
$1,496.06
$2,273.40

$1,158.06
$1,271.14
$1,390.92
$1,816.46

$1,478.46
$1,591.54
$1,711.32
$2,136.86

$1,798.86
$1,911.94
$2,031.72
$2,457.26

$320.40

Toc - Plan #82 Florida Health Care Plans

Expanded Bronze

(HMO) Gym Access IND Bronze HMO OA 1211

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$389.10
$441.63
$497.27
$694.93
$1,056.02

$686.76
$739.29
$794.93
$992.59

$984.42
$1,036.95
$1,092.59
$1,290.25

$1,282.08
$1,334.61
$1,390.25
$1,587.91

$297.66

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$778.20
$883.26
$994.54
$1,389.86
$2,112.04

$1,075.86
$1,180.92
$1,292.20
$1,687.52

$1,373.52
$1,478.58
$1,589.86
$1,985.18

$1,671.18
$1,776.24
$1,887.52
$2,282.84

$297.66

Toc - Plan #83 Florida Health Care Plans

Silver

(HMO) Gym Access IND Silver HMO OA 1009

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$7,900 $15,800 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

$449.66
$510.36
$574.67
$803.09
$1,220.38

$793.65
$854.35
$918.66
$1,147.08

$1,137.64
$1,198.34
$1,262.65
$1,491.07

$1,481.63
$1,542.33
$1,606.64
$1,835.06

$343.99

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$899.32
$1,020.72
$1,149.34
$1,606.18
$2,440.76

$1,243.31
$1,364.71
$1,493.33
$1,950.17

$1,587.30
$1,708.70
$1,837.32
$2,294.16

$1,931.29
$2,052.69
$2,181.31
$2,638.15

$343.99

Toc - Plan #84 Florida Health Care Plans

Expanded Bronze

(HMO) Gym Access IND Bronze HMO OA Standard 2450

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$365.39
$414.72
$466.97
$652.59
$991.67

$644.91
$694.24
$746.49
$932.11

$924.43
$973.76
$1,026.01
$1,211.63

$1,203.95
$1,253.28
$1,305.53
$1,491.15

$279.52

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$730.78
$829.44
$933.94
$1,305.18
$1,983.34

$1,010.30
$1,108.96
$1,213.46
$1,584.70

$1,289.82
$1,388.48
$1,492.98
$1,864.22

$1,569.34
$1,668.00
$1,772.50
$2,143.74

$279.52

Toc - Plan #85 Florida Health Care Plans

Silver

(HMO) Gym Access IND Silver HMO OA Standard 1440

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$424.12
$481.38
$542.03
$757.48
$1,151.06

$748.57
$805.83
$866.48
$1,081.93

$1,073.02
$1,130.28
$1,190.93
$1,406.38

$1,397.47
$1,454.73
$1,515.38
$1,730.83

$324.45

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$848.24
$962.76
$1,084.06
$1,514.96
$2,302.12

$1,172.69
$1,287.21
$1,408.51
$1,839.41

$1,497.14
$1,611.66
$1,732.96
$2,163.86

$1,821.59
$1,936.11
$2,057.41
$2,488.31

$324.45

Toc - Plan #86 Florida Health Care Plans

Gold

(HMO) Gym Access IND Gold HMO OA Standard 3450

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$426.76
$484.37
$545.40
$762.19
$1,158.23

$753.23
$810.84
$871.87
$1,088.66

$1,079.70
$1,137.31
$1,198.34
$1,415.13

$1,406.17
$1,463.78
$1,524.81
$1,741.60

$326.47

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$853.52
$968.74
$1,090.80
$1,524.38
$2,316.46

$1,179.99
$1,295.21
$1,417.27
$1,850.85

$1,506.46
$1,621.68
$1,743.74
$2,177.32

$1,832.93
$1,948.15
$2,070.21
$2,503.79

$326.47

Toc - Plan #87 Florida Health Care Plans

Expanded Bronze

(POS) Gym Access IND Bronze POS OA Standard 2450

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$394.62
$447.89
$504.32
$704.79
$1,071.00

$696.50
$749.77
$806.20
$1,006.67

$998.38
$1,051.65
$1,108.08
$1,308.55

$1,300.26
$1,353.53
$1,409.96
$1,610.43

$301.88

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$789.24
$895.78
$1,008.64
$1,409.58
$2,142.00

$1,091.12
$1,197.66
$1,310.52
$1,711.46

$1,393.00
$1,499.54
$1,612.40
$2,013.34

$1,694.88
$1,801.42
$1,914.28
$2,315.22

$301.88

Toc - Plan #88 Florida Health Care Plans

Silver

(POS) Gym Access IND Silver POS OA Standard 1440

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$458.05
$519.89
$585.39
$818.08
$1,243.15

$808.46
$870.30
$935.80
$1,168.49

$1,158.87
$1,220.71
$1,286.21
$1,518.90

$1,509.28
$1,571.12
$1,636.62
$1,869.31

$350.41

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$916.10
$1,039.78
$1,170.78
$1,636.16
$2,486.30

$1,266.51
$1,390.19
$1,521.19
$1,986.57

$1,616.92
$1,740.60
$1,871.60
$2,336.98

$1,967.33
$2,091.01
$2,222.01
$2,687.39

$350.41

Toc - Plan #89 Florida Health Care Plans

Gold

(POS) Gym Access IND Gold POS OA Standard 3450

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$460.91
$523.13
$589.04
$823.19
$1,250.91

$813.51
$875.73
$941.64
$1,175.79

$1,166.11
$1,228.33
$1,294.24
$1,528.39

$1,518.71
$1,580.93
$1,646.84
$1,880.99

$352.60

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$921.82
$1,046.26
$1,178.08
$1,646.38
$2,501.82

$1,274.42
$1,398.86
$1,530.68
$1,998.98

$1,627.02
$1,751.46
$1,883.28
$2,351.58

$1,979.62
$2,104.06
$2,235.88
$2,704.18

$352.60

Toc - Plan #90 Florida Health Care Plans

Platinum

(POS) Gym Access IND Platinum POS OA Standard 4450

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$643.16
$729.99
$821.96
$1,148.68
$1,745.54

$1,135.18
$1,222.01
$1,313.98
$1,640.70

$1,627.20
$1,714.03
$1,806.00
$2,132.72

$2,119.22
$2,206.05
$2,298.02
$2,624.74

$492.02

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,286.32
$1,459.98
$1,643.92
$2,297.36
$3,491.08

$1,778.34
$1,952.00
$2,135.94
$2,789.38

$2,270.36
$2,444.02
$2,627.96
$3,281.40

$2,762.38
$2,936.04
$3,119.98
$3,773.42

$492.02

Toc - Plan #91 Florida Health Care Plans

Expanded Bronze

(POS) Gym Access IND Bronze POS OA 1211

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

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

$420.22
$476.95
$537.04
$750.51
$1,140.48

$741.69
$798.42
$858.51
$1,071.98

$1,063.16
$1,119.89
$1,179.98
$1,393.45

$1,384.63
$1,441.36
$1,501.45
$1,714.92

$321.47

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$840.44
$953.90
$1,074.08
$1,501.02
$2,280.96

$1,161.91
$1,275.37
$1,395.55
$1,822.49

$1,483.38
$1,596.84
$1,717.02
$2,143.96

$1,804.85
$1,918.31
$2,038.49
$2,465.43

$321.47

Toc - Plan #92 Florida Health Care Plans

Gold

(POS) Gym Access IND Gold POS 4500

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$2,550 $5,100 Annual Deductible

$5,000 $10,000 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

$487.91
$553.78
$623.55
$871.41
$1,324.19

$861.16
$927.03
$996.80
$1,244.66

$1,234.41
$1,300.28
$1,370.05
$1,617.91

$1,607.66
$1,673.53
$1,743.30
$1,991.16

$373.25

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$975.82
$1,107.56
$1,247.10
$1,742.82
$2,648.38

$1,349.07
$1,480.81
$1,620.35
$2,116.07

$1,722.32
$1,854.06
$1,993.60
$2,489.32

$2,095.57
$2,227.31
$2,366.85
$2,862.57

$373.25

Toc - Plan #93 Florida Health Care Plans

Platinum

(POS) Gym Access IND Essential Plus Platinum POS 65

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$2,000 $4,000 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

$632.15
$717.49
$807.89
$1,129.02
$1,715.66

$1,115.74
$1,201.08
$1,291.48
$1,612.61

$1,599.33
$1,684.67
$1,775.07
$2,096.20

$2,082.92
$2,168.26
$2,258.66
$2,579.79

$483.59

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,264.30
$1,434.98
$1,615.78
$2,258.04
$3,431.32

$1,747.89
$1,918.57
$2,099.37
$2,741.63

$2,231.48
$2,402.16
$2,582.96
$3,225.22

$2,715.07
$2,885.75
$3,066.55
$3,708.81

$483.59

Toc - Plan #94 Florida Health Care Plans

Silver

(POS) Gym Access IND Silver POS OA 1009

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-800-232-0578

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$7,900 $15,800 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

$485.63
$551.19
$620.64
$867.34
$1,318.00

$857.14
$922.70
$992.15
$1,238.85

$1,228.65
$1,294.21
$1,363.66
$1,610.36

$1,600.16
$1,665.72
$1,735.17
$1,981.87

$371.51

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$971.26
$1,102.38
$1,241.28
$1,734.68
$2,636.00

$1,342.77
$1,473.89
$1,612.79
$2,106.19

$1,714.28
$1,845.40
$1,984.30
$2,477.70

$2,085.79
$2,216.91
$2,355.81
$2,849.21

$371.51

UnitedHealthcare

Local: 1-888-200-0405 | Toll Free: 1-888-200-0405 | TTY: 1-888-200-0405

Toc - Plan #95 UnitedHealthcare

Silver

(HMO) UHC Silver Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$3,900 $7,800 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

$430.87
$489.04
$550.66
$769.54
$1,169.39

$760.49
$818.66
$880.28
$1,099.16

$1,090.11
$1,148.28
$1,209.90
$1,428.78

$1,419.73
$1,477.90
$1,539.52
$1,758.40

$329.62

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$861.74
$978.08
$1,101.32
$1,539.08
$2,338.78

$1,191.36
$1,307.70
$1,430.94
$1,868.70

$1,520.98
$1,637.32
$1,760.56
$2,198.32

$1,850.60
$1,966.94
$2,090.18
$2,527.94

$329.62

Toc - Plan #96 UnitedHealthcare

Expanded Bronze

(HMO) UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$8,250 $16,500 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

$345.32
$391.93
$441.31
$616.73
$937.19

$609.49
$656.10
$705.48
$880.90

$873.66
$920.27
$969.65
$1,145.07

$1,137.83
$1,184.44
$1,233.82
$1,409.24

$264.17

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$690.64
$783.86
$882.62
$1,233.46
$1,874.38

$954.81
$1,048.03
$1,146.79
$1,497.63

$1,218.98
$1,312.20
$1,410.96
$1,761.80

$1,483.15
$1,576.37
$1,675.13
$2,025.97

$264.17

Toc - Plan #97 UnitedHealthcare

Expanded Bronze

(HMO) UHC Bronze Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$345.85
$392.54
$441.99
$617.68
$938.63

$610.42
$657.11
$706.56
$882.25

$874.99
$921.68
$971.13
$1,146.82

$1,139.56
$1,186.25
$1,235.70
$1,411.39

$264.57

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$691.70
$785.08
$883.98
$1,235.36
$1,877.26

$956.27
$1,049.65
$1,148.55
$1,499.93

$1,220.84
$1,314.22
$1,413.12
$1,764.50

$1,485.41
$1,578.79
$1,677.69
$2,029.07

$264.57

Toc - Plan #98 UnitedHealthcare

Gold

(HMO) UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$0 $0 Annual Deductible

$7,750 $15,500 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

$495.23
$562.09
$632.91
$884.49
$1,344.07

$874.08
$940.94
$1,011.76
$1,263.34

$1,252.93
$1,319.79
$1,390.61
$1,642.19

$1,631.78
$1,698.64
$1,769.46
$2,021.04

$378.85

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$990.46
$1,124.18
$1,265.82
$1,768.98
$2,688.14

$1,369.31
$1,503.03
$1,644.67
$2,147.83

$1,748.16
$1,881.88
$2,023.52
$2,526.68

$2,127.01
$2,260.73
$2,402.37
$2,905.53

$378.85

Toc - Plan #99 UnitedHealthcare

Gold

(HMO) UHC Gold Standard

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$486.81
$552.53
$622.14
$869.44
$1,321.20

$859.22
$924.94
$994.55
$1,241.85

$1,231.63
$1,297.35
$1,366.96
$1,614.26

$1,604.04
$1,669.76
$1,739.37
$1,986.67

$372.41

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$973.62
$1,105.06
$1,244.28
$1,738.88
$2,642.40

$1,346.03
$1,477.47
$1,616.69
$2,111.29

$1,718.44
$1,849.88
$1,989.10
$2,483.70

$2,090.85
$2,222.29
$2,361.51
$2,856.11

$372.41

Toc - Plan #100 UnitedHealthcare

Silver

(HMO) UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$448.21
$508.71
$572.81
$800.50
$1,216.43

$791.09
$851.59
$915.69
$1,143.38

$1,133.97
$1,194.47
$1,258.57
$1,486.26

$1,476.85
$1,537.35
$1,601.45
$1,829.14

$342.88

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$896.42
$1,017.42
$1,145.62
$1,601.00
$2,432.86

$1,239.30
$1,360.30
$1,488.50
$1,943.88

$1,582.18
$1,703.18
$1,831.38
$2,286.76

$1,925.06
$2,046.06
$2,174.26
$2,629.64

$342.88

Toc - Plan #101 UnitedHealthcare

Silver

(HMO) UHC Silver Standard

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$426.09
$483.61
$544.55
$761.00
$1,156.41

$752.05
$809.57
$870.51
$1,086.96

$1,078.01
$1,135.53
$1,196.47
$1,412.92

$1,403.97
$1,461.49
$1,522.43
$1,738.88

$325.96

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$852.18
$967.22
$1,089.10
$1,522.00
$2,312.82

$1,178.14
$1,293.18
$1,415.06
$1,847.96

$1,504.10
$1,619.14
$1,741.02
$2,173.92

$1,830.06
$1,945.10
$2,066.98
$2,499.88

$325.96

Toc - Plan #102 UnitedHealthcare

Bronze

(HMO) UHC Bronze Essential ($0 Virtual Urgent Care, $3 Tier 2 Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$6,350 $12,700 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

$340.25
$386.19
$434.84
$607.69
$923.45

$600.54
$646.48
$695.13
$867.98

$860.83
$906.77
$955.42
$1,128.27

$1,121.12
$1,167.06
$1,215.71
$1,388.56

$260.29

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$680.50
$772.38
$869.68
$1,215.38
$1,846.90

$940.79
$1,032.67
$1,129.97
$1,475.67

$1,201.08
$1,292.96
$1,390.26
$1,735.96

$1,461.37
$1,553.25
$1,650.55
$1,996.25

$260.29

Toc - Plan #103 UnitedHealthcare

Expanded Bronze

(HMO) UHC Bronze Standard

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$346.35
$393.11
$442.64
$618.59
$940.00

$611.31
$658.07
$707.60
$883.55

$876.27
$923.03
$972.56
$1,148.51

$1,141.23
$1,187.99
$1,237.52
$1,413.47

$264.96

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$692.70
$786.22
$885.28
$1,237.18
$1,880.00

$957.66
$1,051.18
$1,150.24
$1,502.14

$1,222.62
$1,316.14
$1,415.20
$1,767.10

$1,487.58
$1,581.10
$1,680.16
$2,032.06

$264.96

Toc - Plan #104 UnitedHealthcare

Expanded Bronze

(HMO) UHC Bronze Copay Focus $0 Indiv Med Ded

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$363.20
$412.23
$464.17
$648.67
$985.72

$641.05
$690.08
$742.02
$926.52

$918.90
$967.93
$1,019.87
$1,204.37

$1,196.75
$1,245.78
$1,297.72
$1,482.22

$277.85

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$726.40
$824.46
$928.34
$1,297.34
$1,971.44

$1,004.25
$1,102.31
$1,206.19
$1,575.19

$1,282.10
$1,380.16
$1,484.04
$1,853.04

$1,559.95
$1,658.01
$1,761.89
$2,130.89

$277.85

Toc - Plan #105 UnitedHealthcare

Silver

(HMO) UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$429.93
$487.97
$549.44
$767.85
$1,166.82

$758.82
$816.86
$878.33
$1,096.74

$1,087.71
$1,145.75
$1,207.22
$1,425.63

$1,416.60
$1,474.64
$1,536.11
$1,754.52

$328.89

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$859.86
$975.94
$1,098.88
$1,535.70
$2,333.64

$1,188.75
$1,304.83
$1,427.77
$1,864.59

$1,517.64
$1,633.72
$1,756.66
$2,193.48

$1,846.53
$1,962.61
$2,085.55
$2,522.37

$328.89

Toc - Plan #106 UnitedHealthcare

Silver

(HMO) UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$2,750 $5,500 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

$434.78
$493.47
$555.65
$776.52
$1,179.99

$767.39
$826.08
$888.26
$1,109.13

$1,100.00
$1,158.69
$1,220.87
$1,441.74

$1,432.61
$1,491.30
$1,553.48
$1,774.35

$332.61

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$869.56
$986.94
$1,111.30
$1,553.04
$2,359.98

$1,202.17
$1,319.55
$1,443.91
$1,885.65

$1,534.78
$1,652.16
$1,776.52
$2,218.26

$1,867.39
$1,984.77
$2,109.13
$2,550.87

$332.61

Toc - Plan #107 UnitedHealthcare

Gold

(HMO) UHC Gold Value ($0 Virtual Urgent Care, $3 Tier 2 Rx)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$1,500 $3,000 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

$484.09
$549.44
$618.66
$864.58
$1,313.82

$854.42
$919.77
$988.99
$1,234.91

$1,224.75
$1,290.10
$1,359.32
$1,605.24

$1,595.08
$1,660.43
$1,729.65
$1,975.57

$370.33

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$968.18
$1,098.88
$1,237.32
$1,729.16
$2,627.64

$1,338.51
$1,469.21
$1,607.65
$2,099.49

$1,708.84
$1,839.54
$1,977.98
$2,469.82

$2,079.17
$2,209.87
$2,348.31
$2,840.15

$370.33

Toc - Plan #108 UnitedHealthcare

Gold

(HMO) UHC Gold Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

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

$485.39
$550.92
$620.33
$866.91
$1,317.36

$856.72
$922.25
$991.66
$1,238.24

$1,228.05
$1,293.58
$1,362.99
$1,609.57

$1,599.38
$1,664.91
$1,734.32
$1,980.90

$371.33

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$970.78
$1,101.84
$1,240.66
$1,733.82
$2,634.72

$1,342.11
$1,473.17
$1,611.99
$2,105.15

$1,713.44
$1,844.50
$1,983.32
$2,476.48

$2,084.77
$2,215.83
$2,354.65
$2,847.81

$371.33

Toc - Plan #109 UnitedHealthcare

Gold

(HMO) UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$500 $1,000 Annual Deductible

$7,750 $15,500 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

$513.20
$582.48
$655.87
$916.58
$1,392.83

$905.80
$975.08
$1,048.47
$1,309.18

$1,298.40
$1,367.68
$1,441.07
$1,701.78

$1,691.00
$1,760.28
$1,833.67
$2,094.38

$392.60

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$1,026.40
$1,164.96
$1,311.74
$1,833.16
$2,785.66

$1,419.00
$1,557.56
$1,704.34
$2,225.76

$1,811.60
$1,950.16
$2,096.94
$2,618.36

$2,204.20
$2,342.76
$2,489.54
$3,010.96

$392.60

Toc - Plan #110 UnitedHealthcare

Silver

(HMO) UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, $0 Insulin)

Benefits & Coverage Plan Brochure Provider Directory

Customer Service Phone: 1-888-200-0405

Annual Out of Pocket Expenses:

Individual Family

$2,750 $5,500 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

$453.88
$515.16
$580.06
$810.64
$1,231.84

$801.10
$862.38
$927.28
$1,157.86

$1,148.32
$1,209.60
$1,274.50
$1,505.08

$1,495.54
$1,556.82
$1,621.72
$1,852.30

$347.22

Age

Couple

Couple
1 Child

Couple
2 Chidren

Couple
3+ Children

Child
0-14

21
30
40
50
60

$907.76
$1,030.32
$1,160.12
$1,621.28
$2,463.68

$1,254.98
$1,377.54
$1,507.34
$1,968.50

$1,602.20
$1,724.76
$1,854.56
$2,315.72

$1,949.42
$2,071.98
$2,201.78
$2,662.94

$347.22

‡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 Flagler County here.

Flagler County is in “Rating Area 17” of Florida.

Currently, there are 110 plans offered in Rating Area 17.

Top

2024 Obamacare Plans for Flagler County, FL

Plan Browser: 110 Plans

Florida Blue (BlueCross BlueShield FL)

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

1. Silver BlueOptions Silver 24J01-03 ($0 Virtual Visits / $0 Labs / Rewards $$$)

2. Expanded Bronze BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$)

3. Platinum BlueOptions Platinum 24J01-05 ($0 Virtual Visits / Rewards $$$)

4. Bronze BlueOptions Bronze 24J01-06 ($0 Virtual Visits / Rewards $$$)

5. Silver BlueOptions Silver 24J01-07 ($0 Virtual Visits / Rewards $$$)

6. Platinum BlueOptions Platinum 24J01-08 ($0 Virtual Visits / Rewards $$$)

7. Gold BlueOptions Gold 24J01-09 ($0 Virtual Visits / $20 PCP Visits / $15 Generic Meds / Rewards $$$)

8. Expanded Bronze BlueOptions Bronze (HSA) 24J01-10 (Rewards $$$ / $4 Condition Care Rx)

9. Gold BlueOptions Gold 24J01-12 ($0 Virtual Visits / $20 Labs / Rewards $$$)

10. Expanded Bronze BlueOptions Bronze 24J01-17 ($0 Virtual Visits / $50 PCP Visits / Rewards $$$)

11. Expanded Bronze BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards $$$)

12. Silver BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards $$$)

13. Gold BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards $$$)

14. Platinum BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$)

Florida Blue HMO (a BlueCross BlueShield FL company)

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

15. Silver BlueCare Silver 24K01-02 ($0 Virtual Visits / Rewards $$$)

16. Expanded Bronze BlueCare Bronze 24K01-03 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$)

17. Platinum BlueCare Platinum 24K01-04 ($0 Virtual Visits / Rewards $$$)

18. Bronze BlueCare Bronze 24K01-05 ($0 Virtual Visits / Rewards $$$)

19. Silver BlueCare Silver 24K01-06 ($0 Virtual Visits / Rewards $$$)

20. Platinum BlueCare Platinum 24K01-07 ($0 Virtual Visits / Rewards $$$)

21. Gold BlueCare Gold 24K01-08 ($0 Virtual Visits / $20 PCP Visit / $15 Generic Meds / Rewards $$$)

22. Expanded Bronze BlueCare Bronze (HSA) 24K01-09 (Rewards $$$ / $4 Condition Care Rx)

23. Gold BlueCare Gold 24K01-10 ($0 Virtual Visits / $20 Labs / Rewards $$$)

24. Expanded Bronze BlueCare Bronze 24K01-25 ($0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / Rewards $$$)

25. Expanded Bronze BlueCare Bronze 24K01-31S (Multilingual Available / Rewards $$$)

26. Silver BlueCare Silver 24K01-32S ($40 PCP Visits / Multilingual Available / Rewards $$$)

27. Gold BlueCare Gold 24K01-33S ($30 PCP Visit / Multilingual Available/ Rewards $$$)

28. Platinum BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$)

Health First Commercial Plans, Inc.

Local: 1-855-443-4735 | Toll Free: 1-855-443-4735 | TTY: 1-800-955-8771

29. Silver Silver Gym Access 1664 (Primary Care & Specialist Copays, Open Access, Fitness Center Included)

30. Silver Silver Gym Access 1688 (Open Access, Fitness Center Included)

31. Gold Gold Gym Access 1736 (Primary Care & Urgent Care Copay, 0% Coinsurance, Open Access)

32. Gold Gold Gym Access 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access)

33. Catastrophic Catastrophic Gym Access 1746 (Primary Care Copay Visits 1-3, Open Access)

34. Expanded Bronze Bronze 1750 (Unlimited Primary Care, Specialist & Urgent Care Copay Visits, Open Access)

35. Gold Gold 1770 (Low Primary Care, Specialist & Urgent Care Copay, Open Access)

36. Expanded Bronze Bronze HSA 1794 (HSA Qualified, Open Access)

37. Silver Silver 1806 ($2,100 Deductible, Open Access)

38. Expanded Bronze Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access)

39. Expanded Bronze Bronze Standard 1828

40. Silver Silver Standard 1829

41. Gold Gold Standard 1833

42. Expanded Bronze Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access)

43. Silver Silver Savings 1821 (Primary Care Copay, Open Access)

44. Gold Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access)

Oscar Insurance Company of Florida

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

45. Expanded Bronze Bronze Elite + PCP Saver Plus

46. Silver Silver Classic

47. Catastrophic Secure

48. Expanded Bronze Bronze Elite + Specialist Saver Plus

49. Gold Gold Classic

50. Silver Silver Simple

51. Silver Silver Elite

52. Expanded Bronze Bronze Classic 4700

53. Silver Silver Simple PCP Saver

54. Gold Gold Elite Saver Plus

55. Gold Gold Elite

56. Expanded Bronze Bronze Elite Saver Plus

57. Expanded Bronze Bronze Classic Standard

58. Silver Silver Classic Standard

59. Gold Gold Classic Standard

Florida Health Care Plans

Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 | TTY: 1-800-955-8771

60. Catastrophic Gym Access IND Essential Plus Catastrophic HMO 36

61. Catastrophic Gym Access IND Essential Plus Catastrophic POS 37

62. Silver Gym Access IND Essential Plus Silver HMO 53

63. Silver Gym Access IND Essential Plus Silver POS 54

64. Platinum Gym Access IND Platinum POS 4000

65. Gold Gym Access IND Gold HMO 55001

66. Gold Gym Access IND Gold POS 55001

67. Gold Gym Access IND Gold HMO 4500

68. Expanded Bronze Gym Access IND Bronze HMO HSA 5065

69. Expanded Bronze Gym Access IND Bronze POS BC 3841

70. Silver Gym Access IND Silver HMO BC 0941

71. Silver Gym Access IND Silver POS BC 0941

72. Silver Gym Access IND Silver HMO BC 7741

73. Silver Gym Access IND Silver POS BC 7741

74. Gold Gym Access IND Gold HMO BC 5651

75. Gold Gym Access IND Gold POS BC 5651

76. Platinum Gym Access IND Platinum POS BC 5841

77. Platinum Gym Access IND Platinum POS BC 1941

78. Expanded Bronze Gym Access IND Bronze Standardized HMO

79. Expanded Bronze Gym Access IND Bronze HMO 1340

80. Expanded Bronze Gym Access IND Bronze POS 1042

81. Gold Gym Access IND Gold HMO H.S.A 9010

82. Expanded Bronze Gym Access IND Bronze HMO OA 1211

83. Silver Gym Access IND Silver HMO OA 1009

84. Expanded Bronze Gym Access IND Bronze HMO OA Standard 2450

85. Silver Gym Access IND Silver HMO OA Standard 1440

86. Gold Gym Access IND Gold HMO OA Standard 3450

87. Expanded Bronze Gym Access IND Bronze POS OA Standard 2450

88. Silver Gym Access IND Silver POS OA Standard 1440

89. Gold Gym Access IND Gold POS OA Standard 3450

90. Platinum Gym Access IND Platinum POS OA Standard 4450

91. Expanded Bronze Gym Access IND Bronze POS OA 1211

92. Gold Gym Access IND Gold POS 4500

93. Platinum Gym Access IND Essential Plus Platinum POS 65

94. Silver Gym Access IND Silver POS OA 1009

UnitedHealthcare

Local: 1-888-200-0405 | Toll Free: 1-888-200-0405 | TTY: 1-888-200-0405

95. Silver UHC Silver Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol)

96. Expanded Bronze UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx)

97. Expanded Bronze UHC Bronze Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol)

98. Gold UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx)

99. Gold UHC Gold Standard

100. Silver UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx)

101. Silver UHC Silver Standard

102. Bronze UHC Bronze Essential ($0 Virtual Urgent Care, $3 Tier 2 Rx)

103. Expanded Bronze UHC Bronze Standard

104. Expanded Bronze UHC Bronze Copay Focus $0 Indiv Med Ded

105. Silver UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx)

106. Silver UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin)

107. Gold UHC Gold Value ($0 Virtual Urgent Care, $3 Tier 2 Rx)

108. Gold UHC Gold Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol)

109. Gold UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision)

110. Silver UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, $0 Insulin)

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

Obamacare Providers, 110 Plans and 2024 Rates for Flagler County, Florida

Obamacare Rates and Providers for Other Years

How To Sign Up for Obamacare in Florida for 2024

Where's the Florida Health Care Exchange?

Florida Medicaid Expansion: Do I Qualify for Medicaid Under the ACA?

Florida Has Not Expanded Medicaid

The Medicaid Coverage Gap

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More Information

Florida Blue (BlueCross BlueShield FL)

(PPO) BlueOptions Silver 24J01-03 ($0 Virtual Visits / $0 Labs / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $6,000 $12,000 Annual Deductible $8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $6,500 $13,000 Annual Deductible $9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Platinum 24J01-05 ($0 Virtual Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $1,000 $2,000 Annual Deductible $4,000 $8,000 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Bronze 24J01-06 ($0 Virtual Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $6,150 $12,300 Annual Deductible $9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Silver 24J01-07 ($0 Virtual Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $2,800 $5,600 Annual Deductible $7,150 $14,300 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Platinum 24J01-08 ($0 Virtual Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $0 $0 Annual Deductible $2,000 $4,000 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Gold 24J01-09 ($0 Virtual Visits / $20 PCP Visits / $15 Generic Meds / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $0 $0 Annual Deductible $6,250 $12,500 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Bronze (HSA) 24J01-10 (Rewards $$$ / $4 Condition Care Rx)

Annual Out of Pocket Expenses:

Individual Family $7,050 $14,100 Annual Deductible $7,050 $14,100 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Gold 24J01-12 ($0 Virtual Visits / $20 Labs / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $1,500 $3,000 Annual Deductible $5,900 $11,800 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Bronze 24J01-17 ($0 Virtual Visits / $50 PCP Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $0 $0 Annual Deductible $9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

(PPO) BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards $$$)

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:

(PPO) BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards $$$)

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:

(PPO) BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards $$$)

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:

(PPO) BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $0 $0 Annual Deductible $3,200 $6,400 Maximum Out of Pocket Per Year

Monthly Premiums:

Florida Blue HMO (a BlueCross BlueShield FL company)

(POS) BlueCare Silver 24K01-02 ($0 Virtual Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $6,000 $12,000 Annual Deductible $8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

(POS) BlueCare Bronze 24K01-03 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family $6,500 $13,000 Annual Deductible $9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

(POS) BlueCare Platinum 24K01-04 ($0 Virtual Visits / Rewards $$$)

Annual Out of Pocket Expenses:

Individual Family

$6,000 $12,000 Annual Deductible

$8,000 $16,000 Maximum Out of Pocket Per Year

Individual Family

$6,500 $13,000 Annual Deductible

$9,450 $18,900 Maximum Out of Pocket Per Year

Individual Family

$1,000 $2,000 Annual Deductible

$4,000 $8,000 Maximum Out of Pocket Per Year

Individual Family

$6,150 $12,300 Annual Deductible

$9,450 $18,900 Maximum Out of Pocket Per Year

Individual Family

$2,800 $5,600 Annual Deductible

$7,150 $14,300 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$2,000 $4,000 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$6,250 $12,500 Maximum Out of Pocket Per Year

Individual Family

$7,050 $14,100 Annual Deductible

$7,050 $14,100 Maximum Out of Pocket Per Year

Individual Family

$1,500 $3,000 Annual Deductible

$5,900 $11,800 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$9,450 $18,900 Maximum Out of Pocket Per Year

Individual Family

$7,500 $15,000 Annual Deductible

$9,400 $18,800 Maximum Out of Pocket Per Year

Individual Family

$5,900 $11,800 Annual Deductible

$9,100 $18,200 Maximum Out of Pocket Per Year

Individual Family

$1,500 $3,000 Annual Deductible

$8,700 $17,400 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$3,200 $6,400 Maximum Out of Pocket Per Year

Individual Family

$6,000 $12,000 Annual Deductible

$8,000 $16,000 Maximum Out of Pocket Per Year

Individual Family

$6,500 $13,000 Annual Deductible

$9,450 $18,900 Maximum Out of Pocket Per Year

Individual Family

$1,000 $2,000 Annual Deductible

$4,000 $8,000 Maximum Out of Pocket Per Year

Individual Family

$6,150 $12,300 Annual Deductible

$9,450 $18,900 Maximum Out of Pocket Per Year

Individual Family

$2,800 $5,600 Annual Deductible

$7,150 $14,300 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$2,000 $4,000 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$6,250 $12,500 Maximum Out of Pocket Per Year

Individual Family

$7,050 $14,100 Annual Deductible

$7,050 $14,100 Maximum Out of Pocket Per Year

Individual Family

$1,500 $3,000 Annual Deductible

$5,900 $11,800 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$9,450 $18,900 Maximum Out of Pocket Per Year

Individual Family

$7,500 $15,000 Annual Deductible

$9,400 $18,800 Maximum Out of Pocket Per Year

Individual Family

$5,900 $11,800 Annual Deductible

$9,100 $18,200 Maximum Out of Pocket Per Year

Individual Family

$1,500 $3,000 Annual Deductible

$8,700 $17,400 Maximum Out of Pocket Per Year

Individual Family

$0 $0 Annual Deductible

$3,200 $6,400 Maximum Out of Pocket Per Year

Individual Family

$5,750 $11,500 Annual Deductible

$9,100 $18,200 Maximum Out of Pocket Per Year

Individual Family

$3,850 $7,700 Annual Deductible

$8,700 $17,400 Maximum Out of Pocket Per Year

Individual Family

$2,650 $5,300 Annual Deductible

$8,150 $16,300 Maximum Out of Pocket Per Year

Individual Family

$1,500 $3,000 Annual Deductible

$7,750 $15,500 Maximum Out of Pocket Per Year