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Providers for Zip Code 19020

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ObamacareByZipCode.com

Obamacare 2016 Marketplace Rates For Bensalem, PA

Friday, April 19th, 2024


The health insurance rates listed below are for calendar year 2016.

2016 Rates and Providers

(click here for 2014)

(click here for 2015)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Bensalem, PA.

Obamacare Providers, Plans and 2016 Rates for Bucks County

Bucks County is in “Rating Area 8” of Pennsylvania.

Currently, there are 5 providers offering 48 plans to Rating Area 8. †

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

The table below shows premiums for the following scenarios for:

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

Each scenario is covered for age

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

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

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

Local: 1-877-760-3345 | Toll Free: 1-877-760-3345

Plan: (HMO) Gold Compass 1000-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-760-3345 - Provider Directory for This Plan: (UnitedHealthcare of Pennsylvania, Inc.)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $251.71
$285.68
$321.68
$449.54
$683.12		 $503.42
$571.36
$643.36
$899.08
$1366.24		 $663.25
$731.19
$803.19
$1058.91		 $823.08
$891.02
$963.02
$1218.74		 $982.91
$1050.85
$1122.85
$1378.57		 $411.54
$445.51
$481.51
$609.37		 $571.37
$605.34
$641.34
$769.20		 $731.20
$765.17
$801.17
$929.03		 $159.83

Plan: (HMO) Gold Compass0-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-760-3345 - Provider Directory for This Plan: (UnitedHealthcare of Pennsylvania, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $247.73
$281.16
$316.58
$442.42
$672.30		 $495.46
$562.32
$633.16
$884.84
$1344.60		 $652.76
$719.62
$790.46
$1042.14		 $810.06
$876.92
$947.76
$1199.44		 $967.36
$1034.22
$1105.06
$1356.74		 $405.03
$438.46
$473.88
$599.72		 $562.33
$595.76
$631.18
$757.02		 $719.63
$753.06
$788.48
$914.32		 $157.30

Plan: (HMO) Silver Compass HSA 2000-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-760-3345 - Provider Directory for This Plan: (UnitedHealthcare of Pennsylvania, Inc.)

Deductible: Individual: $2,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $6,850

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $216.15
$245.32
$276.23
$386.02
$586.60		 $432.30
$490.64
$552.46
$772.04
$1173.20		 $569.55
$627.89
$689.71
$909.29		 $706.80
$765.14
$826.96
$1046.54		 $844.05
$902.39
$964.21
$1183.79		 $353.40
$382.57
$413.48
$523.27		 $490.65
$519.82
$550.73
$660.52		 $627.90
$657.07
$687.98
$797.77		 $137.25

Plan: (HMO) Silver Compass 4500-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-760-3345 - Provider Directory for This Plan: (UnitedHealthcare of Pennsylvania, Inc.)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $225.96
$256.45
$288.76
$403.55
$613.23		 $451.92
$512.90
$577.52
$807.10
$1226.46		 $595.40
$656.38
$721.00
$950.58		 $738.88
$799.86
$864.48
$1094.06		 $882.36
$943.34
$1007.96
$1237.54		 $369.44
$399.93
$432.24
$547.03		 $512.92
$543.41
$575.72
$690.51		 $656.40
$686.89
$719.20
$833.99		 $143.48

Plan: (HMO) Bronze Compass HSA 5500-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-760-3345 - Provider Directory for This Plan: (UnitedHealthcare of Pennsylvania, Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $181.81
$206.35
$232.34
$324.70
$493.41		 $363.62
$412.70
$464.68
$649.40
$986.82		 $479.06
$528.14
$580.12
$764.84		 $594.50
$643.58
$695.56
$880.28		 $709.94
$759.02
$811.00
$995.72		 $297.25
$321.79
$347.78
$440.14		 $412.69
$437.23
$463.22
$555.58		 $528.13
$552.67
$578.66
$671.02		 $115.44

Plan: (HMO) Bronze Compass 6500-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-760-3345 - Provider Directory for This Plan: (UnitedHealthcare of Pennsylvania, Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $191.62
$217.48
$244.88
$342.22
$520.04		 $383.24
$434.96
$489.76
$684.44
$1040.08		 $504.91
$556.63
$611.43
$806.11		 $626.58
$678.30
$733.10
$927.78		 $748.25
$799.97
$854.77
$1049.45		 $313.29
$339.15
$366.55
$463.89		 $434.96
$460.82
$488.22
$585.56		 $556.63
$582.49
$609.89
$707.23		 $121.67
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Independence Blue Cross (QCC Ins. Co.)

Local: 1-855-429-3800 | Toll Free: 1-855-429-3800

TTY: 1-888-857-4816

Plan: (PPO) Personal Choice PPO Platinum

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $443.71
$503.61
$567.06
$792.47
$1204.23		 $887.42
$1007.22
$1134.12
$1584.94
$2408.46		 $1169.18
$1288.98
$1415.88
$1866.70		 $1450.94
$1570.74
$1697.64
$2148.46		 $1732.70
$1852.50
$1979.40
$2430.22		 $725.47
$785.37
$848.82
$1074.23		 $1007.23
$1067.13
$1130.58
$1355.99		 $1288.99
$1348.89
$1412.34
$1637.75		 $281.76

Plan: (PPO) Personal Choice PPO Gold

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $360.70
$409.39
$460.97
$644.21
$978.94		 $721.40
$818.78
$921.94
$1288.42
$1957.88		 $950.44
$1047.82
$1150.98
$1517.46		 $1179.48
$1276.86
$1380.02
$1746.50		 $1408.52
$1505.90
$1609.06
$1975.54		 $589.74
$638.43
$690.01
$873.25		 $818.78
$867.47
$919.05
$1102.29		 $1047.82
$1096.51
$1148.09
$1331.33		 $229.04

Plan: (PPO) Personal Choice PPO Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $304.53
$345.64
$389.18
$543.88
$826.48		 $609.06
$691.28
$778.36
$1087.76
$1652.96		 $802.43
$884.65
$971.73
$1281.13		 $995.80
$1078.02
$1165.10
$1474.50		 $1189.17
$1271.39
$1358.47
$1667.87		 $497.90
$539.01
$582.55
$737.25		 $691.27
$732.38
$775.92
$930.62		 $884.64
$925.75
$969.29
$1123.99		 $193.37

Plan: (PPO) Personal Choice PPO Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $221.31
$251.18
$282.83
$395.25
$600.63		 $442.62
$502.36
$565.66
$790.50
$1201.26		 $583.15
$642.89
$706.19
$931.03		 $723.68
$783.42
$846.72
$1071.56		 $864.21
$923.95
$987.25
$1212.09		 $361.84
$391.71
$423.36
$535.78		 $502.37
$532.24
$563.89
$676.31		 $642.90
$672.77
$704.42
$816.84		 $140.53

Plan: (PPO) Personal Choice PPO Bronze Reserve

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $204.60
$232.22
$261.48
$365.42
$555.29		 $409.20
$464.44
$522.96
$730.84
$1110.58		 $539.12
$594.36
$652.88
$860.76		 $669.04
$724.28
$782.80
$990.68		 $798.96
$854.20
$912.72
$1120.60		 $334.52
$362.14
$391.40
$495.34		 $464.44
$492.06
$521.32
$625.26		 $594.36
$621.98
$651.24
$755.18		 $129.92

Plan: (PPO) Personal Choice Catastrophic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $6,850 : Family: $13,700
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Catastrophic 21
30
40
50
60		 $182.78
$207.45
$233.59
$326.44
$496.05		 $365.56
$414.90
$467.18
$652.88
$992.10		 $481.62
$530.96
$583.24
$768.94		 $597.68
$647.02
$699.30
$885.00		 $713.74
$763.08
$815.36
$1001.06		 $298.84
$323.51
$349.65
$442.50		 $414.90
$439.57
$465.71
$558.56		 $530.96
$555.63
$581.77
$674.62		 $116.06

Plan: (PPO) Personal Choice PPO Platinum Complete

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $481.48
$546.48
$615.34
$859.93
$1306.75		 $962.96
$1092.96
$1230.68
$1719.86
$2613.50		 $1268.70
$1398.70
$1536.42
$2025.60		 $1574.44
$1704.44
$1842.16
$2331.34		 $1880.18
$2010.18
$2147.90
$2637.08		 $787.22
$852.22
$921.08
$1165.67		 $1092.96
$1157.96
$1226.82
$1471.41		 $1398.70
$1463.70
$1532.56
$1777.15		 $305.74

Plan: (PPO) Personal Choice Bronze Basic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $6,850 : Family: $13,700
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $187.03
$212.27
$239.02
$334.03
$507.59		 $374.06
$424.54
$478.04
$668.06
$1015.18		 $492.82
$543.30
$596.80
$786.82		 $611.58
$662.06
$715.56
$905.58		 $730.34
$780.82
$834.32
$1024.34		 $305.79
$331.03
$357.78
$452.79		 $424.55
$449.79
$476.54
$571.55		 $543.31
$568.55
$595.30
$690.31		 $118.76

Plan: (PPO) Blue Cross Gold, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $377.94
$428.96
$483.01
$675.00
$1025.73		 $755.88
$857.92
$966.02
$1350.00
$2051.46		 $995.87
$1097.91
$1206.01
$1589.99		 $1235.86
$1337.90
$1446.00
$1829.98		 $1475.85
$1577.89
$1685.99
$2069.97		 $617.93
$668.95
$723.00
$914.99		 $857.92
$908.94
$962.99
$1154.98		 $1097.91
$1148.93
$1202.98
$1394.97		 $239.99

Plan: (PPO) Blue Cross Silver, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Independence Blue Cross (QCC Ins. Co.))

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $5,750 : Family: $11,500

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $311.59
$353.65
$398.21
$556.50
$845.66		 $623.18
$707.30
$796.42
$1113.00
$1691.32		 $821.04
$905.16
$994.28
$1310.86		 $1018.90
$1103.02
$1192.14
$1508.72		 $1216.76
$1300.88
$1390.00
$1706.58		 $509.45
$551.51
$596.07
$754.36		 $707.31
$749.37
$793.93
$952.22		 $905.17
$947.23
$991.79
$1150.08		 $197.86
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Keystone Health Plan East, Inc

Local: 1-855-429-3800 | Toll Free: 1-855-429-3800

TTY: 1-888-857-4816

Plan: (HMO) Keystone HMO Platinum

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $407.56
$462.58
$520.86
$727.89
$1106.10		 $815.12
$925.16
$1041.72
$1455.78
$2212.20		 $1073.92
$1183.96
$1300.52
$1714.58		 $1332.72
$1442.76
$1559.32
$1973.38		 $1591.52
$1701.56
$1818.12
$2232.18		 $666.36
$721.38
$779.66
$986.69		 $925.16
$980.18
$1038.46
$1245.49		 $1183.96
$1238.98
$1297.26
$1504.29		 $258.80

Plan: (HMO) Keystone HMO Gold

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $318.57
$361.58
$407.13
$568.96
$864.60		 $637.14
$723.16
$814.26
$1137.92
$1729.20		 $839.43
$925.45
$1016.55
$1340.21		 $1041.72
$1127.74
$1218.84
$1542.50		 $1244.01
$1330.03
$1421.13
$1744.79		 $520.86
$563.87
$609.42
$771.25		 $723.15
$766.16
$811.71
$973.54		 $925.44
$968.45
$1014.00
$1175.83		 $202.29

Plan: (HMO) Keystone HMO Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $275.51
$312.71
$352.10
$492.06
$747.74		 $551.02
$625.42
$704.20
$984.12
$1495.48		 $725.97
$800.37
$879.15
$1159.07		 $900.92
$975.32
$1054.10
$1334.02		 $1075.87
$1150.27
$1229.05
$1508.97		 $450.46
$487.66
$527.05
$667.01		 $625.41
$662.61
$702.00
$841.96		 $800.36
$837.56
$876.95
$1016.91		 $174.95

Plan: (HMO) Keystone HMO Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $177.56
$201.53
$226.92
$317.12
$481.89		 $355.12
$403.06
$453.84
$634.24
$963.78		 $467.87
$515.81
$566.59
$746.99		 $580.62
$628.56
$679.34
$859.74		 $693.37
$741.31
$792.09
$972.49		 $290.31
$314.28
$339.67
$429.87		 $403.06
$427.03
$452.42
$542.62		 $515.81
$539.78
$565.17
$655.37		 $112.75

Plan: (HMO) Keystone HMO Gold Proactive

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $287.30
$326.09
$367.18
$513.13
$779.74		 $574.60
$652.18
$734.36
$1026.26
$1559.48		 $757.04
$834.62
$916.80
$1208.70		 $939.48
$1017.06
$1099.24
$1391.14		 $1121.92
$1199.50
$1281.68
$1573.58		 $469.74
$508.53
$549.62
$695.57		 $652.18
$690.97
$732.06
$878.01		 $834.62
$873.41
$914.50
$1060.45		 $182.44

Plan: (HMO) Keystone HMO Silver Proactive

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $233.05
$264.51
$297.84
$416.23
$632.50		 $466.10
$529.02
$595.68
$832.46
$1265.00		 $614.09
$677.01
$743.67
$980.45		 $762.08
$825.00
$891.66
$1128.44		 $910.07
$972.99
$1039.65
$1276.43		 $381.04
$412.50
$445.83
$564.22		 $529.03
$560.49
$593.82
$712.21		 $677.02
$708.48
$741.81
$860.20		 $147.99

Plan: (HMO) Keystone HMO Silver Proactive Value

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-429-3800 - Provider Directory for This Plan: (Keystone Health Plan East, Inc)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $215.97
$245.13
$276.01
$385.73
$586.15		 $431.94
$490.26
$552.02
$771.46
$1172.30		 $569.08
$627.40
$689.16
$908.60		 $706.22
$764.54
$826.30
$1045.74		 $843.36
$901.68
$963.44
$1182.88		 $353.11
$382.27
$413.15
$522.87		 $490.25
$519.41
$550.29
$660.01		 $627.39
$656.55
$687.43
$797.15		 $137.14
ADVERTISEMENT

Aetna Health Inc. (a PA corp.)

Local: 1-855-632-6273 | Toll Free: 1-855-632-6273

TTY: 1-855-632-6273

Plan: (HMO) Aetna Leap Basic Plus

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $191.82
$217.71
$245.14
$342.59
$520.59		 $383.64
$435.42
$490.28
$685.18
$1041.18		 $505.44
$557.22
$612.08
$806.98		 $627.24
$679.02
$733.88
$928.78		 $749.04
$800.82
$855.68
$1050.58		 $313.62
$339.51
$366.94
$464.39		 $435.42
$461.31
$488.74
$586.19		 $557.22
$583.11
$610.54
$707.99		 $121.80

Plan: (HMO) Aetna Leap Basic HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $5,825 : Family: $11,650
Out of Pocket Maximum per year: Individual: $5,825 : Family: $11,650

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $189.62
$215.22
$242.34
$338.67
$514.64		 $379.24
$430.44
$484.68
$677.34
$1029.28		 $499.65
$550.85
$605.09
$797.75		 $620.06
$671.26
$725.50
$918.16		 $740.47
$791.67
$845.91
$1038.57		 $310.03
$335.63
$362.75
$459.08		 $430.44
$456.04
$483.16
$579.49		 $550.85
$576.45
$603.57
$699.90		 $120.41

Plan: (HMO) Aetna Leap Specialty

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $274.85
$311.95
$351.26
$490.88
$745.94		 $549.70
$623.90
$702.52
$981.76
$1491.88		 $724.23
$798.43
$877.05
$1156.29		 $898.76
$972.96
$1051.58
$1330.82		 $1073.29
$1147.49
$1226.11
$1505.35		 $449.38
$486.48
$525.79
$665.41		 $623.91
$661.01
$700.32
$839.94		 $798.44
$835.54
$874.85
$1014.47		 $174.53

Plan: (HMO) Aetna Leap Everyday

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $222.75
$252.82
$284.67
$397.83
$604.54		 $445.50
$505.64
$569.34
$795.66
$1209.08		 $586.95
$647.09
$710.79
$937.11		 $728.40
$788.54
$852.24
$1078.56		 $869.85
$929.99
$993.69
$1220.01		 $364.20
$394.27
$426.12
$539.28		 $505.65
$535.72
$567.57
$680.73		 $647.10
$677.17
$709.02
$822.18		 $141.45

Plan: (HMO) Aetna Leap Everyday Plus

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $4,210 : Family: $8,420
Out of Pocket Maximum per year: Individual: $4,210 : Family: $8,420

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $243.62
$276.51
$311.35
$435.11
$661.19		 $487.24
$553.02
$622.70
$870.22
$1322.38		 $641.94
$707.72
$777.40
$1024.92		 $796.64
$862.42
$932.10
$1179.62		 $951.34
$1017.12
$1086.80
$1334.32		 $398.32
$431.21
$466.05
$589.81		 $553.02
$585.91
$620.75
$744.51		 $707.72
$740.61
$775.45
$899.21		 $154.70

Plan: (HMO) Aetna Leap Basic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $6,450 : Family: $12,900
Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $181.23
$205.70
$231.62
$323.68
$491.87		 $362.46
$411.40
$463.24
$647.36
$983.74		 $477.54
$526.48
$578.32
$762.44		 $592.62
$641.56
$693.40
$877.52		 $707.70
$756.64
$808.48
$992.60		 $296.31
$320.78
$346.70
$438.76		 $411.39
$435.86
$461.78
$553.84		 $526.47
$550.94
$576.86
$668.92		 $115.08

Plan: (HMO) Aetna Leap Diabetes

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-632-6273 - Provider Directory for This Plan: (Aetna Health Inc. (a PA corp.))

Deductible: Individual: $3,200 : Family: $6,400
Out of Pocket Maximum per year: Individual: $3,200 : Family: $6,400

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $280.75
$318.65
$358.80
$501.42
$761.95		 $561.50
$637.30
$717.60
$1002.84
$1523.90		 $739.77
$815.57
$895.87
$1181.11		 $918.04
$993.84
$1074.14
$1359.38		 $1096.31
$1172.11
$1252.41
$1537.65		 $459.02
$496.92
$537.07
$679.69		 $637.29
$675.19
$715.34
$857.96		 $815.56
$853.46
$893.61
$1036.23		 $178.27

†Source: Our summary of lowest costs and numbers of providers is based on a government report released September 25, 2013. For more detailed information about specific plans and providers, see HealthCare.gov.

‡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 Bucks County here.

 

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