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Providers for Zip Code 33770

LegalConsumer.com/obamacare

ObamacareByZipCode.com

Obamacare 2016 Marketplace Rates For Largo, FL

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 Largo, FL.

Obamacare Providers, Plans and 2016 Rates for Pinellas County

Pinellas County is in “Rating Area 52” of Florida.

Currently, there are 6 providers offering 106 plans to Rating Area 52. †

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 Largo, FL area accept this insurance coverage as within the plan's "network".
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Blue Cross and Blue Shield of Florida

Local: 1-855-805-8175 | Toll Free: 1-855-805-8175

Plan: (EPO) BlueOptions Everyday Health 1423

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $5,500 : Family: $11,000
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		 $330.40
$375.00
$422.25
$590.09
$896.71		 $660.80
$750.00
$844.50
$1180.18
$1793.42		 $870.60
$959.80
$1054.30
$1389.98		 $1080.40
$1169.60
$1264.10
$1599.78		 $1290.20
$1379.40
$1473.90
$1809.58		 $540.20
$584.80
$632.05
$799.89		 $750.00
$794.60
$841.85
$1009.69		 $959.80
$1004.40
$1051.65
$1219.49		 $209.80

Plan: (EPO) BlueOptions Essential 1419

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

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		 $280.08
$317.89
$357.94
$500.22
$760.14		 $560.16
$635.78
$715.88
$1000.44
$1520.28		 $738.01
$813.63
$893.73
$1178.29		 $915.86
$991.48
$1071.58
$1356.14		 $1093.71
$1169.33
$1249.43
$1533.99		 $457.93
$495.74
$535.79
$678.07		 $635.78
$673.59
$713.64
$855.92		 $813.63
$851.44
$891.49
$1033.77		 $177.85

Plan: (EPO) BlueOptions Everyday Health 1431

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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		 $363.36
$412.41
$464.37
$648.96
$986.16		 $726.72
$824.82
$928.74
$1297.92
$1972.32		 $957.45
$1055.55
$1159.47
$1528.65		 $1188.18
$1286.28
$1390.20
$1759.38		 $1418.91
$1517.01
$1620.93
$1990.11		 $594.09
$643.14
$695.10
$879.69		 $824.82
$873.87
$925.83
$1110.42		 $1055.55
$1104.60
$1156.56
$1341.15		 $230.73

Plan: (EPO) BlueOptions Everyday Health 1418

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $800 : Family: $1,600
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		 $485.57
$551.12
$620.56
$867.23
$1317.84		 $971.14
$1102.24
$1241.12
$1734.46
$2635.68		 $1279.48
$1410.58
$1549.46
$2042.80		 $1587.82
$1718.92
$1857.80
$2351.14		 $1896.16
$2027.26
$2166.14
$2659.48		 $793.91
$859.46
$928.90
$1175.57		 $1102.25
$1167.80
$1237.24
$1483.91		 $1410.59
$1476.14
$1545.58
$1792.25		 $308.34

Plan: (EPO) BlueOptions Everyday Health Premier 1418V

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $800 : Family: $1,600
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		 $523.73
$594.43
$669.33
$935.38
$1421.40		 $1047.46
$1188.86
$1338.66
$1870.76
$2842.80		 $1380.03
$1521.43
$1671.23
$2203.33		 $1712.60
$1854.00
$2003.80
$2535.90		 $2045.17
$2186.57
$2336.37
$2868.47		 $856.30
$927.00
$1001.90
$1267.95		 $1188.87
$1259.57
$1334.47
$1600.52		 $1521.44
$1592.14
$1667.04
$1933.09		 $332.57

Plan: (EPO) BlueOptions Everyday Health 1416

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,700 : Family: $13,400
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		 $310.60
$352.53
$396.95
$554.73
$842.97		 $621.20
$705.06
$793.90
$1109.46
$1685.94		 $818.43
$902.29
$991.13
$1306.69		 $1015.66
$1099.52
$1188.36
$1503.92		 $1212.89
$1296.75
$1385.59
$1701.15		 $507.83
$549.76
$594.18
$751.96		 $705.06
$746.99
$791.41
$949.19		 $902.29
$944.22
$988.64
$1146.42		 $197.23

Plan: (EPO) BlueOptions All Copay 1424

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

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		 $504.58
$572.70
$644.85
$901.18
$1369.43		 $1009.16
$1145.40
$1289.70
$1802.36
$2738.86		 $1329.57
$1465.81
$1610.11
$2122.77		 $1649.98
$1786.22
$1930.52
$2443.18		 $1970.39
$2106.63
$2250.93
$2763.59		 $824.99
$893.11
$965.26
$1221.59		 $1145.40
$1213.52
$1285.67
$1542.00		 $1465.81
$1533.93
$1606.08
$1862.41		 $320.41

Plan: (EPO) BlueOptions Everyday Health 1410

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,100 : Family: $12,200
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		 $307.51
$349.02
$393.00
$549.21
$834.58		 $615.02
$698.04
$786.00
$1098.42
$1669.16		 $810.29
$893.31
$981.27
$1293.69		 $1005.56
$1088.58
$1176.54
$1488.96		 $1200.83
$1283.85
$1371.81
$1684.23		 $502.78
$544.29
$588.27
$744.48		 $698.05
$739.56
$783.54
$939.75		 $893.32
$934.83
$978.81
$1135.02		 $195.27

Plan: (EPO) BlueOptions All Copay 1505

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

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
Gold 21
30
40
50
60		 $430.48
$488.59
$550.15
$768.84
$1168.32		 $860.96
$977.18
$1100.30
$1537.68
$2336.64		 $1134.31
$1250.53
$1373.65
$1811.03		 $1407.66
$1523.88
$1647.00
$2084.38		 $1681.01
$1797.23
$1920.35
$2357.73		 $703.83
$761.94
$823.50
$1042.19		 $977.18
$1035.29
$1096.85
$1315.54		 $1250.53
$1308.64
$1370.20
$1588.89		 $273.35

Plan: (EPO) BlueSelect Everyday Health 1456

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $5,500 : Family: $11,000
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		 $244.41
$277.41
$312.36
$436.52
$663.33		 $488.82
$554.82
$624.72
$873.04
$1326.66		 $644.02
$710.02
$779.92
$1028.24		 $799.22
$865.22
$935.12
$1183.44		 $954.42
$1020.42
$1090.32
$1338.64		 $399.61
$432.61
$467.56
$591.72		 $554.81
$587.81
$622.76
$746.92		 $710.01
$743.01
$777.96
$902.12		 $155.20

Plan: (EPO) BlueSelect Essential 1452

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

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		 $206.16
$233.99
$263.47
$368.20
$559.52		 $412.32
$467.98
$526.94
$736.40
$1119.04		 $543.23
$598.89
$657.85
$867.31		 $674.14
$729.80
$788.76
$998.22		 $805.05
$860.71
$919.67
$1129.13		 $337.07
$364.90
$394.38
$499.11		 $467.98
$495.81
$525.29
$630.02		 $598.89
$626.72
$656.20
$760.93		 $130.91

Plan: (EPO) BlueSelect Everyday Health 1464

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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		 $269.43
$305.80
$344.33
$481.20
$731.23		 $538.86
$611.60
$688.66
$962.40
$1462.46		 $709.95
$782.69
$859.75
$1133.49		 $881.04
$953.78
$1030.84
$1304.58		 $1052.13
$1124.87
$1201.93
$1475.67		 $440.52
$476.89
$515.42
$652.29		 $611.61
$647.98
$686.51
$823.38		 $782.70
$819.07
$857.60
$994.47		 $171.09

Plan: (EPO) BlueSelect Everyday Health 1451

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $800 : Family: $1,600
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		 $362.10
$410.98
$462.76
$646.71
$982.74		 $724.20
$821.96
$925.52
$1293.42
$1965.48		 $954.13
$1051.89
$1155.45
$1523.35		 $1184.06
$1281.82
$1385.38
$1753.28		 $1413.99
$1511.75
$1615.31
$1983.21		 $592.03
$640.91
$692.69
$876.64		 $821.96
$870.84
$922.62
$1106.57		 $1051.89
$1100.77
$1152.55
$1336.50		 $229.93

Plan: (EPO) BlueSelect Everyday Health Premier 1451V

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $800 : Family: $1,600
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		 $390.56
$443.29
$499.14
$697.54
$1059.98		 $781.12
$886.58
$998.28
$1395.08
$2119.96		 $1029.13
$1134.59
$1246.29
$1643.09		 $1277.14
$1382.60
$1494.30
$1891.10		 $1525.15
$1630.61
$1742.31
$2139.11		 $638.57
$691.30
$747.15
$945.55		 $886.58
$939.31
$995.16
$1193.56		 $1134.59
$1187.32
$1243.17
$1441.57		 $248.01

Plan: (EPO) BlueSelect Everyday Health 1449

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,700 : Family: $13,400
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		 $228.63
$259.50
$292.19
$408.33
$620.50		 $457.26
$519.00
$584.38
$816.66
$1241.00		 $602.44
$664.18
$729.56
$961.84		 $747.62
$809.36
$874.74
$1107.02		 $892.80
$954.54
$1019.92
$1252.20		 $373.81
$404.68
$437.37
$553.51		 $518.99
$549.86
$582.55
$698.69		 $664.17
$695.04
$727.73
$843.87		 $145.18

Plan: (EPO) BlueSelect All Copay 1457

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

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		 $378.46
$429.55
$483.67
$675.93
$1027.14		 $756.92
$859.10
$967.34
$1351.86
$2054.28		 $997.24
$1099.42
$1207.66
$1592.18		 $1237.56
$1339.74
$1447.98
$1832.50		 $1477.88
$1580.06
$1688.30
$2072.82		 $618.78
$669.87
$723.99
$916.25		 $859.10
$910.19
$964.31
$1156.57		 $1099.42
$1150.51
$1204.63
$1396.89		 $240.32

Plan: (EPO) BlueSelect Everyday Health 1443

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

Deductible: Individual: $6,100 : Family: $12,200
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		 $227.48
$258.19
$290.72
$406.28
$617.38		 $454.96
$516.38
$581.44
$812.56
$1234.76		 $599.41
$660.83
$725.89
$957.01		 $743.86
$805.28
$870.34
$1101.46		 $888.31
$949.73
$1014.79
$1245.91		 $371.93
$402.64
$435.17
$550.73		 $516.38
$547.09
$579.62
$695.18		 $660.83
$691.54
$724.07
$839.63		 $144.45

Plan: (EPO) BlueSelect All Copay 1535

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)

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
Gold 21
30
40
50
60		 $324.46
$368.26
$414.66
$579.49
$880.58		 $648.92
$736.52
$829.32
$1158.98
$1761.16		 $854.95
$942.55
$1035.35
$1365.01		 $1060.98
$1148.58
$1241.38
$1571.04		 $1267.01
$1354.61
$1447.41
$1777.07		 $530.49
$574.29
$620.69
$785.52		 $736.52
$780.32
$826.72
$991.55		 $942.55
$986.35
$1032.75
$1197.58		 $206.03
ADVERTISEMENT

Celtic Insurance Company

Local: 1-877-687-1169 | Toll Free: 1-800-955-8770

Plan: (EPO) Ambetter Secure Care 1 (2016) with 3 PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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		 $303.95
$344.97
$388.43
$542.83
$824.88		 $607.90
$689.94
$776.86
$1085.66
$1649.76		 $800.90
$882.94
$969.86
$1278.66		 $993.90
$1075.94
$1162.86
$1471.66		 $1186.90
$1268.94
$1355.86
$1664.66		 $496.95
$537.97
$581.43
$735.83		 $689.95
$730.97
$774.43
$928.83		 $882.95
$923.97
$967.43
$1121.83		 $193.00

Plan: (EPO) Ambetter Balanced Care 1 (2016)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Silver 21
30
40
50
60		 $237.94
$270.06
$304.08
$424.95
$645.75		 $475.88
$540.12
$608.16
$849.90
$1291.50		 $626.97
$691.21
$759.25
$1000.99		 $778.06
$842.30
$910.34
$1152.08		 $929.15
$993.39
$1061.43
$1303.17		 $389.03
$421.15
$455.17
$576.04		 $540.12
$572.24
$606.26
$727.13		 $691.21
$723.33
$757.35
$878.22		 $151.09

Plan: (EPO) Ambetter Balanced Care 2 (2016)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Silver 21
30
40
50
60		 $234.89
$266.59
$300.18
$419.50
$637.47		 $469.78
$533.18
$600.36
$839.00
$1274.94		 $618.93
$682.33
$749.51
$988.15		 $768.08
$831.48
$898.66
$1137.30		 $917.23
$980.63
$1047.81
$1286.45		 $384.04
$415.74
$449.33
$568.65		 $533.19
$564.89
$598.48
$717.80		 $682.34
$714.04
$747.63
$866.95		 $149.15

Plan: (EPO) Ambetter Balanced Care 10 (2016)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $4,500 : Family: $9,000
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
Silver 21
30
40
50
60		 $244.52
$277.52
$312.49
$436.70
$663.60		 $489.04
$555.04
$624.98
$873.40
$1327.20		 $644.30
$710.30
$780.24
$1028.66		 $799.56
$865.56
$935.50
$1183.92		 $954.82
$1020.82
$1090.76
$1339.18		 $399.78
$432.78
$467.75
$591.96		 $555.04
$588.04
$623.01
$747.22		 $710.30
$743.30
$778.27
$902.48		 $155.26

Plan: (EPO) Ambetter Essential Care 1 (2016)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $209.76
$238.07
$268.06
$374.61
$569.26		 $419.52
$476.14
$536.12
$749.22
$1138.52		 $552.71
$609.33
$669.31
$882.41		 $685.90
$742.52
$802.50
$1015.60		 $819.09
$875.71
$935.69
$1148.79		 $342.95
$371.26
$401.25
$507.80		 $476.14
$504.45
$534.44
$640.99		 $609.33
$637.64
$667.63
$774.18		 $133.19

Plan: (EPO) Ambetter Essential Care 5 (2016) with 3 PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $216.34
$245.53
$276.46
$386.36
$587.11		 $432.68
$491.06
$552.92
$772.72
$1174.22		 $570.05
$628.43
$690.29
$910.09		 $707.42
$765.80
$827.66
$1047.46		 $844.79
$903.17
$965.03
$1184.83		 $353.71
$382.90
$413.83
$523.73		 $491.08
$520.27
$551.20
$661.10		 $628.45
$657.64
$688.57
$798.47		 $137.37

Plan: (EPO) Ambetter Balanced Care 1 (2016) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Silver 21
30
40
50
60		 $242.79
$275.55
$310.27
$433.60
$658.90		 $485.58
$551.10
$620.54
$867.20
$1317.80		 $639.74
$705.26
$774.70
$1021.36		 $793.90
$859.42
$928.86
$1175.52		 $948.06
$1013.58
$1083.02
$1329.68		 $396.95
$429.71
$464.43
$587.76		 $551.11
$583.87
$618.59
$741.92		 $705.27
$738.03
$772.75
$896.08		 $154.16

Plan: (EPO) Ambetter Balanced Care 2 (2016)+ Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Silver 21
30
40
50
60		 $239.67
$272.02
$306.29
$428.04
$650.44		 $479.34
$544.04
$612.58
$856.08
$1300.88		 $631.53
$696.23
$764.77
$1008.27		 $783.72
$848.42
$916.96
$1160.46		 $935.91
$1000.61
$1069.15
$1312.65		 $391.86
$424.21
$458.48
$580.23		 $544.05
$576.40
$610.67
$732.42		 $696.24
$728.59
$762.86
$884.61		 $152.19

Plan: (EPO) Ambetter Balanced Care 10 (2016) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $4,500 : Family: $9,000
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
Silver 21
30
40
50
60		 $249.50
$283.17
$318.85
$445.59
$677.11		 $499.00
$566.34
$637.70
$891.18
$1354.22		 $657.43
$724.77
$796.13
$1049.61		 $815.86
$883.20
$954.56
$1208.04		 $974.29
$1041.63
$1112.99
$1366.47		 $407.93
$441.60
$477.28
$604.02		 $566.36
$600.03
$635.71
$762.45		 $724.79
$758.46
$794.14
$920.88		 $158.43

Plan: (EPO) Ambetter Essential Care 1 (2016) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $214.03
$242.91
$273.52
$382.24
$580.85		 $428.06
$485.82
$547.04
$764.48
$1161.70		 $563.96
$621.72
$682.94
$900.38		 $699.86
$757.62
$818.84
$1036.28		 $835.76
$893.52
$954.74
$1172.18		 $349.93
$378.81
$409.42
$518.14		 $485.83
$514.71
$545.32
$654.04		 $621.73
$650.61
$681.22
$789.94		 $135.90

Plan: (EPO) Ambetter Essential Care 5 (2016) with 3 Free PCPS + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $220.74
$250.53
$282.09
$394.22
$599.06		 $441.48
$501.06
$564.18
$788.44
$1198.12		 $581.64
$641.22
$704.34
$928.60		 $721.80
$781.38
$844.50
$1068.76		 $861.96
$921.54
$984.66
$1208.92		 $360.90
$390.69
$422.25
$534.38		 $501.06
$530.85
$562.41
$674.54		 $641.22
$671.01
$702.57
$814.70		 $140.16

Plan: (EPO) Ambetter Balanced Care 1 (2016) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Silver 21
30
40
50
60		 $250.62
$284.44
$320.28
$447.59
$680.15		 $501.24
$568.88
$640.56
$895.18
$1360.30		 $660.38
$728.02
$799.70
$1054.32		 $819.52
$887.16
$958.84
$1213.46		 $978.66
$1046.30
$1117.98
$1372.60		 $409.76
$443.58
$479.42
$606.73		 $568.90
$602.72
$638.56
$765.87		 $728.04
$761.86
$797.70
$925.01		 $159.14

Plan: (EPO) Ambetter Balanced Care 2 (2016) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Silver 21
30
40
50
60		 $247.40
$280.79
$316.17
$441.84
$671.42		 $494.80
$561.58
$632.34
$883.68
$1342.84		 $651.89
$718.67
$789.43
$1040.77		 $808.98
$875.76
$946.52
$1197.86		 $966.07
$1032.85
$1103.61
$1354.95		 $404.49
$437.88
$473.26
$598.93		 $561.58
$594.97
$630.35
$756.02		 $718.67
$752.06
$787.44
$913.11		 $157.09

Plan: (EPO) Ambetter Balanced Care 10 (2016) + Vision +Adult dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $4,500 : Family: $9,000
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
Silver 21
30
40
50
60		 $257.55
$292.30
$329.13
$459.96
$698.95		 $515.10
$584.60
$658.26
$919.92
$1397.90		 $678.63
$748.13
$821.79
$1083.45		 $842.16
$911.66
$985.32
$1246.98		 $1005.69
$1075.19
$1148.85
$1410.51		 $421.08
$455.83
$492.66
$623.49		 $584.61
$619.36
$656.19
$787.02		 $748.14
$782.89
$819.72
$950.55		 $163.53

Plan: (EPO) Ambetter Essential Care 1 (2016) + Vision +Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $220.93
$250.75
$282.34
$394.57
$599.58		 $441.86
$501.50
$564.68
$789.14
$1199.16		 $582.14
$641.78
$704.96
$929.42		 $722.42
$782.06
$845.24
$1069.70		 $862.70
$922.34
$985.52
$1209.98		 $361.21
$391.03
$422.62
$534.85		 $501.49
$531.31
$562.90
$675.13		 $641.77
$671.59
$703.18
$815.41		 $140.28

Plan: (EPO) Ambetter Essential Care 5 (2016) With 3 Free PCP Visits + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-955-8770 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $6,800 : Family: $13,600
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $227.86
$258.61
$291.19
$406.94
$618.38		 $455.72
$517.22
$582.38
$813.88
$1236.76		 $600.40
$661.90
$727.06
$958.56		 $745.08
$806.58
$871.74
$1103.24		 $889.76
$951.26
$1016.42
$1247.92		 $372.54
$403.29
$435.87
$551.62		 $517.22
$547.97
$580.55
$696.30		 $661.90
$692.65
$725.23
$840.98		 $144.68
ADVERTISEMENT

Health Options, Inc.

Local: 1-855-805-8175 | Toll Free: 1-855-805-8175

Plan: (HMO) MyBlue Bronze 1601

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $6,700 : Family: $13,400
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		 $237.67
$269.76
$303.74
$424.48
$645.04		 $475.34
$539.52
$607.48
$848.96
$1290.08		 $626.26
$690.44
$758.40
$999.88		 $777.18
$841.36
$909.32
$1150.80		 $928.10
$992.28
$1060.24
$1301.72		 $388.59
$420.68
$454.66
$575.40		 $539.51
$571.60
$605.58
$726.32		 $690.43
$722.52
$756.50
$877.24		 $150.92

Plan: (HMO) MyBlue Bronze 1602

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)

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		 $208.20
$236.31
$266.08
$371.85
$565.05		 $416.40
$472.62
$532.16
$743.70
$1130.10		 $548.61
$604.83
$664.37
$875.91		 $680.82
$737.04
$796.58
$1008.12		 $813.03
$869.25
$928.79
$1140.33		 $340.41
$368.52
$398.29
$504.06		 $472.62
$500.73
$530.50
$636.27		 $604.83
$632.94
$662.71
$768.48		 $132.21

Plan: (HMO) MyBlue Silver 1603

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $5,500 : Family: $11,000
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		 $244.37
$277.36
$312.30
$436.44
$663.22		 $488.74
$554.72
$624.60
$872.88
$1326.44		 $643.91
$709.89
$779.77
$1028.05		 $799.08
$865.06
$934.94
$1183.22		 $954.25
$1020.23
$1090.11
$1338.39		 $399.54
$432.53
$467.47
$591.61		 $554.71
$587.70
$622.64
$746.78		 $709.88
$742.87
$777.81
$901.95		 $155.17

Plan: (HMO) MyBlue Silver 1604

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $6,100 : Family: $12,200
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		 $234.22
$265.84
$299.33
$418.32
$635.67		 $468.44
$531.68
$598.66
$836.64
$1271.34		 $617.17
$680.41
$747.39
$985.37		 $765.90
$829.14
$896.12
$1134.10		 $914.63
$977.87
$1044.85
$1282.83		 $382.95
$414.57
$448.06
$567.05		 $531.68
$563.30
$596.79
$715.78		 $680.41
$712.03
$745.52
$864.51		 $148.73

Plan: (HMO) MyBlue Gold 1605

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.)

Deductible: Individual: $900 : Family: $1,800
Out of Pocket Maximum per year: Individual: $4,700 : Family: $9,400

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		 $293.17
$332.75
$374.67
$523.60
$795.66		 $586.34
$665.50
$749.34
$1047.20
$1591.32		 $772.50
$851.66
$935.50
$1233.36		 $958.66
$1037.82
$1121.66
$1419.52		 $1144.82
$1223.98
$1307.82
$1605.68		 $479.33
$518.91
$560.83
$709.76		 $665.49
$705.07
$746.99
$895.92		 $851.65
$891.23
$933.15
$1082.08		 $186.16
ADVERTISEMENT

Humana Medical Plan, Inc.

Local: 1-877-720-4854 | Toll Free: 1-877-720-4854

TTY: 1-800-325-2028

Plan: (HMO) Humana Basic 6850/Tampa Bay HUMx (HMOx)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.)

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		 $151.32
$171.75
$193.39
$270.26
$410.68		 $302.64
$343.50
$386.78
$540.52
$821.36		 $398.73
$439.59
$482.87
$636.61		 $494.82
$535.68
$578.96
$732.70		 $590.91
$631.77
$675.05
$828.79		 $247.41
$267.84
$289.48
$366.35		 $343.50
$363.93
$385.57
$462.44		 $439.59
$460.02
$481.66
$558.53		 $96.09

Plan: (HMO) Humana Bronze 6450/Tampa Bay HUMx (HMOx)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.)

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		 $203.23
$230.67
$259.73
$362.97
$551.57		 $406.46
$461.34
$519.46
$725.94
$1103.14		 $535.51
$590.39
$648.51
$854.99		 $664.56
$719.44
$777.56
$984.04		 $793.61
$848.49
$906.61
$1113.09		 $332.28
$359.72
$388.78
$492.02		 $461.33
$488.77
$517.83
$621.07		 $590.38
$617.82
$646.88
$750.12		 $129.05

Plan: (HMO) Humana Bronze 4850/Tampa Bay HUMx (HMOx)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.)

Deductible: Individual: $4,850 : Family: $9,700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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		 $221.32
$251.20
$282.85
$395.28
$600.66		 $442.64
$502.40
$565.70
$790.56
$1201.32		 $583.18
$642.94
$706.24
$931.10		 $723.72
$783.48
$846.78
$1071.64		 $864.26
$924.02
$987.32
$1212.18		 $361.86
$391.74
$423.39
$535.82		 $502.40
$532.28
$563.93
$676.36		 $642.94
$672.82
$704.47
$816.90		 $140.54

Plan: (HMO) Humana Silver 3800/Tampa Bay HUMx (HMOx)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.)

Deductible: Individual: $3,800 : Family: $7,600
Out of Pocket Maximum per year: Individual: $6,300 : Family: $12,600

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		 $239.64
$271.99
$306.26
$428.00
$650.38		 $479.28
$543.98
$612.52
$856.00
$1300.76		 $631.45
$696.15
$764.69
$1008.17		 $783.62
$848.32
$916.86
$1160.34		 $935.79
$1000.49
$1069.03
$1312.51		 $391.81
$424.16
$458.43
$580.17		 $543.98
$576.33
$610.60
$732.34		 $696.15
$728.50
$762.77
$884.51		 $152.17

Plan: (HMO) Humana Gold 2250/Tampa Bay HUMx (HMOx)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.)

Deductible: Individual: $2,250 : Family: $4,500
Out of Pocket Maximum per year: Individual: $3,500 : Family: $7,000

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		 $284.20
$322.57
$363.21
$507.58
$771.32		 $568.40
$645.14
$726.42
$1015.16
$1542.64		 $748.87
$825.61
$906.89
$1195.63		 $929.34
$1006.08
$1087.36
$1376.10		 $1109.81
$1186.55
$1267.83
$1556.57		 $464.67
$503.04
$543.68
$688.05		 $645.14
$683.51
$724.15
$868.52		 $825.61
$863.98
$904.62
$1048.99		 $180.47

Plan: (HMO) Humana Platinum 500/Tampa Bay HUMx (HMOx)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.)

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

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		 $338.65
$384.37
$432.79
$604.83
$919.10		 $677.30
$768.74
$865.58
$1209.66
$1838.20		 $892.34
$983.78
$1080.62
$1424.70		 $1107.38
$1198.82
$1295.66
$1639.74		 $1322.42
$1413.86
$1510.70
$1854.78		 $553.69
$599.41
$647.83
$819.87		 $768.73
$814.45
$862.87
$1034.91		 $983.77
$1029.49
$1077.91
$1249.95		 $215.04
ADVERTISEMENT

UnitedHealthcare of Florida, Inc.

Local: 1-877-887-0441 | Toll Free: 1-877-887-0441

Plan: (HMO) Gold Compass 1500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

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		 $324.02
$367.75
$414.08
$578.68
$879.36		 $648.04
$735.50
$828.16
$1157.36
$1758.72		 $853.78
$941.24
$1033.90
$1363.10		 $1059.52
$1146.98
$1239.64
$1568.84		 $1265.26
$1352.72
$1445.38
$1774.58		 $529.76
$573.49
$619.82
$784.42		 $735.50
$779.23
$825.56
$990.16		 $941.24
$984.97
$1031.30
$1195.90		 $205.74

Plan: (HMO) Gold Compass HSA 1600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

Deductible: Individual: $1,600 : Family: $3,200
Out of Pocket Maximum per year: Individual: $3,500 : 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
Gold 21
30
40
50
60		 $297.74
$337.92
$380.49
$531.74
$808.03		 $595.48
$675.84
$760.98
$1063.48
$1616.06		 $784.54
$864.90
$950.04
$1252.54		 $973.60
$1053.96
$1139.10
$1441.60		 $1162.66
$1243.02
$1328.16
$1630.66		 $486.80
$526.98
$569.55
$720.80		 $675.86
$716.04
$758.61
$909.86		 $864.92
$905.10
$947.67
$1098.92		 $189.06

Plan: (HMO) Silver Compass 4000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

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		 $272.63
$309.43
$348.41
$486.90
$739.90		 $545.26
$618.86
$696.82
$973.80
$1479.80		 $718.37
$791.97
$869.93
$1146.91		 $891.48
$965.08
$1043.04
$1320.02		 $1064.59
$1138.19
$1216.15
$1493.13		 $445.74
$482.54
$521.52
$660.01		 $618.85
$655.65
$694.63
$833.12		 $791.96
$828.76
$867.74
$1006.23		 $173.11

Plan: (HMO) Silver Compass HSA 3600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

Deductible: Individual: $3,600 : Family: $7,200
Out of Pocket Maximum per year: Individual: $3,600 : Family: $7,200

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		 $274.59
$311.65
$350.92
$490.41
$745.22		 $549.18
$623.30
$701.84
$980.82
$1490.44		 $723.54
$797.66
$876.20
$1155.18		 $897.90
$972.02
$1050.56
$1329.54		 $1072.26
$1146.38
$1224.92
$1503.90		 $448.95
$486.01
$525.28
$664.77		 $623.31
$660.37
$699.64
$839.13		 $797.67
$834.73
$874.00
$1013.49		 $174.36

Plan: (HMO) Bronze Compass 4200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

Deductible: Individual: $4,200 : Family: $8,400
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

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		 $232.62
$264.01
$297.28
$415.44
$631.31		 $465.24
$528.02
$594.56
$830.88
$1262.62		 $612.95
$675.73
$742.27
$978.59		 $760.66
$823.44
$889.98
$1126.30		 $908.37
$971.15
$1037.69
$1274.01		 $380.33
$411.72
$444.99
$563.15		 $528.04
$559.43
$592.70
$710.86		 $675.75
$707.14
$740.41
$858.57		 $147.71

Plan: (HMO) Bronze Compass 6400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600

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		 $238.90
$271.14
$305.30
$426.65
$648.34		 $477.80
$542.28
$610.60
$853.30
$1296.68		 $629.49
$693.97
$762.29
$1004.99		 $781.18
$845.66
$913.98
$1156.68		 $932.87
$997.35
$1065.67
$1308.37		 $390.59
$422.83
$456.99
$578.34		 $542.28
$574.52
$608.68
$730.03		 $693.97
$726.21
$760.37
$881.72		 $151.69

Plan: (HMO) Catastrophic Compass 6850

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.)

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		 $192.22
$218.16
$245.64
$343.28
$521.65		 $384.44
$436.32
$491.28
$686.56
$1043.30		 $506.49
$558.37
$613.33
$808.61		 $628.54
$680.42
$735.38
$930.66		 $750.59
$802.47
$857.43
$1052.71		 $314.27
$340.21
$367.69
$465.33		 $436.32
$462.26
$489.74
$587.38		 $558.37
$584.31
$611.79
$709.43		 $122.05

†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 Pinellas County here.

 

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