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 Potomac Falls, VA.
Obamacare Providers, Plans and 2016 Rates for Loudoun County
Loudoun County is in “Rating Area 10” of Virginia.
Currently, there are 6 providers offering 63 plans to Rating Area 10. †
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 Potomac Falls, VA area accept this insurance coverage as within the plan's "network".
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CareFirst BlueChoice, Inc.Local: 1-855-444-3119 | Toll Free: 1-855-444-3119 TTY: 1-202-479-3546 |
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Plan: (HMO) BlueChoice HMO Silver $2,000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
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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 |
$307.90 $349.47 $393.50 $549.91 $835.64 |
$615.80 $698.94 $787.00 $1099.82 $1671.28 |
$811.32 $894.46 $982.52 $1295.34 |
$1006.84 $1089.98 $1178.04 $1490.86 |
$1202.36 $1285.50 $1373.56 $1686.38 |
$503.42 $544.99 $589.02 $745.43 |
$698.94 $740.51 $784.54 $940.95 |
$894.46 $936.03 $980.06 $1136.47 |
$195.52 |
Plan: (HMO) HealthyBlue HMO Gold $250Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$250
: Family:
$500 Monthly Premiums: |
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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 |
$366.76 $416.27 $468.72 $655.03 $995.39 |
$733.52 $832.54 $937.44 $1310.06 $1990.78 |
$966.41 $1065.43 $1170.33 $1542.95 |
$1199.30 $1298.32 $1403.22 $1775.84 |
$1432.19 $1531.21 $1636.11 $2008.73 |
$599.65 $649.16 $701.61 $887.92 |
$832.54 $882.05 $934.50 $1120.81 |
$1065.43 $1114.94 $1167.39 $1353.70 |
$232.89 |
Plan: (HMO) HealthyBlue HMO Gold $1,000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
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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 |
$355.35 $403.32 $454.14 $634.66 $964.42 |
$710.70 $806.64 $908.28 $1269.32 $1928.84 |
$936.35 $1032.29 $1133.93 $1494.97 |
$1162.00 $1257.94 $1359.58 $1720.62 |
$1387.65 $1483.59 $1585.23 $1946.27 |
$581.00 $628.97 $679.79 $860.31 |
$806.65 $854.62 $905.44 $1085.96 |
$1032.30 $1080.27 $1131.09 $1311.61 |
$225.65 |
Plan: (HMO) BlueChoice HMO Young Adult $6,850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
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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 |
$154.70 $175.58 $197.71 $276.29 $419.86 |
$309.40 $351.16 $395.42 $552.58 $839.72 |
$407.63 $449.39 $493.65 $650.81 |
$505.86 $547.62 $591.88 $749.04 |
$604.09 $645.85 $690.11 $847.27 |
$252.93 $273.81 $295.94 $374.52 |
$351.16 $372.04 $394.17 $472.75 |
$449.39 $470.27 $492.40 $570.98 |
$98.23 |
Plan: (HMO) BlueChoice HMO HSA Bronze $6,000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
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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 |
$173.29 $196.68 $221.46 $309.50 $470.31 |
$346.58 $393.36 $442.92 $619.00 $940.62 |
$456.62 $503.40 $552.96 $729.04 |
$566.66 $613.44 $663.00 $839.08 |
$676.70 $723.48 $773.04 $949.12 |
$283.33 $306.72 $331.50 $419.54 |
$393.37 $416.76 $441.54 $529.58 |
$503.41 $526.80 $551.58 $639.62 |
$110.04 |
Plan: (HMO) BlueChoice HMO HSA Silver $1,350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$1,350
: Family:
$2,700 Monthly Premiums: |
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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 |
$278.59 $316.20 $356.04 $497.56 $756.09 |
$557.18 $632.40 $712.08 $995.12 $1512.18 |
$734.08 $809.30 $888.98 $1172.02 |
$910.98 $986.20 $1065.88 $1348.92 |
$1087.88 $1163.10 $1242.78 $1525.82 |
$455.49 $493.10 $532.94 $674.46 |
$632.39 $670.00 $709.84 $851.36 |
$809.29 $846.90 $886.74 $1028.26 |
$176.90 |
Plan: (HMO) BlueChoice HMO HSA Bronze $6,550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
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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 |
$168.39 $191.12 $215.20 $300.74 $457.01 |
$336.78 $382.24 $430.40 $601.48 $914.02 |
$443.71 $489.17 $537.33 $708.41 |
$550.64 $596.10 $644.26 $815.34 |
$657.57 $703.03 $751.19 $922.27 |
$275.32 $298.05 $322.13 $407.67 |
$382.25 $404.98 $429.06 $514.60 |
$489.18 $511.91 $535.99 $621.53 |
$106.93 |
Plan: (POS) BlueChoice Plus Bronze $5,500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
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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 |
$225.42 $255.85 $288.09 $402.60 $611.79 |
$450.84 $511.70 $576.18 $805.20 $1223.58 |
$593.98 $654.84 $719.32 $948.34 |
$737.12 $797.98 $862.46 $1091.48 |
$880.26 $941.12 $1005.60 $1234.62 |
$368.56 $398.99 $431.23 $545.74 |
$511.70 $542.13 $574.37 $688.88 |
$654.84 $685.27 $717.51 $832.02 |
$143.14 |
Plan: (POS) BlueChoice Plus Silver $2,500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
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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 |
$307.98 $349.56 $393.60 $550.05 $835.86 |
$615.96 $699.12 $787.20 $1100.10 $1671.72 |
$811.53 $894.69 $982.77 $1295.67 |
$1007.10 $1090.26 $1178.34 $1491.24 |
$1202.67 $1285.83 $1373.91 $1686.81 |
$503.55 $545.13 $589.17 $745.62 |
$699.12 $740.70 $784.74 $941.19 |
$894.69 $936.27 $980.31 $1136.76 |
$195.57 |
Plan: (POS) HealthyBlue Plus Gold $750Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (CareFirst BlueChoice, Inc.)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
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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 |
$373.86 $424.33 $477.79 $667.71 $1014.66 |
$747.72 $848.66 $955.58 $1335.42 $2029.32 |
$985.12 $1086.06 $1192.98 $1572.82 |
$1222.52 $1323.46 $1430.38 $1810.22 |
$1459.92 $1560.86 $1667.78 $2047.62 |
$611.26 $661.73 $715.19 $905.11 |
$848.66 $899.13 $952.59 $1142.51 |
$1086.06 $1136.53 $1189.99 $1379.91 |
$237.40 |
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Innovation Health Insurance CompanyLocal: 1-866-833-2957 | Toll Free: 1-866-833-2957 TTY: 1-866-833-2957 |
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Plan: (PPO) Innovation Health Leap Bronze PlusSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
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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 |
$168.05 $190.73 $214.76 $300.13 $456.08 |
$336.10 $381.46 $429.52 $600.26 $912.16 |
$442.81 $488.17 $536.23 $706.97 |
$549.52 $594.88 $642.94 $813.68 |
$656.23 $701.59 $749.65 $920.39 |
$274.76 $297.44 $321.47 $406.84 |
$381.47 $404.15 $428.18 $513.55 |
$488.18 $510.86 $534.89 $620.26 |
$106.71 |
Plan: (PPO) Innovation Health Leap CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
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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 |
$139.79 $158.66 $178.65 $249.66 $379.39 |
$279.58 $317.32 $357.30 $499.32 $758.78 |
$368.35 $406.09 $446.07 $588.09 |
$457.12 $494.86 $534.84 $676.86 |
$545.89 $583.63 $623.61 $765.63 |
$228.56 $247.43 $267.42 $338.43 |
$317.33 $336.20 $356.19 $427.20 |
$406.10 $424.97 $444.96 $515.97 |
$88.77 |
Plan: (PPO) Innovation Health Leap Silver BasicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$5,250
: Family:
$10,500 Monthly Premiums: |
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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 |
$211.63 $240.20 $270.47 $377.98 $574.37 |
$423.26 $480.40 $540.94 $755.96 $1148.74 |
$557.65 $614.79 $675.33 $890.35 |
$692.04 $749.18 $809.72 $1024.74 |
$826.43 $883.57 $944.11 $1159.13 |
$346.02 $374.59 $404.86 $512.37 |
$480.41 $508.98 $539.25 $646.76 |
$614.80 $643.37 $673.64 $781.15 |
$134.39 |
Plan: (PPO) Innovation Health Leap Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$6,450
: Family:
$12,900 Monthly Premiums: |
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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 |
$166.51 $188.99 $212.80 $297.39 $451.91 |
$333.02 $377.98 $425.60 $594.78 $903.82 |
$438.75 $483.71 $531.33 $700.51 |
$544.48 $589.44 $637.06 $806.24 |
$650.21 $695.17 $742.79 $911.97 |
$272.24 $294.72 $318.53 $403.12 |
$377.97 $400.45 $424.26 $508.85 |
$483.70 $506.18 $529.99 $614.58 |
$105.73 |
Plan: (PPO) Innovation Health Leap Gold BasicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
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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 |
$298.47 $338.76 $381.44 $533.06 $810.04 |
$596.94 $677.52 $762.88 $1066.12 $1620.08 |
$786.47 $867.05 $952.41 $1255.65 |
$976.00 $1056.58 $1141.94 $1445.18 |
$1165.53 $1246.11 $1331.47 $1634.71 |
$488.00 $528.29 $570.97 $722.59 |
$677.53 $717.82 $760.50 $912.12 |
$867.06 $907.35 $950.03 $1101.65 |
$189.53 |
Plan: (PPO) Innovation Health Leap Silver PlusSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$4,510
: Family:
$9,020 Monthly Premiums: |
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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 |
$227.33 $258.02 $290.53 $406.01 $616.97 |
$454.66 $516.04 $581.06 $812.02 $1233.94 |
$599.01 $660.39 $725.41 $956.37 |
$743.36 $804.74 $869.76 $1100.72 |
$887.71 $949.09 $1014.11 $1245.07 |
$371.68 $402.37 $434.88 $550.36 |
$516.03 $546.72 $579.23 $694.71 |
$660.38 $691.07 $723.58 $839.06 |
$144.35 |
Plan: (PPO) Innovation Health Leap Bronze BasicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
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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 |
$162.03 $183.90 $207.07 $289.38 $439.74 |
$324.06 $367.80 $414.14 $578.76 $879.48 |
$426.95 $470.69 $517.03 $681.65 |
$529.84 $573.58 $619.92 $784.54 |
$632.73 $676.47 $722.81 $887.43 |
$264.92 $286.79 $309.96 $392.27 |
$367.81 $389.68 $412.85 $495.16 |
$470.70 $492.57 $515.74 $598.05 |
$102.89 |
Plan: (PPO) Innovation Health Leap Gold DiabetesSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-866-833-2957 - Provider Directory for This Plan: (Innovation Health Insurance Company)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
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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 |
$310.29 $352.18 $396.55 $554.18 $842.14 |
$620.58 $704.36 $793.10 $1108.36 $1684.28 |
$817.62 $901.40 $990.14 $1305.40 |
$1014.66 $1098.44 $1187.18 $1502.44 |
$1211.70 $1295.48 $1384.22 $1699.48 |
$507.33 $549.22 $593.59 $751.22 |
$704.37 $746.26 $790.63 $948.26 |
$901.41 $943.30 $987.67 $1145.30 |
$197.04 |
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UnitedHealthcare of the Mid-Atlantic IncLocal: 1-877-632-4195 | Toll Free: 1-877-632-4195 |
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Plan: (HMO) Gold Compass 0-1Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of the Mid-Atlantic Inc)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
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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 |
$272.11 $308.83 $347.75 $485.97 $738.48 |
$544.22 $617.66 $695.50 $971.94 $1476.96 |
$717.00 $790.44 $868.28 $1144.72 |
$889.78 $963.22 $1041.06 $1317.50 |
$1062.56 $1136.00 $1213.84 $1490.28 |
$444.89 $481.61 $520.53 $658.75 |
$617.67 $654.39 $693.31 $831.53 |
$790.45 $827.17 $866.09 $1004.31 |
$172.78 |
Plan: (HMO) Gold Compass 1000-1Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of the Mid-Atlantic Inc)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
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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 |
$276.98 $314.36 $353.96 $494.66 $751.68 |
$553.96 $628.72 $707.92 $989.32 $1503.36 |
$729.83 $804.59 $883.79 $1165.19 |
$905.70 $980.46 $1059.66 $1341.06 |
$1081.57 $1156.33 $1235.53 $1516.93 |
$452.85 $490.23 $529.83 $670.53 |
$628.72 $666.10 $705.70 $846.40 |
$804.59 $841.97 $881.57 $1022.27 |
$175.87 |
Plan: (HMO) Silver Compass HSA 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of the Mid-Atlantic Inc)
Deductible: Individual:
$2,000
: Family:
$6,000 Monthly Premiums: |
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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 |
$225.73 $256.20 $288.48 $403.14 $612.61 |
$451.46 $512.40 $576.96 $806.28 $1225.22 |
$594.79 $655.73 $720.29 $949.61 |
$738.12 $799.06 $863.62 $1092.94 |
$881.45 $942.39 $1006.95 $1236.27 |
$369.06 $399.53 $431.81 $546.47 |
$512.39 $542.86 $575.14 $689.80 |
$655.72 $686.19 $718.47 $833.13 |
$143.33 |
Plan: (HMO) Silver Compass 4500-1Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of the Mid-Atlantic Inc)
Deductible: Individual:
$4,500
: Family:
$9,000 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 |
$236.11 $267.98 $301.74 $421.68 $640.78 |
$472.22 $535.96 $603.48 $843.36 $1281.56 |
$622.14 $685.88 $753.40 $993.28 |
$772.06 $835.80 $903.32 $1143.20 |
$921.98 $985.72 $1053.24 $1293.12 |
$386.03 $417.90 $451.66 $571.60 |
$535.95 $567.82 $601.58 $721.52 |
$685.87 $717.74 $751.50 $871.44 |
$149.92 |
Plan: (HMO) Bronze Compass HSA 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of the Mid-Atlantic Inc)
Deductible: Individual:
$5,500
: Family:
$11,000 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 |
$190.71 $216.44 $243.71 $340.59 $517.55 |
$381.42 $432.88 $487.42 $681.18 $1035.10 |
$502.51 $553.97 $608.51 $802.27 |
$623.60 $675.06 $729.60 $923.36 |
$744.69 $796.15 $850.69 $1044.45 |
$311.80 $337.53 $364.80 $461.68 |
$432.89 $458.62 $485.89 $582.77 |
$553.98 $579.71 $606.98 $703.86 |
$121.09 |
Plan: (HMO) Bronze Compass 6500-1Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of the Mid-Atlantic Inc)
Deductible: 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 |
$205.95 $233.74 $263.19 $367.81 $558.92 |
$411.90 $467.48 $526.38 $735.62 $1117.84 |
$542.67 $598.25 $657.15 $866.39 |
$673.44 $729.02 $787.92 $997.16 |
$804.21 $859.79 $918.69 $1127.93 |
$336.72 $364.51 $393.96 $498.58 |
$467.49 $495.28 $524.73 $629.35 |
$598.26 $626.05 $655.50 $760.12 |
$130.77 |
ADVERTISEMENT
|
||||||||||
Group Hospitalization and Medical Services Inc.Local: 1-855-444-3119 | Toll Free: 1-855-444-3119 TTY: 1-202-479-3546 |
||||||||||
Plan: (PPO) BlueCross BlueShield Preferred 500, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (Group Hospitalization and Medical Services Inc.)
Deductible: Individual:
$500
: Family:
$1,000 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 |
$435.29 $494.05 $556.30 $777.43 $1181.38 |
$870.58 $988.10 $1112.60 $1554.86 $2362.76 |
$1146.99 $1264.51 $1389.01 $1831.27 |
$1423.40 $1540.92 $1665.42 $2107.68 |
$1699.81 $1817.33 $1941.83 $2384.09 |
$711.70 $770.46 $832.71 $1053.84 |
$988.11 $1046.87 $1109.12 $1330.25 |
$1264.52 $1323.28 $1385.53 $1606.66 |
$276.41 |
Plan: (PPO) BlueCross BlueShield Preferred 1600, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (Group Hospitalization and Medical Services Inc.)
Deductible: Individual:
$1,600
: Family:
$3,200 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 |
$322.75 $366.32 $412.47 $576.43 $875.94 |
$645.50 $732.64 $824.94 $1152.86 $1751.88 |
$850.45 $937.59 $1029.89 $1357.81 |
$1055.40 $1142.54 $1234.84 $1562.76 |
$1260.35 $1347.49 $1439.79 $1767.71 |
$527.70 $571.27 $617.42 $781.38 |
$732.65 $776.22 $822.37 $986.33 |
$937.60 $981.17 $1027.32 $1191.28 |
$204.95 |
Plan: (PPO) BluePreferred PPO HSA Bronze $4,500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-444-3119 - Provider Directory for This Plan: (Group Hospitalization and Medical Services Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 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 |
$223.02 $253.13 $285.02 $398.31 $605.28 |
$446.04 $506.26 $570.04 $796.62 $1210.56 |
$587.66 $647.88 $711.66 $938.24 |
$729.28 $789.50 $853.28 $1079.86 |
$870.90 $931.12 $994.90 $1221.48 |
$364.64 $394.75 $426.64 $539.93 |
$506.26 $536.37 $568.26 $681.55 |
$647.88 $677.99 $709.88 $823.17 |
$141.62 |
ADVERTISEMENT
|
||||||||||
HealthKeepers, Inc.Local: 1-855-748-1810 | Toll Free: 1-855-748-1810 |
||||||||||
Plan: (HMO) Anthem HealthKeepers Catastrophic X 6850 0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: 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 |
$171.87 $195.07 $219.65 $306.96 $466.46 |
$343.74 $390.14 $439.30 $613.92 $932.92 |
$452.88 $499.28 $548.44 $723.06 |
$562.02 $608.42 $657.58 $832.20 |
$671.16 $717.56 $766.72 $941.34 |
$281.01 $304.21 $328.79 $416.10 |
$390.15 $413.35 $437.93 $525.24 |
$499.29 $522.49 $547.07 $634.38 |
$109.14 |
Plan: (HMO) Anthem HealthKeepers Bronze X 15 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$213.44 $242.25 $272.78 $381.20 $579.28 |
$426.88 $484.50 $545.56 $762.40 $1158.56 |
$562.41 $620.03 $681.09 $897.93 |
$697.94 $755.56 $816.62 $1033.46 |
$833.47 $891.09 $952.15 $1168.99 |
$348.97 $377.78 $408.31 $516.73 |
$484.50 $513.31 $543.84 $652.26 |
$620.03 $648.84 $679.37 $787.79 |
$135.53 |
Plan: (HMO) Anthem HealthKeepers Bronze X 5500 25Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 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 |
$210.09 $238.45 $268.50 $375.22 $570.18 |
$420.18 $476.90 $537.00 $750.44 $1140.36 |
$553.59 $610.31 $670.41 $883.85 |
$687.00 $743.72 $803.82 $1017.26 |
$820.41 $877.13 $937.23 $1150.67 |
$343.50 $371.86 $401.91 $508.63 |
$476.91 $505.27 $535.32 $642.04 |
$610.32 $638.68 $668.73 $775.45 |
$133.41 |
Plan: (HMO) Anthem HealthKeepers Bronze X 4650 35Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$4,650
: Family:
$9,300 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 |
$212.21 $240.86 $271.20 $379.01 $575.94 |
$424.42 $481.72 $542.40 $758.02 $1151.88 |
$559.17 $616.47 $677.15 $892.77 |
$693.92 $751.22 $811.90 $1027.52 |
$828.67 $885.97 $946.65 $1162.27 |
$346.96 $375.61 $405.95 $513.76 |
$481.71 $510.36 $540.70 $648.51 |
$616.46 $645.11 $675.45 $783.26 |
$134.75 |
Plan: (HMO) Anthem HealthKeepers Bronze X 35 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$4,000
: Family:
$8,000 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 |
$220.57 $250.35 $281.89 $393.94 $598.63 |
$441.14 $500.70 $563.78 $787.88 $1197.26 |
$581.20 $640.76 $703.84 $927.94 |
$721.26 $780.82 $843.90 $1068.00 |
$861.32 $920.88 $983.96 $1208.06 |
$360.63 $390.41 $421.95 $534.00 |
$500.69 $530.47 $562.01 $674.06 |
$640.75 $670.53 $702.07 $814.12 |
$140.06 |
Plan: (HMO) Anthem HealthKeepers Silver X 3350 15Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$3,350
: Family:
$6,700 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 |
$236.81 $268.78 $302.64 $422.94 $642.70 |
$473.62 $537.56 $605.28 $845.88 $1285.40 |
$623.99 $687.93 $755.65 $996.25 |
$774.36 $838.30 $906.02 $1146.62 |
$924.73 $988.67 $1056.39 $1296.99 |
$387.18 $419.15 $453.01 $573.31 |
$537.55 $569.52 $603.38 $723.68 |
$687.92 $719.89 $753.75 $874.05 |
$150.37 |
Plan: (HMO) Anthem HealthKeepers Silver X 2600 20Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$2,600
: Family:
$5,200 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 |
$242.86 $275.65 $310.38 $433.75 $659.12 |
$485.72 $551.30 $620.76 $867.50 $1318.24 |
$639.94 $705.52 $774.98 $1021.72 |
$794.16 $859.74 $929.20 $1175.94 |
$948.38 $1013.96 $1083.42 $1330.16 |
$397.08 $429.87 $464.60 $587.97 |
$551.30 $584.09 $618.82 $742.19 |
$705.52 $738.31 $773.04 $896.41 |
$154.22 |
Plan: (HMO) Anthem HealthKeepers Silver X 2250 20Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$2,250
: Family:
$4,500 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 |
$248.40 $281.93 $317.46 $443.64 $674.16 |
$496.80 $563.86 $634.92 $887.28 $1348.32 |
$654.53 $721.59 $792.65 $1045.01 |
$812.26 $879.32 $950.38 $1202.74 |
$969.99 $1037.05 $1108.11 $1360.47 |
$406.13 $439.66 $475.19 $601.37 |
$563.86 $597.39 $632.92 $759.10 |
$721.59 $755.12 $790.65 $916.83 |
$157.73 |
Plan: (HMO) Anthem HealthKeepers Bronze X 50 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$6,100
: Family:
$12,200 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 |
$205.67 $233.44 $262.85 $367.33 $558.19 |
$411.34 $466.88 $525.70 $734.66 $1116.38 |
$541.94 $597.48 $656.30 $865.26 |
$672.54 $728.08 $786.90 $995.86 |
$803.14 $858.68 $917.50 $1126.46 |
$336.27 $364.04 $393.45 $497.93 |
$466.87 $494.64 $524.05 $628.53 |
$597.47 $625.24 $654.65 $759.13 |
$130.60 |
Plan: (HMO) Anthem HealthKeepers Silver, a Blue Cross and Blue Shield Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$1,550
: Family:
$3,100 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 |
$252.64 $286.75 $322.87 $451.22 $685.66 |
$505.28 $573.50 $645.74 $902.44 $1371.32 |
$665.71 $733.93 $806.17 $1062.87 |
$826.14 $894.36 $966.60 $1223.30 |
$986.57 $1054.79 $1127.03 $1383.73 |
$413.07 $447.18 $483.30 $611.65 |
$573.50 $607.61 $643.73 $772.08 |
$733.93 $768.04 $804.16 $932.51 |
$160.43 |
Plan: (HMO) Anthem HealthKeepers Gold, a Blue Cross and Blue Shield Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$750
: Family:
$1,500 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 |
Gold | 21 30 40 50 60 |
$313.29 $355.58 $400.38 $559.54 $850.27 |
$626.58 $711.16 $800.76 $1119.08 $1700.54 |
$825.52 $910.10 $999.70 $1318.02 |
$1024.46 $1109.04 $1198.64 $1516.96 |
$1223.40 $1307.98 $1397.58 $1715.90 |
$512.23 $554.52 $599.32 $758.48 |
$711.17 $753.46 $798.26 $957.42 |
$910.11 $952.40 $997.20 $1156.36 |
$198.94 |
Plan: (POS) Anthem HealthKeepers Bronze X POS 4100 30Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$4,100
: Family:
$8,200 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 |
$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: (POS) Anthem HealthKeepers Silver X POS 2000 20Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$257.51 $292.27 $329.10 $459.91 $698.88 |
$515.02 $584.54 $658.20 $919.82 $1397.76 |
$678.54 $748.06 $821.72 $1083.34 |
$842.06 $911.58 $985.24 $1246.86 |
$1005.58 $1075.10 $1148.76 $1410.38 |
$421.03 $455.79 $492.62 $623.43 |
$584.55 $619.31 $656.14 $786.95 |
$748.07 $782.83 $819.66 $950.47 |
$163.52 |
Plan: (POS) Anthem HealthKeepers Gold X POS 1100 15Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$1,100
: Family:
$2,200 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 |
$319.08 $362.16 $407.78 $569.88 $865.98 |
$638.16 $724.32 $815.56 $1139.76 $1731.96 |
$840.78 $926.94 $1018.18 $1342.38 |
$1043.40 $1129.56 $1220.80 $1545.00 |
$1246.02 $1332.18 $1423.42 $1747.62 |
$521.70 $564.78 $610.40 $772.50 |
$724.32 $767.40 $813.02 $975.12 |
$926.94 $970.02 $1015.64 $1177.74 |
$202.62 |
Plan: (POS) Anthem HealthKeepers Bronze POS X 0 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)
Deductible: Individual:
$5,350
: Family:
$10,700 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 |
$229.07 $259.99 $292.75 $409.12 $621.70 |
$458.14 $519.98 $585.50 $818.24 $1243.40 |
$603.60 $665.44 $730.96 $963.70 |
$749.06 $810.90 $876.42 $1109.16 |
$894.52 $956.36 $1021.88 $1254.62 |
$374.53 $405.45 $438.21 $554.58 |
$519.99 $550.91 $583.67 $700.04 |
$665.45 $696.37 $729.13 $845.50 |
$145.46 |
ADVERTISEMENT
|
||||||||||
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.Local: 1-800-807-1140 | Toll Free: 1-800-807-1140 TTY: 1-703-359-7616 |
||||||||||
Plan: (HMO) KP VA Gold 0/20/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: Individual:
$0
: Family:
$0 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 |
$303.77 $344.76 $388.02 $542.41 $823.86 |
$607.54 $689.52 $776.04 $1084.82 $1647.72 |
$800.18 $882.16 $968.68 $1277.46 |
$992.82 $1074.80 $1161.32 $1470.10 |
$1185.46 $1267.44 $1353.96 $1662.74 |
$496.41 $537.40 $580.66 $735.05 |
$689.05 $730.04 $773.30 $927.69 |
$881.69 $922.68 $965.94 $1120.33 |
$192.64 |
Plan: (HMO) KP VA Gold 1000/20/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: Individual:
$1,000
: Family:
$2,000 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 |
$283.01 $321.20 $361.51 $505.35 $767.57 |
$566.02 $642.40 $723.02 $1010.70 $1535.14 |
$745.50 $821.88 $902.50 $1190.18 |
$924.98 $1001.36 $1081.98 $1369.66 |
$1104.46 $1180.84 $1261.46 $1549.14 |
$462.49 $500.68 $540.99 $684.83 |
$641.97 $680.16 $720.47 $864.31 |
$821.45 $859.64 $899.95 $1043.79 |
$179.48 |
Plan: (HMO) KP VA Silver 1500/30/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$246.44 $279.70 $314.80 $440.05 $668.39 |
$492.88 $559.40 $629.60 $880.10 $1336.78 |
$649.17 $715.69 $785.89 $1036.39 |
$805.46 $871.98 $942.18 $1192.68 |
$961.75 $1028.27 $1098.47 $1348.97 |
$402.73 $435.99 $471.09 $596.34 |
$559.02 $592.28 $627.38 $752.63 |
$715.31 $748.57 $783.67 $908.92 |
$156.29 |
Plan: (HMO) KP VA Silver 2500/30/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$234.25 $265.86 $299.23 $418.28 $635.33 |
$468.50 $531.72 $598.46 $836.56 $1270.66 |
$617.06 $680.28 $747.02 $985.12 |
$765.62 $828.84 $895.58 $1133.68 |
$914.18 $977.40 $1044.14 $1282.24 |
$382.81 $414.42 $447.79 $566.84 |
$531.37 $562.98 $596.35 $715.40 |
$679.93 $711.54 $744.91 $863.96 |
$148.56 |
Plan: (HMO) KP VA Silver 2750/20%/HSA/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: Individual:
$2,750
: Family:
$5,500 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 |
$222.06 $252.03 $283.65 $396.51 $602.26 |
$444.12 $504.06 $567.30 $793.02 $1204.52 |
$584.95 $644.89 $708.13 $933.85 |
$725.78 $785.72 $848.96 $1074.68 |
$866.61 $926.55 $989.79 $1215.51 |
$362.89 $392.86 $424.48 $537.34 |
$503.72 $533.69 $565.31 $678.17 |
$644.55 $674.52 $706.14 $819.00 |
$140.83 |
Plan: (HMO) KP VA Bronze 4500/50/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 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 |
$195.70 $222.11 $249.98 $349.44 $530.77 |
$391.40 $444.22 $499.96 $698.88 $1061.54 |
$515.51 $568.33 $624.07 $822.99 |
$639.62 $692.44 $748.18 $947.10 |
$763.73 $816.55 $872.29 $1071.21 |
$319.81 $346.22 $374.09 $473.55 |
$443.92 $470.33 $498.20 $597.66 |
$568.03 $594.44 $622.31 $721.77 |
$124.11 |
Plan: (HMO) KP VA Bronze 5000/50/HSA/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: 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 |
Bronze | 21 30 40 50 60 |
$187.47 $212.76 $239.46 $334.74 $508.44 |
$374.94 $425.52 $478.92 $669.48 $1016.88 |
$493.83 $544.41 $597.81 $788.37 |
$612.72 $663.30 $716.70 $907.26 |
$731.61 $782.19 $835.59 $1026.15 |
$306.36 $331.65 $358.35 $453.63 |
$425.25 $450.54 $477.24 $572.52 |
$544.14 $569.43 $596.13 $691.41 |
$118.89 |
Plan: (HMO) KP VA Bronze 6000/20%/HSA/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$175.28 $198.93 $223.89 $312.98 $475.38 |
$350.56 $397.86 $447.78 $625.96 $950.76 |
$461.72 $509.02 $558.94 $737.12 |
$572.88 $620.18 $670.10 $848.28 |
$684.04 $731.34 $781.26 $959.44 |
$286.44 $310.09 $335.05 $424.14 |
$397.60 $421.25 $446.21 $535.30 |
$508.76 $532.41 $557.37 $646.46 |
$111.16 |
Plan: (HMO) KP VA Catastrophic 6850/0/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: 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 |
$153.79 $174.54 $196.45 $274.61 $417.10 |
$307.58 $349.08 $392.90 $549.22 $834.20 |
$405.11 $446.61 $490.43 $646.75 |
$502.64 $544.14 $587.96 $744.28 |
$600.17 $641.67 $685.49 $841.81 |
$251.32 $272.07 $293.98 $372.14 |
$348.85 $369.60 $391.51 $469.67 |
$446.38 $467.13 $489.04 $567.20 |
$97.53 |
Plan: (HMO) KP VA Platinum 0/20/Dental/Ped DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-807-1140 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.)
Deductible: Individual:
$0
: Family:
$0 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 |
$320.24 $363.45 $409.06 $571.82 $868.54 |
$640.48 $726.90 $818.12 $1143.64 $1737.08 |
$843.57 $929.99 $1021.21 $1346.73 |
$1046.66 $1133.08 $1224.30 $1549.82 |
$1249.75 $1336.17 $1427.39 $1752.91 |
$523.33 $566.54 $612.15 $774.91 |
$726.42 $769.63 $815.24 $978.00 |
$929.51 $972.72 $1018.33 $1181.09 |
$203.09 |
†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 Loudoun County here.