ADVERTISEMENT

Providers for Zip Code 17111

LegalConsumer.com/obamacare

ObamacareByZipCode.com

Obamacare 2016 Marketplace Rates For Swatara, PA

Monday, April 15th, 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 Swatara, PA.

Obamacare Providers, Plans and 2016 Rates for Dauphin County

Dauphin County is in “Rating Area 9” of Pennsylvania.

Currently, there are 8 providers offering 93 plans to Rating Area 9. †

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 Swatara, PA area accept this insurance coverage as within the plan's "network".
ADVERTISEMENT

Geisinger Health Plan

Local: 1-800-447-4000 | Toll Free: 1-800-447-4000

TTY: 1-800-447-2833

Plan: (HMO) Geisinger Health Plan Marketplace Extra 10/50/500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-447-4000 - Provider Directory for This Plan: (Geisinger Health Plan)

Deductible: Individual: $500 : Family: $1,000
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
Gold 21
30
40
50
60		 $235.19
$266.93
$300.56
$420.04
$638.28		 $470.38
$533.86
$601.12
$840.08
$1276.56		 $619.72
$683.20
$750.46
$989.42		 $769.06
$832.54
$899.80
$1138.76		 $918.40
$981.88
$1049.14
$1288.10		 $384.53
$416.27
$449.90
$569.38		 $533.87
$565.61
$599.24
$718.72		 $683.21
$714.95
$748.58
$868.06		 $149.34

Plan: (HMO) Geisinger Health Plan Marketplace Extra 10/50/2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-447-4000 - Provider Directory for This Plan: (Geisinger Health Plan)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

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		 $193.43
$219.54
$247.20
$345.46
$524.96		 $386.86
$439.08
$494.40
$690.92
$1049.92		 $509.69
$561.91
$617.23
$813.75		 $632.52
$684.74
$740.06
$936.58		 $755.35
$807.57
$862.89
$1059.41		 $316.26
$342.37
$370.03
$468.29		 $439.09
$465.20
$492.86
$591.12		 $561.92
$588.03
$615.69
$713.95		 $122.83

Plan: (POS) Geisinger Health Plan Marketplace Value

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-447-4000 - Provider Directory for This Plan: (Geisinger Health Plan)

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		 $145.14
$164.72
$185.48
$259.20
$393.89		 $290.28
$329.44
$370.96
$518.40
$787.78		 $382.44
$421.60
$463.12
$610.56		 $474.60
$513.76
$555.28
$702.72		 $566.76
$605.92
$647.44
$794.88		 $237.30
$256.88
$277.64
$351.36		 $329.46
$349.04
$369.80
$443.52		 $421.62
$441.20
$461.96
$535.68		 $92.16
ADVERTISEMENT

Highmark Select Resources Inc.

Local: 1-800-544-6679 | Toll Free:

Plan: (PPO) Alliance Flex Blue PPO 2100

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (Highmark Select Resources Inc.)

Deductible: Individual: $2,100 : Family: $4,200
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		 $231.95
$263.26
$296.43
$414.26
$629.51		 $463.90
$526.52
$592.86
$828.52
$1259.02		 $611.19
$673.81
$740.15
$975.81		 $758.48
$821.10
$887.44
$1123.10		 $905.77
$968.39
$1034.73
$1270.39		 $379.24
$410.55
$443.72
$561.55		 $526.53
$557.84
$591.01
$708.84		 $673.82
$705.13
$738.30
$856.13		 $147.29

Plan: (PPO) Alliance Flex Blue PPO 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (Highmark Select Resources Inc.)

Deductible: Individual: $1,000 : Family: $2,000
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
Gold 21
30
40
50
60		 $274.93
$312.05
$351.36
$491.02
$746.16		 $549.86
$624.10
$702.72
$982.04
$1492.32		 $724.44
$798.68
$877.30
$1156.62		 $899.02
$973.26
$1051.88
$1331.20		 $1073.60
$1147.84
$1226.46
$1505.78		 $449.51
$486.63
$525.94
$665.60		 $624.09
$661.21
$700.52
$840.18		 $798.67
$835.79
$875.10
$1014.76		 $174.58
ADVERTISEMENT

Capital Advantage Assurance Company

Local: 1-800-730-7219 | Toll Free: 1-800-730-7219

TTY: 1-800-242-4816

Plan: (PPO) Healthy Benefits PPO 6300.50

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

Deductible: Individual: $6,300 : Family: $12,600
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		 $222.05
$252.03
$283.78
$396.58
$602.64		 $444.10
$504.06
$567.56
$793.16
$1205.28		 $585.10
$645.06
$708.56
$934.16		 $726.10
$786.06
$849.56
$1075.16		 $867.10
$927.06
$990.56
$1216.16		 $363.05
$393.03
$424.78
$537.58		 $504.05
$534.03
$565.78
$678.58		 $645.05
$675.03
$706.78
$819.58		 $141.00

Plan: (PPO) Healthy Benefits PPO 4500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

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		 $263.69
$299.29
$337.00
$470.96
$715.67		 $527.38
$598.58
$674.00
$941.92
$1431.34		 $694.82
$766.02
$841.44
$1109.36		 $862.26
$933.46
$1008.88
$1276.80		 $1029.70
$1100.90
$1176.32
$1444.24		 $431.13
$466.73
$504.44
$638.40		 $598.57
$634.17
$671.88
$805.84		 $766.01
$801.61
$839.32
$973.28		 $167.44

Plan: (PPO) Healthy Benefits PPO 3500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

Deductible: Individual: $3,500 : Family: $7,000
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		 $268.16
$304.37
$342.72
$478.95
$727.80		 $536.32
$608.74
$685.44
$957.90
$1455.60		 $706.60
$779.02
$855.72
$1128.18		 $876.88
$949.30
$1026.00
$1298.46		 $1047.16
$1119.58
$1196.28
$1468.74		 $438.44
$474.65
$513.00
$649.23		 $608.72
$644.93
$683.28
$819.51		 $779.00
$815.21
$853.56
$989.79		 $170.28

Plan: (PPO) Healthy Benefits PPO 2500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

Deductible: Individual: $2,500 : Family: $5,000
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		 $272.91
$309.76
$348.79
$487.43
$740.70		 $545.82
$619.52
$697.58
$974.86
$1481.40		 $719.12
$792.82
$870.88
$1148.16		 $892.42
$966.12
$1044.18
$1321.46		 $1065.72
$1139.42
$1217.48
$1494.76		 $446.21
$483.06
$522.09
$660.73		 $619.51
$656.36
$695.39
$834.03		 $792.81
$829.66
$868.69
$1007.33		 $173.30

Plan: (PPO) Healthy Benefits PPO 1000.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

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		 $327.97
$372.26
$419.16
$585.77
$890.13		 $655.94
$744.52
$838.32
$1171.54
$1780.26		 $864.20
$952.78
$1046.58
$1379.80		 $1072.46
$1161.04
$1254.84
$1588.06		 $1280.72
$1369.30
$1463.10
$1796.32		 $536.23
$580.52
$627.42
$794.03		 $744.49
$788.78
$835.68
$1002.29		 $952.75
$997.04
$1043.94
$1210.55		 $208.26

Plan: (PPO) Healthy Benefits PPO 500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

Deductible: Individual: $500 : Family: $1,000
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		 $337.76
$383.36
$431.66
$603.24
$916.68		 $675.52
$766.72
$863.32
$1206.48
$1833.36		 $890.00
$981.20
$1077.80
$1420.96		 $1104.48
$1195.68
$1292.28
$1635.44		 $1318.96
$1410.16
$1506.76
$1849.92		 $552.24
$597.84
$646.14
$817.72		 $766.72
$812.32
$860.62
$1032.20		 $981.20
$1026.80
$1075.10
$1246.68		 $214.48

Plan: (PPO) Healthy Benefits PPO 0.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

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		 $287.73
$326.58
$367.72
$513.89
$780.90		 $575.46
$653.16
$735.44
$1027.78
$1561.80		 $758.17
$835.87
$918.15
$1210.49		 $940.88
$1018.58
$1100.86
$1393.20		 $1123.59
$1201.29
$1283.57
$1575.91		 $470.44
$509.29
$550.43
$696.60		 $653.15
$692.00
$733.14
$879.31		 $835.86
$874.71
$915.85
$1062.02		 $182.71

Plan: (PPO) Healthy Benefits PPO 0.0.10

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

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
Platinum 21
30
40
50
60		 $425.24
$482.65
$543.46
$759.48
$1154.10		 $850.48
$965.30
$1086.92
$1518.96
$2308.20		 $1120.51
$1235.33
$1356.95
$1788.99		 $1390.54
$1505.36
$1626.98
$2059.02		 $1660.57
$1775.39
$1897.01
$2329.05		 $695.27
$752.68
$813.49
$1029.51		 $965.30
$1022.71
$1083.52
$1299.54		 $1235.33
$1292.74
$1353.55
$1569.57		 $270.03

Plan: (PPO) Healthy Benefits PPO HSA 3000.10

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $260.34
$295.49
$332.72
$464.97
$706.56		 $520.68
$590.98
$665.44
$929.94
$1413.12		 $685.99
$756.29
$830.75
$1095.25		 $851.30
$921.60
$996.06
$1260.56		 $1016.61
$1086.91
$1161.37
$1425.87		 $425.65
$460.80
$498.03
$630.28		 $590.96
$626.11
$663.34
$795.59		 $756.27
$791.42
$828.65
$960.90		 $165.31

Plan: (PPO) Healthy Benefits PPO 1500.30

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Capital Advantage Assurance Company)

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		 $282.70
$320.87
$361.29
$504.90
$767.25		 $565.40
$641.74
$722.58
$1009.80
$1534.50		 $744.91
$821.25
$902.09
$1189.31		 $924.42
$1000.76
$1081.60
$1368.82		 $1103.93
$1180.27
$1261.11
$1548.33		 $462.21
$500.38
$540.80
$684.41		 $641.72
$679.89
$720.31
$863.92		 $821.23
$859.40
$899.82
$1043.43		 $179.51
ADVERTISEMENT

Keystone Health Plan Central

Local: 1-800-730-7219 | Toll Free: 1-800-730-7219

TTY: 1-800-669-7075

Plan: (HMO) BlueCross Value 750.0, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

Deductible: Individual: $750 : Family: $1,500
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		 $273.63
$310.56
$349.69
$488.69
$742.61		 $547.26
$621.12
$699.38
$977.38
$1485.22		 $721.01
$794.87
$873.13
$1151.13		 $894.76
$968.62
$1046.88
$1324.88		 $1068.51
$1142.37
$1220.63
$1498.63		 $447.38
$484.31
$523.44
$662.44		 $621.13
$658.06
$697.19
$836.19		 $794.88
$831.81
$870.94
$1009.94		 $173.75

Plan: (HMO) BlueCross Value 0.50, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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		 $228.84
$259.73
$292.46
$408.71
$621.07		 $457.68
$519.46
$584.92
$817.42
$1242.14		 $603.00
$664.78
$730.24
$962.74		 $748.32
$810.10
$875.56
$1108.06		 $893.64
$955.42
$1020.88
$1253.38		 $374.16
$405.05
$437.78
$554.03		 $519.48
$550.37
$583.10
$699.35		 $664.80
$695.69
$728.42
$844.67		 $145.32

Plan: (HMO) Healthy Benefits Value HMO 6850.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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		 $110.72
$125.66
$141.50
$197.74
$300.48		 $221.44
$251.32
$283.00
$395.48
$600.96		 $291.75
$321.63
$353.31
$465.79		 $362.06
$391.94
$423.62
$536.10		 $432.37
$462.25
$493.93
$606.41		 $181.03
$195.97
$211.81
$268.05		 $251.34
$266.28
$282.12
$338.36		 $321.65
$336.59
$352.43
$408.67		 $70.31

Plan: (HMO) Healthy Benefits Value HMO 6300.50

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

Deductible: Individual: $6,300 : Family: $12,600
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		 $181.32
$205.79
$231.72
$323.83
$492.09		 $362.64
$411.58
$463.44
$647.66
$984.18		 $477.78
$526.72
$578.58
$762.80		 $592.92
$641.86
$693.72
$877.94		 $708.06
$757.00
$808.86
$993.08		 $296.46
$320.93
$346.86
$438.97		 $411.60
$436.07
$462.00
$554.11		 $526.74
$551.21
$577.14
$669.25		 $115.14

Plan: (HMO) Healthy Benefits Value HMO 4500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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		 $215.59
$244.69
$275.52
$385.04
$585.11		 $431.18
$489.38
$551.04
$770.08
$1170.22		 $568.08
$626.28
$687.94
$906.98		 $704.98
$763.18
$824.84
$1043.88		 $841.88
$900.08
$961.74
$1180.78		 $352.49
$381.59
$412.42
$521.94		 $489.39
$518.49
$549.32
$658.84		 $626.29
$655.39
$686.22
$795.74		 $136.90

Plan: (HMO) Healthy Benefits Value HMO 3500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

Deductible: Individual: $3,500 : Family: $7,000
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		 $219.25
$248.84
$280.20
$391.57
$595.03		 $438.50
$497.68
$560.40
$783.14
$1190.06		 $577.72
$636.90
$699.62
$922.36		 $716.94
$776.12
$838.84
$1061.58		 $856.16
$915.34
$978.06
$1200.80		 $358.47
$388.06
$419.42
$530.79		 $497.69
$527.28
$558.64
$670.01		 $636.91
$666.50
$697.86
$809.23		 $139.22

Plan: (HMO) Healthy Benefits Value HMO 2500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

Deductible: Individual: $2,500 : Family: $5,000
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		 $223.13
$253.24
$285.16
$398.51
$605.57		 $446.26
$506.48
$570.32
$797.02
$1211.14		 $587.95
$648.17
$712.01
$938.71		 $729.64
$789.86
$853.70
$1080.40		 $871.33
$931.55
$995.39
$1222.09		 $364.82
$394.93
$426.85
$540.20		 $506.51
$536.62
$568.54
$681.89		 $648.20
$678.31
$710.23
$823.58		 $141.69

Plan: (HMO) Healthy Benefits Value HMO 1000.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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		 $268.14
$304.33
$342.68
$478.90
$727.73		 $536.28
$608.66
$685.36
$957.80
$1455.46		 $706.55
$778.93
$855.63
$1128.07		 $876.82
$949.20
$1025.90
$1298.34		 $1047.09
$1119.47
$1196.17
$1468.61		 $438.41
$474.60
$512.95
$649.17		 $608.68
$644.87
$683.22
$819.44		 $778.95
$815.14
$853.49
$989.71		 $170.27

Plan: (HMO) Healthy Benefits Value HMO 500.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

Deductible: Individual: $500 : Family: $1,000
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		 $276.14
$313.41
$352.90
$493.18
$749.43		 $552.28
$626.82
$705.80
$986.36
$1498.86		 $727.63
$802.17
$881.15
$1161.71		 $902.98
$977.52
$1056.50
$1337.06		 $1078.33
$1152.87
$1231.85
$1512.41		 $451.49
$488.76
$528.25
$668.53		 $626.84
$664.11
$703.60
$843.88		 $802.19
$839.46
$878.95
$1019.23		 $175.35

Plan: (HMO) Healthy Benefits Value HMO 0.0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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		 $235.24
$266.99
$300.64
$420.14
$638.43		 $470.48
$533.98
$601.28
$840.28
$1276.86		 $619.86
$683.36
$750.66
$989.66		 $769.24
$832.74
$900.04
$1139.04		 $918.62
$982.12
$1049.42
$1288.42		 $384.62
$416.37
$450.02
$569.52		 $534.00
$565.75
$599.40
$718.90		 $683.38
$715.13
$748.78
$868.28		 $149.38

Plan: (HMO) Healthy Benefits Value HMO 0.0.10

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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
Platinum 21
30
40
50
60		 $347.65
$394.58
$444.30
$620.91
$943.52		 $695.30
$789.16
$888.60
$1241.82
$1887.04		 $916.06
$1009.92
$1109.36
$1462.58		 $1136.82
$1230.68
$1330.12
$1683.34		 $1357.58
$1451.44
$1550.88
$1904.10		 $568.41
$615.34
$665.06
$841.67		 $789.17
$836.10
$885.82
$1062.43		 $1009.93
$1056.86
$1106.58
$1283.19		 $220.76

Plan: (HMO) Healthy Benefits Value HMO 1500.30

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-730-7219 - Provider Directory for This Plan: (Keystone Health Plan Central)

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		 $231.13
$262.32
$295.38
$412.79
$627.27		 $462.26
$524.64
$590.76
$825.58
$1254.54		 $609.03
$671.41
$737.53
$972.35		 $755.80
$818.18
$884.30
$1119.12		 $902.57
$964.95
$1031.07
$1265.89		 $377.90
$409.09
$442.15
$559.56		 $524.67
$555.86
$588.92
$706.33		 $671.44
$702.63
$735.69
$853.10		 $146.77
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 PinnacleHealth Gold $10 Copay

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: $1,400 : Family: $2,800
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		 $250.72
$284.57
$320.42
$447.79
$680.46		 $501.44
$569.14
$640.84
$895.58
$1360.92		 $660.65
$728.35
$800.05
$1054.79		 $819.86
$887.56
$959.26
$1214.00		 $979.07
$1046.77
$1118.47
$1373.21		 $409.93
$443.78
$479.63
$607.00		 $569.14
$602.99
$638.84
$766.21		 $728.35
$762.20
$798.05
$925.42		 $159.21

Plan: (HMO) Aetna PinnacleHealth Silver $10 Copay

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: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

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		 $211.74
$240.33
$270.61
$378.18
$574.68		 $423.48
$480.66
$541.22
$756.36
$1149.36		 $557.94
$615.12
$675.68
$890.82		 $692.40
$749.58
$810.14
$1025.28		 $826.86
$884.04
$944.60
$1159.74		 $346.20
$374.79
$405.07
$512.64		 $480.66
$509.25
$539.53
$647.10		 $615.12
$643.71
$673.99
$781.56		 $134.46

Plan: (HMO) Aetna PinnacleHealth Bronze $15 Copay

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: $6,850 : 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		 $173.88
$197.35
$222.21
$310.54
$471.90		 $347.76
$394.70
$444.42
$621.08
$943.80		 $458.17
$505.11
$554.83
$731.49		 $568.58
$615.52
$665.24
$841.90		 $678.99
$725.93
$775.65
$952.31		 $284.29
$307.76
$332.62
$420.95		 $394.70
$418.17
$443.03
$531.36		 $505.11
$528.58
$553.44
$641.77		 $110.41

Plan: (HMO) Aetna PinnacleHealth Bronze Deductible Only HSA Eligible

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		 $163.68
$185.78
$209.18
$292.33
$444.23		 $327.36
$371.56
$418.36
$584.66
$888.46		 $431.30
$475.50
$522.30
$688.60		 $535.24
$579.44
$626.24
$792.54		 $639.18
$683.38
$730.18
$896.48		 $267.62
$289.72
$313.12
$396.27		 $371.56
$393.66
$417.06
$500.21		 $475.50
$497.60
$521.00
$604.15		 $103.94

Plan: (HMO) Coventry Gold $10 Copay OAHMO

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: $1,400 : Family: $2,800
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		 $286.52
$325.20
$366.17
$511.73
$777.62		 $573.04
$650.40
$732.34
$1023.46
$1555.24		 $754.98
$832.34
$914.28
$1205.40		 $936.92
$1014.28
$1096.22
$1387.34		 $1118.86
$1196.22
$1278.16
$1569.28		 $468.46
$507.14
$548.11
$693.67		 $650.40
$689.08
$730.05
$875.61		 $832.34
$871.02
$911.99
$1057.55		 $181.94

Plan: (HMO) Coventry Silver $10 Copay OAHMO

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: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

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		 $241.98
$274.65
$309.25
$432.18
$656.74		 $483.96
$549.30
$618.50
$864.36
$1313.48		 $637.62
$702.96
$772.16
$1018.02		 $791.28
$856.62
$925.82
$1171.68		 $944.94
$1010.28
$1079.48
$1325.34		 $395.64
$428.31
$462.91
$585.84		 $549.30
$581.97
$616.57
$739.50		 $702.96
$735.63
$770.23
$893.16		 $153.66

Plan: (HMO) Coventry Bronze $15 Copay OAHMO

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: $6,850 : 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		 $198.72
$225.55
$253.97
$354.92
$539.34		 $397.44
$451.10
$507.94
$709.84
$1078.68		 $523.63
$577.29
$634.13
$836.03		 $649.82
$703.48
$760.32
$962.22		 $776.01
$829.67
$886.51
$1088.41		 $324.91
$351.74
$380.16
$481.11		 $451.10
$477.93
$506.35
$607.30		 $577.29
$604.12
$632.54
$733.49		 $126.19

Plan: (HMO) Coventry Bronze Deductible Only HSA Eligible OAHMO

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		 $187.04
$212.29
$239.04
$334.06
$507.63		 $374.08
$424.58
$478.08
$668.12
$1015.26		 $492.85
$543.35
$596.85
$786.89		 $611.62
$662.12
$715.62
$905.66		 $730.39
$780.89
$834.39
$1024.43		 $305.81
$331.06
$357.81
$452.83		 $424.58
$449.83
$476.58
$571.60		 $543.35
$568.60
$595.35
$690.37		 $118.77
ADVERTISEMENT

Highmark Health Insurance Company

Local: 1-877-959-2553 | Toll Free: 1-877-959-2553

TTY: 1-800-862-0709

Plan: (PPO) Blue Shield Shared Cost 3200, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-959-2553 - Provider Directory for This Plan: (Highmark Health Insurance Company)

Deductible: Individual: $3,200 : Family: $6,400
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		 $278.91
$316.56
$356.45
$498.13
$756.96		 $557.82
$633.12
$712.90
$996.26
$1513.92		 $734.93
$810.23
$890.01
$1173.37		 $912.04
$987.34
$1067.12
$1350.48		 $1089.15
$1164.45
$1244.23
$1527.59		 $456.02
$493.67
$533.56
$675.24		 $633.13
$670.78
$710.67
$852.35		 $810.24
$847.89
$887.78
$1029.46		 $177.11

Plan: (PPO) Blue Shield Shared Cost 1500, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-959-2553 - Provider Directory for This Plan: (Highmark Health Insurance Company)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: 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
Gold 21
30
40
50
60		 $336.75
$382.21
$430.37
$601.44
$913.94		 $673.50
$764.42
$860.74
$1202.88
$1827.88		 $887.34
$978.26
$1074.58
$1416.72		 $1101.18
$1192.10
$1288.42
$1630.56		 $1315.02
$1405.94
$1502.26
$1844.40		 $550.59
$596.05
$644.21
$815.28		 $764.43
$809.89
$858.05
$1029.12		 $978.27
$1023.73
$1071.89
$1242.96		 $213.84

Plan: (PPO) Shared Cost Blue PPO 6000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-959-2553 - Provider Directory for This Plan: (Highmark Health Insurance Company)

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		 $231.48
$262.73
$295.83
$413.42
$628.24		 $462.96
$525.46
$591.66
$826.84
$1256.48		 $609.95
$672.45
$738.65
$973.83		 $756.94
$819.44
$885.64
$1120.82		 $903.93
$966.43
$1032.63
$1267.81		 $378.47
$409.72
$442.82
$560.41		 $525.46
$556.71
$589.81
$707.40		 $672.45
$703.70
$736.80
$854.39		 $146.99

Plan: (PPO) Health Savings Embedded Blue PPO 4500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-959-2553 - Provider Directory for This Plan: (Highmark Health Insurance Company)

Deductible: Individual: $4,500 : Family: $9,000
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
Bronze 21
30
40
50
60		 $220.24
$249.97
$281.47
$393.35
$597.73		 $440.48
$499.94
$562.94
$786.70
$1195.46		 $580.33
$639.79
$702.79
$926.55		 $720.18
$779.64
$842.64
$1066.40		 $860.03
$919.49
$982.49
$1206.25		 $360.09
$389.82
$421.32
$533.20		 $499.94
$529.67
$561.17
$673.05		 $639.79
$669.52
$701.02
$812.90		 $139.85

Plan: (PPO) Health Savings Embedded Blue PPO 2700

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-959-2553 - Provider Directory for This Plan: (Highmark Health Insurance Company)

Deductible: Individual: $2,700 : Family: $5,400
Out of Pocket Maximum per year: Individual: $5,400 : Family: $10,800

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
Silver 21
30
40
50
60		 $283.05
$321.26
$361.74
$505.53
$768.20		 $566.10
$642.52
$723.48
$1011.06
$1536.40		 $745.84
$822.26
$903.22
$1190.80		 $925.58
$1002.00
$1082.96
$1370.54		 $1105.32
$1181.74
$1262.70
$1550.28		 $462.79
$501.00
$541.48
$685.27		 $642.53
$680.74
$721.22
$865.01		 $822.27
$860.48
$900.96
$1044.75		 $179.74

Plan: (PPO) Health Savings Blue PPO 1400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-959-2553 - Provider Directory for This Plan: (Highmark Health Insurance Company)

Deductible: Individual: $1,400 : Family: $2,800
Out of Pocket Maximum per year: Individual: $2,800 : Family: $5,600

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
Gold 21
30
40
50
60		 $347.06
$393.91
$443.54
$619.85
$941.92		 $694.12
$787.82
$887.08
$1239.70
$1883.84		 $914.50
$1008.20
$1107.46
$1460.08		 $1134.88
$1228.58
$1327.84
$1680.46		 $1355.26
$1448.96
$1548.22
$1900.84		 $567.44
$614.29
$663.92
$840.23		 $787.82
$834.67
$884.30
$1060.61		 $1008.20
$1055.05
$1104.68
$1280.99		 $220.38
ADVERTISEMENT

Geisinger Quality Options

Local: 1-800-631-1656 | Toll Free: 1-800-504-0443

TTY: 1-800-447-2833

Plan: (PPO) Geisinger Choice Markeptlace PPO 25/50/1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-504-0443 - Provider Directory for This Plan: (Geisinger Quality Options)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: 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
Gold 21
30
40
50
60		 $252.30
$286.35
$322.43
$450.60
$684.73		 $504.60
$572.70
$644.86
$901.20
$1369.46		 $664.81
$732.91
$805.07
$1061.41		 $825.02
$893.12
$965.28
$1221.62		 $985.23
$1053.33
$1125.49
$1381.83		 $412.51
$446.56
$482.64
$610.81		 $572.72
$606.77
$642.85
$771.02		 $732.93
$766.98
$803.06
$931.23		 $160.21

Plan: (PPO) Geisinger Choice Marketplace PPO 30/50/5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-504-0443 - Provider Directory for This Plan: (Geisinger Quality Options)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $205.14
$232.83
$262.17
$366.37
$556.74		 $410.28
$465.66
$524.34
$732.74
$1113.48		 $540.54
$595.92
$654.60
$863.00		 $670.80
$726.18
$784.86
$993.26		 $801.06
$856.44
$915.12
$1123.52		 $335.40
$363.09
$392.43
$496.63		 $465.66
$493.35
$522.69
$626.89		 $595.92
$623.61
$652.95
$757.15		 $130.26

†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 Dauphin County here.

 

Speak with a Health Insurance Expert 800-943-6832Ads by +HealthNetwork