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Providers for Zip Code 04654

LegalConsumer.com/obamacare

ObamacareByZipCode.com

Obamacare 2016 Marketplace Rates For Washington County, Maine

Thursday, April 18th, 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 Washington County, Maine.

Obamacare Providers, Plans and 2016 Rates for Washington County

Washington County is in “Rating Area 4” of Maine.

Currently, there are 2 providers offering 19 plans to Rating Area 4. †

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 Machias, ME area accept this insurance coverage as within the plan's "network".
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Maine Community Health Options

Local: 1-207-402-3330 | Toll Free: 1-855-624-6463

Plan: (PPO) Community Safe Harbor

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

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		 $193.31
$219.40
$247.05
$345.25
$524.64		 $386.62
$438.80
$494.10
$690.50
$1049.28		 $509.37
$561.55
$616.85
$813.25		 $632.12
$684.30
$739.60
$936.00		 $754.87
$807.05
$862.35
$1058.75		 $316.06
$342.15
$369.80
$468.00		 $438.81
$464.90
$492.55
$590.75		 $561.56
$587.65
$615.30
$713.50		 $122.75

Plan: (PPO) Community Option

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

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
Bronze 21
30
40
50
60		 $250.48
$284.29
$320.11
$447.35
$679.80		 $500.96
$568.58
$640.22
$894.70
$1359.60		 $660.01
$727.63
$799.27
$1053.75		 $819.06
$886.68
$958.32
$1212.80		 $978.11
$1045.73
$1117.37
$1371.85		 $409.53
$443.34
$479.16
$606.40		 $568.58
$602.39
$638.21
$765.45		 $727.63
$761.44
$797.26
$924.50		 $159.05

Plan: (PPO) Community Choice

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

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		 $305.75
$347.02
$390.74
$546.06
$829.80		 $611.50
$694.04
$781.48
$1092.12
$1659.60		 $805.65
$888.19
$975.63
$1286.27		 $999.80
$1082.34
$1169.78
$1480.42		 $1193.95
$1276.49
$1363.93
$1674.57		 $499.90
$541.17
$584.89
$740.21		 $694.05
$735.32
$779.04
$934.36		 $888.20
$929.47
$973.19
$1128.51		 $194.15

Plan: (PPO) Community Preferred

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

Deductible: Individual: $2,450 : Family: $4,900
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		 $325.74
$369.71
$416.29
$581.77
$884.05		 $651.48
$739.42
$832.58
$1163.54
$1768.10		 $858.32
$946.26
$1039.42
$1370.38		 $1065.16
$1153.10
$1246.26
$1577.22		 $1272.00
$1359.94
$1453.10
$1784.06		 $532.58
$576.55
$623.13
$788.61		 $739.42
$783.39
$829.97
$995.45		 $946.26
$990.23
$1036.81
$1202.29		 $206.84

Plan: (PPO) Community Value

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

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		 $294.72
$334.50
$376.65
$526.36
$799.87		 $589.44
$669.00
$753.30
$1052.72
$1599.74		 $776.58
$856.14
$940.44
$1239.86		 $963.72
$1043.28
$1127.58
$1427.00		 $1150.86
$1230.42
$1314.72
$1614.14		 $481.86
$521.64
$563.79
$713.50		 $669.00
$708.78
$750.93
$900.64		 $856.14
$895.92
$938.07
$1087.78		 $187.14

Plan: (PPO) Community Advantage

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $4,250 : Family: $8,500

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		 $378.84
$429.98
$484.15
$676.60
$1028.17		 $757.68
$859.96
$968.30
$1353.20
$2056.34		 $998.24
$1100.52
$1208.86
$1593.76		 $1238.80
$1341.08
$1449.42
$1834.32		 $1479.36
$1581.64
$1689.98
$2074.88		 $619.40
$670.54
$724.71
$917.16		 $859.96
$911.10
$965.27
$1157.72		 $1100.52
$1151.66
$1205.83
$1398.28		 $240.56

Plan: (PPO) Community Option HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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
Bronze 21
30
40
50
60		 $252.39
$286.46
$322.55
$450.76
$684.98		 $504.78
$572.92
$645.10
$901.52
$1369.96		 $665.04
$733.18
$805.36
$1061.78		 $825.30
$893.44
$965.62
$1222.04		 $985.56
$1053.70
$1125.88
$1382.30		 $412.65
$446.72
$482.81
$611.02		 $572.91
$606.98
$643.07
$771.28		 $733.17
$767.24
$803.33
$931.54		 $160.26

Plan: (PPO) Community Align

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

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
Bronze 21
30
40
50
60		 $265.68
$301.54
$339.53
$474.50
$721.05		 $531.36
$603.08
$679.06
$949.00
$1442.10		 $700.06
$771.78
$847.76
$1117.70		 $868.76
$940.48
$1016.46
$1286.40		 $1037.46
$1109.18
$1185.16
$1455.10		 $434.38
$470.24
$508.23
$643.20		 $603.08
$638.94
$676.93
$811.90		 $771.78
$807.64
$845.63
$980.60		 $168.70

Plan: (PPO) Community Advance

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

Deductible: Individual: $2,450 : Family: $4,900
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		 $343.12
$389.44
$438.50
$612.81
$931.22		 $686.24
$778.88
$877.00
$1225.62
$1862.44		 $904.12
$996.76
$1094.88
$1443.50		 $1122.00
$1214.64
$1312.76
$1661.38		 $1339.88
$1432.52
$1530.64
$1879.26		 $561.00
$607.32
$656.38
$830.69		 $778.88
$825.20
$874.26
$1048.57		 $996.76
$1043.08
$1092.14
$1266.45		 $217.88

Plan: (PPO) Community Complete

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-624-6463 - Provider Directory for This Plan: (Maine Community Health Options)

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		 $309.92
$351.75
$396.07
$553.51
$841.12		 $619.84
$703.50
$792.14
$1107.02
$1682.24		 $816.63
$900.29
$988.93
$1303.81		 $1013.42
$1097.08
$1185.72
$1500.60		 $1210.21
$1293.87
$1382.51
$1697.39		 $506.71
$548.54
$592.86
$750.30		 $703.50
$745.33
$789.65
$947.09		 $900.29
$942.12
$986.44
$1143.88		 $196.79
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Anthem Health Plans of ME(Anthem BCBS)

Local: 1-855-738-6674 | Toll Free: 1-855-738-6674

Plan: (POS) Anthem Bronze X POS 5500 30

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

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
Bronze 21
30
40
50
60		 $310.00
$351.85
$396.18
$553.66
$841.34		 $620.00
$703.70
$792.36
$1107.32
$1682.68		 $816.85
$900.55
$989.21
$1304.17		 $1013.70
$1097.40
$1186.06
$1501.02		 $1210.55
$1294.25
$1382.91
$1697.87		 $506.85
$548.70
$593.03
$750.51		 $703.70
$745.55
$789.88
$947.36		 $900.55
$942.40
$986.73
$1144.21		 $196.85

Plan: (POS) Anthem Bronze X POS 4200 50

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $4,200 : Family: $8,400
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		 $312.38
$354.55
$399.22
$557.91
$847.80		 $624.76
$709.10
$798.44
$1115.82
$1695.60		 $823.12
$907.46
$996.80
$1314.18		 $1021.48
$1105.82
$1195.16
$1512.54		 $1219.84
$1304.18
$1393.52
$1710.90		 $510.74
$552.91
$597.58
$756.27		 $709.10
$751.27
$795.94
$954.63		 $907.46
$949.63
$994.30
$1152.99		 $198.36

Plan: (POS) Anthem Silver X POS 2800 30

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $2,800 : Family: $5,600
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
Silver 21
30
40
50
60		 $359.99
$408.59
$460.07
$642.94
$977.01		 $719.98
$817.18
$920.14
$1285.88
$1954.02		 $948.57
$1045.77
$1148.73
$1514.47		 $1177.16
$1274.36
$1377.32
$1743.06		 $1405.75
$1502.95
$1605.91
$1971.65		 $588.58
$637.18
$688.66
$871.53		 $817.17
$865.77
$917.25
$1100.12		 $1045.76
$1094.36
$1145.84
$1328.71		 $228.59

Plan: (POS) Anthem Silver X POS 1800 25

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $1,800 : Family: $3,600
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
Silver 21
30
40
50
60		 $395.54
$448.94
$505.50
$706.43
$1073.50		 $791.08
$897.88
$1011.00
$1412.86
$2147.00		 $1042.25
$1149.05
$1262.17
$1664.03		 $1293.42
$1400.22
$1513.34
$1915.20		 $1544.59
$1651.39
$1764.51
$2166.37		 $646.71
$700.11
$756.67
$957.60		 $897.88
$951.28
$1007.84
$1208.77		 $1149.05
$1202.45
$1259.01
$1459.94		 $251.17

Plan: (POS) Anthem Bronze X POS 6100 15

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

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
Bronze 21
30
40
50
60		 $309.45
$351.23
$395.48
$552.68
$839.85		 $618.90
$702.46
$790.96
$1105.36
$1679.70		 $815.40
$898.96
$987.46
$1301.86		 $1011.90
$1095.46
$1183.96
$1498.36		 $1208.40
$1291.96
$1380.46
$1694.86		 $505.95
$547.73
$591.98
$749.18		 $702.45
$744.23
$788.48
$945.68		 $898.95
$940.73
$984.98
$1142.18		 $196.50

Plan: (POS) Anthem Gold X POS 1000 20

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $4,900 : Family: $9,800

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
Gold 21
30
40
50
60		 $505.47
$573.71
$645.99
$902.77
$1371.85		 $1010.94
$1147.42
$1291.98
$1805.54
$2743.70		 $1331.91
$1468.39
$1612.95
$2126.51		 $1652.88
$1789.36
$1933.92
$2447.48		 $1973.85
$2110.33
$2254.89
$2768.45		 $826.44
$894.68
$966.96
$1223.74		 $1147.41
$1215.65
$1287.93
$1544.71		 $1468.38
$1536.62
$1608.90
$1865.68		 $320.97

Plan: (POS) Anthem Bronze X POS 10 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $5,900 : Family: $11,800
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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
Bronze 21
30
40
50
60		 $312.90
$355.14
$399.89
$558.84
$849.21		 $625.80
$710.28
$799.78
$1117.68
$1698.42		 $824.49
$908.97
$998.47
$1316.37		 $1023.18
$1107.66
$1197.16
$1515.06		 $1221.87
$1306.35
$1395.85
$1713.75		 $511.59
$553.83
$598.58
$757.53		 $710.28
$752.52
$797.27
$956.22		 $908.97
$951.21
$995.96
$1154.91		 $198.69

Plan: (POS) Anthem Bronze X POS 5150 25

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $5,150 : Family: $10,300
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		 $310.80
$352.76
$397.20
$555.09
$843.51		 $621.60
$705.52
$794.40
$1110.18
$1687.02		 $818.96
$902.88
$991.76
$1307.54		 $1016.32
$1100.24
$1189.12
$1504.90		 $1213.68
$1297.60
$1386.48
$1702.26		 $508.16
$550.12
$594.56
$752.45		 $705.52
$747.48
$791.92
$949.81		 $902.88
$944.84
$989.28
$1147.17		 $197.36

Plan: (POS) Anthem Bronze X POS 40 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $3,800 : Family: $7,600
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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
Bronze 21
30
40
50
60		 $326.49
$370.57
$417.25
$583.11
$886.09		 $652.98
$741.14
$834.50
$1166.22
$1772.18		 $860.30
$948.46
$1041.82
$1373.54		 $1067.62
$1155.78
$1249.14
$1580.86		 $1274.94
$1363.10
$1456.46
$1788.18		 $533.81
$577.89
$624.57
$790.43		 $741.13
$785.21
$831.89
$997.75		 $948.45
$992.53
$1039.21
$1205.07		 $207.32

Plan: (POS) Anthem Silver X POS 10 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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		 $369.23
$419.08
$471.88
$659.44
$1002.09		 $738.46
$838.16
$943.76
$1318.88
$2004.18		 $972.92
$1072.62
$1178.22
$1553.34		 $1207.38
$1307.08
$1412.68
$1787.80		 $1441.84
$1541.54
$1647.14
$2022.26		 $603.69
$653.54
$706.34
$893.90		 $838.15
$888.00
$940.80
$1128.36		 $1072.61
$1122.46
$1175.26
$1362.82		 $234.46

Plan: (POS) Anthem Catastrophic X POS 6850 0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

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		 $249.09
$282.72
$318.34
$444.87
$676.03		 $498.18
$565.44
$636.68
$889.74
$1352.06		 $656.35
$723.61
$794.85
$1047.91		 $814.52
$881.78
$953.02
$1206.08		 $972.69
$1039.95
$1111.19
$1364.25		 $407.26
$440.89
$476.51
$603.04		 $565.43
$599.06
$634.68
$761.21		 $723.60
$757.23
$792.85
$919.38		 $158.17

Plan: (POS) Anthem Bronze X POS 50 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $6,200 : Family: $12,400
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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
Bronze 21
30
40
50
60		 $298.57
$338.88
$381.57
$533.25
$810.32		 $597.14
$677.76
$763.14
$1066.50
$1620.64		 $786.73
$867.35
$952.73
$1256.09		 $976.32
$1056.94
$1142.32
$1445.68		 $1165.91
$1246.53
$1331.91
$1635.27		 $488.16
$528.47
$571.16
$722.84		 $677.75
$718.06
$760.75
$912.43		 $867.34
$907.65
$950.34
$1102.02		 $189.59

Plan: (POS) Anthem Silver X POS 2250 50

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $2,250 : Family: $4,500
Out of Pocket Maximum per year: Individual: $6,650 : Family: $13,300

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
Silver 21
30
40
50
60		 $352.71
$400.33
$450.76
$629.94
$957.25		 $705.42
$800.66
$901.52
$1259.88
$1914.50		 $929.39
$1024.63
$1125.49
$1483.85		 $1153.36
$1248.60
$1349.46
$1707.82		 $1377.33
$1472.57
$1573.43
$1931.79		 $576.68
$624.30
$674.73
$853.91		 $800.65
$848.27
$898.70
$1077.88		 $1024.62
$1072.24
$1122.67
$1301.85		 $223.97

Plan: (POS) Anthem Blue Cross and Blue Shield Silver Guided Access, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

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		 $378.80
$429.94
$484.11
$676.54
$1028.06		 $757.60
$859.88
$968.22
$1353.08
$2056.12		 $998.14
$1100.42
$1208.76
$1593.62		 $1238.68
$1340.96
$1449.30
$1834.16		 $1479.22
$1581.50
$1689.84
$2074.70		 $619.34
$670.48
$724.65
$917.08		 $859.88
$911.02
$965.19
$1157.62		 $1100.42
$1151.56
$1205.73
$1398.16		 $240.54

Plan: (POS) Anthem Blue Cross and Blue Shield Gold Guided Access, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6674 - Provider Directory for This Plan: (Anthem Health Plans of ME(Anthem BCBS))

Deductible: Individual: $1,400 : Family: $2,800
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		 $497.93
$565.15
$636.35
$889.30
$1351.38		 $995.86
$1130.30
$1272.70
$1778.60
$2702.76		 $1312.05
$1446.49
$1588.89
$2094.79		 $1628.24
$1762.68
$1905.08
$2410.98		 $1944.43
$2078.87
$2221.27
$2727.17		 $814.12
$881.34
$952.54
$1205.49		 $1130.31
$1197.53
$1268.73
$1521.68		 $1446.50
$1513.72
$1584.92
$1837.87		 $316.19
ADVERTISEMENT

Harvard Pilgrim Health Care Inc.

Local: 1-877-907-4742 | Toll Free: 1-877-907-4742

TTY: 1-800-637-8257

Plan: (HMO) Gold HMO 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care Inc.)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $4,300 : Family: $8,600

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		 $504.55
$572.66
$644.82
$901.13
$1369.35		 $1009.10
$1145.32
$1289.64
$1802.26
$2738.70		 $1329.49
$1465.71
$1610.03
$2122.65		 $1649.88
$1786.10
$1930.42
$2443.04		 $1970.27
$2106.49
$2250.81
$2763.43		 $824.94
$893.05
$965.21
$1221.52		 $1145.33
$1213.44
$1285.60
$1541.91		 $1465.72
$1533.83
$1605.99
$1862.30		 $320.39

Plan: (HMO) Silver HMO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care Inc.)

Deductible: Individual: $2,000 : Family: $4,000
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		 $381.44
$432.93
$487.47
$681.24
$1035.21		 $762.88
$865.86
$974.94
$1362.48
$2070.42		 $1005.09
$1108.07
$1217.15
$1604.69		 $1247.30
$1350.28
$1459.36
$1846.90		 $1489.51
$1592.49
$1701.57
$2089.11		 $623.65
$675.14
$729.68
$923.45		 $865.86
$917.35
$971.89
$1165.66		 $1108.07
$1159.56
$1214.10
$1407.87		 $242.21

Plan: (HMO) Best Buy HSA HMO 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care Inc.)

Deductible: Individual: $5,000 : Family: $10,000
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		 $285.62
$324.18
$365.03
$510.12
$775.18		 $571.24
$648.36
$730.06
$1020.24
$1550.36		 $752.61
$829.73
$911.43
$1201.61		 $933.98
$1011.10
$1092.80
$1382.98		 $1115.35
$1192.47
$1274.17
$1564.35		 $466.99
$505.55
$546.40
$691.49		 $648.36
$686.92
$727.77
$872.86		 $829.73
$868.29
$909.14
$1054.23		 $181.37

Plan: (HMO) Bronze HMO 6000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-907-4742 - Provider Directory for This Plan: (Harvard Pilgrim Health Care Inc.)

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

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $272.93
$309.77
$348.80
$487.45
$740.73		 $545.86
$619.54
$697.60
$974.90
$1481.46		 $719.17
$792.85
$870.91
$1148.21		 $892.48
$966.16
$1044.22
$1321.52		 $1065.79
$1139.47
$1217.53
$1494.83		 $446.24
$483.08
$522.11
$660.76		 $619.55
$656.39
$695.42
$834.07		 $792.86
$829.70
$868.73
$1007.38		 $173.31

†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 Washington County here.

 

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