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Providers for Zip Code 15834

Obamacare 2016 Marketplace Rates For Cameron County, Pennsylvania

Saturday, November 25th, 2017


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 Cameron County, Pennsylvania.

Obamacare Providers, Plans and 2016 Rates for Cameron County

Cameron County is in “Rating Area 2” of Pennsylvania.

Currently, there are 6 providers offering 67 plans to Rating Area 2.

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

UPMC Health Options, Inc.

Local: 1-855-489-3494 | Toll Free: 1-855-489-3494

TTY: 1-800-361-2629

Plan: (PPO) UPMC Advantage Silver $0/$50 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$199.66
$226.62
$255.17
$356.60
$541.88
$399.32
$453.24
$510.34
$713.20
$1083.76
$526.11
$580.03
$637.13
$839.99
$652.90
$706.82
$763.92
$966.78
$779.69
$833.61
$890.71
$1093.57
$326.45
$353.41
$381.96
$483.39
$453.24
$480.20
$508.75
$610.18
$580.03
$606.99
$635.54
$736.97
$126.79

Plan: (PPO) UPMC Advantage Silver $1750/$30 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

Deductible: Individual: $1,750 : Family: $3,500
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$198.94
$225.80
$254.25
$355.31
$539.93
$397.88
$451.60
$508.50
$710.62
$1079.86
$524.21
$577.93
$634.83
$836.95
$650.54
$704.26
$761.16
$963.28
$776.87
$830.59
$887.49
$1089.61
$325.27
$352.13
$380.58
$481.64
$451.60
$478.46
$506.91
$607.97
$577.93
$604.79
$633.24
$734.30
$126.33

Plan: (PPO) UPMC Advantage Silver $3,250/$10 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

Deductible: Individual: $3,250 : Family: $6,500
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$195.72
$222.15
$250.14
$349.56
$531.19
$391.44
$444.30
$500.28
$699.12
$1062.38
$515.73
$568.59
$624.57
$823.41
$640.02
$692.88
$748.86
$947.70
$764.31
$817.17
$873.15
$1071.99
$320.01
$346.44
$374.43
$473.85
$444.30
$470.73
$498.72
$598.14
$568.59
$595.02
$623.01
$722.43
$124.29

Plan: (PPO) UPMC Advantage Gold $750/$10 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$233.71
$265.27
$298.69
$417.41
$634.29
$467.42
$530.54
$597.38
$834.82
$1268.58
$615.83
$678.95
$745.79
$983.23
$764.24
$827.36
$894.20
$1131.64
$912.65
$975.77
$1042.61
$1280.05
$382.12
$413.68
$447.10
$565.82
$530.53
$562.09
$595.51
$714.23
$678.94
$710.50
$743.92
$862.64
$148.41

Plan: (PPO) UPMC Advantage Platinum $250/$20 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

Deductible: Individual: $250 : Family: $500
Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Platinum 21
30
40
50
60
$380.01
$431.32
$485.66
$678.70
$1031.35
$760.02
$862.64
$971.32
$1357.40
$2062.70
$1001.33
$1103.95
$1212.63
$1598.71
$1242.64
$1345.26
$1453.94
$1840.02
$1483.95
$1586.57
$1695.25
$2081.33
$621.32
$672.63
$726.97
$920.01
$862.63
$913.94
$968.28
$1161.32
$1103.94
$1155.25
$1209.59
$1402.63
$241.31

Plan: (PPO) UPMC Advantage Bronze $6,200/$35 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

Deductible: Individual: $6,200 : Family: $12,400
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
$175.89
$199.64
$224.79
$314.14
$477.37
$351.78
$399.28
$449.58
$628.28
$954.74
$463.48
$510.98
$561.28
$739.98
$575.18
$622.68
$672.98
$851.68
$686.88
$734.38
$784.68
$963.38
$287.59
$311.34
$336.49
$425.84
$399.29
$423.04
$448.19
$537.54
$510.99
$534.74
$559.89
$649.24
$111.70

Plan: (PPO) UPMC Advantage Silver HSA $2,600/20% - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

Deductible: Individual: $2,600 : Family: $5,200
Out of Pocket Maximum per year: Individual: $3,600 : Family: $7,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$199.30
$226.21
$254.71
$355.95
$540.91
$398.60
$452.42
$509.42
$711.90
$1081.82
$525.16
$578.98
$635.98
$838.46
$651.72
$705.54
$762.54
$965.02
$778.28
$832.10
$889.10
$1091.58
$325.86
$352.77
$381.27
$482.51
$452.42
$479.33
$507.83
$609.07
$578.98
$605.89
$634.39
$735.63
$126.56

Plan: (PPO) UPMC Advantage Catastrophic $6,850/$0 - Premium Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-489-3494 - Provider Directory for This Plan: (UPMC Health Options, Inc.)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$153.03
$173.69
$195.58
$273.32
$415.33
$306.06
$347.38
$391.16
$546.64
$830.66
$403.24
$444.56
$488.34
$643.82
$500.42
$541.74
$585.52
$741.00
$597.60
$638.92
$682.70
$838.18
$250.21
$270.87
$292.76
$370.50
$347.39
$368.05
$389.94
$467.68
$444.57
$465.23
$487.12
$564.86
$97.18

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 HMO 20/40/3000

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

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
Gold 21
30
40
50
60
$262.37
$297.78
$335.30
$468.58
$712.05
$524.74
$595.56
$670.60
$937.16
$1424.10
$691.34
$762.16
$837.20
$1103.76
$857.94
$928.76
$1003.80
$1270.36
$1024.54
$1095.36
$1170.40
$1436.96
$428.97
$464.38
$501.90
$635.18
$595.57
$630.98
$668.50
$801.78
$762.17
$797.58
$835.10
$968.38
$166.60

Plan: (POS) Geisinger Health Plan Marketplace POS 25/50/2500

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

Deductible: Individual: $2,500 : Family: $5,000
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
$228.09
$258.88
$291.49
$407.36
$619.02
$456.18
$517.76
$582.98
$814.72
$1238.04
$601.01
$662.59
$727.81
$959.55
$745.84
$807.42
$872.64
$1104.38
$890.67
$952.25
$1017.47
$1249.21
$372.92
$403.71
$436.32
$552.19
$517.75
$548.54
$581.15
$697.02
$662.58
$693.37
$725.98
$841.85
$144.83

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
$158.69
$180.11
$202.80
$283.41
$430.67
$317.38
$360.22
$405.60
$566.82
$861.34
$418.14
$460.98
$506.36
$667.58
$518.90
$561.74
$607.12
$768.34
$619.66
$662.50
$707.88
$869.10
$259.45
$280.87
$303.56
$384.17
$360.21
$381.63
$404.32
$484.93
$460.97
$482.39
$505.08
$585.69
$100.76

Aetna Health Inc. (a PA corp.)

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

TTY: 1-855-632-6273

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
$242.04
$274.72
$309.33
$432.29
$656.91
$484.08
$549.44
$618.66
$864.58
$1313.82
$637.78
$703.14
$772.36
$1018.28
$791.48
$856.84
$926.06
$1171.98
$945.18
$1010.54
$1079.76
$1325.68
$395.74
$428.42
$463.03
$585.99
$549.44
$582.12
$616.73
$739.69
$703.14
$735.82
$770.43
$893.39
$153.70

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
$204.42
$232.02
$261.25
$365.09
$554.79
$408.84
$464.04
$522.50
$730.18
$1109.58
$538.65
$593.85
$652.31
$859.99
$668.46
$723.66
$782.12
$989.80
$798.27
$853.47
$911.93
$1119.61
$334.23
$361.83
$391.06
$494.90
$464.04
$491.64
$520.87
$624.71
$593.85
$621.45
$650.68
$754.52
$129.81

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
$167.88
$190.54
$214.55
$299.83
$455.62
$335.76
$381.08
$429.10
$599.66
$911.24
$442.36
$487.68
$535.70
$706.26
$548.96
$594.28
$642.30
$812.86
$655.56
$700.88
$748.90
$919.46
$274.48
$297.14
$321.15
$406.43
$381.08
$403.74
$427.75
$513.03
$487.68
$510.34
$534.35
$619.63
$106.60

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
$158.01
$179.34
$201.93
$282.20
$428.83
$316.02
$358.68
$403.86
$564.40
$857.66
$416.36
$459.02
$504.20
$664.74
$516.70
$559.36
$604.54
$765.08
$617.04
$659.70
$704.88
$865.42
$258.35
$279.68
$302.27
$382.54
$358.69
$380.02
$402.61
$482.88
$459.03
$480.36
$502.95
$583.22
$100.34
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Highmark Health Insurance Company

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

TTY: 1-800-862-0709

Plan: (PPO) Blue Cross 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
$260.89
$296.11
$333.42
$465.95
$708.06
$521.78
$592.22
$666.84
$931.90
$1416.12
$687.45
$757.89
$832.51
$1097.57
$853.12
$923.56
$998.18
$1263.24
$1018.79
$1089.23
$1163.85
$1428.91
$426.56
$461.78
$499.09
$631.62
$592.23
$627.45
$664.76
$797.29
$757.90
$793.12
$830.43
$962.96
$165.67

Plan: (PPO) Blue Cross 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
$315.00
$357.53
$402.57
$562.59
$854.91
$630.00
$715.06
$805.14
$1125.18
$1709.82
$830.03
$915.09
$1005.17
$1325.21
$1030.06
$1115.12
$1205.20
$1525.24
$1230.09
$1315.15
$1405.23
$1725.27
$515.03
$557.56
$602.60
$762.62
$715.06
$757.59
$802.63
$962.65
$915.09
$957.62
$1002.66
$1162.68
$200.03

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
$216.99
$246.28
$277.31
$387.54
$588.91
$433.98
$492.56
$554.62
$775.08
$1177.82
$571.77
$630.35
$692.41
$912.87
$709.56
$768.14
$830.20
$1050.66
$847.35
$905.93
$967.99
$1188.45
$354.78
$384.07
$415.10
$525.33
$492.57
$521.86
$552.89
$663.12
$630.36
$659.65
$690.68
$800.91
$137.79

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
$206.11
$233.93
$263.41
$368.11
$559.38
$412.22
$467.86
$526.82
$736.22
$1118.76
$543.10
$598.74
$657.70
$867.10
$673.98
$729.62
$788.58
$997.98
$804.86
$860.50
$919.46
$1128.86
$336.99
$364.81
$394.29
$498.99
$467.87
$495.69
$525.17
$629.87
$598.75
$626.57
$656.05
$760.75
$130.88

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
$264.48
$300.18
$338.01
$472.36
$717.80
$528.96
$600.36
$676.02
$944.72
$1435.60
$696.90
$768.30
$843.96
$1112.66
$864.84
$936.24
$1011.90
$1280.60
$1032.78
$1104.18
$1179.84
$1448.54
$432.42
$468.12
$505.95
$640.30
$600.36
$636.06
$673.89
$808.24
$768.30
$804.00
$841.83
$976.18
$167.94

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
$324.77
$368.61
$415.06
$580.04
$881.43
$649.54
$737.22
$830.12
$1160.08
$1762.86
$855.77
$943.45
$1036.35
$1366.31
$1062.00
$1149.68
$1242.58
$1572.54
$1268.23
$1355.91
$1448.81
$1778.77
$531.00
$574.84
$621.29
$786.27
$737.23
$781.07
$827.52
$992.50
$943.46
$987.30
$1033.75
$1198.73
$206.23

Plan: (PPO) Comprehensive Care Blue PPO 1500

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: $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
$266.16
$302.09
$340.15
$475.36
$722.36
$532.32
$604.18
$680.30
$950.72
$1444.72
$701.33
$773.19
$849.31
$1119.73
$870.34
$942.20
$1018.32
$1288.74
$1039.35
$1111.21
$1187.33
$1457.75
$435.17
$471.10
$509.16
$644.37
$604.18
$640.11
$678.17
$813.38
$773.19
$809.12
$847.18
$982.39
$169.01

Plan: (PPO) Comprehensive Care Flex Blue PPO 500

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: $500 : Family: $1,000
Out of Pocket Maximum per year: Individual: $1,650 : Family: $3,300

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
Platinum 21
30
40
50
60
$399.34
$453.25
$510.36
$713.22
$1083.81
$798.68
$906.50
$1020.72
$1426.44
$2167.62
$1052.26
$1160.08
$1274.30
$1680.02
$1305.84
$1413.66
$1527.88
$1933.60
$1559.42
$1667.24
$1781.46
$2187.18
$652.92
$706.83
$763.94
$966.80
$906.50
$960.41
$1017.52
$1220.38
$1160.08
$1213.99
$1271.10
$1473.96
$253.58

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
$279.84
$317.61
$357.63
$499.78
$759.47
$559.68
$635.22
$715.26
$999.56
$1518.94
$737.37
$812.91
$892.95
$1177.25
$915.06
$990.60
$1070.64
$1354.94
$1092.75
$1168.29
$1248.33
$1532.63
$457.53
$495.30
$535.32
$677.47
$635.22
$672.99
$713.01
$855.16
$812.91
$850.68
$890.70
$1032.85
$177.69

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
$226.61
$257.20
$289.60
$404.72
$615.01
$453.22
$514.40
$579.20
$809.44
$1230.02
$597.12
$658.30
$723.10
$953.34
$741.02
$802.20
$867.00
$1097.24
$884.92
$946.10
$1010.90
$1241.14
$370.51
$401.10
$433.50
$548.62
$514.41
$545.00
$577.40
$692.52
$658.31
$688.90
$721.30
$836.42
$143.90

†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 Cameron County here.