Obamacare Providers, Plans and 2017 Rates for Wayne County
The health insurance rates listed below are for calendar year 2017.
2017 Rates and Providers
(click here for 2014)
(click here for 2015)
(click here for 2016)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Wayne County, Michigan.
Currently, there are 90 plans offered in Wayne County.
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:
- 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 Detroit, MI area accept this insurance coverage as within the plan's "network".
‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Wayne County here.
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Health Alliance Plan (HAP)Local: 1-313-872-8100 | Toll Free: 1-855-948-4427 |
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Plan: (HMO) HAP Personal Alliance 6550 HMO (HSA)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$205.75 $233.53 $262.95 $367.47 $558.41 |
$411.50 $467.06 $525.90 $734.94 $1116.82 |
$542.15 $597.71 $656.55 $865.59 |
$672.80 $728.36 $787.20 $996.24 |
$803.45 $859.01 $917.85 $1126.89 |
$336.40 $364.18 $393.60 $498.12 |
$467.05 $494.83 $524.25 $628.77 |
$597.70 $625.48 $654.90 $759.42 |
$130.65 |
Plan: (HMO) HAP Personal Alliance 1000 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$284.68 $323.11 $363.82 $508.44 $772.62 |
$569.36 $646.22 $727.64 $1016.88 $1545.24 |
$750.13 $826.99 $908.41 $1197.65 |
$930.90 $1007.76 $1089.18 $1378.42 |
$1111.67 $1188.53 $1269.95 $1559.19 |
$465.45 $503.88 $544.59 $689.21 |
$646.22 $684.65 $725.36 $869.98 |
$826.99 $865.42 $906.13 $1050.75 |
$180.77 |
Plan: (HMO) HAP Personal Alliance 6550 HMO (HSA) Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$154.37 $175.21 $197.28 $275.70 $418.96 |
$308.74 $350.42 $394.56 $551.40 $837.92 |
$406.76 $448.44 $492.58 $649.42 |
$504.78 $546.46 $590.60 $747.44 |
$602.80 $644.48 $688.62 $845.46 |
$252.39 $273.23 $295.30 $373.72 |
$350.41 $371.25 $393.32 $471.74 |
$448.43 $469.27 $491.34 $569.76 |
$98.02 |
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Molina Healthcare of Michigan, Inc.Local: 1-888-560-4087 | Toll Free: 1-888-560-4087 TTY: 1-888-665-4629 |
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Plan: (HMO) Molina Marketplace Gold PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: Individual:
$1,025
: Family:
$2,050 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 |
$239.32 $271.62 $305.85 $427.42 $649.50 |
$478.64 $543.24 $611.70 $854.84 $1299.00 |
$630.61 $695.21 $763.67 $1006.81 |
$782.58 $847.18 $915.64 $1158.78 |
$934.55 $999.15 $1067.61 $1310.75 |
$391.29 $423.59 $457.82 $579.39 |
$543.26 $575.56 $609.79 $731.36 |
$695.23 $727.53 $761.76 $883.33 |
$151.97 |
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Humana Medical Plan of Michigan, Inc.Local: 1-877-720-4854 | Toll Free: 1-877-720-4854 TTY: 711 |
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Plan: (HMO) Humana Bronze 6550/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, 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 |
$192.59 $218.59 $246.13 $343.97 $522.69 |
$385.18 $437.18 $492.26 $687.94 $1045.38 |
$507.47 $559.47 $614.55 $810.23 |
$629.76 $681.76 $736.84 $932.52 |
$752.05 $804.05 $859.13 $1054.81 |
$314.88 $340.88 $368.42 $466.26 |
$437.17 $463.17 $490.71 $588.55 |
$559.46 $585.46 $613.00 $710.84 |
$122.29 |
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McLaren Health Plan CommunityLocal: 1-888-327-0671 | Toll Free: 1-888-327-0671 TTY: 1-800-356-3232 |
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Plan: (HMO) McLaren Rewards GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$1,400
: Family:
$2,800 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 |
$339.95 $385.85 $434.46 $607.15 $922.63 |
$679.90 $771.70 $868.92 $1214.30 $1845.26 |
$895.77 $987.57 $1084.79 $1430.17 |
$1111.64 $1203.44 $1300.66 $1646.04 |
$1327.51 $1419.31 $1516.53 $1861.91 |
$555.82 $601.72 $650.33 $823.02 |
$771.69 $817.59 $866.20 $1038.89 |
$987.56 $1033.46 $1082.07 $1254.76 |
$215.87 |
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Blue Cross Blue Shield of Michigan Mutual Insurance CompanyLocal: 1-888-288-2738 | Toll Free: 1-888-288-2738 TTY: 1-800-481-8704 |
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Plan: (PPO) Blue Cross® Premier PPO ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
$191.90 $217.81 $245.25 $342.73 $520.82 |
$383.80 $435.62 $490.50 $685.46 $1041.64 |
$505.66 $557.48 $612.36 $807.32 |
$627.52 $679.34 $734.22 $929.18 |
$749.38 $801.20 $856.08 $1051.04 |
$313.76 $339.67 $367.11 $464.59 |
$435.62 $461.53 $488.97 $586.45 |
$557.48 $583.39 $610.83 $708.31 |
$121.86 |
Plan: (PPO) Blue Cross® Premier PPO Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
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 |
$248.66 $282.23 $317.79 $444.11 $674.86 |
$497.32 $564.46 $635.58 $888.22 $1349.72 |
$655.22 $722.36 $793.48 $1046.12 |
$813.12 $880.26 $951.38 $1204.02 |
$971.02 $1038.16 $1109.28 $1361.92 |
$406.56 $440.13 $475.69 $602.01 |
$564.46 $598.03 $633.59 $759.91 |
$722.36 $755.93 $791.49 $917.81 |
$157.90 |
Plan: (PPO) Blue Cross® Premier PPO SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$1,800
: Family:
$3,600 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 |
$333.39 $378.40 $426.07 $595.43 $904.82 |
$666.78 $756.80 $852.14 $1190.86 $1809.64 |
$878.48 $968.50 $1063.84 $1402.56 |
$1090.18 $1180.20 $1275.54 $1614.26 |
$1301.88 $1391.90 $1487.24 $1825.96 |
$545.09 $590.10 $637.77 $807.13 |
$756.79 $801.80 $849.47 $1018.83 |
$968.49 $1013.50 $1061.17 $1230.53 |
$211.70 |
Plan: (PPO) Blue Cross® Premier PPO GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
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 |
$411.84 $467.44 $526.33 $735.55 $1117.73 |
$823.68 $934.88 $1052.66 $1471.10 $2235.46 |
$1085.20 $1196.40 $1314.18 $1732.62 |
$1346.72 $1457.92 $1575.70 $1994.14 |
$1608.24 $1719.44 $1837.22 $2255.66 |
$673.36 $728.96 $787.85 $997.07 |
$934.88 $990.48 $1049.37 $1258.59 |
$1196.40 $1252.00 $1310.89 $1520.11 |
$261.52 |
Plan: (PPO) Blue Cross® Premier PPO Bronze SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
$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) Blue Cross® Premier PPO Silver Saver HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$4,000
: Family:
$8,000 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 |
$305.63 $346.89 $390.60 $545.86 $829.48 |
$611.26 $693.78 $781.20 $1091.72 $1658.96 |
$805.34 $887.86 $975.28 $1285.80 |
$999.42 $1081.94 $1169.36 $1479.88 |
$1193.50 $1276.02 $1363.44 $1673.96 |
$499.71 $540.97 $584.68 $739.94 |
$693.79 $735.05 $778.76 $934.02 |
$887.87 $929.13 $972.84 $1128.10 |
$194.08 |
Plan: (PPO) Blue Cross® PPO Silver Extra with Dental and Vision, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual 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 |
Silver | 21 30 40 50 60 |
$363.84 $412.96 $464.99 $649.82 $987.46 |
$727.68 $825.92 $929.98 $1299.64 $1974.92 |
$958.72 $1056.96 $1161.02 $1530.68 |
$1189.76 $1288.00 $1392.06 $1761.72 |
$1420.80 $1519.04 $1623.10 $1992.76 |
$594.88 $644.00 $696.03 $880.86 |
$825.92 $875.04 $927.07 $1111.90 |
$1056.96 $1106.08 $1158.11 $1342.94 |
$231.04 |
Plan: (PPO) Blue Cross® PPO Gold Extra with Dental and Vision, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$454.38 $515.72 $580.70 $811.52 $1233.19 |
$908.76 $1031.44 $1161.40 $1623.04 $2466.38 |
$1197.29 $1319.97 $1449.93 $1911.57 |
$1485.82 $1608.50 $1738.46 $2200.10 |
$1774.35 $1897.03 $2026.99 $2488.63 |
$742.91 $804.25 $869.23 $1100.05 |
$1031.44 $1092.78 $1157.76 $1388.58 |
$1319.97 $1381.31 $1446.29 $1677.11 |
$288.53 |
Plan: (EPO) Blue Cross® Metro Detroit EPO Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
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 |
$226.32 $256.87 $289.24 $404.21 $614.23 |
$452.64 $513.74 $578.48 $808.42 $1228.46 |
$596.35 $657.45 $722.19 $952.13 |
$740.06 $801.16 $865.90 $1095.84 |
$883.77 $944.87 $1009.61 $1239.55 |
$370.03 $400.58 $432.95 $547.92 |
$513.74 $544.29 $576.66 $691.63 |
$657.45 $688.00 $720.37 $835.34 |
$143.71 |
Plan: (EPO) Blue Cross® Metro Detroit EPO Silver Well-BeingSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual 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 |
Silver | 21 30 40 50 60 |
$290.11 $329.27 $370.76 $518.14 $787.36 |
$580.22 $658.54 $741.52 $1036.28 $1574.72 |
$764.44 $842.76 $925.74 $1220.50 |
$948.66 $1026.98 $1109.96 $1404.72 |
$1132.88 $1211.20 $1294.18 $1588.94 |
$474.33 $513.49 $554.98 $702.36 |
$658.55 $697.71 $739.20 $886.58 |
$842.77 $881.93 $923.42 $1070.80 |
$184.22 |
Plan: (PPO) Blue Cross® Premier PPO Bronze ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual Insurance Company)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
$258.38 $293.26 $330.21 $461.47 $701.24 |
$516.76 $586.52 $660.42 $922.94 $1402.48 |
$680.83 $750.59 $824.49 $1087.01 |
$844.90 $914.66 $988.56 $1251.08 |
$1008.97 $1078.73 $1152.63 $1415.15 |
$422.45 $457.33 $494.28 $625.54 |
$586.52 $621.40 $658.35 $789.61 |
$750.59 $785.47 $822.42 $953.68 |
$164.07 |
Plan: (PPO) Blue Cross® Premier PPO Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-288-2738 - Provider Directory for This Plan: (Blue Cross Blue Shield of Michigan Mutual 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 |
Silver | 21 30 40 50 60 |
$346.53 $393.31 $442.87 $618.90 $940.48 |
$693.06 $786.62 $885.74 $1237.80 $1880.96 |
$913.11 $1006.67 $1105.79 $1457.85 |
$1133.16 $1226.72 $1325.84 $1677.90 |
$1353.21 $1446.77 $1545.89 $1897.95 |
$566.58 $613.36 $662.92 $838.95 |
$786.63 $833.41 $882.97 $1059.00 |
$1006.68 $1053.46 $1103.02 $1279.05 |
$220.05 |
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Priority HealthLocal: 1-855-682-5217 | Toll Free: 1-855-682-5217 TTY: 1-888-551-6761 |
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Plan: (HMO) MyPriority HMO RxPlus Silver 1900Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,900
: Family:
$3,800 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 |
$265.88 $301.77 $339.79 $474.86 $721.60 |
$531.76 $603.54 $679.58 $949.72 $1443.20 |
$700.59 $772.37 $848.41 $1118.55 |
$869.42 $941.20 $1017.24 $1287.38 |
$1038.25 $1110.03 $1186.07 $1456.21 |
$434.71 $470.60 $508.62 $643.69 |
$603.54 $639.43 $677.45 $812.52 |
$772.37 $808.26 $846.28 $981.35 |
$168.83 |
Plan: (HMO) MyPriority HMO RxPlus Silver 1800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,800
: Family:
$3,600 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 |
$260.03 $295.13 $332.32 $464.41 $705.72 |
$520.06 $590.26 $664.64 $928.82 $1411.44 |
$685.18 $755.38 $829.76 $1093.94 |
$850.30 $920.50 $994.88 $1259.06 |
$1015.42 $1085.62 $1160.00 $1424.18 |
$425.15 $460.25 $497.44 $629.53 |
$590.27 $625.37 $662.56 $794.65 |
$755.39 $790.49 $827.68 $959.77 |
$165.12 |
Plan: (HMO) MyPriority HMO HSA Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$202.08 $229.36 $258.26 $360.91 $548.45 |
$404.16 $458.72 $516.52 $721.82 $1096.90 |
$532.48 $587.04 $644.84 $850.14 |
$660.80 $715.36 $773.16 $978.46 |
$789.12 $843.68 $901.48 $1106.78 |
$330.40 $357.68 $386.58 $489.23 |
$458.72 $486.00 $514.90 $617.55 |
$587.04 $614.32 $643.22 $745.87 |
$128.32 |
Plan: (HMO) MyPriority HMO RxPlus Bronze 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$212.82 $241.55 $271.98 $380.10 $577.59 |
$425.64 $483.10 $543.96 $760.20 $1155.18 |
$560.78 $618.24 $679.10 $895.34 |
$695.92 $753.38 $814.24 $1030.48 |
$831.06 $888.52 $949.38 $1165.62 |
$347.96 $376.69 $407.12 $515.24 |
$483.10 $511.83 $542.26 $650.38 |
$618.24 $646.97 $677.40 $785.52 |
$135.14 |
Plan: (HMO) MyPriority HMO HSA Silver 1500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$267.72 $303.86 $342.15 $478.15 $726.59 |
$535.44 $607.72 $684.30 $956.30 $1453.18 |
$705.44 $777.72 $854.30 $1126.30 |
$875.44 $947.72 $1024.30 $1296.30 |
$1045.44 $1117.72 $1194.30 $1466.30 |
$437.72 $473.86 $512.15 $648.15 |
$607.72 $643.86 $682.15 $818.15 |
$777.72 $813.86 $852.15 $988.15 |
$170.00 |
Plan: (HMO) MyPriority HMO Bronze 6700Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$6,700
: Family:
$13,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$199.27 $226.17 $254.67 $355.90 $540.82 |
$398.54 $452.34 $509.34 $711.80 $1081.64 |
$525.08 $578.88 $635.88 $838.34 |
$651.62 $705.42 $762.42 $964.88 |
$778.16 $831.96 $888.96 $1091.42 |
$325.81 $352.71 $381.21 $482.44 |
$452.35 $479.25 $507.75 $608.98 |
$578.89 $605.79 $634.29 $735.52 |
$126.54 |
Plan: (HMO) MyPriority HMO Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,400
: Family:
$2,800 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 |
$266.40 $302.36 $340.46 $475.79 $723.01 |
$532.80 $604.72 $680.92 $951.58 $1446.02 |
$701.96 $773.88 $850.08 $1120.74 |
$871.12 $943.04 $1019.24 $1289.90 |
$1040.28 $1112.20 $1188.40 $1459.06 |
$435.56 $471.52 $509.62 $644.95 |
$604.72 $640.68 $678.78 $814.11 |
$773.88 $809.84 $847.94 $983.27 |
$169.16 |
Plan: (HMO) MyPriority HMO Federal Standard Silver 3500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$270.41 $306.92 $345.58 $482.95 $733.89 |
$540.82 $613.84 $691.16 $965.90 $1467.78 |
$712.53 $785.55 $862.87 $1137.61 |
$884.24 $957.26 $1034.58 $1309.32 |
$1055.95 $1128.97 $1206.29 $1481.03 |
$442.12 $478.63 $517.29 $654.66 |
$613.83 $650.34 $689.00 $826.37 |
$785.54 $822.05 $860.71 $998.08 |
$171.71 |
Plan: (HMO) MyPriority HMO Holistic Bronze 5550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$5,550
: Family:
$11,100 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 |
$209.46 $237.74 $267.69 $374.10 $568.47 |
$418.92 $475.48 $535.38 $748.20 $1136.94 |
$551.93 $608.49 $668.39 $881.21 |
$684.94 $741.50 $801.40 $1014.22 |
$817.95 $874.51 $934.41 $1147.23 |
$342.47 $370.75 $400.70 $507.11 |
$475.48 $503.76 $533.71 $640.12 |
$608.49 $636.77 $666.72 $773.13 |
$133.01 |
Plan: (POS) MyPriority POS HSA Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: 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 |
$203.52 $231.00 $260.10 $363.49 $552.35 |
$407.04 $462.00 $520.20 $726.98 $1104.70 |
$536.28 $591.24 $649.44 $856.22 |
$665.52 $720.48 $778.68 $985.46 |
$794.76 $849.72 $907.92 $1114.70 |
$332.76 $360.24 $389.34 $492.73 |
$462.00 $489.48 $518.58 $621.97 |
$591.24 $618.72 $647.82 $751.21 |
$129.24 |
Plan: (HMO) MyPriority HMO RxPlus Silver 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$244.51 $277.52 $312.48 $436.69 $663.60 |
$489.02 $555.04 $624.96 $873.38 $1327.20 |
$644.28 $710.30 $780.22 $1028.64 |
$799.54 $865.56 $935.48 $1183.90 |
$954.80 $1020.82 $1090.74 $1339.16 |
$399.77 $432.78 $467.74 $591.95 |
$555.03 $588.04 $623.00 $747.21 |
$710.29 $743.30 $778.26 $902.47 |
$155.26 |
Plan: (HMO) MyPriority HMO Silver 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$251.53 $285.49 $321.46 $449.23 $682.65 |
$503.06 $570.98 $642.92 $898.46 $1365.30 |
$662.78 $730.70 $802.64 $1058.18 |
$822.50 $890.42 $962.36 $1217.90 |
$982.22 $1050.14 $1122.08 $1377.62 |
$411.25 $445.21 $481.18 $608.95 |
$570.97 $604.93 $640.90 $768.67 |
$730.69 $764.65 $800.62 $928.39 |
$159.72 |
Plan: (HMO) MyPriority HMO Holistic Silver 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$248.28 $281.80 $317.30 $443.43 $673.83 |
$496.56 $563.60 $634.60 $886.86 $1347.66 |
$654.22 $721.26 $792.26 $1044.52 |
$811.88 $878.92 $949.92 $1202.18 |
$969.54 $1036.58 $1107.58 $1359.84 |
$405.94 $439.46 $474.96 $601.09 |
$563.60 $597.12 $632.62 $758.75 |
$721.26 $754.78 $790.28 $916.41 |
$157.66 |
Plan: (POS) MyPriority POS RxPlus Silver 1800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,800
: Family:
$3,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$263.86 $299.48 $337.21 $471.25 $716.12 |
$527.72 $598.96 $674.42 $942.50 $1432.24 |
$695.27 $766.51 $841.97 $1110.05 |
$862.82 $934.06 $1009.52 $1277.60 |
$1030.37 $1101.61 $1177.07 $1445.15 |
$431.41 $467.03 $504.76 $638.80 |
$598.96 $634.58 $672.31 $806.35 |
$766.51 $802.13 $839.86 $973.90 |
$167.55 |
Plan: (POS) MyPriority POS RxPlus Bronze 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$214.96 $243.98 $274.72 $383.92 $583.40 |
$429.92 $487.96 $549.44 $767.84 $1166.80 |
$566.42 $624.46 $685.94 $904.34 |
$702.92 $760.96 $822.44 $1040.84 |
$839.42 $897.46 $958.94 $1177.34 |
$351.46 $380.48 $411.22 $520.42 |
$487.96 $516.98 $547.72 $656.92 |
$624.46 $653.48 $684.22 $793.42 |
$136.50 |
Plan: (POS) MyPriority POS HSA Silver 1500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$271.59 $308.25 $347.09 $485.06 $737.10 |
$543.18 $616.50 $694.18 $970.12 $1474.20 |
$715.64 $788.96 $866.64 $1142.58 |
$888.10 $961.42 $1039.10 $1315.04 |
$1060.56 $1133.88 $1211.56 $1487.50 |
$444.05 $480.71 $519.55 $657.52 |
$616.51 $653.17 $692.01 $829.98 |
$788.97 $825.63 $864.47 $1002.44 |
$172.46 |
Plan: (POS) MyPriority POS Bronze 6700Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$6,700
: Family:
$13,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$200.52 $227.59 $256.26 $358.13 $544.21 |
$401.04 $455.18 $512.52 $716.26 $1088.42 |
$528.37 $582.51 $639.85 $843.59 |
$655.70 $709.84 $767.18 $970.92 |
$783.03 $837.17 $894.51 $1098.25 |
$327.85 $354.92 $383.59 $485.46 |
$455.18 $482.25 $510.92 $612.79 |
$582.51 $609.58 $638.25 $740.12 |
$127.33 |
Plan: (POS) MyPriority POS Silver 1400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$1,400
: Family:
$2,800 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 |
$270.77 $307.32 $346.04 $483.60 $734.87 |
$541.54 $614.64 $692.08 $967.20 $1469.74 |
$713.48 $786.58 $864.02 $1139.14 |
$885.42 $958.52 $1035.96 $1311.08 |
$1057.36 $1130.46 $1207.90 $1483.02 |
$442.71 $479.26 $517.98 $655.54 |
$614.65 $651.20 $689.92 $827.48 |
$786.59 $823.14 $861.86 $999.42 |
$171.94 |
Plan: (POS) MyPriority POS Holistic Bronze 5550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
Deductible: Individual:
$5,550
: Family:
$11,100 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 |
$210.84 $239.30 $269.45 $376.56 $572.22 |
$421.68 $478.60 $538.90 $753.12 $1144.44 |
$555.56 $612.48 $672.78 $887.00 |
$689.44 $746.36 $806.66 $1020.88 |
$823.32 $880.24 $940.54 $1154.76 |
$344.72 $373.18 $403.33 $510.44 |
$478.60 $507.06 $537.21 $644.32 |
$612.48 $640.94 $671.09 $778.20 |
$133.88 |
Plan: (POS) MyPriority POS Holistic Silver 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$250.67 $284.51 $320.36 $447.70 $680.32 |
$501.34 $569.02 $640.72 $895.40 $1360.64 |
$660.52 $728.20 $799.90 $1054.58 |
$819.70 $887.38 $959.08 $1213.76 |
$978.88 $1046.56 $1118.26 $1372.94 |
$409.85 $443.69 $479.54 $606.88 |
$569.03 $602.87 $638.72 $766.06 |
$728.21 $762.05 $797.90 $925.24 |
$159.18 |
Plan: (POS) MyPriority POS RxPlus Silver 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$247.30 $280.69 $316.05 $441.68 $671.17 |
$494.60 $561.38 $632.10 $883.36 $1342.34 |
$651.64 $718.42 $789.14 $1040.40 |
$808.68 $875.46 $946.18 $1197.44 |
$965.72 $1032.50 $1103.22 $1354.48 |
$404.34 $437.73 $473.09 $598.72 |
$561.38 $594.77 $630.13 $755.76 |
$718.42 $751.81 $787.17 $912.80 |
$157.04 |
Plan: (POS) MyPriority POS Silver 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-682-5217 - Provider Directory for This Plan: (Priority Health)
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 |
$254.83 $289.23 $325.67 $455.13 $691.61 |
$509.66 $578.46 $651.34 $910.26 $1383.22 |
$671.48 $740.28 $813.16 $1072.08 |
$833.30 $902.10 $974.98 $1233.90 |
$995.12 $1063.92 $1136.80 $1395.72 |
$416.65 $451.05 $487.49 $616.95 |
$578.47 $612.87 $649.31 $778.77 |
$740.29 $774.69 $811.13 $940.59 |
$161.82 |
ADVERTISEMENT
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||||||||||
Health Alliance Plan (HAP)Local: 1-313-872-8100 | Toll Free: 1-855-948-4427 |
||||||||||
Plan: (HMO) HAP Personal Alliance 2500 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$325.79 $369.77 $416.36 $581.86 $884.19 |
$651.58 $739.54 $832.72 $1163.72 $1768.38 |
$858.46 $946.42 $1039.60 $1370.60 |
$1065.34 $1153.30 $1246.48 $1577.48 |
$1272.22 $1360.18 $1453.36 $1784.36 |
$532.67 $576.65 $623.24 $788.74 |
$739.55 $783.53 $830.12 $995.62 |
$946.43 $990.41 $1037.00 $1202.50 |
$206.88 |
Plan: (HMO) HAP Personal Alliance 5000 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$240.78 $273.29 $307.72 $430.03 $653.48 |
$481.56 $546.58 $615.44 $860.06 $1306.96 |
$634.46 $699.48 $768.34 $1012.96 |
$787.36 $852.38 $921.24 $1165.86 |
$940.26 $1005.28 $1074.14 $1318.76 |
$393.68 $426.19 $460.62 $582.93 |
$546.58 $579.09 $613.52 $735.83 |
$699.48 $731.99 $766.42 $888.73 |
$152.90 |
Plan: (HMO) HAP Personal Alliance 5500 HMO (HSA)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$208.08 $236.17 $265.93 $371.63 $564.73 |
$416.16 $472.34 $531.86 $743.26 $1129.46 |
$548.29 $604.47 $663.99 $875.39 |
$680.42 $736.60 $796.12 $1007.52 |
$812.55 $868.73 $928.25 $1139.65 |
$340.21 $368.30 $398.06 $503.76 |
$472.34 $500.43 $530.19 $635.89 |
$604.47 $632.56 $662.32 $768.02 |
$132.13 |
Plan: (HMO) HAP Personal Alliance 7150 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$163.48 $185.55 $208.93 $291.98 $443.68 |
$326.96 $371.10 $417.86 $583.96 $887.36 |
$430.77 $474.91 $521.67 $687.77 |
$534.58 $578.72 $625.48 $791.58 |
$638.39 $682.53 $729.29 $895.39 |
$267.29 $289.36 $312.74 $395.79 |
$371.10 $393.17 $416.55 $499.60 |
$474.91 $496.98 $520.36 $603.41 |
$103.81 |
Plan: (HMO) HAP Personal Alliance 3250 HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$3,250
: Family:
$6,500 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 |
$311.31 $353.34 $397.85 $556.00 $844.90 |
$622.62 $706.68 $795.70 $1112.00 $1689.80 |
$820.30 $904.36 $993.38 $1309.68 |
$1017.98 $1102.04 $1191.06 $1507.36 |
$1215.66 $1299.72 $1388.74 $1705.04 |
$508.99 $551.02 $595.53 $753.68 |
$706.67 $748.70 $793.21 $951.36 |
$904.35 $946.38 $990.89 $1149.04 |
$197.68 |
Plan: (HMO) HAP Personal Alliance 2500 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$244.51 $277.52 $312.48 $436.69 $663.60 |
$489.02 $555.04 $624.96 $873.38 $1327.20 |
$644.28 $710.30 $780.22 $1028.64 |
$799.54 $865.56 $935.48 $1183.90 |
$954.80 $1020.82 $1090.74 $1339.16 |
$399.77 $432.78 $467.74 $591.95 |
$555.03 $588.04 $623.00 $747.21 |
$710.29 $743.30 $778.26 $902.47 |
$155.26 |
Plan: (HMO) HAP Personal Alliance 5000 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$180.76 $205.16 $231.01 $322.84 $490.58 |
$361.52 $410.32 $462.02 $645.68 $981.16 |
$476.30 $525.10 $576.80 $760.46 |
$591.08 $639.88 $691.58 $875.24 |
$705.86 $754.66 $806.36 $990.02 |
$295.54 $319.94 $345.79 $437.62 |
$410.32 $434.72 $460.57 $552.40 |
$525.10 $549.50 $575.35 $667.18 |
$114.78 |
Plan: (HMO) HAP Personal Alliance 5500 HMO (HSA) Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
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 |
$156.24 $177.33 $199.67 $279.04 $424.04 |
$312.48 $354.66 $399.34 $558.08 $848.08 |
$411.69 $453.87 $498.55 $657.29 |
$510.90 $553.08 $597.76 $756.50 |
$610.11 $652.29 $696.97 $855.71 |
$255.45 $276.54 $298.88 $378.25 |
$354.66 $375.75 $398.09 $477.46 |
$453.87 $474.96 $497.30 $576.67 |
$99.21 |
Plan: (HMO) HAP Personal Alliance 7150 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$122.61 $139.16 $156.70 $218.98 $332.76 |
$245.22 $278.32 $313.40 $437.96 $665.52 |
$323.08 $356.18 $391.26 $515.82 |
$400.94 $434.04 $469.12 $593.68 |
$478.80 $511.90 $546.98 $671.54 |
$200.47 $217.02 $234.56 $296.84 |
$278.33 $294.88 $312.42 $374.70 |
$356.19 $372.74 $390.28 $452.56 |
$77.86 |
Plan: (HMO) HAP Personal Alliance 3250 HMO Henry Ford ChoiceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-948-4427 - Provider Directory for This Plan: (Health Alliance Plan (HAP))
Deductible: Individual:
$3,250
: Family:
$6,500 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 |
$233.77 $265.33 $298.76 $417.51 $634.45 |
$467.54 $530.66 $597.52 $835.02 $1268.90 |
$615.98 $679.10 $745.96 $983.46 |
$764.42 $827.54 $894.40 $1131.90 |
$912.86 $975.98 $1042.84 $1280.34 |
$382.21 $413.77 $447.20 $565.95 |
$530.65 $562.21 $595.64 $714.39 |
$679.09 $710.65 $744.08 $862.83 |
$148.44 |
ADVERTISEMENT
|
||||||||||
Molina Healthcare of Michigan, Inc.Local: 1-888-560-4087 | Toll Free: 1-888-560-4087 TTY: 1-888-665-4629 |
||||||||||
Plan: (HMO) Molina Marketplace Silver PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: Individual:
$2,400
: Family:
$4,800 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 |
$185.12 $210.11 $236.58 $330.63 $502.42 |
$370.24 $420.22 $473.16 $661.26 $1004.84 |
$487.79 $537.77 $590.71 $778.81 |
$605.34 $655.32 $708.26 $896.36 |
$722.89 $772.87 $825.81 $1013.91 |
$302.67 $327.66 $354.13 $448.18 |
$420.22 $445.21 $471.68 $565.73 |
$537.77 $562.76 $589.23 $683.28 |
$117.55 |
Plan: (HMO) Molina Marketplace Bronze PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: 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 |
Bronze | 21 30 40 50 60 |
$150.35 $170.65 $192.15 $268.52 $408.05 |
$300.70 $341.30 $384.30 $537.04 $816.10 |
$396.17 $436.77 $479.77 $632.51 |
$491.64 $532.24 $575.24 $727.98 |
$587.11 $627.71 $670.71 $823.45 |
$245.82 $266.12 $287.62 $363.99 |
$341.29 $361.59 $383.09 $459.46 |
$436.76 $457.06 $478.56 $554.93 |
$95.47 |
Plan: (HMO) Molina Marketplace Options Silver PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$186.95 $212.18 $238.92 $333.89 $507.37 |
$373.90 $424.36 $477.84 $667.78 $1014.74 |
$492.61 $543.07 $596.55 $786.49 |
$611.32 $661.78 $715.26 $905.20 |
$730.03 $780.49 $833.97 $1023.91 |
$305.66 $330.89 $357.63 $452.60 |
$424.37 $449.60 $476.34 $571.31 |
$543.08 $568.31 $595.05 $690.02 |
$118.71 |
Plan: (HMO) Molina Marketplace Options Bronze PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-4087 - Provider Directory for This Plan: (Molina Healthcare of Michigan, Inc.)
Deductible: 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 |
Bronze | 21 30 40 50 60 |
$153.19 $173.87 $195.78 $273.60 $415.76 |
$306.38 $347.74 $391.56 $547.20 $831.52 |
$403.66 $445.02 $488.84 $644.48 |
$500.94 $542.30 $586.12 $741.76 |
$598.22 $639.58 $683.40 $839.04 |
$250.47 $271.15 $293.06 $370.88 |
$347.75 $368.43 $390.34 $468.16 |
$445.03 $465.71 $487.62 $565.44 |
$97.28 |
ADVERTISEMENT
|
||||||||||
Humana Medical Plan of Michigan, Inc.Local: 1-877-720-4854 | Toll Free: 1-877-720-4854 TTY: 711 |
||||||||||
Plan: (HMO) Humana Basic 7150/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$148.18 $168.18 $189.37 $264.65 $402.16 |
$296.36 $336.36 $378.74 $529.30 $804.32 |
$390.45 $430.45 $472.83 $623.39 |
$484.54 $524.54 $566.92 $717.48 |
$578.63 $618.63 $661.01 $811.57 |
$242.27 $262.27 $283.46 $358.74 |
$336.36 $356.36 $377.55 $452.83 |
$430.45 $450.45 $471.64 $546.92 |
$94.09 |
Plan: (HMO) Humana Silver 3550/Detroit HMOxSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan of Michigan, Inc.)
Deductible: Individual:
$3,550
: Family:
$7,100 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 |
$246.40 $279.66 $314.90 $440.07 $668.73 |
$492.80 $559.32 $629.80 $880.14 $1337.46 |
$649.26 $715.78 $786.26 $1036.60 |
$805.72 $872.24 $942.72 $1193.06 |
$962.18 $1028.70 $1099.18 $1349.52 |
$402.86 $436.12 $471.36 $596.53 |
$559.32 $592.58 $627.82 $752.99 |
$715.78 $749.04 $784.28 $909.45 |
$156.46 |
ADVERTISEMENT
|
||||||||||
Meridian Health Plan of Michigan, Inc.Local: 1-855-537-9746 | Toll Free: 1-855-537-9746 |
||||||||||
Plan: (HMO) Meridian CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-537-9746 - Provider Directory for This Plan: (Meridian Health Plan of Michigan, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$147.33 $167.20 $188.27 $263.11 $399.82 |
$294.66 $334.40 $376.54 $526.22 $799.64 |
$388.21 $427.95 $470.09 $619.77 |
$481.76 $521.50 $563.64 $713.32 |
$575.31 $615.05 $657.19 $806.87 |
$240.88 $260.75 $281.82 $356.66 |
$334.43 $354.30 $375.37 $450.21 |
$427.98 $447.85 $468.92 $543.76 |
$93.55 |
Plan: (HMO) Meridian Healthy BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-537-9746 - Provider Directory for This Plan: (Meridian Health Plan of Michigan, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
$158.12 $179.45 $202.06 $282.38 $429.11 |
$316.24 $358.90 $404.12 $564.76 $858.22 |
$416.64 $459.30 $504.52 $665.16 |
$517.04 $559.70 $604.92 $765.56 |
$617.44 $660.10 $705.32 $865.96 |
$258.52 $279.85 $302.46 $382.78 |
$358.92 $380.25 $402.86 $483.18 |
$459.32 $480.65 $503.26 $583.58 |
$100.40 |
Plan: (HMO) Meridian Healthy SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-537-9746 - Provider Directory for This Plan: (Meridian Health Plan of Michigan, Inc.)
Deductible: 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 |
$182.61 $207.25 $233.36 $326.12 $495.58 |
$365.22 $414.50 $466.72 $652.24 $991.16 |
$481.17 $530.45 $582.67 $768.19 |
$597.12 $646.40 $698.62 $884.14 |
$713.07 $762.35 $814.57 $1000.09 |
$298.56 $323.20 $349.31 $442.07 |
$414.51 $439.15 $465.26 $558.02 |
$530.46 $555.10 $581.21 $673.97 |
$115.95 |
Plan: (HMO) Meridian Healthy GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-537-9746 - Provider Directory for This Plan: (Meridian Health Plan of Michigan, Inc.)
Deductible: Individual:
$2,200
: Family:
$4,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$245.19 $278.27 $313.33 $437.88 $665.41 |
$490.38 $556.54 $626.66 $875.76 $1330.82 |
$646.07 $712.23 $782.35 $1031.45 |
$801.76 $867.92 $938.04 $1187.14 |
$957.45 $1023.61 $1093.73 $1342.83 |
$400.88 $433.96 $469.02 $593.57 |
$556.57 $589.65 $624.71 $749.26 |
$712.26 $745.34 $780.40 $904.95 |
$155.69 |
Plan: (HMO) Meridian Smart SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-537-9746 - Provider Directory for This Plan: (Meridian Health Plan of Michigan, 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 |
Silver | 21 30 40 50 60 |
$247.87 $281.32 $316.76 $442.67 $672.68 |
$495.74 $562.64 $633.52 $885.34 $1345.36 |
$653.13 $720.03 $790.91 $1042.73 |
$810.52 $877.42 $948.30 $1200.12 |
$967.91 $1034.81 $1105.69 $1357.51 |
$405.26 $438.71 $474.15 $600.06 |
$562.65 $596.10 $631.54 $757.45 |
$720.04 $753.49 $788.93 $914.84 |
$157.39 |
Plan: (HMO) Meridian Standard SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-537-9746 - Provider Directory for This Plan: (Meridian Health Plan of Michigan, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$225.30 $255.71 $287.92 $402.37 $611.44 |
$450.60 $511.42 $575.84 $804.74 $1222.88 |
$593.66 $654.48 $718.90 $947.80 |
$736.72 $797.54 $861.96 $1090.86 |
$879.78 $940.60 $1005.02 $1233.92 |
$368.36 $398.77 $430.98 $545.43 |
$511.42 $541.83 $574.04 $688.49 |
$654.48 $684.89 $717.10 $831.55 |
$143.06 |
ADVERTISEMENT
|
||||||||||
Total Health Care USA, Inc.Local: 1-313-871-2000 x350 | Toll Free: 1-800-826-2862 TTY: 1-800-649-3777 |
||||||||||
Plan: (HMO) Total HMO StandardSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, 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 |
$243.58 $276.45 $311.28 $435.01 $661.04 |
$487.16 $552.90 $622.56 $870.02 $1322.08 |
$641.82 $707.56 $777.22 $1024.68 |
$796.48 $862.22 $931.88 $1179.34 |
$951.14 $1016.88 $1086.54 $1334.00 |
$398.24 $431.11 $465.94 $589.67 |
$552.90 $585.77 $620.60 $744.33 |
$707.56 $740.43 $775.26 $898.99 |
$154.66 |
Plan: (HMO) Totally YouSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, Inc.)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$209.80 $238.11 $268.11 $374.68 $569.37 |
$419.60 $476.22 $536.22 $749.36 $1138.74 |
$552.82 $609.44 $669.44 $882.58 |
$686.04 $742.66 $802.66 $1015.80 |
$819.26 $875.88 $935.88 $1149.02 |
$343.02 $371.33 $401.33 $507.90 |
$476.24 $504.55 $534.55 $641.12 |
$609.46 $637.77 $667.77 $774.34 |
$133.22 |
Plan: (HMO) Totally You - CompleteSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, 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 |
Silver | 21 30 40 50 60 |
$191.13 $216.92 $244.25 $341.34 $518.70 |
$382.26 $433.84 $488.50 $682.68 $1037.40 |
$503.62 $555.20 $609.86 $804.04 |
$624.98 $676.56 $731.22 $925.40 |
$746.34 $797.92 $852.58 $1046.76 |
$312.49 $338.28 $365.61 $462.70 |
$433.85 $459.64 $486.97 $584.06 |
$555.21 $581.00 $608.33 $705.42 |
$121.36 |
Plan: (HMO) Totally You - StandardizedSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$210.22 $238.59 $268.65 $375.43 $570.51 |
$420.44 $477.18 $537.30 $750.86 $1141.02 |
$553.92 $610.66 $670.78 $884.34 |
$687.40 $744.14 $804.26 $1017.82 |
$820.88 $877.62 $937.74 $1151.30 |
$343.70 $372.07 $402.13 $508.91 |
$477.18 $505.55 $535.61 $642.39 |
$610.66 $639.03 $669.09 $775.87 |
$133.48 |
Plan: (HMO) Total Saver PlusSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, 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 |
$162.39 $184.30 $207.52 $290.01 $440.69 |
$324.78 $368.60 $415.04 $580.02 $881.38 |
$427.89 $471.71 $518.15 $683.13 |
$531.00 $574.82 $621.26 $786.24 |
$634.11 $677.93 $724.37 $889.35 |
$265.50 $287.41 $310.63 $393.12 |
$368.61 $390.52 $413.74 $496.23 |
$471.72 $493.63 $516.85 $599.34 |
$103.11 |
Plan: (HMO) Total Saver CompleteSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-826-2862 - Provider Directory for This Plan: (Total Health Care USA, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
$158.40 $179.77 $202.42 $282.89 $429.87 |
$316.80 $359.54 $404.84 $565.78 $859.74 |
$417.38 $460.12 $505.42 $666.36 |
$517.96 $560.70 $606.00 $766.94 |
$618.54 $661.28 $706.58 $867.52 |
$258.98 $280.35 $303.00 $383.47 |
$359.56 $380.93 $403.58 $484.05 |
$460.14 $481.51 $504.16 $584.63 |
$100.58 |
ADVERTISEMENT
|
||||||||||
McLaren Health Plan CommunityLocal: 1-888-327-0671 | Toll Free: 1-888-327-0671 TTY: 1-800-356-3232 |
||||||||||
Plan: (HMO) McLaren Rewards PlatinumSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
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 |
Platinum | 21 30 40 50 60 |
$387.52 $439.84 $495.25 $692.11 $1051.73 |
$775.04 $879.68 $990.50 $1384.22 $2103.46 |
$1021.12 $1125.76 $1236.58 $1630.30 |
$1267.20 $1371.84 $1482.66 $1876.38 |
$1513.28 $1617.92 $1728.74 $2122.46 |
$633.60 $685.92 $741.33 $938.19 |
$879.68 $932.00 $987.41 $1184.27 |
$1125.76 $1178.08 $1233.49 $1430.35 |
$246.08 |
Plan: (HMO) McLaren Young Adult/CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$187.40 $212.69 $239.49 $334.69 $508.59 |
$374.80 $425.38 $478.98 $669.38 $1017.18 |
$493.80 $544.38 $597.98 $788.38 |
$612.80 $663.38 $716.98 $907.38 |
$731.80 $782.38 $835.98 $1026.38 |
$306.40 $331.69 $358.49 $453.69 |
$425.40 $450.69 $477.49 $572.69 |
$544.40 $569.69 $596.49 $691.69 |
$119.00 |
Plan: (HMO) Silver Standard PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$241.21 $273.77 $308.26 $430.80 $654.64 |
$482.42 $547.54 $616.52 $861.60 $1309.28 |
$635.59 $700.71 $769.69 $1014.77 |
$788.76 $853.88 $922.86 $1167.94 |
$941.93 $1007.05 $1076.03 $1321.11 |
$394.38 $426.94 $461.43 $583.97 |
$547.55 $580.11 $614.60 $737.14 |
$700.72 $733.28 $767.77 $890.31 |
$153.17 |
Plan: (HMO) Gold Standard PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$311.50 $353.56 $398.10 $556.34 $845.42 |
$623.00 $707.12 $796.20 $1112.68 $1690.84 |
$820.80 $904.92 $994.00 $1310.48 |
$1018.60 $1102.72 $1191.80 $1508.28 |
$1216.40 $1300.52 $1389.60 $1706.08 |
$509.30 $551.36 $595.90 $754.14 |
$707.10 $749.16 $793.70 $951.94 |
$904.90 $946.96 $991.50 $1149.74 |
$197.80 |
Plan: (HMO) McLaren BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-327-0671 - Provider Directory for This Plan: (McLaren Health Plan Community)
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 |
$184.77 $209.71 $236.14 $330.00 $501.46 |
$369.54 $419.42 $472.28 $660.00 $1002.92 |
$486.87 $536.75 $589.61 $777.33 |
$604.20 $654.08 $706.94 $894.66 |
$721.53 $771.41 $824.27 $1011.99 |
$302.10 $327.04 $353.47 $447.33 |
$419.43 $444.37 $470.80 $564.66 |
$536.76 $561.70 $588.13 $681.99 |
$117.33 |
ADVERTISEMENT
|
||||||||||
Blue Care Network of MichiganLocal: 1-800-662-6667 | Toll Free: 1-800-662-6667 TTY: 1-800-257-9980 |
||||||||||
Plan: (HMO) Blue Cross® Select HMO ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$157.44 $178.69 $201.21 $281.19 $427.29 |
$314.88 $357.38 $402.42 $562.38 $854.58 |
$414.85 $457.35 $502.39 $662.35 |
$514.82 $557.32 $602.36 $762.32 |
$614.79 $657.29 $702.33 $862.29 |
$257.41 $278.66 $301.18 $381.16 |
$357.38 $378.63 $401.15 $481.13 |
$457.35 $478.60 $501.12 $581.10 |
$99.97 |
Plan: (HMO) Blue Cross® Select HMO SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$247.02 $280.37 $315.69 $441.18 $670.41 |
$494.04 $560.74 $631.38 $882.36 $1340.82 |
$650.90 $717.60 $788.24 $1039.22 |
$807.76 $874.46 $945.10 $1196.08 |
$964.62 $1031.32 $1101.96 $1352.94 |
$403.88 $437.23 $472.55 $598.04 |
$560.74 $594.09 $629.41 $754.90 |
$717.60 $750.95 $786.27 $911.76 |
$156.86 |
Plan: (HMO) Blue Cross® Preferred HMO SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$268.31 $304.53 $342.90 $479.20 $728.19 |
$536.62 $609.06 $685.80 $958.40 $1456.38 |
$707.00 $779.44 $856.18 $1128.78 |
$877.38 $949.82 $1026.56 $1299.16 |
$1047.76 $1120.20 $1196.94 $1469.54 |
$438.69 $474.91 $513.28 $649.58 |
$609.07 $645.29 $683.66 $819.96 |
$779.45 $815.67 $854.04 $990.34 |
$170.38 |
Plan: (HMO) Blue Cross® Select HMO GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$250
: Family:
$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 |
$325.39 $369.32 $415.85 $581.15 $883.11 |
$650.78 $738.64 $831.70 $1162.30 $1766.22 |
$857.40 $945.26 $1038.32 $1368.92 |
$1064.02 $1151.88 $1244.94 $1575.54 |
$1270.64 $1358.50 $1451.56 $1782.16 |
$532.01 $575.94 $622.47 $787.77 |
$738.63 $782.56 $829.09 $994.39 |
$945.25 $989.18 $1035.71 $1201.01 |
$206.62 |
Plan: (HMO) Blue Cross® Metro Detroit HMO SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$223.95 $254.18 $286.21 $399.97 $607.80 |
$447.90 $508.36 $572.42 $799.94 $1215.60 |
$590.11 $650.57 $714.63 $942.15 |
$732.32 $792.78 $856.84 $1084.36 |
$874.53 $934.99 $999.05 $1226.57 |
$366.16 $396.39 $428.42 $542.18 |
$508.37 $538.60 $570.63 $684.39 |
$650.58 $680.81 $712.84 $826.60 |
$142.21 |
Plan: (HMO) Blue Cross® Select HMO Silver SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
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 |
$225.14 $255.53 $287.73 $402.10 $611.03 |
$450.28 $511.06 $575.46 $804.20 $1222.06 |
$593.24 $654.02 $718.42 $947.16 |
$736.20 $796.98 $861.38 $1090.12 |
$879.16 $939.94 $1004.34 $1233.08 |
$368.10 $398.49 $430.69 $545.06 |
$511.06 $541.45 $573.65 $688.02 |
$654.02 $684.41 $716.61 $830.98 |
$142.96 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Silver SaverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
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 |
$204.11 $231.66 $260.85 $364.54 $553.95 |
$408.22 $463.32 $521.70 $729.08 $1107.90 |
$537.83 $592.93 $651.31 $858.69 |
$667.44 $722.54 $780.92 $988.30 |
$797.05 $852.15 $910.53 $1117.91 |
$333.72 $361.27 $390.46 $494.15 |
$463.33 $490.88 $520.07 $623.76 |
$592.94 $620.49 $649.68 $753.37 |
$129.61 |
Plan: (HMO) Blue Cross® Select HMO Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$5,950
: Family:
$11,900 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 |
$190.40 $216.10 $243.33 $340.05 $516.75 |
$380.80 $432.20 $486.66 $680.10 $1033.50 |
$501.70 $553.10 $607.56 $801.00 |
$622.60 $674.00 $728.46 $921.90 |
$743.50 $794.90 $849.36 $1042.80 |
$311.30 $337.00 $364.23 $460.95 |
$432.20 $457.90 $485.13 $581.85 |
$553.10 $578.80 $606.03 $702.75 |
$120.90 |
Plan: (HMO) Blue Cross® Preferred HMO Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$5,950
: Family:
$11,900 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 |
$206.80 $234.72 $264.29 $369.34 $561.26 |
$413.60 $469.44 $528.58 $738.68 $1122.52 |
$544.92 $600.76 $659.90 $870.00 |
$676.24 $732.08 $791.22 $1001.32 |
$807.56 $863.40 $922.54 $1132.64 |
$338.12 $366.04 $395.61 $500.66 |
$469.44 $497.36 $526.93 $631.98 |
$600.76 $628.68 $658.25 $763.30 |
$131.32 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$5,950
: Family:
$11,900 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 |
$172.61 $195.91 $220.60 $308.28 $468.46 |
$345.22 $391.82 $441.20 $616.56 $936.92 |
$454.83 $501.43 $550.81 $726.17 |
$564.44 $611.04 $660.42 $835.78 |
$674.05 $720.65 $770.03 $945.39 |
$282.22 $305.52 $330.21 $417.89 |
$391.83 $415.13 $439.82 $527.50 |
$501.44 $524.74 $549.43 $637.11 |
$109.61 |
Plan: (HMO) Blue Cross® Select HMO Bronze Saver HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: 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 |
$179.25 $203.45 $229.08 $320.14 $486.48 |
$358.50 $406.90 $458.16 $640.28 $972.96 |
$472.32 $520.72 $571.98 $754.10 |
$586.14 $634.54 $685.80 $867.92 |
$699.96 $748.36 $799.62 $981.74 |
$293.07 $317.27 $342.90 $433.96 |
$406.89 $431.09 $456.72 $547.78 |
$520.71 $544.91 $570.54 $661.60 |
$113.82 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Bronze Saver HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: 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 |
$162.52 $184.46 $207.70 $290.26 $441.08 |
$325.04 $368.92 $415.40 $580.52 $882.16 |
$428.24 $472.12 $518.60 $683.72 |
$531.44 $575.32 $621.80 $786.92 |
$634.64 $678.52 $725.00 $890.12 |
$265.72 $287.66 $310.90 $393.46 |
$368.92 $390.86 $414.10 $496.66 |
$472.12 $494.06 $517.30 $599.86 |
$103.20 |
Plan: (HMO) Blue Cross® Select HMO Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$257.79 $292.59 $329.46 $460.41 $699.64 |
$515.58 $585.18 $658.92 $920.82 $1399.28 |
$679.28 $748.88 $822.62 $1084.52 |
$842.98 $912.58 $986.32 $1248.22 |
$1006.68 $1076.28 $1150.02 $1411.92 |
$421.49 $456.29 $493.16 $624.11 |
$585.19 $619.99 $656.86 $787.81 |
$748.89 $783.69 $820.56 $951.51 |
$163.70 |
Plan: (HMO) Blue Cross® Preferred HMO Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$280.00 $317.80 $357.84 $500.08 $759.92 |
$560.00 $635.60 $715.68 $1000.16 $1519.84 |
$737.80 $813.40 $893.48 $1177.96 |
$915.60 $991.20 $1071.28 $1355.76 |
$1093.40 $1169.00 $1249.08 $1533.56 |
$457.80 $495.60 $535.64 $677.88 |
$635.60 $673.40 $713.44 $855.68 |
$813.40 $851.20 $891.24 $1033.48 |
$177.80 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Silver ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$233.70 $265.25 $298.67 $417.39 $634.26 |
$467.40 $530.50 $597.34 $834.78 $1268.52 |
$615.80 $678.90 $745.74 $983.18 |
$764.20 $827.30 $894.14 $1131.58 |
$912.60 $975.70 $1042.54 $1279.98 |
$382.10 $413.65 $447.07 $565.79 |
$530.50 $562.05 $595.47 $714.19 |
$678.90 $710.45 $743.87 $862.59 |
$148.40 |
Plan: (HMO) Blue Cross® Select HMO Bronze ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: 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 |
Bronze | 21 30 40 50 60 |
$214.65 $243.63 $274.32 $383.36 $582.56 |
$429.30 $487.26 $548.64 $766.72 $1165.12 |
$565.60 $623.56 $684.94 $903.02 |
$701.90 $759.86 $821.24 $1039.32 |
$838.20 $896.16 $957.54 $1175.62 |
$350.95 $379.93 $410.62 $519.66 |
$487.25 $516.23 $546.92 $655.96 |
$623.55 $652.53 $683.22 $792.26 |
$136.30 |
Plan: (HMO) Blue Cross® Metro Detroit HMO Bronze ExtraSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-662-6667 - Provider Directory for This Plan: (Blue Care Network of Michigan)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
$194.60 $220.87 $248.70 $347.56 $528.14 |
$389.20 $441.74 $497.40 $695.12 $1056.28 |
$512.77 $565.31 $620.97 $818.69 |
$636.34 $688.88 $744.54 $942.26 |
$759.91 $812.45 $868.11 $1065.83 |
$318.17 $344.44 $372.27 $471.13 |
$441.74 $468.01 $495.84 $594.70 |
$565.31 $591.58 $619.41 $718.27 |
$123.57 |