Obamacare Providers, Plans and 2017 Rates for Clackamas 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 Clackamas County, Oregon.
Currently, there are 39 plans offered in Clackamas 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 Oregon City, OR 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 Clackamas County here.
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PacificSource Health PlansLocal: 1-541-686-1242 | Toll Free: 1-800-624-6052 |
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Plan: (PPO) PacificSource Oregon Standard Gold Plan LHNSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-624-6052 - Provider Directory for This Plan: (PacificSource Health Plans)
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 |
$430.00 $488.00 $550.00 $769.00 $1168.00 |
$860.00 $976.00 $1100.00 $1538.00 $2336.00 |
$1133.00 $1249.00 $1373.00 $1811.00 |
$1406.00 $1522.00 $1646.00 $2084.00 |
$1679.00 $1795.00 $1919.00 $2357.00 |
$703.00 $761.00 $823.00 $1042.00 |
$976.00 $1034.00 $1096.00 $1315.00 |
$1249.00 $1307.00 $1369.00 $1588.00 |
$273.00 |
Plan: (PPO) Legacy CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-624-6052 - Provider Directory for This Plan: (PacificSource Health Plans)
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 |
$217.00 $246.00 $277.00 $388.00 $589.00 |
$434.00 $492.00 $554.00 $776.00 $1178.00 |
$572.00 $630.00 $692.00 $914.00 |
$710.00 $768.00 $830.00 $1052.00 |
$848.00 $906.00 $968.00 $1190.00 |
$355.00 $384.00 $415.00 $526.00 |
$493.00 $522.00 $553.00 $664.00 |
$631.00 $660.00 $691.00 $802.00 |
$138.00 |
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Moda Health Plan, Inc.Local: 1-888-393-2940 | Toll Free: 1-888-393-2940 TTY: 1-888-393-2940 |
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Plan: (PPO) Moda Health Beacon Be IntegratedSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
Deductible: Individual:
$500
: Family:
$1,000 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 |
$344.00 $390.00 $440.00 $614.00 $934.00 |
$688.00 $780.00 $880.00 $1228.00 $1868.00 |
$906.00 $998.00 $1098.00 $1446.00 |
$1124.00 $1216.00 $1316.00 $1664.00 |
$1342.00 $1434.00 $1534.00 $1882.00 |
$562.00 $608.00 $658.00 $832.00 |
$780.00 $826.00 $876.00 $1050.00 |
$998.00 $1044.00 $1094.00 $1268.00 |
$218.00 |
Plan: (PPO) Moda Health Oregon Standard Gold (Beacon)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$337.00 $382.00 $431.00 $602.00 $914.00 |
$674.00 $764.00 $862.00 $1204.00 $1828.00 |
$888.00 $978.00 $1076.00 $1418.00 |
$1102.00 $1192.00 $1290.00 $1632.00 |
$1316.00 $1406.00 $1504.00 $1846.00 |
$551.00 $596.00 $645.00 $816.00 |
$765.00 $810.00 $859.00 $1030.00 |
$979.00 $1024.00 $1073.00 $1244.00 |
$214.00 |
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PacificSource Health PlansLocal: 1-541-686-1242 | Toll Free: 1-800-624-6052 |
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Plan: (PPO) PacificSource Oregon Standard Bronze Plan LHNSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-624-6052 - Provider Directory for This Plan: (PacificSource Health Plans)
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 |
$273.00 $309.00 $348.00 $487.00 $740.00 |
$546.00 $618.00 $696.00 $974.00 $1480.00 |
$719.00 $791.00 $869.00 $1147.00 |
$892.00 $964.00 $1042.00 $1320.00 |
$1065.00 $1137.00 $1215.00 $1493.00 |
$446.00 $482.00 $521.00 $660.00 |
$619.00 $655.00 $694.00 $833.00 |
$792.00 $828.00 $867.00 $1006.00 |
$173.00 |
Plan: (PPO) PacificSource Oregon Standard Silver Plan LHNSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-624-6052 - Provider Directory for This Plan: (PacificSource Health Plans)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Silver | 21 30 40 50 60 |
$346.00 $393.00 $442.00 $618.00 $939.00 |
$692.00 $786.00 $884.00 $1236.00 $1878.00 |
$912.00 $1006.00 $1104.00 $1456.00 |
$1132.00 $1226.00 $1324.00 $1676.00 |
$1352.00 $1446.00 $1544.00 $1896.00 |
$566.00 $613.00 $662.00 $838.00 |
$786.00 $833.00 $882.00 $1058.00 |
$1006.00 $1053.00 $1102.00 $1278.00 |
$220.00 |
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Moda Health Plan, Inc.Local: 1-888-393-2940 | Toll Free: 1-888-393-2940 TTY: 1-888-393-2940 |
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Plan: (PPO) Moda Health Oregon Standard Silver (Beacon)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Silver | 21 30 40 50 60 |
$309.00 $351.00 $395.00 $552.00 $839.00 |
$618.00 $702.00 $790.00 $1104.00 $1678.00 |
$814.00 $898.00 $986.00 $1300.00 |
$1010.00 $1094.00 $1182.00 $1496.00 |
$1206.00 $1290.00 $1378.00 $1692.00 |
$505.00 $547.00 $591.00 $748.00 |
$701.00 $743.00 $787.00 $944.00 |
$897.00 $939.00 $983.00 $1140.00 |
$196.00 |
Plan: (PPO) Moda Health Oregon Standard Bronze (Beacon)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
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 |
$275.00 $312.00 $352.00 $491.00 $747.00 |
$550.00 $624.00 $704.00 $982.00 $1494.00 |
$725.00 $799.00 $879.00 $1157.00 |
$900.00 $974.00 $1054.00 $1332.00 |
$1075.00 $1149.00 $1229.00 $1507.00 |
$450.00 $487.00 $527.00 $666.00 |
$625.00 $662.00 $702.00 $841.00 |
$800.00 $837.00 $877.00 $1016.00 |
$175.00 |
Plan: (PPO) Moda Health Beacon Be ProtectedSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$340.00 $386.00 $435.00 $608.00 $924.00 |
$680.00 $772.00 $870.00 $1216.00 $1848.00 |
$896.00 $988.00 $1086.00 $1432.00 |
$1112.00 $1204.00 $1302.00 $1648.00 |
$1328.00 $1420.00 $1518.00 $1864.00 |
$556.00 $602.00 $651.00 $824.00 |
$772.00 $818.00 $867.00 $1040.00 |
$988.00 $1034.00 $1083.00 $1256.00 |
$216.00 |
Plan: (PPO) Moda Health Beacon Be PreparedSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
Deductible: Individual:
$2,250
: Family:
$4,500 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Silver | 21 30 40 50 60 |
$317.00 $359.00 $405.00 $565.00 $859.00 |
$634.00 $718.00 $810.00 $1130.00 $1718.00 |
$835.00 $919.00 $1011.00 $1331.00 |
$1036.00 $1120.00 $1212.00 $1532.00 |
$1237.00 $1321.00 $1413.00 $1733.00 |
$518.00 $560.00 $606.00 $766.00 |
$719.00 $761.00 $807.00 $967.00 |
$920.00 $962.00 $1008.00 $1168.00 |
$201.00 |
Plan: (PPO) Moda Health Beacon Be SteadySummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-393-2940 - Provider Directory for This Plan: (Moda Health Plan, Inc.)
Deductible: Individual:
$3,650
: Family:
$7,300 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 |
| Silver | 21 30 40 50 60 |
$302.00 $343.00 $386.00 $539.00 $819.00 |
$604.00 $686.00 $772.00 $1078.00 $1638.00 |
$796.00 $878.00 $964.00 $1270.00 |
$988.00 $1070.00 $1156.00 $1462.00 |
$1180.00 $1262.00 $1348.00 $1654.00 |
$494.00 $535.00 $578.00 $731.00 |
$686.00 $727.00 $770.00 $923.00 |
$878.00 $919.00 $962.00 $1115.00 |
$192.00 |
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Providence Health PlanLocal: 1-503-574-5000 | Toll Free: 1-800-878-4445 TTY: 1-888-244-6642 |
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Plan: (EPO) Balance 2500 SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Silver | 21 30 40 50 60 |
$278.00 $315.00 $355.00 $496.00 $753.00 |
$556.00 $630.00 $710.00 $992.00 $1506.00 |
$732.00 $806.00 $886.00 $1168.00 |
$908.00 $982.00 $1062.00 $1344.00 |
$1084.00 $1158.00 $1238.00 $1520.00 |
$454.00 $491.00 $531.00 $672.00 |
$630.00 $667.00 $707.00 $848.00 |
$806.00 $843.00 $883.00 $1024.00 |
$176.00 |
Plan: (EPO) Balance 7150 BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
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 |
$224.00 $255.00 $287.00 $401.00 $609.00 |
$448.00 $510.00 $574.00 $802.00 $1218.00 |
$590.00 $652.00 $716.00 $944.00 |
$732.00 $794.00 $858.00 $1086.00 |
$874.00 $936.00 $1000.00 $1228.00 |
$366.00 $397.00 $429.00 $543.00 |
$508.00 $539.00 $571.00 $685.00 |
$650.00 $681.00 $713.00 $827.00 |
$142.00 |
Plan: (EPO) Providence Oregon Standard Silver PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Silver | 21 30 40 50 60 |
$278.00 $316.00 $355.00 $497.00 $755.00 |
$556.00 $632.00 $710.00 $994.00 $1510.00 |
$733.00 $809.00 $887.00 $1171.00 |
$910.00 $986.00 $1064.00 $1348.00 |
$1087.00 $1163.00 $1241.00 $1525.00 |
$455.00 $493.00 $532.00 $674.00 |
$632.00 $670.00 $709.00 $851.00 |
$809.00 $847.00 $886.00 $1028.00 |
$177.00 |
Plan: (EPO) HSA 6000 BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Bronze | 21 30 40 50 60 |
$189.00 $215.00 $242.00 $338.00 $514.00 |
$378.00 $430.00 $484.00 $676.00 $1028.00 |
$498.00 $550.00 $604.00 $796.00 |
$618.00 $670.00 $724.00 $916.00 |
$738.00 $790.00 $844.00 $1036.00 |
$309.00 $335.00 $362.00 $458.00 |
$429.00 $455.00 $482.00 $578.00 |
$549.00 $575.00 $602.00 $698.00 |
$120.00 |
Plan: (EPO) Choice 2500 SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
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| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Silver | 21 30 40 50 60 |
$266.00 $302.00 $340.00 $475.00 $722.00 |
$532.00 $604.00 $680.00 $950.00 $1444.00 |
$701.00 $773.00 $849.00 $1119.00 |
$870.00 $942.00 $1018.00 $1288.00 |
$1039.00 $1111.00 $1187.00 $1457.00 |
$435.00 $471.00 $509.00 $644.00 |
$604.00 $640.00 $678.00 $813.00 |
$773.00 $809.00 $847.00 $982.00 |
$169.00 |
Plan: (EPO) Choice 7150 BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
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 |
$215.00 $244.00 $275.00 $384.00 $584.00 |
$430.00 $488.00 $550.00 $768.00 $1168.00 |
$567.00 $625.00 $687.00 $905.00 |
$704.00 $762.00 $824.00 $1042.00 |
$841.00 $899.00 $961.00 $1179.00 |
$352.00 $381.00 $412.00 $521.00 |
$489.00 $518.00 $549.00 $658.00 |
$626.00 $655.00 $686.00 $795.00 |
$137.00 |
Plan: (EPO) Connect 2500 SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
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 |
$255.00 $289.00 $326.00 $455.00 $692.00 |
$510.00 $578.00 $652.00 $910.00 $1384.00 |
$672.00 $740.00 $814.00 $1072.00 |
$834.00 $902.00 $976.00 $1234.00 |
$996.00 $1064.00 $1138.00 $1396.00 |
$417.00 $451.00 $488.00 $617.00 |
$579.00 $613.00 $650.00 $779.00 |
$741.00 $775.00 $812.00 $941.00 |
$162.00 |
Plan: (EPO) Connect 7150 BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
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 |
$206.00 $234.00 $263.00 $368.00 $559.00 |
$412.00 $468.00 $526.00 $736.00 $1118.00 |
$543.00 $599.00 $657.00 $867.00 |
$674.00 $730.00 $788.00 $998.00 |
$805.00 $861.00 $919.00 $1129.00 |
$337.00 $365.00 $394.00 $499.00 |
$468.00 $496.00 $525.00 $630.00 |
$599.00 $627.00 $656.00 $761.00 |
$131.00 |
Plan: (EPO) Providence Oregon Standard Gold PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$337.00 $382.00 $431.00 $602.00 $915.00 |
$674.00 $764.00 $862.00 $1204.00 $1830.00 |
$888.00 $978.00 $1076.00 $1418.00 |
$1102.00 $1192.00 $1290.00 $1632.00 |
$1316.00 $1406.00 $1504.00 $1846.00 |
$551.00 $596.00 $645.00 $816.00 |
$765.00 $810.00 $859.00 $1030.00 |
$979.00 $1024.00 $1073.00 $1244.00 |
$214.00 |
Plan: (EPO) Providence Oregon Standard Bronze PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-878-4445 - Provider Directory for This Plan: (Providence Health Plan)
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 |
$227.00 $257.00 $290.00 $405.00 $615.00 |
$454.00 $514.00 $580.00 $810.00 $1230.00 |
$598.00 $658.00 $724.00 $954.00 |
$742.00 $802.00 $868.00 $1098.00 |
$886.00 $946.00 $1012.00 $1242.00 |
$371.00 $401.00 $434.00 $549.00 |
$515.00 $545.00 $578.00 $693.00 |
$659.00 $689.00 $722.00 $837.00 |
$144.00 |
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BridgeSpan Health CompanyLocal: 1-855-857-9943 | Toll Free: 1-855-857-9943 TTY: 1-800-735-2900 |
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Plan: (PPO) BridgeSpan Standard Gold Plan RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$398.96 $452.82 $509.87 $712.54 $1082.78 |
$797.92 $905.64 $1019.74 $1425.08 $2165.56 |
$1051.26 $1158.98 $1273.08 $1678.42 |
$1304.60 $1412.32 $1526.42 $1931.76 |
$1557.94 $1665.66 $1779.76 $2185.10 |
$652.30 $706.16 $763.21 $965.88 |
$905.64 $959.50 $1016.55 $1219.22 |
$1158.98 $1212.84 $1269.89 $1472.56 |
$253.34 |
Plan: (PPO) BridgeSpan Standard Silver Plan RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$318.40 $361.38 $406.91 $568.66 $864.14 |
$636.80 $722.76 $813.82 $1137.32 $1728.28 |
$838.98 $924.94 $1016.00 $1339.50 |
$1041.16 $1127.12 $1218.18 $1541.68 |
$1243.34 $1329.30 $1420.36 $1743.86 |
$520.58 $563.56 $609.09 $770.84 |
$722.76 $765.74 $811.27 $973.02 |
$924.94 $967.92 $1013.45 $1175.20 |
$202.18 |
Plan: (PPO) BridgeSpan Standard Bronze Plan RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$259.77 $294.84 $331.98 $463.95 $705.01 |
$519.54 $589.68 $663.96 $927.90 $1410.02 |
$684.49 $754.63 $828.91 $1092.85 |
$849.44 $919.58 $993.86 $1257.80 |
$1014.39 $1084.53 $1158.81 $1422.75 |
$424.72 $459.79 $496.93 $628.90 |
$589.67 $624.74 $661.88 $793.85 |
$754.62 $789.69 $826.83 $958.80 |
$164.95 |
Plan: (PPO) Silver HDHP 3000 RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$282.55 $320.69 $361.10 $504.63 $766.84 |
$565.10 $641.38 $722.20 $1009.26 $1533.68 |
$744.52 $820.80 $901.62 $1188.68 |
$923.94 $1000.22 $1081.04 $1368.10 |
$1103.36 $1179.64 $1260.46 $1547.52 |
$461.97 $500.11 $540.52 $684.05 |
$641.39 $679.53 $719.94 $863.47 |
$820.81 $858.95 $899.36 $1042.89 |
$179.42 |
Plan: (PPO) Bronze HDHP 6000 RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$235.53 $267.33 $301.01 $420.66 $639.24 |
$471.06 $534.66 $602.02 $841.32 $1278.48 |
$620.62 $684.22 $751.58 $990.88 |
$770.18 $833.78 $901.14 $1140.44 |
$919.74 $983.34 $1050.70 $1290.00 |
$385.09 $416.89 $450.57 $570.22 |
$534.65 $566.45 $600.13 $719.78 |
$684.21 $716.01 $749.69 $869.34 |
$149.56 |
Plan: (PPO) Silver Essential 4000 RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$294.68 $334.46 $376.60 $526.29 $799.75 |
$589.36 $668.92 $753.20 $1052.58 $1599.50 |
$776.48 $856.04 $940.32 $1239.70 |
$963.60 $1043.16 $1127.44 $1426.82 |
$1150.72 $1230.28 $1314.56 $1613.94 |
$481.80 $521.58 $563.72 $713.41 |
$668.92 $708.70 $750.84 $900.53 |
$856.04 $895.82 $937.96 $1087.65 |
$187.12 |
Plan: (PPO) Bronze Essential 7150 RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$264.43 $300.12 $337.94 $472.26 $717.65 |
$528.86 $600.24 $675.88 $944.52 $1435.30 |
$696.77 $768.15 $843.79 $1112.43 |
$864.68 $936.06 $1011.70 $1280.34 |
$1032.59 $1103.97 $1179.61 $1448.25 |
$432.34 $468.03 $505.85 $640.17 |
$600.25 $635.94 $673.76 $808.08 |
$768.16 $803.85 $841.67 $975.99 |
$167.91 |
|
ADVERTISEMENT
|
||||||||||
Kaiser Foundation Healthplan of the NWLocal: 1-800-801-1270 | Toll Free: 1-800-801-1270 TTY: 1-800-735-2900 |
||||||||||
Plan: (EPO) KP OR Catastrophic 7150/0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
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 |
$176.00 $200.00 $225.00 $315.00 $478.00 |
$352.00 $400.00 $450.00 $630.00 $956.00 |
$464.00 $512.00 $562.00 $742.00 |
$576.00 $624.00 $674.00 $854.00 |
$688.00 $736.00 $786.00 $966.00 |
$288.00 $312.00 $337.00 $427.00 |
$400.00 $424.00 $449.00 $539.00 |
$512.00 $536.00 $561.00 $651.00 |
$112.00 |
|
ADVERTISEMENT
|
||||||||||
BridgeSpan Health CompanyLocal: 1-855-857-9943 | Toll Free: 1-855-857-9943 TTY: 1-800-735-2900 |
||||||||||
Plan: (EPO) Bronze Essential 7150 EPO RealValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-857-9943 - Provider Directory for This Plan: (BridgeSpan Health Company)
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 |
$262.63 $298.09 $335.64 $469.06 $712.78 |
$525.26 $596.18 $671.28 $938.12 $1425.56 |
$692.03 $762.95 $838.05 $1104.89 |
$858.80 $929.72 $1004.82 $1271.66 |
$1025.57 $1096.49 $1171.59 $1438.43 |
$429.40 $464.86 $502.41 $635.83 |
$596.17 $631.63 $669.18 $802.60 |
$762.94 $798.40 $835.95 $969.37 |
$166.77 |
|
ADVERTISEMENT
|
||||||||||
Kaiser Foundation Healthplan of the NWLocal: 1-800-801-1270 | Toll Free: 1-800-801-1270 TTY: 1-800-735-2900 |
||||||||||
Plan: (EPO) KP OR Gold 0/20Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$299.00 $340.00 $383.00 $535.00 $812.00 |
$598.00 $680.00 $766.00 $1070.00 $1624.00 |
$788.00 $870.00 $956.00 $1260.00 |
$978.00 $1060.00 $1146.00 $1450.00 |
$1168.00 $1250.00 $1336.00 $1640.00 |
$489.00 $530.00 $573.00 $725.00 |
$679.00 $720.00 $763.00 $915.00 |
$869.00 $910.00 $953.00 $1105.00 |
$190.00 |
Plan: (EPO) Kaiser Permanete Oregon Standard Gold PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$281.00 $319.00 $359.00 $501.00 $762.00 |
$562.00 $638.00 $718.00 $1002.00 $1524.00 |
$740.00 $816.00 $896.00 $1180.00 |
$918.00 $994.00 $1074.00 $1358.00 |
$1096.00 $1172.00 $1252.00 $1536.00 |
$459.00 $497.00 $537.00 $679.00 |
$637.00 $675.00 $715.00 $857.00 |
$815.00 $853.00 $893.00 $1035.00 |
$178.00 |
Plan: (EPO) Kaiser Permanente Oregon Standard Silver PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
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 |
$244.00 $277.00 $312.00 $436.00 $662.00 |
$488.00 $554.00 $624.00 $872.00 $1324.00 |
$643.00 $709.00 $779.00 $1027.00 |
$798.00 $864.00 $934.00 $1182.00 |
$953.00 $1019.00 $1089.00 $1337.00 |
$399.00 $432.00 $467.00 $591.00 |
$554.00 $587.00 $622.00 $746.00 |
$709.00 $742.00 $777.00 $901.00 |
$155.00 |
Plan: (EPO) Kaiser Permanente Oregon Standard Bronze PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
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 |
$191.00 $216.00 $244.00 $341.00 $517.00 |
$382.00 $432.00 $488.00 $682.00 $1034.00 |
$503.00 $553.00 $609.00 $803.00 |
$624.00 $674.00 $730.00 $924.00 |
$745.00 $795.00 $851.00 $1045.00 |
$312.00 $337.00 $365.00 $462.00 |
$433.00 $458.00 $486.00 $583.00 |
$554.00 $579.00 $607.00 $704.00 |
$121.00 |
Plan: (EPO) KP OR Gold 1000/20Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
||||||||||
| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Gold | 21 30 40 50 60 |
$286.00 $325.00 $366.00 $511.00 $777.00 |
$572.00 $650.00 $732.00 $1022.00 $1554.00 |
$754.00 $832.00 $914.00 $1204.00 |
$936.00 $1014.00 $1096.00 $1386.00 |
$1118.00 $1196.00 $1278.00 $1568.00 |
$468.00 $507.00 $548.00 $693.00 |
$650.00 $689.00 $730.00 $875.00 |
$832.00 $871.00 $912.00 $1057.00 |
$182.00 |
Plan: (EPO) KP OR Silver 2000/30Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
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 |
$250.00 $284.00 $319.00 $446.00 $678.00 |
$500.00 $568.00 $638.00 $892.00 $1356.00 |
$659.00 $727.00 $797.00 $1051.00 |
$818.00 $886.00 $956.00 $1210.00 |
$977.00 $1045.00 $1115.00 $1369.00 |
$409.00 $443.00 $478.00 $605.00 |
$568.00 $602.00 $637.00 $764.00 |
$727.00 $761.00 $796.00 $923.00 |
$159.00 |
Plan: (EPO) KP OR Silver 3000/30Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
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 |
$236.00 $268.00 $302.00 $422.00 $641.00 |
$472.00 $536.00 $604.00 $844.00 $1282.00 |
$622.00 $686.00 $754.00 $994.00 |
$772.00 $836.00 $904.00 $1144.00 |
$922.00 $986.00 $1054.00 $1294.00 |
$386.00 $418.00 $452.00 $572.00 |
$536.00 $568.00 $602.00 $722.00 |
$686.00 $718.00 $752.00 $872.00 |
$150.00 |
Plan: (EPO) KP OR Bronze 5000/50Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
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 |
$186.00 $212.00 $238.00 $333.00 $506.00 |
$372.00 $424.00 $476.00 $666.00 $1012.00 |
$490.00 $542.00 $594.00 $784.00 |
$608.00 $660.00 $712.00 $902.00 |
$726.00 $778.00 $830.00 $1020.00 |
$304.00 $330.00 $356.00 $451.00 |
$422.00 $448.00 $474.00 $569.00 |
$540.00 $566.00 $592.00 $687.00 |
$118.00 |
Plan: (EPO) KP OR Bronze 6500/50Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-801-1270 - Provider Directory for This Plan: (Kaiser Foundation Healthplan of the NW)
Deductible: Individual:
$6,500
: Family:
$13,000 Monthly Premiums: |
||||||||||
| Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
| Bronze | 21 30 40 50 60 |
$183.00 $208.00 $234.00 $327.00 $496.00 |
$366.00 $416.00 $468.00 $654.00 $992.00 |
$482.00 $532.00 $584.00 $770.00 |
$598.00 $648.00 $700.00 $886.00 |
$714.00 $764.00 $816.00 $1002.00 |
$299.00 $324.00 $350.00 $443.00 |
$415.00 $440.00 $466.00 $559.00 |
$531.00 $556.00 $582.00 $675.00 |
$116.00 |