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Providers for Zip Code 30269

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ObamacareByZipCode.com

Obamacare 2019 Marketplace Rates For Fayette County, Georgia

Thursday, April 18th, 2024


The health insurance rates listed below are for calendar year 2019.

2019 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

(click here for 2017)

(click here for 2018)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Fayette County, Georgia.

Obamacare Providers, Plans and 2019 Rates for Fayette County

Fayette County is in “Rating Area 3” of Georgia.

Currently, there are 35 plans offered in Rating Area 3.

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

The table below shows premiums for the following scenarios for:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Peachtree City, GA area accept this insurance coverage as within the plan's "network".
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Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.

Local: 1-855-738-6652 | Toll Free: 1-855-738-6652

Plan: (HMO) Anthem Bronze Pathway X Guided Access HMO 0 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $6,700 : Family: $13,400
Out of Pocket Maximum per year: 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		 $254.36
$288.70
$325.07
$454.29
$690.33		 $508.72
$577.40
$650.14
$908.58
$1,380.66		 $703.31
$771.99
$844.73
$1,103.17		 $897.90
$966.58
$1,039.32
$1,297.76		 $1,092.49
$1,161.17
$1,233.91
$1,492.35		 $448.95
$483.29
$519.66
$648.88		 $643.54
$677.88
$714.25
$843.47		 $838.13
$872.47
$908.84
$1,038.06		 $232.23

Plan: (HMO) Anthem Silver Pathway X Guided Access HMO 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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		 $384.72
$436.66
$491.67
$687.11
$1,044.13		 $769.44
$873.32
$983.34
$1,374.22
$2,088.26		 $1,063.75
$1,167.63
$1,277.65
$1,668.53		 $1,358.06
$1,461.94
$1,571.96
$1,962.84		 $1,652.37
$1,756.25
$1,866.27
$2,257.15		 $679.03
$730.97
$785.98
$981.42		 $973.34
$1,025.28
$1,080.29
$1,275.73		 $1,267.65
$1,319.59
$1,374.60
$1,570.04		 $351.25

Plan: (HMO) Anthem Silver Pathway X Guided Access HMO 5300

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $5,300 : Family: $10,600
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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		 $347.94
$394.91
$444.67
$621.42
$944.31		 $695.88
$789.82
$889.34
$1,242.84
$1,888.62		 $962.05
$1,055.99
$1,155.51
$1,509.01		 $1,228.22
$1,322.16
$1,421.68
$1,775.18		 $1,494.39
$1,588.33
$1,687.85
$2,041.35		 $614.11
$661.08
$710.84
$887.59		 $880.28
$927.25
$977.01
$1,153.76		 $1,146.45
$1,193.42
$1,243.18
$1,419.93		 $317.67

Plan: (HMO) Anthem Bronze Pathway X Guided Access HMO 5200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $5,200 : Family: $10,400
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Bronze 21
30
40
50
60		 $260.98
$296.21
$333.53
$466.11
$708.30		 $521.96
$592.42
$667.06
$932.22
$1,416.60		 $721.61
$792.07
$866.71
$1,131.87		 $921.26
$991.72
$1,066.36
$1,331.52		 $1,120.91
$1,191.37
$1,266.01
$1,531.17		 $460.63
$495.86
$533.18
$665.76		 $660.28
$695.51
$732.83
$865.41		 $859.93
$895.16
$932.48
$1,065.06		 $238.27

Plan: (HMO) Anthem Bronze Pathway X Guided Access HMO 5500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Bronze 21
30
40
50
60		 $254.91
$289.32
$325.77
$455.27
$691.83		 $509.82
$578.64
$651.54
$910.54
$1,383.66		 $704.83
$773.65
$846.55
$1,105.55		 $899.84
$968.66
$1,041.56
$1,300.56		 $1,094.85
$1,163.67
$1,236.57
$1,495.57		 $449.92
$484.33
$520.78
$650.28		 $644.93
$679.34
$715.79
$845.29		 $839.94
$874.35
$910.80
$1,040.30		 $232.73

Plan: (HMO) Anthem Catastrophic Pathway X Guided Access HMO 7900

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $7,900 : Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Catastrophic 21
30
40
50
60		 $168.29
$191.01
$215.07
$300.57
$456.74		 $336.58
$382.02
$430.14
$601.14
$913.48		 $465.32
$510.76
$558.88
$729.88		 $594.06
$639.50
$687.62
$858.62		 $722.80
$768.24
$816.36
$987.36		 $297.03
$319.75
$343.81
$429.31		 $425.77
$448.49
$472.55
$558.05		 $554.51
$577.23
$601.29
$686.79		 $153.65

Plan: (HMO) Anthem Silver Pathway X Guided Access HMO 3000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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		 $388.33
$440.75
$496.29
$693.56
$1,053.93		 $776.66
$881.50
$992.58
$1,387.12
$2,107.86		 $1,073.73
$1,178.57
$1,289.65
$1,684.19		 $1,370.80
$1,475.64
$1,586.72
$1,981.26		 $1,667.87
$1,772.71
$1,883.79
$2,278.33		 $685.40
$737.82
$793.36
$990.63		 $982.47
$1,034.89
$1,090.43
$1,287.70		 $1,279.54
$1,331.96
$1,387.50
$1,584.77		 $354.55

Plan: (HMO) Anthem Bronze Pathway X Guided Access HMO 6750

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $6,750 : Family: $13,500
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Bronze 21
30
40
50
60		 $247.13
$280.49
$315.83
$441.37
$670.71		 $494.26
$560.98
$631.66
$882.74
$1,341.42		 $683.31
$750.03
$820.71
$1,071.79		 $872.36
$939.08
$1,009.76
$1,260.84		 $1,061.41
$1,128.13
$1,198.81
$1,449.89		 $436.18
$469.54
$504.88
$630.42		 $625.23
$658.59
$693.93
$819.47		 $814.28
$847.64
$882.98
$1,008.52		 $225.63

Plan: (HMO) Anthem Silver Pathway X Guided Access HMO 4950

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $4,950 : Family: $9,900
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $363.28
$412.32
$464.27
$648.82
$985.94		 $726.56
$824.64
$928.54
$1,297.64
$1,971.88		 $1,004.47
$1,102.55
$1,206.45
$1,575.55		 $1,282.38
$1,380.46
$1,484.36
$1,853.46		 $1,560.29
$1,658.37
$1,762.27
$2,131.37		 $641.19
$690.23
$742.18
$926.73		 $919.10
$968.14
$1,020.09
$1,204.64		 $1,197.01
$1,246.05
$1,298.00
$1,482.55		 $331.67

Plan: (HMO) Anthem Gold Pathway X Guided Access HMO 1300

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $1,300 : Family: $3,900
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $532.05
$603.88
$679.96
$950.24
$1,443.98		 $1,064.10
$1,207.76
$1,359.92
$1,900.48
$2,887.96		 $1,471.12
$1,614.78
$1,766.94
$2,307.50		 $1,878.14
$2,021.80
$2,173.96
$2,714.52		 $2,285.16
$2,428.82
$2,580.98
$3,121.54		 $939.07
$1,010.90
$1,086.98
$1,357.26		 $1,346.09
$1,417.92
$1,494.00
$1,764.28		 $1,753.11
$1,824.94
$1,901.02
$2,171.30		 $485.76

Plan: (HMO) Anthem Bronze Pathway X Guided Access HMO 4600 Online Plus

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $4,600 : Family: $9,200
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Bronze 21
30
40
50
60		 $279.59
$317.33
$357.32
$499.35
$758.81		 $559.18
$634.66
$714.64
$998.70
$1,517.62		 $773.07
$848.55
$928.53
$1,212.59		 $986.96
$1,062.44
$1,142.42
$1,426.48		 $1,200.85
$1,276.33
$1,356.31
$1,640.37		 $493.48
$531.22
$571.21
$713.24		 $707.37
$745.11
$785.10
$927.13		 $921.26
$959.00
$998.99
$1,141.02		 $255.27

Plan: (HMO) Anthem Silver Pathway X Guided Access HMO 2100 Online Plus

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $2,100 : Family: $4,200
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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		 $411.04
$466.53
$525.31
$734.12
$1,115.56		 $822.08
$933.06
$1,050.62
$1,468.24
$2,231.12		 $1,136.53
$1,247.51
$1,365.07
$1,782.69		 $1,450.98
$1,561.96
$1,679.52
$2,097.14		 $1,765.43
$1,876.41
$1,993.97
$2,411.59		 $725.49
$780.98
$839.76
$1,048.57		 $1,039.94
$1,095.43
$1,154.21
$1,363.02		 $1,354.39
$1,409.88
$1,468.66
$1,677.47		 $375.28

Plan: (HMO) Anthem Silver Pathway X Guided Access HMO 6000 30%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-738-6652 - Provider Directory for This Plan: (Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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		 $342.99
$389.29
$438.34
$612.58
$930.87		 $685.98
$778.58
$876.68
$1,225.16
$1,861.74		 $948.37
$1,040.97
$1,139.07
$1,487.55		 $1,210.76
$1,303.36
$1,401.46
$1,749.94		 $1,473.15
$1,565.75
$1,663.85
$2,012.33		 $605.38
$651.68
$700.73
$874.97		 $867.77
$914.07
$963.12
$1,137.36		 $1,130.16
$1,176.46
$1,225.51
$1,399.75		 $313.15
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Ambetter of Peach State Inc.

Local: 1-877-687-1180 | Toll Free: 1-877-687-1180

TTY: 1-877-941-9231

Plan: (HMO) Ambetter Secure Care 1 (2019) with 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $388.62
$441.07
$496.64
$694.06
$1,054.69		 $777.24
$882.14
$993.28
$1,388.12
$2,109.38		 $1,074.53
$1,179.43
$1,290.57
$1,685.41		 $1,371.82
$1,476.72
$1,587.86
$1,982.70		 $1,669.11
$1,774.01
$1,885.15
$2,279.99		 $685.91
$738.36
$793.93
$991.35		 $983.20
$1,035.65
$1,091.22
$1,288.64		 $1,280.49
$1,332.94
$1,388.51
$1,585.93		 $354.80

Plan: (HMO) Ambetter Balanced Care 1 (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $376.32
$427.11
$480.92
$672.09
$1,021.30		 $752.64
$854.22
$961.84
$1,344.18
$2,042.60		 $1,040.52
$1,142.10
$1,249.72
$1,632.06		 $1,328.40
$1,429.98
$1,537.60
$1,919.94		 $1,616.28
$1,717.86
$1,825.48
$2,207.82		 $664.20
$714.99
$768.80
$959.97		 $952.08
$1,002.87
$1,056.68
$1,247.85		 $1,239.96
$1,290.75
$1,344.56
$1,535.73		 $343.57

Plan: (HMO) Ambetter Balanced Care 2 (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $371.98
$422.18
$475.37
$664.33
$1,009.52		 $743.96
$844.36
$950.74
$1,328.66
$2,019.04		 $1,028.51
$1,128.91
$1,235.29
$1,613.21		 $1,313.06
$1,413.46
$1,519.84
$1,897.76		 $1,597.61
$1,698.01
$1,804.39
$2,182.31		 $656.53
$706.73
$759.92
$948.88		 $941.08
$991.28
$1,044.47
$1,233.43		 $1,225.63
$1,275.83
$1,329.02
$1,517.98		 $339.61

Plan: (HMO) Ambetter Essential Care 1 (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $7,900 : Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Bronze 21
30
40
50
60		 $310.83
$352.78
$397.22
$555.12
$843.55		 $621.66
$705.56
$794.44
$1,110.24
$1,687.10		 $859.43
$943.33
$1,032.21
$1,348.01		 $1,097.20
$1,181.10
$1,269.98
$1,585.78		 $1,334.97
$1,418.87
$1,507.75
$1,823.55		 $548.60
$590.55
$634.99
$792.89		 $786.37
$828.32
$872.76
$1,030.66		 $1,024.14
$1,066.09
$1,110.53
$1,268.43		 $283.78

Plan: (HMO) Ambetter Balanced Care 4 (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $7,050 : Family: $14,100
Out of Pocket Maximum per year: Individual: $7,050 : Family: $14,100

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		 $361.84
$410.68
$462.42
$646.24
$982.02		 $723.68
$821.36
$924.84
$1,292.48
$1,964.04		 $1,000.48
$1,098.16
$1,201.64
$1,569.28		 $1,277.28
$1,374.96
$1,478.44
$1,846.08		 $1,554.08
$1,651.76
$1,755.24
$2,122.88		 $638.64
$687.48
$739.22
$923.04		 $915.44
$964.28
$1,016.02
$1,199.84		 $1,192.24
$1,241.08
$1,292.82
$1,476.64		 $330.36

Plan: (HMO) Ambetter Balanced Care 3 (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,750 : Family: $13,500

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		 $394.77
$448.05
$504.51
$705.04
$1,071.38		 $789.54
$896.10
$1,009.02
$1,410.08
$2,142.76		 $1,091.53
$1,198.09
$1,311.01
$1,712.07		 $1,393.52
$1,500.08
$1,613.00
$2,014.06		 $1,695.51
$1,802.07
$1,914.99
$2,316.05		 $696.76
$750.04
$806.50
$1,007.03		 $998.75
$1,052.03
$1,108.49
$1,309.02		 $1,300.74
$1,354.02
$1,410.48
$1,611.01		 $360.42

Plan: (HMO) Ambetter Balanced Care 11 (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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		 $344.11
$390.56
$439.77
$614.57
$933.90		 $688.22
$781.12
$879.54
$1,229.14
$1,867.80		 $951.46
$1,044.36
$1,142.78
$1,492.38		 $1,214.70
$1,307.60
$1,406.02
$1,755.62		 $1,477.94
$1,570.84
$1,669.26
$2,018.86		 $607.35
$653.80
$703.01
$877.81		 $870.59
$917.04
$966.25
$1,141.05		 $1,133.83
$1,180.28
$1,229.49
$1,404.29		 $314.17

Plan: (HMO) Ambetter Essential Care 2 HSA (2019)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

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

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $321.68
$365.10
$411.10
$574.50
$873.02		 $643.36
$730.20
$822.20
$1,149.00
$1,746.04		 $889.44
$976.28
$1,068.28
$1,395.08		 $1,135.52
$1,222.36
$1,314.36
$1,641.16		 $1,381.60
$1,468.44
$1,560.44
$1,887.24		 $567.76
$611.18
$657.18
$820.58		 $813.84
$857.26
$903.26
$1,066.66		 $1,059.92
$1,103.34
$1,149.34
$1,312.74		 $293.69

Plan: (HMO) Ambetter Balanced Care 1 (2019) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $380.78
$432.18
$486.63
$680.06
$1,033.42		 $761.56
$864.36
$973.26
$1,360.12
$2,066.84		 $1,052.85
$1,155.65
$1,264.55
$1,651.41		 $1,344.14
$1,446.94
$1,555.84
$1,942.70		 $1,635.43
$1,738.23
$1,847.13
$2,233.99		 $672.07
$723.47
$777.92
$971.35		 $963.36
$1,014.76
$1,069.21
$1,262.64		 $1,254.65
$1,306.05
$1,360.50
$1,553.93		 $347.65

Plan: (HMO) Ambetter Balanced Care 2 (2019) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $376.39
$427.19
$481.01
$672.22
$1,021.50		 $752.78
$854.38
$962.02
$1,344.44
$2,043.00		 $1,040.71
$1,142.31
$1,249.95
$1,632.37		 $1,328.64
$1,430.24
$1,537.88
$1,920.30		 $1,616.57
$1,718.17
$1,825.81
$2,208.23		 $664.32
$715.12
$768.94
$960.15		 $952.25
$1,003.05
$1,056.87
$1,248.08		 $1,240.18
$1,290.98
$1,344.80
$1,536.01		 $343.64

Plan: (HMO) Ambetter Balanced Care 3 (2019) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,750 : Family: $13,500

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		 $399.46
$453.37
$510.49
$713.41
$1,084.10		 $798.92
$906.74
$1,020.98
$1,426.82
$2,168.20		 $1,104.50
$1,212.32
$1,326.56
$1,732.40		 $1,410.08
$1,517.90
$1,632.14
$2,037.98		 $1,715.66
$1,823.48
$1,937.72
$2,343.56		 $705.04
$758.95
$816.07
$1,018.99		 $1,010.62
$1,064.53
$1,121.65
$1,324.57		 $1,316.20
$1,370.11
$1,427.23
$1,630.15		 $364.69

Plan: (HMO) Ambetter Balanced Care 1 (2019) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $393.21
$446.28
$502.50
$702.25
$1,067.13		 $786.42
$892.56
$1,005.00
$1,404.50
$2,134.26		 $1,087.22
$1,193.36
$1,305.80
$1,705.30		 $1,388.02
$1,494.16
$1,606.60
$2,006.10		 $1,688.82
$1,794.96
$1,907.40
$2,306.90		 $694.01
$747.08
$803.30
$1,003.05		 $994.81
$1,047.88
$1,104.10
$1,303.85		 $1,295.61
$1,348.68
$1,404.90
$1,604.65		 $358.99

Plan: (HMO) Ambetter Balanced Care 2 (2019) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $388.67
$441.13
$496.71
$694.15
$1,054.82		 $777.34
$882.26
$993.42
$1,388.30
$2,109.64		 $1,074.66
$1,179.58
$1,290.74
$1,685.62		 $1,371.98
$1,476.90
$1,588.06
$1,982.94		 $1,669.30
$1,774.22
$1,885.38
$2,280.26		 $685.99
$738.45
$794.03
$991.47		 $983.31
$1,035.77
$1,091.35
$1,288.79		 $1,280.63
$1,333.09
$1,388.67
$1,586.11		 $354.85

Plan: (HMO) Ambetter Balanced Care 3 (2019) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1180 - Provider Directory for This Plan: (Ambetter of Peach State Inc.)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,750 : Family: $13,500

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		 $412.49
$468.16
$527.15
$736.69
$1,119.46		 $824.98
$936.32
$1,054.30
$1,473.38
$2,238.92		 $1,140.53
$1,251.87
$1,369.85
$1,788.93		 $1,456.08
$1,567.42
$1,685.40
$2,104.48		 $1,771.63
$1,882.97
$2,000.95
$2,420.03		 $728.04
$783.71
$842.70
$1,052.24		 $1,043.59
$1,099.26
$1,158.25
$1,367.79		 $1,359.14
$1,414.81
$1,473.80
$1,683.34		 $376.59
ADVERTISEMENT

Kaiser Foundation Health Plan of Georgia

Local: 1-800-494-5314 | Toll Free: 1-800-494-5314

Plan: (HMO) KP GA Gold 500/20

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $500 : Family: $1,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $518.12
$588.06
$662.15
$925.35
$1,406.16		 $1,036.24
$1,176.12
$1,324.30
$1,850.70
$2,812.32		 $1,432.60
$1,572.48
$1,720.66
$2,247.06		 $1,828.96
$1,968.84
$2,117.02
$2,643.42		 $2,225.32
$2,365.20
$2,513.38
$3,039.78		 $914.48
$984.42
$1,058.51
$1,321.71		 $1,310.84
$1,380.78
$1,454.87
$1,718.07		 $1,707.20
$1,777.14
$1,851.23
$2,114.43		 $473.04

Plan: (HMO) KP GA Silver 3000/30

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $490.17
$556.34
$626.44
$875.44
$1,330.32		 $980.34
$1,112.68
$1,252.88
$1,750.88
$2,660.64		 $1,355.32
$1,487.66
$1,627.86
$2,125.86		 $1,730.30
$1,862.64
$2,002.84
$2,500.84		 $2,105.28
$2,237.62
$2,377.82
$2,875.82		 $865.15
$931.32
$1,001.42
$1,250.42		 $1,240.13
$1,306.30
$1,376.40
$1,625.40		 $1,615.11
$1,681.28
$1,751.38
$2,000.38		 $447.53

Plan: (HMO) KP GA Silver 3200/20% HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $3,200 : Family: $6,400
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $468.64
$531.91
$598.93
$837.00
$1,271.90		 $937.28
$1,063.82
$1,197.86
$1,674.00
$2,543.80		 $1,295.79
$1,422.33
$1,556.37
$2,032.51		 $1,654.30
$1,780.84
$1,914.88
$2,391.02		 $2,012.81
$2,139.35
$2,273.39
$2,749.53		 $827.15
$890.42
$957.44
$1,195.51		 $1,185.66
$1,248.93
$1,315.95
$1,554.02		 $1,544.17
$1,607.44
$1,674.46
$1,912.53		 $427.87

Plan: (HMO) KP GA Bronze 5000/50

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Expanded Bronze 21
30
40
50
60		 $369.29
$419.14
$471.95
$659.55
$1,002.25		 $738.58
$838.28
$943.90
$1,319.10
$2,004.50		 $1,021.09
$1,120.79
$1,226.41
$1,601.61		 $1,303.60
$1,403.30
$1,508.92
$1,884.12		 $1,586.11
$1,685.81
$1,791.43
$2,166.63		 $651.80
$701.65
$754.46
$942.06		 $934.31
$984.16
$1,036.97
$1,224.57		 $1,216.82
$1,266.67
$1,319.48
$1,507.08		 $337.16

Plan: (HMO) KP GA Bronze 6200/40%/HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

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

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $363.18
$412.21
$464.14
$648.64
$985.67		 $726.36
$824.42
$928.28
$1,297.28
$1,971.34		 $1,004.19
$1,102.25
$1,206.11
$1,575.11		 $1,282.02
$1,380.08
$1,483.94
$1,852.94		 $1,559.85
$1,657.91
$1,761.77
$2,130.77		 $641.01
$690.04
$741.97
$926.47		 $918.84
$967.87
$1,019.80
$1,204.30		 $1,196.67
$1,245.70
$1,297.63
$1,482.13		 $331.58

Plan: (HMO) KP GA Catastrophic 7900/0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $7,900 : Family: $15,800
Out of Pocket Maximum per year: Individual: $7,900 : Family: $15,800

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
Catastrophic 21
30
40
50
60		 $320.23
$363.47
$409.26
$571.94
$869.11		 $640.46
$726.94
$818.52
$1,143.88
$1,738.22		 $885.44
$971.92
$1,063.50
$1,388.86		 $1,130.42
$1,216.90
$1,308.48
$1,633.84		 $1,375.40
$1,461.88
$1,553.46
$1,878.82		 $565.21
$608.45
$654.24
$816.92		 $810.19
$853.43
$899.22
$1,061.90		 $1,055.17
$1,098.41
$1,144.20
$1,306.88		 $292.37

Plan: (HMO) KP GA Gold 1500/20

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $503.12
$571.04
$642.99
$898.58
$1,365.47		 $1,006.24
$1,142.08
$1,285.98
$1,797.16
$2,730.94		 $1,391.13
$1,526.97
$1,670.87
$2,182.05		 $1,776.02
$1,911.86
$2,055.76
$2,566.94		 $2,160.91
$2,296.75
$2,440.65
$2,951.83		 $888.01
$955.93
$1,027.88
$1,283.47		 $1,272.90
$1,340.82
$1,412.77
$1,668.36		 $1,657.79
$1,725.71
$1,797.66
$2,053.25		 $459.35

Plan: (HMO) KP GA Silver 4700/35

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-494-5314 - Provider Directory for This Plan: (Kaiser Foundation Health Plan of Georgia)

Deductible: Individual: $4,700 : Family: $9,400
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $454.50
$515.86
$580.85
$811.74
$1,233.51		 $909.00
$1,031.72
$1,161.70
$1,623.48
$2,467.02		 $1,256.69
$1,379.41
$1,509.39
$1,971.17		 $1,604.38
$1,727.10
$1,857.08
$2,318.86		 $1,952.07
$2,074.79
$2,204.77
$2,666.55		 $802.19
$863.55
$928.54
$1,159.43		 $1,149.88
$1,211.24
$1,276.23
$1,507.12		 $1,497.57
$1,558.93
$1,623.92
$1,854.81		 $414.96

‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Fayette County here.

 

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