Obamacare 2020 Rates and Health Insurance Providers for Dodge County , Wisconsin
Obamacare > Rates > Wisconsin > Dodge County
Obamacare Rates and Providers for Other Years
Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Dodge County, WI.
The health insurance rates listed below are for calendar year 2020.
Obamacare Providers, Plans and 2020 Rates for Dodge County, Wisconsin
Below, you’ll find a summary of the 72 plans for Dodge County, Wisconsin 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 take one of the following actions:
The table below shows premiums for the following profiles at various ages:
- Individuals
- Couples
- Couples with 1, 2, or 3 children
- Individuals with 1, 2, or 3 children
- A child alone
Each plan links to the insurance provider's website. You can find the following:
- Summary of plan benefits and costs
- Plan brochure
- Provider Directory where you can find out which doctors and hospitals in the Beaver Dam, WI area accept this insurance coverage as within the plan's network.
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
2020 Obamacare Rates, Providers, and Plans for Dodge County
ADVERTISEMENT
|
|||||||||||||||||||
Quartz Health Benefit Plans CorporationLocal: 1-608-644-3430 | Toll Free: 1-800-362-3310 | TTY: 1-800-877-8973 |
|||||||||||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I302 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$427.09 $484.74 $545.82 $762.78 $1,159.12 |
$854.18 $969.48 $1,091.64 $1,525.56 $2,318.24 |
$1,180.90 $1,296.20 $1,418.36 $1,852.28 |
$1,507.62 $1,622.92 $1,745.08 $2,179.00 |
$1,834.34 $1,949.64 $2,071.80 $2,505.72 |
$753.81 $811.46 $872.54 $1,089.50 |
$1,080.53 $1,138.18 $1,199.26 $1,416.22 |
$1,407.25 $1,464.90 $1,525.98 $1,742.94 |
$326.72 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I303 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$415.25 $471.31 $530.69 $741.63 $1,126.98 |
$830.50 $942.62 $1,061.38 $1,483.26 $2,253.96 |
$1,148.16 $1,260.28 $1,379.04 $1,800.92 |
$1,465.82 $1,577.94 $1,696.70 $2,118.58 |
$1,783.48 $1,895.60 $2,014.36 $2,436.24 |
$732.91 $788.97 $848.35 $1,059.29 |
$1,050.57 $1,106.63 $1,166.01 $1,376.95 |
$1,368.23 $1,424.29 $1,483.67 $1,694.61 |
$317.66 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz Prime Gold I402 Maintenance with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$394.89 $448.19 $504.66 $705.26 $1,071.72 |
$789.78 $896.38 $1,009.32 $1,410.52 $2,143.44 |
$1,091.87 $1,198.47 $1,311.41 $1,712.61 |
$1,393.96 $1,500.56 $1,613.50 $2,014.70 |
$1,696.05 $1,802.65 $1,915.59 $2,316.79 |
$696.98 $750.28 $806.75 $1,007.35 |
$999.07 $1,052.37 $1,108.84 $1,309.44 |
$1,301.16 $1,354.46 $1,410.93 $1,611.53 |
$302.09 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz Prime Gold I401 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$389.83 $442.45 $498.19 $696.22 $1,057.98 |
$779.66 $884.90 $996.38 $1,392.44 $2,115.96 |
$1,077.87 $1,183.11 $1,294.59 $1,690.65 |
$1,376.08 $1,481.32 $1,592.80 $1,988.86 |
$1,674.29 $1,779.53 $1,891.01 $2,287.07 |
$688.04 $740.66 $796.40 $994.43 |
$986.25 $1,038.87 $1,094.61 $1,292.64 |
$1,284.46 $1,337.08 $1,392.82 $1,590.85 |
$298.21 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I301 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$4,300
| Family:
$8,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$429.00 $486.91 $548.26 $766.19 $1,164.30 |
$858.00 $973.82 $1,096.52 $1,532.38 $2,328.60 |
$1,186.18 $1,302.00 $1,424.70 $1,860.56 |
$1,514.36 $1,630.18 $1,752.88 $2,188.74 |
$1,842.54 $1,958.36 $2,081.06 $2,516.92 |
$757.18 $815.09 $876.44 $1,094.37 |
$1,085.36 $1,143.27 $1,204.62 $1,422.55 |
$1,413.54 $1,471.45 $1,532.80 $1,750.73 |
$328.18 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz Prime Bronze I201 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$291.51 $330.86 $372.54 $520.62 $791.14 |
$583.02 $661.72 $745.08 $1,041.24 $1,582.28 |
$806.02 $884.72 $968.08 $1,264.24 |
$1,029.02 $1,107.72 $1,191.08 $1,487.24 |
$1,252.02 $1,330.72 $1,414.08 $1,710.24 |
$514.51 $553.86 $595.54 $743.62 |
$737.51 $776.86 $818.54 $966.62 |
$960.51 $999.86 $1,041.54 $1,189.62 |
$223.00 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz Prime Bronze I202 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$298.36 $338.63 $381.29 $532.86 $809.73 |
$596.72 $677.26 $762.58 $1,065.72 $1,619.46 |
$824.96 $905.50 $990.82 $1,293.96 |
$1,053.20 $1,133.74 $1,219.06 $1,522.20 |
$1,281.44 $1,361.98 $1,447.30 $1,750.44 |
$526.60 $566.87 $609.53 $761.10 |
$754.84 $795.11 $837.77 $989.34 |
$983.08 $1,023.35 $1,066.01 $1,217.58 |
$228.24 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I302
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$407.21 $462.18 $520.41 $727.27 $1,105.15 |
$814.42 $924.36 $1,040.82 $1,454.54 $2,210.30 |
$1,125.93 $1,235.87 $1,352.33 $1,766.05 |
$1,437.44 $1,547.38 $1,663.84 $2,077.56 |
$1,748.95 $1,858.89 $1,975.35 $2,389.07 |
$718.72 $773.69 $831.92 $1,038.78 |
$1,030.23 $1,085.20 $1,143.43 $1,350.29 |
$1,341.74 $1,396.71 $1,454.94 $1,661.80 |
$311.51 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I303
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$395.92 $449.36 $505.98 $707.11 $1,074.52 |
$791.84 $898.72 $1,011.96 $1,414.22 $2,149.04 |
$1,094.72 $1,201.60 $1,314.84 $1,717.10 |
$1,397.60 $1,504.48 $1,617.72 $2,019.98 |
$1,700.48 $1,807.36 $1,920.60 $2,322.86 |
$698.80 $752.24 $808.86 $1,009.99 |
$1,001.68 $1,055.12 $1,111.74 $1,312.87 |
$1,304.56 $1,358.00 $1,414.62 $1,615.75 |
$302.88 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz Prime Gold I402 Maintenance
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$376.51 $427.33 $481.17 $672.43 $1,021.82 |
$753.02 $854.66 $962.34 $1,344.86 $2,043.64 |
$1,041.04 $1,142.68 $1,250.36 $1,632.88 |
$1,329.06 $1,430.70 $1,538.38 $1,920.90 |
$1,617.08 $1,718.72 $1,826.40 $2,208.92 |
$664.53 $715.35 $769.19 $960.45 |
$952.55 $1,003.37 $1,057.21 $1,248.47 |
$1,240.57 $1,291.39 $1,345.23 $1,536.49 |
$288.02 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz Prime Gold I401
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$371.68 $421.85 $475.00 $663.81 $1,008.72 |
$743.36 $843.70 $950.00 $1,327.62 $2,017.44 |
$1,027.69 $1,128.03 $1,234.33 $1,611.95 |
$1,312.02 $1,412.36 $1,518.66 $1,896.28 |
$1,596.35 $1,696.69 $1,802.99 $2,180.61 |
$656.01 $706.18 $759.33 $948.14 |
$940.34 $990.51 $1,043.66 $1,232.47 |
$1,224.67 $1,274.84 $1,327.99 $1,516.80 |
$284.33 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I301
Annual Out of Pocket Expenses
Deductible: Individual:
$4,300
| Family:
$8,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$409.03 $464.24 $522.73 $730.52 $1,110.10 |
$818.06 $928.48 $1,045.46 $1,461.04 $2,220.20 |
$1,130.96 $1,241.38 $1,358.36 $1,773.94 |
$1,443.86 $1,554.28 $1,671.26 $2,086.84 |
$1,756.76 $1,867.18 $1,984.16 $2,399.74 |
$721.93 $777.14 $835.63 $1,043.42 |
$1,034.83 $1,090.04 $1,148.53 $1,356.32 |
$1,347.73 $1,402.94 $1,461.43 $1,669.22 |
$312.90 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz Prime Bronze I201
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$277.94 $315.45 $355.20 $496.39 $754.31 |
$555.88 $630.90 $710.40 $992.78 $1,508.62 |
$768.50 $843.52 $923.02 $1,205.40 |
$981.12 $1,056.14 $1,135.64 $1,418.02 |
$1,193.74 $1,268.76 $1,348.26 $1,630.64 |
$490.56 $528.07 $567.82 $709.01 |
$703.18 $740.69 $780.44 $921.63 |
$915.80 $953.31 $993.06 $1,134.25 |
$212.62 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz Prime Bronze I202
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$284.47 $322.86 $363.54 $508.05 $772.03 |
$568.94 $645.72 $727.08 $1,016.10 $1,544.06 |
$786.55 $863.33 $944.69 $1,233.71 |
$1,004.16 $1,080.94 $1,162.30 $1,451.32 |
$1,221.77 $1,298.55 $1,379.91 $1,668.93 |
$502.08 $540.47 $581.15 $725.66 |
$719.69 $758.08 $798.76 $943.27 |
$937.30 $975.69 $1,016.37 $1,160.88 |
$217.61 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz Prime Gold I404 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$392.18 $445.11 $501.19 $700.42 $1,064.35 |
$784.36 $890.22 $1,002.38 $1,400.84 $2,128.70 |
$1,084.37 $1,190.23 $1,302.39 $1,700.85 |
$1,384.38 $1,490.24 $1,602.40 $2,000.86 |
$1,684.39 $1,790.25 $1,902.41 $2,300.87 |
$692.19 $745.12 $801.20 $1,000.43 |
$992.20 $1,045.13 $1,101.21 $1,300.44 |
$1,292.21 $1,345.14 $1,401.22 $1,600.45 |
$300.01 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz Prime Bronze I203 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$6,750
| Family:
$13,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$288.50 $327.44 $368.69 $515.25 $782.97 |
$577.00 $654.88 $737.38 $1,030.50 $1,565.94 |
$797.70 $875.58 $958.08 $1,251.20 |
$1,018.40 $1,096.28 $1,178.78 $1,471.90 |
$1,239.10 $1,316.98 $1,399.48 $1,692.60 |
$509.20 $548.14 $589.39 $735.95 |
$729.90 $768.84 $810.09 $956.65 |
$950.60 $989.54 $1,030.79 $1,177.35 |
$220.70 | ||||||||||
Catastrophic |
|||||||||||||||||||
(HMO) Quartz Prime Catastrophic I101
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$211.73 $240.31 $270.59 $378.15 $574.63 |
$423.46 $480.62 $541.18 $756.30 $1,149.26 |
$585.43 $642.59 $703.15 $918.27 |
$747.40 $804.56 $865.12 $1,080.24 |
$909.37 $966.53 $1,027.09 $1,242.21 |
$373.70 $402.28 $432.56 $540.12 |
$535.67 $564.25 $594.53 $702.09 |
$697.64 $726.22 $756.50 $864.06 |
$161.97 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz Prime Silver I304 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$5,250
| Family:
$10,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$428.62 $486.48 $547.77 $765.51 $1,163.27 |
$857.24 $972.96 $1,095.54 $1,531.02 $2,326.54 |
$1,185.13 $1,300.85 $1,423.43 $1,858.91 |
$1,513.02 $1,628.74 $1,751.32 $2,186.80 |
$1,840.91 $1,956.63 $2,079.21 $2,514.69 |
$756.51 $814.37 $875.66 $1,093.40 |
$1,084.40 $1,142.26 $1,203.55 $1,421.29 |
$1,412.29 $1,470.15 $1,531.44 $1,749.18 |
$327.89 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz Prime Gold I403 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$3,000
| Family:
$6,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$395.64 $449.05 $505.62 $706.60 $1,073.75 |
$791.28 $898.10 $1,011.24 $1,413.20 $2,147.50 |
$1,093.94 $1,200.76 $1,313.90 $1,715.86 |
$1,396.60 $1,503.42 $1,616.56 $2,018.52 |
$1,699.26 $1,806.08 $1,919.22 $2,321.18 |
$698.30 $751.71 $808.28 $1,009.26 |
$1,000.96 $1,054.37 $1,110.94 $1,311.92 |
$1,303.62 $1,357.03 $1,413.60 $1,614.58 |
$302.66 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
Security Health Plan of Wisconsin, Inc.Local: 1-715-221-9258x19258 | Toll Free: 1-844-293-9624 | TTY: 1-877-727-2232 |
|||||||||||||||||||
Catastrophic |
|||||||||||||||||||
(EPO) Select Protection
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$226.82 $257.43 $289.87 $405.09 $615.57 |
$453.64 $514.86 $579.74 $810.18 $1,231.14 |
$627.15 $688.37 $753.25 $983.69 |
$800.66 $861.88 $926.76 $1,157.20 |
$974.17 $1,035.39 $1,100.27 $1,330.71 |
$400.33 $430.94 $463.38 $578.60 |
$573.84 $604.45 $636.89 $752.11 |
$747.35 $777.96 $810.40 $925.62 |
$173.51 | ||||||||||
Bronze |
|||||||||||||||||||
(EPO) Select $8,150
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$331.61 $376.37 $423.78 $592.24 $899.96 |
$663.22 $752.74 $847.56 $1,184.48 $1,799.92 |
$916.89 $1,006.41 $1,101.23 $1,438.15 |
$1,170.56 $1,260.08 $1,354.90 $1,691.82 |
$1,424.23 $1,513.75 $1,608.57 $1,945.49 |
$585.28 $630.04 $677.45 $845.91 |
$838.95 $883.71 $931.12 $1,099.58 |
$1,092.62 $1,137.38 $1,184.79 $1,353.25 |
$253.67 | ||||||||||
Silver |
|||||||||||||||||||
(EPO) Select $7,100 - 30%
Annual Out of Pocket Expenses
Deductible: Individual:
$7,100
| Family:
$14,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$522.28 $592.78 $667.46 $932.77 $1,417.44 |
$1,044.56 $1,185.56 $1,334.92 $1,865.54 $2,834.88 |
$1,444.10 $1,585.10 $1,734.46 $2,265.08 |
$1,843.64 $1,984.64 $2,134.00 $2,664.62 |
$2,243.18 $2,384.18 $2,533.54 $3,064.16 |
$921.82 $992.32 $1,067.00 $1,332.31 |
$1,321.36 $1,391.86 $1,466.54 $1,731.85 |
$1,720.90 $1,791.40 $1,866.08 $2,131.39 |
$399.54 | ||||||||||
Gold |
|||||||||||||||||||
(EPO) Select $3,500 - 30%
Annual Out of Pocket Expenses
Deductible: Individual:
$3,500
| Family:
$7,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$447.01 $507.34 $571.26 $798.34 $1,213.15 |
$894.02 $1,014.68 $1,142.52 $1,596.68 $2,426.30 |
$1,235.97 $1,356.63 $1,484.47 $1,938.63 |
$1,577.92 $1,698.58 $1,826.42 $2,280.58 |
$1,919.87 $2,040.53 $2,168.37 $2,622.53 |
$788.96 $849.29 $913.21 $1,140.29 |
$1,130.91 $1,191.24 $1,255.16 $1,482.24 |
$1,472.86 $1,533.19 $1,597.11 $1,824.19 |
$341.95 | ||||||||||
Silver |
|||||||||||||||||||
(EPO) Select $4,500 HDHP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,500
| Family:
$9,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$538.86 $611.59 $688.65 $962.39 $1,462.44 |
$1,077.72 $1,223.18 $1,377.30 $1,924.78 $2,924.88 |
$1,489.94 $1,635.40 $1,789.52 $2,337.00 |
$1,902.16 $2,047.62 $2,201.74 $2,749.22 |
$2,314.38 $2,459.84 $2,613.96 $3,161.44 |
$951.08 $1,023.81 $1,100.87 $1,374.61 |
$1,363.30 $1,436.03 $1,513.09 $1,786.83 |
$1,775.52 $1,848.25 $1,925.31 $2,199.05 |
$412.22 | ||||||||||
Bronze |
|||||||||||||||||||
(EPO) Select $7,000
Annual Out of Pocket Expenses
Deductible: Individual:
$7,000
| Family:
$14,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$337.58 $383.14 $431.41 $602.90 $916.16 |
$675.16 $766.28 $862.82 $1,205.80 $1,832.32 |
$933.40 $1,024.52 $1,121.06 $1,464.04 |
$1,191.64 $1,282.76 $1,379.30 $1,722.28 |
$1,449.88 $1,541.00 $1,637.54 $1,980.52 |
$595.82 $641.38 $689.65 $861.14 |
$854.06 $899.62 $947.89 $1,119.38 |
$1,112.30 $1,157.86 $1,206.13 $1,377.62 |
$258.24 | ||||||||||
Silver |
|||||||||||||||||||
(EPO) Select $4,800 - 30%
Annual Out of Pocket Expenses
Deductible: Individual:
$4,800
| Family:
$9,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$522.94 $593.53 $668.31 $933.96 $1,419.24 |
$1,045.88 $1,187.06 $1,336.62 $1,867.92 $2,838.48 |
$1,445.92 $1,587.10 $1,736.66 $2,267.96 |
$1,845.96 $1,987.14 $2,136.70 $2,668.00 |
$2,246.00 $2,387.18 $2,536.74 $3,068.04 |
$922.98 $993.57 $1,068.35 $1,334.00 |
$1,323.02 $1,393.61 $1,468.39 $1,734.04 |
$1,723.06 $1,793.65 $1,868.43 $2,134.08 |
$400.04 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(EPO) Select $6,000 HDHP
Annual Out of Pocket Expenses
Deductible: Individual:
$6,000
| Family:
$12,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$363.11 $412.12 $464.04 $648.50 $985.46 |
$726.22 $824.24 $928.08 $1,297.00 $1,970.92 |
$1,003.99 $1,102.01 $1,205.85 $1,574.77 |
$1,281.76 $1,379.78 $1,483.62 $1,852.54 |
$1,559.53 $1,657.55 $1,761.39 $2,130.31 |
$640.88 $689.89 $741.81 $926.27 |
$918.65 $967.66 $1,019.58 $1,204.04 |
$1,196.42 $1,245.43 $1,297.35 $1,481.81 |
$277.77 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
Dean Health PlanLocal: 1-608-828-1302 | Toll Free: 1-800-279-1302 | TTY: 1-800-947-3529 |
|||||||||||||||||||
Catastrophic |
|||||||||||||||||||
(HMO) Dean Catastrophic Safety Net
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$221.15 $251.01 $282.63 $394.98 $600.21 |
$442.30 $502.02 $565.26 $789.96 $1,200.42 |
$611.48 $671.20 $734.44 $959.14 |
$780.66 $840.38 $903.62 $1,128.32 |
$949.84 $1,009.56 $1,072.80 $1,297.50 |
$390.33 $420.19 $451.81 $564.16 |
$559.51 $589.37 $620.99 $733.34 |
$728.69 $758.55 $790.17 $902.52 |
$169.18 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver Copay Plus 4400X
Annual Out of Pocket Expenses
Deductible: Individual:
$4,400
| Family:
$8,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$429.11 $487.04 $548.40 $766.38 $1,164.59 |
$858.22 $974.08 $1,096.80 $1,532.76 $2,329.18 |
$1,186.49 $1,302.35 $1,425.07 $1,861.03 |
$1,514.76 $1,630.62 $1,753.34 $2,189.30 |
$1,843.03 $1,958.89 $2,081.61 $2,517.57 |
$757.38 $815.31 $876.67 $1,094.65 |
$1,085.65 $1,143.58 $1,204.94 $1,422.92 |
$1,413.92 $1,471.85 $1,533.21 $1,751.19 |
$328.27 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver Classic 5000X
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$416.05 $472.21 $531.71 $743.06 $1,129.15 |
$832.10 $944.42 $1,063.42 $1,486.12 $2,258.30 |
$1,150.38 $1,262.70 $1,381.70 $1,804.40 |
$1,468.66 $1,580.98 $1,699.98 $2,122.68 |
$1,786.94 $1,899.26 $2,018.26 $2,440.96 |
$734.33 $790.49 $849.99 $1,061.34 |
$1,052.61 $1,108.77 $1,168.27 $1,379.62 |
$1,370.89 $1,427.05 $1,486.55 $1,697.90 |
$318.28 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver Value Copay 5000X
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$426.20 $483.74 $544.68 $761.19 $1,156.71 |
$852.40 $967.48 $1,089.36 $1,522.38 $2,313.42 |
$1,178.44 $1,293.52 $1,415.40 $1,848.42 |
$1,504.48 $1,619.56 $1,741.44 $2,174.46 |
$1,830.52 $1,945.60 $2,067.48 $2,500.50 |
$752.24 $809.78 $870.72 $1,087.23 |
$1,078.28 $1,135.82 $1,196.76 $1,413.27 |
$1,404.32 $1,461.86 $1,522.80 $1,739.31 |
$326.04 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Dean Gold Value Copay 3700X
Annual Out of Pocket Expenses
Deductible: Individual:
$3,700
| Family:
$7,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$418.92 $475.47 $535.38 $748.19 $1,136.94 |
$837.84 $950.94 $1,070.76 $1,496.38 $2,273.88 |
$1,158.31 $1,271.41 $1,391.23 $1,816.85 |
$1,478.78 $1,591.88 $1,711.70 $2,137.32 |
$1,799.25 $1,912.35 $2,032.17 $2,457.79 |
$739.39 $795.94 $855.85 $1,068.66 |
$1,059.86 $1,116.41 $1,176.32 $1,389.13 |
$1,380.33 $1,436.88 $1,496.79 $1,709.60 |
$320.47 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Dean Bronze Value Copay 8100X
Annual Out of Pocket Expenses
Deductible: Individual:
$8,100
| Family:
$16,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$294.99 $334.81 $376.99 $526.85 $800.59 |
$589.98 $669.62 $753.98 $1,053.70 $1,601.18 |
$815.64 $895.28 $979.64 $1,279.36 |
$1,041.30 $1,120.94 $1,205.30 $1,505.02 |
$1,266.96 $1,346.60 $1,430.96 $1,730.68 |
$520.65 $560.47 $602.65 $752.51 |
$746.31 $786.13 $828.31 $978.17 |
$971.97 $1,011.79 $1,053.97 $1,203.83 |
$225.66 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver HSA-E 4000X
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$409.99 $465.34 $523.97 $732.24 $1,112.72 |
$819.98 $930.68 $1,047.94 $1,464.48 $2,225.44 |
$1,133.62 $1,244.32 $1,361.58 $1,778.12 |
$1,447.26 $1,557.96 $1,675.22 $2,091.76 |
$1,760.90 $1,871.60 $1,988.86 $2,405.40 |
$723.63 $778.98 $837.61 $1,045.88 |
$1,037.27 $1,092.62 $1,151.25 $1,359.52 |
$1,350.91 $1,406.26 $1,464.89 $1,673.16 |
$313.64 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Dean Gold Copay Plus 1500X
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$438.45 $497.64 $560.34 $783.08 $1,189.96 |
$876.90 $995.28 $1,120.68 $1,566.16 $2,379.92 |
$1,212.32 $1,330.70 $1,456.10 $1,901.58 |
$1,547.74 $1,666.12 $1,791.52 $2,237.00 |
$1,883.16 $2,001.54 $2,126.94 $2,572.42 |
$773.87 $833.06 $895.76 $1,118.50 |
$1,109.29 $1,168.48 $1,231.18 $1,453.92 |
$1,444.71 $1,503.90 $1,566.60 $1,789.34 |
$335.42 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Dean Bronze HSA-E 6700X
Annual Out of Pocket Expenses
Deductible: Individual:
$6,700
| Family:
$13,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$292.64 $332.15 $373.99 $522.66 $794.23 |
$585.28 $664.30 $747.98 $1,045.32 $1,588.46 |
$809.15 $888.17 $971.85 $1,269.19 |
$1,033.02 $1,112.04 $1,195.72 $1,493.06 |
$1,256.89 $1,335.91 $1,419.59 $1,716.93 |
$516.51 $556.02 $597.86 $746.53 |
$740.38 $779.89 $821.73 $970.40 |
$964.25 $1,003.76 $1,045.60 $1,194.27 |
$223.87 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Dean Bronze Copay Plus 8100X
Annual Out of Pocket Expenses
Deductible: Individual:
$8,100
| Family:
$16,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$302.37 $343.19 $386.43 $540.04 $820.64 |
$604.74 $686.38 $772.86 $1,080.08 $1,641.28 |
$836.06 $917.70 $1,004.18 $1,311.40 |
$1,067.38 $1,149.02 $1,235.50 $1,542.72 |
$1,298.70 $1,380.34 $1,466.82 $1,774.04 |
$533.69 $574.51 $617.75 $771.36 |
$765.01 $805.83 $849.07 $1,002.68 |
$996.33 $1,037.15 $1,080.39 $1,234.00 |
$231.32 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
Molina Healthcare of Wisconsin, Inc.Local: 1-888-560-2043 | Toll Free: 1-888-560-2043 |
|||||||||||||||||||
Gold |
|||||||||||||||||||
(HMO) Confident Care Gold 1
Annual Out of Pocket Expenses
Deductible: Individual:
$2,925
| Family:
$5,850 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$379.44 $430.66 $484.92 $677.67 $1,029.79 |
$758.88 $861.32 $969.84 $1,355.34 $2,059.58 |
$1,049.15 $1,151.59 $1,260.11 $1,645.61 |
$1,339.42 $1,441.86 $1,550.38 $1,935.88 |
$1,629.69 $1,732.13 $1,840.65 $2,226.15 |
$669.71 $720.93 $775.19 $967.94 |
$959.98 $1,011.20 $1,065.46 $1,258.21 |
$1,250.25 $1,301.47 $1,355.73 $1,548.48 |
$290.27 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Constant Care Silver 1
Annual Out of Pocket Expenses
Deductible: Individual:
$6,000
| Family:
$12,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$364.91 $414.18 $466.36 $651.74 $990.38 |
$729.82 $828.36 $932.72 $1,303.48 $1,980.76 |
$1,008.98 $1,107.52 $1,211.88 $1,582.64 |
$1,288.14 $1,386.68 $1,491.04 $1,861.80 |
$1,567.30 $1,665.84 $1,770.20 $2,140.96 |
$644.07 $693.34 $745.52 $930.90 |
$923.23 $972.50 $1,024.68 $1,210.06 |
$1,202.39 $1,251.66 $1,303.84 $1,489.22 |
$279.16 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Core Care Bronze 1
Annual Out of Pocket Expenses
Deductible: Individual:
$6,800
| Family:
$13,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$270.92 $307.50 $346.24 $483.87 $735.29 |
$541.84 $615.00 $692.48 $967.74 $1,470.58 |
$749.10 $822.26 $899.74 $1,175.00 |
$956.36 $1,029.52 $1,107.00 $1,382.26 |
$1,163.62 $1,236.78 $1,314.26 $1,589.52 |
$478.18 $514.76 $553.50 $691.13 |
$685.44 $722.02 $760.76 $898.39 |
$892.70 $929.28 $968.02 $1,105.65 |
$207.26 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Confident Care Gold 1 + Vision
Annual Out of Pocket Expenses
Deductible: Individual:
$2,925
| Family:
$5,850 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$382.38 $434.00 $488.68 $682.93 $1,037.77 |
$764.76 $868.00 $977.36 $1,365.86 $2,075.54 |
$1,057.28 $1,160.52 $1,269.88 $1,658.38 |
$1,349.80 $1,453.04 $1,562.40 $1,950.90 |
$1,642.32 $1,745.56 $1,854.92 $2,243.42 |
$674.90 $726.52 $781.20 $975.45 |
$967.42 $1,019.04 $1,073.72 $1,267.97 |
$1,259.94 $1,311.56 $1,366.24 $1,560.49 |
$292.52 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Constant Care Silver 1 + Vision
Annual Out of Pocket Expenses
Deductible: Individual:
$6,000
| Family:
$12,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$367.93 $417.60 $470.21 $657.12 $998.56 |
$735.86 $835.20 $940.42 $1,314.24 $1,997.12 |
$1,017.33 $1,116.67 $1,221.89 $1,595.71 |
$1,298.80 $1,398.14 $1,503.36 $1,877.18 |
$1,580.27 $1,679.61 $1,784.83 $2,158.65 |
$649.40 $699.07 $751.68 $938.59 |
$930.87 $980.54 $1,033.15 $1,220.06 |
$1,212.34 $1,262.01 $1,314.62 $1,501.53 |
$281.47 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Core Care Bronze 1 + Vision
Annual Out of Pocket Expenses
Deductible: Individual:
$6,800
| Family:
$13,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$273.87 $310.84 $350.00 $489.13 $743.27 |
$547.74 $621.68 $700.00 $978.26 $1,486.54 |
$757.25 $831.19 $909.51 $1,187.77 |
$966.76 $1,040.70 $1,119.02 $1,397.28 |
$1,176.27 $1,250.21 $1,328.53 $1,606.79 |
$483.38 $520.35 $559.51 $698.64 |
$692.89 $729.86 $769.02 $908.15 |
$902.40 $939.37 $978.53 $1,117.66 |
$209.51 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Constant Care Silver 2
Annual Out of Pocket Expenses
Deductible: Individual:
$6,500
| Family:
$13,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$353.63 $401.37 $451.94 $631.59 $959.76 |
$707.26 $802.74 $903.88 $1,263.18 $1,919.52 |
$977.79 $1,073.27 $1,174.41 $1,533.71 |
$1,248.32 $1,343.80 $1,444.94 $1,804.24 |
$1,518.85 $1,614.33 $1,715.47 $2,074.77 |
$624.16 $671.90 $722.47 $902.12 |
$894.69 $942.43 $993.00 $1,172.65 |
$1,165.22 $1,212.96 $1,263.53 $1,443.18 |
$270.53 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Core Care Bronze 2
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$258.20 $293.06 $329.98 $461.15 $700.76 |
$516.40 $586.12 $659.96 $922.30 $1,401.52 |
$713.93 $783.65 $857.49 $1,119.83 |
$911.46 $981.18 $1,055.02 $1,317.36 |
$1,108.99 $1,178.71 $1,252.55 $1,514.89 |
$455.73 $490.59 $527.51 $658.68 |
$653.26 $688.12 $725.04 $856.21 |
$850.79 $885.65 $922.57 $1,053.74 |
$197.53 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
WPS Health Plan, Inc.Local: 1-920-490-6900 | Toll Free: 1-800-332-6249 | TTY: 1-888-332-0144 |
|||||||||||||||||||
Bronze |
|||||||||||||||||||
(HMO) HMO Bronze 8150
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$335.85 $381.19 $429.22 $599.83 $911.50 |
$671.70 $762.38 $858.44 $1,199.66 $1,823.00 |
$928.63 $1,019.31 $1,115.37 $1,456.59 |
$1,185.56 $1,276.24 $1,372.30 $1,713.52 |
$1,442.49 $1,533.17 $1,629.23 $1,970.45 |
$592.78 $638.12 $686.15 $856.76 |
$849.71 $895.05 $943.08 $1,113.69 |
$1,106.64 $1,151.98 $1,200.01 $1,370.62 |
$256.93 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) HMO Bronze 6250 with 3 Free PCP Visits
Annual Out of Pocket Expenses
Deductible: Individual:
$6,250
| Family:
$12,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$349.59 $396.78 $446.78 $624.37 $948.79 |
$699.18 $793.56 $893.56 $1,248.74 $1,897.58 |
$966.62 $1,061.00 $1,161.00 $1,516.18 |
$1,234.06 $1,328.44 $1,428.44 $1,783.62 |
$1,501.50 $1,595.88 $1,695.88 $2,051.06 |
$617.03 $664.22 $714.22 $891.81 |
$884.47 $931.66 $981.66 $1,159.25 |
$1,151.91 $1,199.10 $1,249.10 $1,426.69 |
$267.44 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) HMO Bronze 7200
Annual Out of Pocket Expenses
Deductible: Individual:
$7,200
| Family:
$14,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$340.84 $386.85 $435.59 $608.74 $925.04 |
$681.68 $773.70 $871.18 $1,217.48 $1,850.08 |
$942.42 $1,034.44 $1,131.92 $1,478.22 |
$1,203.16 $1,295.18 $1,392.66 $1,738.96 |
$1,463.90 $1,555.92 $1,653.40 $1,999.70 |
$601.58 $647.59 $696.33 $869.48 |
$862.32 $908.33 $957.07 $1,130.22 |
$1,123.06 $1,169.07 $1,217.81 $1,390.96 |
$260.74 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) HMO Silver 7150
Annual Out of Pocket Expenses
Deductible: Individual:
$7,150
| Family:
$14,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$495.93 $562.88 $633.80 $885.73 $1,345.95 |
$991.86 $1,125.76 $1,267.60 $1,771.46 $2,691.90 |
$1,371.25 $1,505.15 $1,646.99 $2,150.85 |
$1,750.64 $1,884.54 $2,026.38 $2,530.24 |
$2,130.03 $2,263.93 $2,405.77 $2,909.63 |
$875.32 $942.27 $1,013.19 $1,265.12 |
$1,254.71 $1,321.66 $1,392.58 $1,644.51 |
$1,634.10 $1,701.05 $1,771.97 $2,023.90 |
$379.39 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) HMO Silver 4500
Annual Out of Pocket Expenses
Deductible: Individual:
$4,500
| Family:
$9,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$496.30 $563.30 $634.27 $886.39 $1,346.96 |
$992.60 $1,126.60 $1,268.54 $1,772.78 $2,693.92 |
$1,372.27 $1,506.27 $1,648.21 $2,152.45 |
$1,751.94 $1,885.94 $2,027.88 $2,532.12 |
$2,131.61 $2,265.61 $2,407.55 $2,911.79 |
$875.97 $942.97 $1,013.94 $1,266.06 |
$1,255.64 $1,322.64 $1,393.61 $1,645.73 |
$1,635.31 $1,702.31 $1,773.28 $2,025.40 |
$379.67 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) HMO Silver 5000 with 3 Free PCP Visits
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$515.95 $585.60 $659.38 $921.49 $1,400.29 |
$1,031.90 $1,171.20 $1,318.76 $1,842.98 $2,800.58 |
$1,426.60 $1,565.90 $1,713.46 $2,237.68 |
$1,821.30 $1,960.60 $2,108.16 $2,632.38 |
$2,216.00 $2,355.30 $2,502.86 $3,027.08 |
$910.65 $980.30 $1,054.08 $1,316.19 |
$1,305.35 $1,375.00 $1,448.78 $1,710.89 |
$1,700.05 $1,769.70 $1,843.48 $2,105.59 |
$394.70 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) HMO Gold 2250
Annual Out of Pocket Expenses
Deductible: Individual:
$2,250
| Family:
$4,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$694.06 $787.76 $887.01 $1,239.59 $1,883.68 |
$1,388.12 $1,575.52 $1,774.02 $2,479.18 $3,767.36 |
$1,919.08 $2,106.48 $2,304.98 $3,010.14 |
$2,450.04 $2,637.44 $2,835.94 $3,541.10 |
$2,981.00 $3,168.40 $3,366.90 $4,072.06 |
$1,225.02 $1,318.72 $1,417.97 $1,770.55 |
$1,755.98 $1,849.68 $1,948.93 $2,301.51 |
$2,286.94 $2,380.64 $2,479.89 $2,832.47 |
$530.96 | ||||||||||
Catastrophic |
|||||||||||||||||||
(HMO) HMO Catastrophic 8150 with 3 Free PCP Visits
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$291.84 $331.24 $372.97 $521.23 $792.05 |
$583.68 $662.48 $745.94 $1,042.46 $1,584.10 |
$806.94 $885.74 $969.20 $1,265.72 |
$1,030.20 $1,109.00 $1,192.46 $1,488.98 |
$1,253.46 $1,332.26 $1,415.72 $1,712.24 |
$515.10 $554.50 $596.23 $744.49 |
$738.36 $777.76 $819.49 $967.75 |
$961.62 $1,001.02 $1,042.75 $1,191.01 |
$223.26 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) HMO HDHP Bronze 6900
Annual Out of Pocket Expenses
Deductible: Individual:
$6,900
| Family:
$13,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$346.67 $393.47 $443.04 $619.15 $940.86 |
$693.34 $786.94 $886.08 $1,238.30 $1,881.72 |
$958.54 $1,052.14 $1,151.28 $1,503.50 |
$1,223.74 $1,317.34 $1,416.48 $1,768.70 |
$1,488.94 $1,582.54 $1,681.68 $2,033.90 |
$611.87 $658.67 $708.24 $884.35 |
$877.07 $923.87 $973.44 $1,149.55 |
$1,142.27 $1,189.07 $1,238.64 $1,414.75 |
$265.20 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) HMO HDHP Bronze 6450
Annual Out of Pocket Expenses
Deductible: Individual:
$6,450
| Family:
$12,900 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$356.35 $404.46 $455.42 $636.44 $967.13 |
$712.70 $808.92 $910.84 $1,272.88 $1,934.26 |
$985.31 $1,081.53 $1,183.45 $1,545.49 |
$1,257.92 $1,354.14 $1,456.06 $1,818.10 |
$1,530.53 $1,626.75 $1,728.67 $2,090.71 |
$628.96 $677.07 $728.03 $909.05 |
$901.57 $949.68 $1,000.64 $1,181.66 |
$1,174.18 $1,222.29 $1,273.25 $1,454.27 |
$272.61 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) HMO HDHP Bronze 5500
Annual Out of Pocket Expenses
Deductible: Individual:
$5,500
| Family:
$11,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$348.45 $395.49 $445.32 $622.33 $945.69 |
$696.90 $790.98 $890.64 $1,244.66 $1,891.38 |
$963.46 $1,057.54 $1,157.20 $1,511.22 |
$1,230.02 $1,324.10 $1,423.76 $1,777.78 |
$1,496.58 $1,590.66 $1,690.32 $2,044.34 |
$615.01 $662.05 $711.88 $888.89 |
$881.57 $928.61 $978.44 $1,155.45 |
$1,148.13 $1,195.17 $1,245.00 $1,422.01 |
$266.56 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) HMO HDHP Silver 2800
Annual Out of Pocket Expenses
Deductible: Individual:
$2,800
| Family:
$5,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$506.47 $574.84 $647.27 $904.56 $1,374.56 |
$1,012.94 $1,149.68 $1,294.54 $1,809.12 $2,749.12 |
$1,400.39 $1,537.13 $1,681.99 $2,196.57 |
$1,787.84 $1,924.58 $2,069.44 $2,584.02 |
$2,175.29 $2,312.03 $2,456.89 $2,971.47 |
$893.92 $962.29 $1,034.72 $1,292.01 |
$1,281.37 $1,349.74 $1,422.17 $1,679.46 |
$1,668.82 $1,737.19 $1,809.62 $2,066.91 |
$387.45 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) HMO HDHP Silver 4500
Annual Out of Pocket Expenses
Deductible: Individual:
$4,500
| Family:
$9,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$504.69 $572.82 $644.99 $901.38 $1,369.73 |
$1,009.38 $1,145.64 $1,289.98 $1,802.76 $2,739.46 |
$1,395.47 $1,531.73 $1,676.07 $2,188.85 |
$1,781.56 $1,917.82 $2,062.16 $2,574.94 |
$2,167.65 $2,303.91 $2,448.25 $2,961.03 |
$890.78 $958.91 $1,031.08 $1,287.47 |
$1,276.87 $1,345.00 $1,417.17 $1,673.56 |
$1,662.96 $1,731.09 $1,803.26 $2,059.65 |
$386.09 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) HMO HDHP Silver 5500
Annual Out of Pocket Expenses
Deductible: Individual:
$5,500
| Family:
$11,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$479.20 $543.89 $612.42 $855.85 $1,300.55 |
$958.40 $1,087.78 $1,224.84 $1,711.70 $2,601.10 |
$1,324.99 $1,454.37 $1,591.43 $2,078.29 |
$1,691.58 $1,820.96 $1,958.02 $2,444.88 |
$2,058.17 $2,187.55 $2,324.61 $2,811.47 |
$845.79 $910.48 $979.01 $1,222.44 |
$1,212.38 $1,277.07 $1,345.60 $1,589.03 |
$1,578.97 $1,643.66 $1,712.19 $1,955.62 |
$366.59 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
Group Health Cooperative of South Central WisconsinLocal: 1-608-828-4831 | Toll Free: 1-855-344-2729 | TTY: 1-608-828-4815 |
|||||||||||||||||||
Platinum |
|||||||||||||||||||
(HMO) Platinum 500 Ded/1500 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$500
| Family:
$1,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$462.01 $524.38 $590.44 $825.14 $1,253.87 |
$924.02 $1,048.76 $1,180.88 $1,650.28 $2,507.74 |
$1,277.46 $1,402.20 $1,534.32 $2,003.72 |
$1,630.90 $1,755.64 $1,887.76 $2,357.16 |
$1,984.34 $2,109.08 $2,241.20 $2,710.60 |
$815.45 $877.82 $943.88 $1,178.58 |
$1,168.89 $1,231.26 $1,297.32 $1,532.02 |
$1,522.33 $1,584.70 $1,650.76 $1,885.46 |
$353.44 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold 2500 Ded/2500 MOOP HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$2,500
| Family:
$5,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$393.35 $446.46 $502.70 $702.53 $1,067.55 |
$786.70 $892.92 $1,005.40 $1,405.06 $2,135.10 |
$1,087.62 $1,193.84 $1,306.32 $1,705.98 |
$1,388.54 $1,494.76 $1,607.24 $2,006.90 |
$1,689.46 $1,795.68 $1,908.16 $2,307.82 |
$694.27 $747.38 $803.62 $1,003.45 |
$995.19 $1,048.30 $1,104.54 $1,304.37 |
$1,296.11 $1,349.22 $1,405.46 $1,605.29 |
$300.92 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Bronze 4000 Ded/7350 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$308.96 $350.67 $394.85 $551.80 $838.51 |
$617.92 $701.34 $789.70 $1,103.60 $1,677.02 |
$854.28 $937.70 $1,026.06 $1,339.96 |
$1,090.64 $1,174.06 $1,262.42 $1,576.32 |
$1,327.00 $1,410.42 $1,498.78 $1,812.68 |
$545.32 $587.03 $631.21 $788.16 |
$781.68 $823.39 $867.57 $1,024.52 |
$1,018.04 $1,059.75 $1,103.93 $1,260.88 |
$236.36 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Bronze 6900 Ded/6900 MOOP HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$6,900
| Family:
$13,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$300.59 $341.16 $384.15 $536.84 $815.78 |
$601.18 $682.32 $768.30 $1,073.68 $1,631.56 |
$831.13 $912.27 $998.25 $1,303.63 |
$1,061.08 $1,142.22 $1,228.20 $1,533.58 |
$1,291.03 $1,372.17 $1,458.15 $1,763.53 |
$530.54 $571.11 $614.10 $766.79 |
$760.49 $801.06 $844.05 $996.74 |
$990.44 $1,031.01 $1,074.00 $1,226.69 |
$229.95 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold 2500 Ded/6500 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$2,500
| Family:
$5,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$376.01 $426.77 $480.54 $671.55 $1,020.49 |
$752.02 $853.54 $961.08 $1,343.10 $2,040.98 |
$1,039.67 $1,141.19 $1,248.73 $1,630.75 |
$1,327.32 $1,428.84 $1,536.38 $1,918.40 |
$1,614.97 $1,716.49 $1,824.03 $2,206.05 |
$663.66 $714.42 $768.19 $959.20 |
$951.31 $1,002.07 $1,055.84 $1,246.85 |
$1,238.96 $1,289.72 $1,343.49 $1,534.50 |
$287.65 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold Simple Choice 1600 Ded/5200 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$1,600
| Family:
$3,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$392.27 $445.23 $501.32 $700.59 $1,064.61 |
$784.54 $890.46 $1,002.64 $1,401.18 $2,129.22 |
$1,084.63 $1,190.55 $1,302.73 $1,701.27 |
$1,384.72 $1,490.64 $1,602.82 $2,001.36 |
$1,684.81 $1,790.73 $1,902.91 $2,301.45 |
$692.36 $745.32 $801.41 $1,000.68 |
$992.45 $1,045.41 $1,101.50 $1,300.77 |
$1,292.54 $1,345.50 $1,401.59 $1,600.86 |
$300.09 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Silver Simple Choice 4550X Ded/7900 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$410.48 $465.89 $524.59 $733.11 $1,114.02 |
$820.96 $931.78 $1,049.18 $1,466.22 $2,228.04 |
$1,134.98 $1,245.80 $1,363.20 $1,780.24 |
$1,449.00 $1,559.82 $1,677.22 $2,094.26 |
$1,763.02 $1,873.84 $1,991.24 $2,408.28 |
$724.50 $779.91 $838.61 $1,047.13 |
$1,038.52 $1,093.93 $1,152.63 $1,361.15 |
$1,352.54 $1,407.95 $1,466.65 $1,675.17 |
$314.02 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Bronze Simple Choice 6750 Ded/7650 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$6,750
| Family:
$13,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$317.32 $360.15 $405.53 $566.72 $861.18 |
$634.64 $720.30 $811.06 $1,133.44 $1,722.36 |
$877.39 $963.05 $1,053.81 $1,376.19 |
$1,120.14 $1,205.80 $1,296.56 $1,618.94 |
$1,362.89 $1,448.55 $1,539.31 $1,861.69 |
$560.07 $602.90 $648.28 $809.47 |
$802.82 $845.65 $891.03 $1,052.22 |
$1,045.57 $1,088.40 $1,133.78 $1,294.97 |
$242.75 | ||||||||||
Platinum |
|||||||||||||||||||
(HMO) Platinum No Ded/2000 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$0
| Family:
$0 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$466.26 $529.21 $595.88 $832.74 $1,265.43 |
$932.52 $1,058.42 $1,191.76 $1,665.48 $2,530.86 |
$1,289.21 $1,415.11 $1,548.45 $2,022.17 |
$1,645.90 $1,771.80 $1,905.14 $2,378.86 |
$2,002.59 $2,128.49 $2,261.83 $2,735.55 |
$822.95 $885.90 $952.57 $1,189.43 |
$1,179.64 $1,242.59 $1,309.26 $1,546.12 |
$1,536.33 $1,599.28 $1,665.95 $1,902.81 |
$356.69 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Bronze 8150 Ded/8150 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$296.10 $336.08 $378.42 $528.84 $803.62 |
$592.20 $672.16 $756.84 $1,057.68 $1,607.24 |
$818.72 $898.68 $983.36 $1,284.20 |
$1,045.24 $1,125.20 $1,209.88 $1,510.72 |
$1,271.76 $1,351.72 $1,436.40 $1,737.24 |
$522.62 $562.60 $604.94 $755.36 |
$749.14 $789.12 $831.46 $981.88 |
$975.66 $1,015.64 $1,057.98 $1,208.40 |
$226.52 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Silver 4900 Ded/7900 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,900
| Family:
$9,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$408.56 $463.72 $522.14 $729.68 $1,108.82 |
$817.12 $927.44 $1,044.28 $1,459.36 $2,217.64 |
$1,129.67 $1,239.99 $1,356.83 $1,771.91 |
$1,442.22 $1,552.54 $1,669.38 $2,084.46 |
$1,754.77 $1,865.09 $1,981.93 $2,397.01 |
$721.11 $776.27 $834.69 $1,042.23 |
$1,033.66 $1,088.82 $1,147.24 $1,354.78 |
$1,346.21 $1,401.37 $1,459.79 $1,667.33 |
$312.55 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold 1500 Ded/8150 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$365.49 $414.83 $467.10 $652.76 $991.93 |
$730.98 $829.66 $934.20 $1,305.52 $1,983.86 |
$1,010.58 $1,109.26 $1,213.80 $1,585.12 |
$1,290.18 $1,388.86 $1,493.40 $1,864.72 |
$1,569.78 $1,668.46 $1,773.00 $2,144.32 |
$645.09 $694.43 $746.70 $932.36 |
$924.69 $974.03 $1,026.30 $1,211.96 |
$1,204.29 $1,253.63 $1,305.90 $1,491.56 |
$279.60 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Silver 8100X Ded/8150 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$7,500
| Family:
$15,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$402.85 $457.23 $514.84 $719.48 $1,093.32 |
$805.70 $914.46 $1,029.68 $1,438.96 $2,186.64 |
$1,113.88 $1,222.64 $1,337.86 $1,747.14 |
$1,422.06 $1,530.82 $1,646.04 $2,055.32 |
$1,730.24 $1,839.00 $1,954.22 $2,363.50 |
$711.03 $765.41 $823.02 $1,027.66 |
$1,019.21 $1,073.59 $1,131.20 $1,335.84 |
$1,327.39 $1,381.77 $1,439.38 $1,644.02 |
$308.18 |
‡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 Dodge County here.
Dodge County is in “Rating Area 11” of Wisconsin.
Currently, there are 72 plans offered in Rating Area 11.
- AL
- AK
- AZ
- AR
- CA
- CO
- CT
- DE
- FL
- GA
- HI
- ID
- IL
- IN
- IA
- KS
- KY
- LA
- ME
- MD
- MA
- MI
- MN
- MS
- MO
- MT
- NE
- NV
- NH
- NJ
- NM
- NY
- NC
- ND
- OH
- OK
- OR
- PA
- RI
- SC
- SD
- TN
- TX
- UT
- VT
- VA
- WA
- DC
- WV
- WI
- WY
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016| 2017 | 2018 | 2019
You may also be interested in:
-
Do I Qualify For a Tax Credit to Pay My Premiums?
-
How do I sign up in Wisconsin?
-
Using a Broker to Help You Sign Up
Ways to Save Money on Health Insurance in Wisconsin
There are three primary ways to reduce the cost of health plans under the Affordable Care Act in Wisconsin.
- You may be able to lower the cost of monthly premiums when you sign up for a private health insurance plan. Your subsidies will come in the form of a federal tax credit. This article is updated to cover the tax credits available under the American Rescue Plan Act of 2021 and extended under the Inflation Reduction Act through 2025.
- You may be able to reduce your out-of-pocket costs -- including copayments, deductibles, and coinsurance -- with cost-sharing subsidies paid for by insurers.
- You may qualify for free or low-cost coverage through Medicaid in Wisconsin, or your children may be able to obtain coverage through the Children’s Health Insurance Program (CHIP).
Each of these forms of assistance depends on your income and family size.
Many people who apply for coverage at the Wisconsin exchange will be eligible for some form of financial assistance. Read on to learn more about each option.
What's New