Obamacare 2021 Rates for Newton County

Obamacare > Rates > Georgia > Newton County

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 Newton County, GA.

The health insurance rates listed below are for calendar year 2021.

For information on subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 53 Plans and 2021 Rates for Newton County, Georgia

Below, you’ll find a summary of the 53 plans for Newton County, Georgia and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Blue Cross Blue Shield Healthcare Plan of Georgia, Inc

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

Toc - Plan #1 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$310,25
$352,13
$396,50
$554,11
$842,02
$547,59
$589,47
$633,84
$791,45
$784,93
$826,81
$871,18
$1 028,79
$1 022,27
$1 064,15
$1 108,52
$1 266,13
$237,34
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$620,50
$704,26
$793,00
$1 108,22
$1 684,04
$857,84
$941,60
$1 030,34
$1 345,56
$1 095,18
$1 178,94
$1 267,68
$1 582,90
$1 332,52
$1 416,28
$1 505,02
$1 820,24
$237,34
Toc - Plan #2 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 3000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$7,700 $15,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$365,79
$415,17
$467,48
$653,30
$992,75
$645,62
$695,00
$747,31
$933,13
$925,45
$974,83
$1 027,14
$1 212,96
$1 205,28
$1 254,66
$1 306,97
$1 492,79
$279,83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$731,58
$830,34
$934,96
$1 306,60
$1 985,50
$1 011,41
$1 110,17
$1 214,79
$1 586,43
$1 291,24
$1 390,00
$1 494,62
$1 866,26
$1 571,07
$1 669,83
$1 774,45
$2 146,09
$279,83
Toc - Plan #3 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 5500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$348,84
$395,93
$445,82
$623,03
$946,75
$615,70
$662,79
$712,68
$889,89
$882,56
$929,65
$979,54
$1 156,75
$1 149,42
$1 196,51
$1 246,40
$1 423,61
$266,86
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$697,68
$791,86
$891,64
$1 246,06
$1 893,50
$964,54
$1 058,72
$1 158,50
$1 512,92
$1 231,40
$1 325,58
$1 425,36
$1 779,78
$1 498,26
$1 592,44
$1 692,22
$2 046,64
$266,86
Toc - Plan #4 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 5600

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$5,600 $11,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$308,12
$349,72
$393,78
$550,30
$836,24
$543,83
$585,43
$629,49
$786,01
$779,54
$821,14
$865,20
$1 021,72
$1 015,25
$1 056,85
$1 100,91
$1 257,43
$235,71
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$616,24
$699,44
$787,56
$1 100,60
$1 672,48
$851,95
$935,15
$1 023,27
$1 336,31
$1 087,66
$1 170,86
$1 258,98
$1 572,02
$1 323,37
$1 406,57
$1 494,69
$1 807,73
$235,71
Toc - Plan #5 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 6000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$303,55
$344,53
$387,94
$542,14
$823,83
$535,77
$576,75
$620,16
$774,36
$767,99
$808,97
$852,38
$1 006,58
$1 000,21
$1 041,19
$1 084,60
$1 238,80
$232,22
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$607,10
$689,06
$775,88
$1 084,28
$1 647,66
$839,32
$921,28
$1 008,10
$1 316,50
$1 071,54
$1 153,50
$1 240,32
$1 548,72
$1 303,76
$1 385,72
$1 472,54
$1 780,94
$232,22
Toc - Plan #6 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Catastrophic

(HMO) Anthem Catastrophic Pathway X Guided Access HMO 8550

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$211,59
$240,15
$270,41
$377,90
$574,26
$373,46
$402,02
$432,28
$539,77
$535,33
$563,89
$594,15
$701,64
$697,20
$725,76
$756,02
$863,51
$161,87
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$423,18
$480,30
$540,82
$755,80
$1 148,52
$585,05
$642,17
$702,69
$917,67
$746,92
$804,04
$864,56
$1 079,54
$908,79
$965,91
$1 026,43
$1 241,41
$161,87
Toc - Plan #7 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 6750

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$6,750 $13,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$293,18
$332,76
$374,68
$523,62
$795,69
$517,46
$557,04
$598,96
$747,90
$741,74
$781,32
$823,24
$972,18
$966,02
$1 005,60
$1 047,52
$1 196,46
$224,28
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$586,36
$665,52
$749,36
$1 047,24
$1 591,38
$810,64
$889,80
$973,64
$1 271,52
$1 034,92
$1 114,08
$1 197,92
$1 495,80
$1 259,20
$1 338,36
$1 422,20
$1 720,08
$224,28
Toc - Plan #8 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 4950

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$4,950 $9,900 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$359,09
$407,57
$458,92
$641,33
$974,57
$633,79
$682,27
$733,62
$916,03
$908,49
$956,97
$1 008,32
$1 190,73
$1 183,19
$1 231,67
$1 283,02
$1 465,43
$274,70
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$718,18
$815,14
$917,84
$1 282,66
$1 949,14
$992,88
$1 089,84
$1 192,54
$1 557,36
$1 267,58
$1 364,54
$1 467,24
$1 832,06
$1 542,28
$1 639,24
$1 741,94
$2 106,76
$274,70
Toc - Plan #9 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Gold

(HMO) Anthem Gold Pathway X Guided Access HMO 1850

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$1,850 $3,700 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$428,49
$486,34
$547,61
$765,28
$1 162,92
$756,28
$814,13
$875,40
$1 093,07
$1 084,07
$1 141,92
$1 203,19
$1 420,86
$1 411,86
$1 469,71
$1 530,98
$1 748,65
$327,79
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$856,98
$972,68
$1 095,22
$1 530,56
$2 325,84
$1 184,77
$1 300,47
$1 423,01
$1 858,35
$1 512,56
$1 628,26
$1 750,80
$2 186,14
$1 840,35
$1 956,05
$2 078,59
$2 513,93
$327,79
Toc - Plan #10 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Expanded Bronze

(HMO) Anthem Bronze Pathway X Guided Access HMO 4900

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$4,900 $9,800 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$320,54
$363,81
$409,65
$572,48
$869,95
$565,75
$609,02
$654,86
$817,69
$810,96
$854,23
$900,07
$1 062,90
$1 056,17
$1 099,44
$1 145,28
$1 308,11
$245,21
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$641,08
$727,62
$819,30
$1 144,96
$1 739,90
$886,29
$972,83
$1 064,51
$1 390,17
$1 131,50
$1 218,04
$1 309,72
$1 635,38
$1 376,71
$1 463,25
$1 554,93
$1 880,59
$245,21
Toc - Plan #11 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 2600

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$2,600 $5,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$395,74
$449,16
$505,76
$706,79
$1 074,04
$698,48
$751,90
$808,50
$1 009,53
$1 001,22
$1 054,64
$1 111,24
$1 312,27
$1 303,96
$1 357,38
$1 413,98
$1 615,01
$302,74
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$791,48
$898,32
$1 011,52
$1 413,58
$2 148,08
$1 094,22
$1 201,06
$1 314,26
$1 716,32
$1 396,96
$1 503,80
$1 617,00
$2 019,06
$1 699,70
$1 806,54
$1 919,74
$2 321,80
$302,74
Toc - Plan #12 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc
Silver

(HMO) Anthem Silver Pathway X Guided Access HMO 6250

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-738-6652

Annual Out of Pocket Expenses:

Individual Family
$6,250 $12,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$342,29
$388,50
$437,45
$611,33
$928,98
$604,14
$650,35
$699,30
$873,18
$865,99
$912,20
$961,15
$1 135,03
$1 127,84
$1 174,05
$1 223,00
$1 396,88
$261,85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$684,58
$777,00
$874,90
$1 222,66
$1 857,96
$946,43
$1 038,85
$1 136,75
$1 484,51
$1 208,28
$1 300,70
$1 398,60
$1 746,36
$1 470,13
$1 562,55
$1 660,45
$2 008,21
$261,85

ADVERTISEMENT

CareSource

Local: 1-833-230-2030 | Toll Free: 1-833-230-2030 | TTY: 1-800-255-0056

Toc - Plan #13 CareSource
Expanded Bronze

(HMO) CareSource Marketplace Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$7,700 $15,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$278,42
$316,00
$355,81
$497,25
$755,61
$491,41
$528,99
$568,80
$710,24
$704,40
$741,98
$781,79
$923,23
$917,39
$954,97
$994,78
$1 136,22
$212,99
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$556,84
$632,00
$711,62
$994,50
$1 511,22
$769,83
$844,99
$924,61
$1 207,49
$982,82
$1 057,98
$1 137,60
$1 420,48
$1 195,81
$1 270,97
$1 350,59
$1 633,47
$212,99
Toc - Plan #14 CareSource
Gold

(HMO) CareSource Marketplace Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$389,09
$441,61
$497,25
$694,90
$1 055,97
$686,74
$739,26
$794,90
$992,55
$984,39
$1 036,91
$1 092,55
$1 290,20
$1 282,04
$1 334,56
$1 390,20
$1 587,85
$297,65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$778,18
$883,22
$994,50
$1 389,80
$2 111,94
$1 075,83
$1 180,87
$1 292,15
$1 687,45
$1 373,48
$1 478,52
$1 589,80
$1 985,10
$1 671,13
$1 776,17
$1 887,45
$2 282,75
$297,65
Toc - Plan #15 CareSource
Silver

(HMO) CareSource Marketplace Low Premium Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$390,09
$442,75
$498,53
$696,69
$1 058,69
$688,51
$741,17
$796,95
$995,11
$986,93
$1 039,59
$1 095,37
$1 293,53
$1 285,35
$1 338,01
$1 393,79
$1 591,95
$298,42
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$780,18
$885,50
$997,06
$1 393,38
$2 117,38
$1 078,60
$1 183,92
$1 295,48
$1 691,80
$1 377,02
$1 482,34
$1 593,90
$1 990,22
$1 675,44
$1 780,76
$1 892,32
$2 288,64
$298,42
Toc - Plan #16 CareSource
Silver

(HMO) CareSource Marketplace Standard Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$7,900 $15,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$408,98
$464,19
$522,67
$730,44
$1 109,97
$721,85
$777,06
$835,54
$1 043,31
$1 034,72
$1 089,93
$1 148,41
$1 356,18
$1 347,59
$1 402,80
$1 461,28
$1 669,05
$312,87
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$817,96
$928,38
$1 045,34
$1 460,88
$2 219,94
$1 130,83
$1 241,25
$1 358,21
$1 773,75
$1 443,70
$1 554,12
$1 671,08
$2 086,62
$1 756,57
$1 866,99
$1 983,95
$2 399,49
$312,87
Toc - Plan #17 CareSource
Silver

(HMO) CareSource Marketplace Low Deductible Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$5,100 $10,200 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$419,57
$476,21
$536,20
$749,34
$1 138,70
$740,54
$797,18
$857,17
$1 070,31
$1 061,51
$1 118,15
$1 178,14
$1 391,28
$1 382,48
$1 439,12
$1 499,11
$1 712,25
$320,97
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$839,14
$952,42
$1 072,40
$1 498,68
$2 277,40
$1 160,11
$1 273,39
$1 393,37
$1 819,65
$1 481,08
$1 594,36
$1 714,34
$2 140,62
$1 802,05
$1 915,33
$2 035,31
$2 461,59
$320,97
Toc - Plan #18 CareSource
Expanded Bronze

(HMO) CareSource Marketplace HSA Eligible Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$5,400 $10,800 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$303,99
$345,03
$388,50
$542,93
$825,03
$536,54
$577,58
$621,05
$775,48
$769,09
$810,13
$853,60
$1 008,03
$1 001,64
$1 042,68
$1 086,15
$1 240,58
$232,55
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$607,98
$690,06
$777,00
$1 085,86
$1 650,06
$840,53
$922,61
$1 009,55
$1 318,41
$1 073,08
$1 155,16
$1 242,10
$1 550,96
$1 305,63
$1 387,71
$1 474,65
$1 783,51
$232,55
Toc - Plan #19 CareSource
Expanded Bronze

(HMO) CareSource Marketplace Bronze Dental, Vision, & Fitness

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$7,700 $15,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$293,78
$333,44
$375,45
$524,69
$797,32
$518,52
$558,18
$600,19
$749,43
$743,26
$782,92
$824,93
$974,17
$968,00
$1 007,66
$1 049,67
$1 198,91
$224,74
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$587,56
$666,88
$750,90
$1 049,38
$1 594,64
$812,30
$891,62
$975,64
$1 274,12
$1 037,04
$1 116,36
$1 200,38
$1 498,86
$1 261,78
$1 341,10
$1 425,12
$1 723,60
$224,74
Toc - Plan #20 CareSource
Gold

(HMO) CareSource Marketplace Gold Dental, Vision, & Fitness

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$409,61
$464,90
$523,48
$731,56
$1 111,67
$722,96
$778,25
$836,83
$1 044,91
$1 036,31
$1 091,60
$1 150,18
$1 358,26
$1 349,66
$1 404,95
$1 463,53
$1 671,61
$313,35
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$819,22
$929,80
$1 046,96
$1 463,12
$2 223,34
$1 132,57
$1 243,15
$1 360,31
$1 776,47
$1 445,92
$1 556,50
$1 673,66
$2 089,82
$1 759,27
$1 869,85
$1 987,01
$2 403,17
$313,35
Toc - Plan #21 CareSource
Silver

(HMO) CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$407,59
$462,62
$520,90
$727,96
$1 106,20
$719,40
$774,43
$832,71
$1 039,77
$1 031,21
$1 086,24
$1 144,52
$1 351,58
$1 343,02
$1 398,05
$1 456,33
$1 663,39
$311,81
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$815,18
$925,24
$1 041,80
$1 455,92
$2 212,40
$1 126,99
$1 237,05
$1 353,61
$1 767,73
$1 438,80
$1 548,86
$1 665,42
$2 079,54
$1 750,61
$1 860,67
$1 977,23
$2 391,35
$311,81
Toc - Plan #22 CareSource
Silver

(HMO) CareSource Marketplace Standard Silver Dental, Vision, & Fitness

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$7,900 $15,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$427,81
$485,56
$546,74
$764,07
$1 161,08
$755,08
$812,83
$874,01
$1 091,34
$1 082,35
$1 140,10
$1 201,28
$1 418,61
$1 409,62
$1 467,37
$1 528,55
$1 745,88
$327,27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$855,62
$971,12
$1 093,48
$1 528,14
$2 322,16
$1 182,89
$1 298,39
$1 420,75
$1 855,41
$1 510,16
$1 625,66
$1 748,02
$2 182,68
$1 837,43
$1 952,93
$2 075,29
$2 509,95
$327,27
Toc - Plan #23 CareSource
Silver

(HMO) CareSource Marketplace Low Deductible Silver Dental, Vision, & Fitness

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-230-2030

Annual Out of Pocket Expenses:

Individual Family
$5,100 $10,200 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$439,63
$498,97
$561,84
$785,16
$1 193,13
$775,94
$835,28
$898,15
$1 121,47
$1 112,25
$1 171,59
$1 234,46
$1 457,78
$1 448,56
$1 507,90
$1 570,77
$1 794,09
$336,31
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$879,26
$997,94
$1 123,68
$1 570,32
$2 386,26
$1 215,57
$1 334,25
$1 459,99
$1 906,63
$1 551,88
$1 670,56
$1 796,30
$2 242,94
$1 888,19
$2 006,87
$2 132,61
$2 579,25
$336,31

ADVERTISEMENT

Ambetter from Peach State Health Plan

Local: 1-877-687-1180 | Toll Free: 1-877-687-1180 | TTY: 1-877-941-9231

Toc - Plan #24 Ambetter from Peach State Health Plan
Bronze

(HMO) Ambetter Essential Care 1 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$8,300 $16,600 Annual Deductible
$8,300 $16,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$276,61
$313,94
$353,49
$494,00
$750,69
$488,21
$525,54
$565,09
$705,60
$699,81
$737,14
$776,69
$917,20
$911,41
$948,74
$988,29
$1 128,80
$211,60
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$553,22
$627,88
$706,98
$988,00
$1 501,38
$764,82
$839,48
$918,58
$1 199,60
$976,42
$1 051,08
$1 130,18
$1 411,20
$1 188,02
$1 262,68
$1 341,78
$1 622,80
$211,60
Toc - Plan #25 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 4 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$372,13
$422,36
$475,57
$664,61
$1 009,94
$656,80
$707,03
$760,24
$949,28
$941,47
$991,70
$1 044,91
$1 233,95
$1 226,14
$1 276,37
$1 329,58
$1 518,62
$284,67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$744,26
$844,72
$951,14
$1 329,22
$2 019,88
$1 028,93
$1 129,39
$1 235,81
$1 613,89
$1 313,60
$1 414,06
$1 520,48
$1 898,56
$1 598,27
$1 698,73
$1 805,15
$2 183,23
$284,67
Toc - Plan #26 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 11 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$360,97
$409,69
$461,30
$644,67
$979,64
$637,10
$685,82
$737,43
$920,80
$913,23
$961,95
$1 013,56
$1 196,93
$1 189,36
$1 238,08
$1 289,69
$1 473,06
$276,13
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$721,94
$819,38
$922,60
$1 289,34
$1 959,28
$998,07
$1 095,51
$1 198,73
$1 565,47
$1 274,20
$1 371,64
$1 474,86
$1 841,60
$1 550,33
$1 647,77
$1 750,99
$2 117,73
$276,13
Toc - Plan #27 Ambetter from Peach State Health Plan
Gold

(HMO) Ambetter Secure Care 5 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$6,300 $12,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$372,02
$422,23
$475,43
$664,41
$1 009,64
$656,61
$706,82
$760,02
$949,00
$941,20
$991,41
$1 044,61
$1 233,59
$1 225,79
$1 276,00
$1 329,20
$1 518,18
$284,59
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$744,04
$844,46
$950,86
$1 328,82
$2 019,28
$1 028,63
$1 129,05
$1 235,45
$1 613,41
$1 313,22
$1 413,64
$1 520,04
$1 898,00
$1 597,81
$1 698,23
$1 804,63
$2 182,59
$284,59
Toc - Plan #28 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 12 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$353,67
$401,41
$451,98
$631,65
$959,85
$624,22
$671,96
$722,53
$902,20
$894,77
$942,51
$993,08
$1 172,75
$1 165,32
$1 213,06
$1 263,63
$1 443,30
$270,55
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$707,34
$802,82
$903,96
$1 263,30
$1 919,70
$977,89
$1 073,37
$1 174,51
$1 533,85
$1 248,44
$1 343,92
$1 445,06
$1 804,40
$1 518,99
$1 614,47
$1 715,61
$2 074,95
$270,55
Toc - Plan #29 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 29 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$5,450 $10,900 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$350,66
$397,99
$448,13
$626,26
$951,67
$618,91
$666,24
$716,38
$894,51
$887,16
$934,49
$984,63
$1 162,76
$1 155,41
$1 202,74
$1 252,88
$1 431,01
$268,25
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$701,32
$795,98
$896,26
$1 252,52
$1 903,34
$969,57
$1 064,23
$1 164,51
$1 520,77
$1 237,82
$1 332,48
$1 432,76
$1 789,02
$1 506,07
$1 600,73
$1 701,01
$2 057,27
$268,25
Toc - Plan #30 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 25 HSA (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$4,800 $9,600 Annual Deductible
$4,800 $9,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$367,52
$417,12
$469,68
$656,37
$997,42
$648,66
$698,26
$750,82
$937,51
$929,80
$979,40
$1 031,96
$1 218,65
$1 210,94
$1 260,54
$1 313,10
$1 499,79
$281,14
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$735,04
$834,24
$939,36
$1 312,74
$1 994,84
$1 016,18
$1 115,38
$1 220,50
$1 593,88
$1 297,32
$1 396,52
$1 501,64
$1 875,02
$1 578,46
$1 677,66
$1 782,78
$2 156,16
$281,14
Toc - Plan #31 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 26 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$5,450 $10,900 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$371,09
$421,18
$474,24
$662,75
$1 007,11
$654,97
$705,06
$758,12
$946,63
$938,85
$988,94
$1 042,00
$1 230,51
$1 222,73
$1 272,82
$1 325,88
$1 514,39
$283,88
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$742,18
$842,36
$948,48
$1 325,50
$2 014,22
$1 026,06
$1 126,24
$1 232,36
$1 609,38
$1 309,94
$1 410,12
$1 516,24
$1 893,26
$1 593,82
$1 694,00
$1 800,12
$2 177,14
$283,88
Toc - Plan #32 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 27 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$2,750 $5,500 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$386,76
$438,96
$494,26
$690,73
$1 049,63
$682,62
$734,82
$790,12
$986,59
$978,48
$1 030,68
$1 085,98
$1 282,45
$1 274,34
$1 326,54
$1 381,84
$1 578,31
$295,86
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$773,52
$877,92
$988,52
$1 381,46
$2 099,26
$1 069,38
$1 173,78
$1 284,38
$1 677,32
$1 365,24
$1 469,64
$1 580,24
$1 973,18
$1 661,10
$1 765,50
$1 876,10
$2 269,04
$295,86
Toc - Plan #33 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 28 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$389,55
$442,13
$497,83
$695,71
$1 057,20
$687,55
$740,13
$795,83
$993,71
$985,55
$1 038,13
$1 093,83
$1 291,71
$1 283,55
$1 336,13
$1 391,83
$1 589,71
$298,00
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$779,10
$884,26
$995,66
$1 391,42
$2 114,40
$1 077,10
$1 182,26
$1 293,66
$1 689,42
$1 375,10
$1 480,26
$1 591,66
$1 987,42
$1 673,10
$1 778,26
$1 889,66
$2 285,42
$298,00
Toc - Plan #34 Ambetter from Peach State Health Plan
Expanded Bronze

(HMO) Ambetter Essential Care 2 HSA (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$301,32
$341,98
$385,07
$538,13
$817,75
$531,82
$572,48
$615,57
$768,63
$762,32
$802,98
$846,07
$999,13
$992,82
$1 033,48
$1 076,57
$1 229,63
$230,50
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$602,64
$683,96
$770,14
$1 076,26
$1 635,50
$833,14
$914,46
$1 000,64
$1 306,76
$1 063,64
$1 144,96
$1 231,14
$1 537,26
$1 294,14
$1 375,46
$1 461,64
$1 767,76
$230,50
Toc - Plan #35 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 12 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$368,01
$417,68
$470,31
$657,25
$998,76
$649,53
$699,20
$751,83
$938,77
$931,05
$980,72
$1 033,35
$1 220,29
$1 212,57
$1 262,24
$1 314,87
$1 501,81
$281,52
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$736,02
$835,36
$940,62
$1 314,50
$1 997,52
$1 017,54
$1 116,88
$1 222,14
$1 596,02
$1 299,06
$1 398,40
$1 503,66
$1 877,54
$1 580,58
$1 679,92
$1 785,18
$2 159,06
$281,52
Toc - Plan #36 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 4 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$387,22
$439,48
$494,85
$691,55
$1 050,88
$683,43
$735,69
$791,06
$987,76
$979,64
$1 031,90
$1 087,27
$1 283,97
$1 275,85
$1 328,11
$1 383,48
$1 580,18
$296,21
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$774,44
$878,96
$989,70
$1 383,10
$2 101,76
$1 070,65
$1 175,17
$1 285,91
$1 679,31
$1 366,86
$1 471,38
$1 582,12
$1 975,52
$1 663,07
$1 767,59
$1 878,33
$2 271,73
$296,21
Toc - Plan #37 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 11 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$375,60
$426,30
$480,01
$670,81
$1 019,35
$662,93
$713,63
$767,34
$958,14
$950,26
$1 000,96
$1 054,67
$1 245,47
$1 237,59
$1 288,29
$1 342,00
$1 532,80
$287,33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$751,20
$852,60
$960,02
$1 341,62
$2 038,70
$1 038,53
$1 139,93
$1 247,35
$1 628,95
$1 325,86
$1 427,26
$1 534,68
$1 916,28
$1 613,19
$1 714,59
$1 822,01
$2 203,61
$287,33
Toc - Plan #38 Ambetter from Peach State Health Plan
Bronze

(HMO) Ambetter Essential Care 1 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$8,300 $16,600 Annual Deductible
$8,300 $16,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$287,82
$326,67
$367,82
$514,03
$781,12
$508,00
$546,85
$588,00
$734,21
$728,18
$767,03
$808,18
$954,39
$948,36
$987,21
$1 028,36
$1 174,57
$220,18
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$575,64
$653,34
$735,64
$1 028,06
$1 562,24
$795,82
$873,52
$955,82
$1 248,24
$1 016,00
$1 093,70
$1 176,00
$1 468,42
$1 236,18
$1 313,88
$1 396,18
$1 688,60
$220,18
Toc - Plan #39 Ambetter from Peach State Health Plan
Gold

(HMO) Ambetter Secure Care 5 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$6,300 $12,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$387,10
$439,35
$494,70
$691,34
$1 050,57
$683,22
$735,47
$790,82
$987,46
$979,34
$1 031,59
$1 086,94
$1 283,58
$1 275,46
$1 327,71
$1 383,06
$1 579,70
$296,12
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$774,20
$878,70
$989,40
$1 382,68
$2 101,14
$1 070,32
$1 174,82
$1 285,52
$1 678,80
$1 366,44
$1 470,94
$1 581,64
$1 974,92
$1 662,56
$1 767,06
$1 877,76
$2 271,04
$296,12
Toc - Plan #40 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 25 HSA (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$4,800 $9,600 Annual Deductible
$4,800 $9,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$382,42
$434,03
$488,71
$682,98
$1 037,85
$674,96
$726,57
$781,25
$975,52
$967,50
$1 019,11
$1 073,79
$1 268,06
$1 260,04
$1 311,65
$1 366,33
$1 560,60
$292,54
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$764,84
$868,06
$977,42
$1 365,96
$2 075,70
$1 057,38
$1 160,60
$1 269,96
$1 658,50
$1 349,92
$1 453,14
$1 562,50
$1 951,04
$1 642,46
$1 745,68
$1 855,04
$2 243,58
$292,54
Toc - Plan #41 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 26 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$5,450 $10,900 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$386,13
$438,25
$493,47
$689,62
$1 047,94
$681,51
$733,63
$788,85
$985,00
$976,89
$1 029,01
$1 084,23
$1 280,38
$1 272,27
$1 324,39
$1 379,61
$1 575,76
$295,38
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$772,26
$876,50
$986,94
$1 379,24
$2 095,88
$1 067,64
$1 171,88
$1 282,32
$1 674,62
$1 363,02
$1 467,26
$1 577,70
$1 970,00
$1 658,40
$1 762,64
$1 873,08
$2 265,38
$295,38
Toc - Plan #42 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 27 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$2,750 $5,500 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$402,43
$456,75
$514,30
$718,73
$1 092,18
$710,28
$764,60
$822,15
$1 026,58
$1 018,13
$1 072,45
$1 130,00
$1 334,43
$1 325,98
$1 380,30
$1 437,85
$1 642,28
$307,85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$804,86
$913,50
$1 028,60
$1 437,46
$2 184,36
$1 112,71
$1 221,35
$1 336,45
$1 745,31
$1 420,56
$1 529,20
$1 644,30
$2 053,16
$1 728,41
$1 837,05
$1 952,15
$2 361,01
$307,85
Toc - Plan #43 Ambetter from Peach State Health Plan
Silver

(HMO) Ambetter Balanced Care 28 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$405,34
$460,05
$518,01
$723,92
$1 100,06
$715,42
$770,13
$828,09
$1 034,00
$1 025,50
$1 080,21
$1 138,17
$1 344,08
$1 335,58
$1 390,29
$1 448,25
$1 654,16
$310,08
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$810,68
$920,10
$1 036,02
$1 447,84
$2 200,12
$1 120,76
$1 230,18
$1 346,10
$1 757,92
$1 430,84
$1 540,26
$1 656,18
$2 068,00
$1 740,92
$1 850,34
$1 966,26
$2 378,08
$310,08
Toc - Plan #44 Ambetter from Peach State Health Plan
Expanded Bronze

(HMO) Ambetter Essential Care 2 HSA (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-687-1180

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$313,53
$355,85
$400,68
$559,95
$850,90
$553,37
$595,69
$640,52
$799,79
$793,21
$835,53
$880,36
$1 039,63
$1 033,05
$1 075,37
$1 120,20
$1 279,47
$239,84
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$627,06
$711,70
$801,36
$1 119,90
$1 701,80
$866,90
$951,54
$1 041,20
$1 359,74
$1 106,74
$1 191,38
$1 281,04
$1 599,58
$1 346,58
$1 431,22
$1 520,88
$1 839,42
$239,84

ADVERTISEMENT

Kaiser Permanente

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

Toc - Plan #45 Kaiser Permanente
Gold

(HMO) KP GA Gold 500/20

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$500 $1,000 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$415,68
$471,79
$531,23
$742,40
$1 128,15
$733,67
$789,78
$849,22
$1 060,39
$1 051,66
$1 107,77
$1 167,21
$1 378,38
$1 369,65
$1 425,76
$1 485,20
$1 696,37
$317,99
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$831,36
$943,58
$1 062,46
$1 484,80
$2 256,30
$1 149,35
$1 261,57
$1 380,45
$1 802,79
$1 467,34
$1 579,56
$1 698,44
$2 120,78
$1 785,33
$1 897,55
$2 016,43
$2 438,77
$317,99
Toc - Plan #46 Kaiser Permanente
Silver

(HMO) KP GA Silver 3000/30

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$407,68
$462,72
$521,01
$728,11
$1 106,44
$719,55
$774,59
$832,88
$1 039,98
$1 031,42
$1 086,46
$1 144,75
$1 351,85
$1 343,29
$1 398,33
$1 456,62
$1 663,72
$311,87
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$815,36
$925,44
$1 042,02
$1 456,22
$2 212,88
$1 127,23
$1 237,31
$1 353,89
$1 768,09
$1 439,10
$1 549,18
$1 665,76
$2 079,96
$1 750,97
$1 861,05
$1 977,63
$2 391,83
$311,87
Toc - Plan #47 Kaiser Permanente
Silver

(HMO) KP GA Silver 3500/20% HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$384,09
$435,94
$490,87
$685,99
$1 042,42
$677,92
$729,77
$784,70
$979,82
$971,75
$1 023,60
$1 078,53
$1 273,65
$1 265,58
$1 317,43
$1 372,36
$1 567,48
$293,83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$768,18
$871,88
$981,74
$1 371,98
$2 084,84
$1 062,01
$1 165,71
$1 275,57
$1 665,81
$1 355,84
$1 459,54
$1 569,40
$1 959,64
$1 649,67
$1 753,37
$1 863,23
$2 253,47
$293,83
Toc - Plan #48 Kaiser Permanente
Expanded Bronze

(HMO) KP GA Bronze 5000/50

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$296,65
$336,70
$379,12
$529,82
$805,11
$523,59
$563,64
$606,06
$756,76
$750,53
$790,58
$833,00
$983,70
$977,47
$1 017,52
$1 059,94
$1 210,64
$226,94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$593,30
$673,40
$758,24
$1 059,64
$1 610,22
$820,24
$900,34
$985,18
$1 286,58
$1 047,18
$1 127,28
$1 212,12
$1 513,52
$1 274,12
$1 354,22
$1 439,06
$1 740,46
$226,94
Toc - Plan #49 Kaiser Permanente
Expanded Bronze

(HMO) KP GA Bronze 6500/40%/HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$296,65
$336,70
$379,12
$529,82
$805,11
$523,59
$563,64
$606,06
$756,76
$750,53
$790,58
$833,00
$983,70
$977,47
$1 017,52
$1 059,94
$1 210,64
$226,94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$593,30
$673,40
$758,24
$1 059,64
$1 610,22
$820,24
$900,34
$985,18
$1 286,58
$1 047,18
$1 127,28
$1 212,12
$1 513,52
$1 274,12
$1 354,22
$1 439,06
$1 740,46
$226,94
Toc - Plan #50 Kaiser Permanente
Catastrophic

(HMO) KP GA Catastrophic 8550/0

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$260,73
$295,93
$333,21
$465,67
$707,62
$460,19
$495,39
$532,67
$665,13
$659,65
$694,85
$732,13
$864,59
$859,11
$894,31
$931,59
$1 064,05
$199,46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$521,46
$591,86
$666,42
$931,34
$1 415,24
$720,92
$791,32
$865,88
$1 130,80
$920,38
$990,78
$1 065,34
$1 330,26
$1 119,84
$1 190,24
$1 264,80
$1 529,72
$199,46
Toc - Plan #51 Kaiser Permanente
Gold

(HMO) KP GA Gold 1500/20

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$404,32
$458,90
$516,72
$722,11
$1 097,32
$713,62
$768,20
$826,02
$1 031,41
$1 022,92
$1 077,50
$1 135,32
$1 340,71
$1 332,22
$1 386,80
$1 444,62
$1 650,01
$309,30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$808,64
$917,80
$1 033,44
$1 444,22
$2 194,64
$1 117,94
$1 227,10
$1 342,74
$1 753,52
$1 427,24
$1 536,40
$1 652,04
$2 062,82
$1 736,54
$1 845,70
$1 961,34
$2 372,12
$309,30
Toc - Plan #52 Kaiser Permanente
Silver

(HMO) KP GA Silver 4500/35

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$383,06
$434,78
$489,56
$684,15
$1 039,64
$676,10
$727,82
$782,60
$977,19
$969,14
$1 020,86
$1 075,64
$1 270,23
$1 262,18
$1 313,90
$1 368,68
$1 563,27
$293,04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$766,12
$869,56
$979,12
$1 368,30
$2 079,28
$1 059,16
$1 162,60
$1 272,16
$1 661,34
$1 352,20
$1 455,64
$1 565,20
$1 954,38
$1 645,24
$1 748,68
$1 858,24
$2 247,42
$293,04
Toc - Plan #53 Kaiser Permanente
Gold

(HMO) KP GA Gold 1700/25

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-494-5314

Annual Out of Pocket Expenses:

Individual Family
$1,700 $3,400 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$385,69
$437,76
$492,92
$688,85
$1 046,77
$680,75
$732,82
$787,98
$983,91
$975,81
$1 027,88
$1 083,04
$1 278,97
$1 270,87
$1 322,94
$1 378,10
$1 574,03
$295,06
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$771,38
$875,52
$985,84
$1 377,70
$2 093,54
$1 066,44
$1 170,58
$1 280,90
$1 672,76
$1 361,50
$1 465,64
$1 575,96
$1 967,82
$1 656,56
$1 760,70
$1 871,02
$2 262,88
$295,06

‡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 Newton County here.

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

Currently, there are 53 plans offered in Rating Area 3.

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2021 Obamacare Plans for Newton County, GA

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