Obamacare 2021 Rates for Johnson County

Obamacare > Rates > Kansas > Johnson 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 Johnson County, KS.

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, 51 Plans and 2021 Rates for Johnson County, Kansas

Below, you’ll find a summary of the 51 plans for Johnson County, Kansas 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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Medica

Local: 1-888-592-8211 | Toll Free: 1-888-592-8211 | TTY: 1-866-735-2957

Toc - Plan #1 Medica
Gold

(EPO) Select by Medica Gold Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

Annual Out of Pocket Expenses:

Individual Family
$850 $2,550 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
$466,16
$529,08
$595,74
$832,54
$1 265,13
$822,76
$885,68
$952,34
$1 189,14
$1 179,36
$1 242,28
$1 308,94
$1 545,74
$1 535,96
$1 598,88
$1 665,54
$1 902,34
$356,60
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$932,32
$1 058,16
$1 191,48
$1 665,08
$2 530,26
$1 288,92
$1 414,76
$1 548,08
$2 021,68
$1 645,52
$1 771,36
$1 904,68
$2 378,28
$2 002,12
$2 127,96
$2 261,28
$2 734,88
$356,60
Toc - Plan #2 Medica
Silver

(EPO) Select by Medica Silver Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

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
$501,69
$569,40
$641,14
$895,99
$1 361,55
$885,47
$953,18
$1 024,92
$1 279,77
$1 269,25
$1 336,96
$1 408,70
$1 663,55
$1 653,03
$1 720,74
$1 792,48
$2 047,33
$383,78
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1 003,38
$1 138,80
$1 282,28
$1 791,98
$2 723,10
$1 387,16
$1 522,58
$1 666,06
$2 175,76
$1 770,94
$1 906,36
$2 049,84
$2 559,54
$2 154,72
$2 290,14
$2 433,62
$2 943,32
$383,78
Toc - Plan #3 Medica
Expanded Bronze

(EPO) Select by Medica Bronze H S A

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

Annual Out of Pocket Expenses:

Individual Family
$6,700 $13,400 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
$347,79
$394,73
$444,46
$621,13
$943,87
$613,84
$660,78
$710,51
$887,18
$879,89
$926,83
$976,56
$1 153,23
$1 145,94
$1 192,88
$1 242,61
$1 419,28
$266,05
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$695,58
$789,46
$888,92
$1 242,26
$1 887,74
$961,63
$1 055,51
$1 154,97
$1 508,31
$1 227,68
$1 321,56
$1 421,02
$1 774,36
$1 493,73
$1 587,61
$1 687,07
$2 040,41
$266,05
Toc - Plan #4 Medica
Catastrophic

(EPO) Select by Medica Catastrophic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

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
$229,02
$259,93
$292,68
$409,02
$621,54
$404,21
$435,12
$467,87
$584,21
$579,40
$610,31
$643,06
$759,40
$754,59
$785,50
$818,25
$934,59
$175,19
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$458,04
$519,86
$585,36
$818,04
$1 243,08
$633,23
$695,05
$760,55
$993,23
$808,42
$870,24
$935,74
$1 168,42
$983,61
$1 045,43
$1 110,93
$1 343,61
$175,19
Toc - Plan #5 Medica
Gold

(EPO) Select by Medica Gold Share

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

Annual Out of Pocket Expenses:

Individual Family
$550 $1,650 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
$463,17
$525,69
$591,92
$827,21
$1 257,03
$817,49
$880,01
$946,24
$1 181,53
$1 171,81
$1 234,33
$1 300,56
$1 535,85
$1 526,13
$1 588,65
$1 654,88
$1 890,17
$354,32
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$926,34
$1 051,38
$1 183,84
$1 654,42
$2 514,06
$1 280,66
$1 405,70
$1 538,16
$2 008,74
$1 634,98
$1 760,02
$1 892,48
$2 363,06
$1 989,30
$2 114,34
$2 246,80
$2 717,38
$354,32
Toc - Plan #6 Medica
Expanded Bronze

(EPO) Select by Medica Bronze Share Plus

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

Annual Out of Pocket Expenses:

Individual Family
$2,300 $6,900 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
$323,37
$367,01
$413,25
$577,52
$877,60
$570,74
$614,38
$660,62
$824,89
$818,11
$861,75
$907,99
$1 072,26
$1 065,48
$1 109,12
$1 155,36
$1 319,63
$247,37
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$646,74
$734,02
$826,50
$1 155,04
$1 755,20
$894,11
$981,39
$1 073,87
$1 402,41
$1 141,48
$1 228,76
$1 321,24
$1 649,78
$1 388,85
$1 476,13
$1 568,61
$1 897,15
$247,37
Toc - Plan #7 Medica
Bronze

(EPO) Select by Medica Bronze Value

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

Annual Out of Pocket Expenses:

Individual Family
$7,900 $15,800 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
$315,34
$357,90
$403,00
$563,19
$855,81
$556,57
$599,13
$644,23
$804,42
$797,80
$840,36
$885,46
$1 045,65
$1 039,03
$1 081,59
$1 126,69
$1 286,88
$241,23
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$630,68
$715,80
$806,00
$1 126,38
$1 711,62
$871,91
$957,03
$1 047,23
$1 367,61
$1 113,14
$1 198,26
$1 288,46
$1 608,84
$1 354,37
$1 439,49
$1 529,69
$1 850,07
$241,23
Toc - Plan #8 Medica
Expanded Bronze

(EPO) Select by Medica Bronze Copay Preferred Primary Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-592-8211

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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
$320,63
$363,90
$409,75
$572,62
$870,16
$565,90
$609,17
$655,02
$817,89
$811,17
$854,44
$900,29
$1 063,16
$1 056,44
$1 099,71
$1 145,56
$1 308,43
$245,27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$641,26
$727,80
$819,50
$1 145,24
$1 740,32
$886,53
$973,07
$1 064,77
$1 390,51
$1 131,80
$1 218,34
$1 310,04
$1 635,78
$1 377,07
$1 463,61
$1 555,31
$1 881,05
$245,27

ADVERTISEMENT

Oscar Insurance Company

Local: 1-855-672-2755 | Toll Free: 1-855-672-2755

Toc - Plan #9 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic PCP Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

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
$291,11
$330,40
$372,02
$519,90
$790,04
$513,80
$553,09
$594,71
$742,59
$736,49
$775,78
$817,40
$965,28
$959,18
$998,47
$1 040,09
$1 187,97
$222,69
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$582,22
$660,80
$744,04
$1 039,80
$1 580,08
$804,91
$883,49
$966,73
$1 262,49
$1 027,60
$1 106,18
$1 189,42
$1 485,18
$1 250,29
$1 328,87
$1 412,11
$1 707,87
$222,69
Toc - Plan #10 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

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
$298,81
$339,14
$381,87
$533,66
$810,95
$527,39
$567,72
$610,45
$762,24
$755,97
$796,30
$839,03
$990,82
$984,55
$1 024,88
$1 067,61
$1 219,40
$228,58
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$597,62
$678,28
$763,74
$1 067,32
$1 621,90
$826,20
$906,86
$992,32
$1 295,90
$1 054,78
$1 135,44
$1 220,90
$1 524,48
$1 283,36
$1 364,02
$1 449,48
$1 753,06
$228,58
Toc - Plan #11 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic Next

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$345,54
$392,18
$441,59
$617,12
$937,78
$609,87
$656,51
$705,92
$881,45
$874,20
$920,84
$970,25
$1 145,78
$1 138,53
$1 185,17
$1 234,58
$1 410,11
$264,33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$691,08
$784,36
$883,18
$1 234,24
$1 875,56
$955,41
$1 048,69
$1 147,51
$1 498,57
$1 219,74
$1 313,02
$1 411,84
$1 762,90
$1 484,07
$1 577,35
$1 676,17
$2 027,23
$264,33
Toc - Plan #12 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 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
$365,27
$414,56
$466,80
$652,35
$991,30
$644,69
$693,98
$746,22
$931,77
$924,11
$973,40
$1 025,64
$1 211,19
$1 203,53
$1 252,82
$1 305,06
$1 490,61
$279,42
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$730,54
$829,12
$933,60
$1 304,70
$1 982,60
$1 009,96
$1 108,54
$1 213,02
$1 584,12
$1 289,38
$1 387,96
$1 492,44
$1 863,54
$1 568,80
$1 667,38
$1 771,86
$2 142,96
$279,42
Toc - Plan #13 Oscar Insurance Company
Silver

(EPO) Oscar Silver Saver 2

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$6,200 $12,400 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
$358,78
$407,21
$458,51
$640,77
$973,71
$633,24
$681,67
$732,97
$915,23
$907,70
$956,13
$1 007,43
$1 189,69
$1 182,16
$1 230,59
$1 281,89
$1 464,15
$274,46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$717,56
$814,42
$917,02
$1 281,54
$1 947,42
$992,02
$1 088,88
$1 191,48
$1 556,00
$1 266,48
$1 363,34
$1 465,94
$1 830,46
$1 540,94
$1 637,80
$1 740,40
$2 104,92
$274,46
Toc - Plan #14 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic Next

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,000 $16,000 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
$367,13
$416,68
$469,18
$655,68
$996,37
$647,98
$697,53
$750,03
$936,53
$928,83
$978,38
$1 030,88
$1 217,38
$1 209,68
$1 259,23
$1 311,73
$1 498,23
$280,85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$734,26
$833,36
$938,36
$1 311,36
$1 992,74
$1 015,11
$1 114,21
$1 219,21
$1 592,21
$1 295,96
$1 395,06
$1 500,06
$1 873,06
$1 576,81
$1 675,91
$1 780,91
$2 153,91
$280,85
Toc - Plan #15 Oscar Insurance Company
Catastrophic

(EPO) Oscar Secure

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

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
$246,24
$279,48
$314,69
$439,78
$668,28
$434,61
$467,85
$503,06
$628,15
$622,98
$656,22
$691,43
$816,52
$811,35
$844,59
$879,80
$1 004,89
$188,37
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$492,48
$558,96
$629,38
$879,56
$1 336,56
$680,85
$747,33
$817,75
$1 067,93
$869,22
$935,70
$1 006,12
$1 256,30
$1 057,59
$1 124,07
$1 194,49
$1 444,67
$188,37
Toc - Plan #16 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic Next 2

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$345,59
$392,23
$441,65
$617,21
$937,91
$609,96
$656,60
$706,02
$881,58
$874,33
$920,97
$970,39
$1 145,95
$1 138,70
$1 185,34
$1 234,76
$1 410,32
$264,37
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$691,18
$784,46
$883,30
$1 234,42
$1 875,82
$955,55
$1 048,83
$1 147,67
$1 498,79
$1 219,92
$1 313,20
$1 412,04
$1 763,16
$1 484,29
$1 577,57
$1 676,41
$2 027,53
$264,37
Toc - Plan #17 Oscar Insurance Company
Gold

(EPO) Oscar Gold Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$6,000 $12,000 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
$395,90
$449,34
$505,95
$707,07
$1 074,45
$698,76
$752,20
$808,81
$1 009,93
$1 001,62
$1 055,06
$1 111,67
$1 312,79
$1 304,48
$1 357,92
$1 414,53
$1 615,65
$302,86
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$791,80
$898,68
$1 011,90
$1 414,14
$2 148,90
$1 094,66
$1 201,54
$1 314,76
$1 717,00
$1 397,52
$1 504,40
$1 617,62
$2 019,86
$1 700,38
$1 807,26
$1 920,48
$2 322,72
$302,86
Toc - Plan #18 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$5,200 $10,400 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
$306,66
$348,05
$391,90
$547,68
$832,25
$541,25
$582,64
$626,49
$782,27
$775,84
$817,23
$861,08
$1 016,86
$1 010,43
$1 051,82
$1 095,67
$1 251,45
$234,59
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$613,32
$696,10
$783,80
$1 095,36
$1 664,50
$847,91
$930,69
$1 018,39
$1 329,95
$1 082,50
$1 165,28
$1 252,98
$1 564,54
$1 317,09
$1 399,87
$1 487,57
$1 799,13
$234,59
Toc - Plan #19 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 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
$373,33
$423,72
$477,11
$666,75
$1 013,20
$658,92
$709,31
$762,70
$952,34
$944,51
$994,90
$1 048,29
$1 237,93
$1 230,10
$1 280,49
$1 333,88
$1 523,52
$285,59
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$746,66
$847,44
$954,22
$1 333,50
$2 026,40
$1 032,25
$1 133,03
$1 239,81
$1 619,09
$1 317,84
$1 418,62
$1 525,40
$1 904,68
$1 603,43
$1 704,21
$1 810,99
$2 190,27
$285,59
Toc - Plan #20 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic $0 Ded

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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
$383,71
$435,50
$490,37
$685,30
$1 041,37
$677,24
$729,03
$783,90
$978,83
$970,77
$1 022,56
$1 077,43
$1 272,36
$1 264,30
$1 316,09
$1 370,96
$1 565,89
$293,53
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$767,42
$871,00
$980,74
$1 370,60
$2 082,74
$1 060,95
$1 164,53
$1 274,27
$1 664,13
$1 354,48
$1 458,06
$1 567,80
$1 957,66
$1 648,01
$1 751,59
$1 861,33
$2 251,19
$293,53

ADVERTISEMENT

Cigna Healthcare

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777

Toc - Plan #21 Cigna Healthcare
Bronze

(EPO) Cigna Connect 6500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 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
$337,05
$382,55
$430,75
$601,97
$914,76
$594,89
$640,39
$688,59
$859,81
$852,73
$898,23
$946,43
$1 117,65
$1 110,57
$1 156,07
$1 204,27
$1 375,49
$257,84
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$674,10
$765,10
$861,50
$1 203,94
$1 829,52
$931,94
$1 022,94
$1 119,34
$1 461,78
$1 189,78
$1 280,78
$1 377,18
$1 719,62
$1 447,62
$1 538,62
$1 635,02
$1 977,46
$257,84
Toc - Plan #22 Cigna Healthcare
Expanded Bronze

(EPO) Cigna Connect 5900

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 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
$353,29
$400,99
$451,51
$630,98
$958,84
$623,56
$671,26
$721,78
$901,25
$893,83
$941,53
$992,05
$1 171,52
$1 164,10
$1 211,80
$1 262,32
$1 441,79
$270,27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$706,58
$801,98
$903,02
$1 261,96
$1 917,68
$976,85
$1 072,25
$1 173,29
$1 532,23
$1 247,12
$1 342,52
$1 443,56
$1 802,50
$1 517,39
$1 612,79
$1 713,83
$2 072,77
$270,27
Toc - Plan #23 Cigna Healthcare
Silver

(EPO) Cigna Connect 5200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$5,200 $10,400 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
$419,53
$476,17
$536,17
$749,29
$1 138,62
$740,47
$797,11
$857,11
$1 070,23
$1 061,41
$1 118,05
$1 178,05
$1 391,17
$1 382,35
$1 438,99
$1 498,99
$1 712,11
$320,94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$839,06
$952,34
$1 072,34
$1 498,58
$2 277,24
$1 160,00
$1 273,28
$1 393,28
$1 819,52
$1 480,94
$1 594,22
$1 714,22
$2 140,46
$1 801,88
$1 915,16
$2 035,16
$2 461,40
$320,94
Toc - Plan #24 Cigna Healthcare
Silver

(EPO) Cigna Connect 4200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$4,200 $8,400 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
$418,46
$474,95
$534,79
$747,36
$1 135,69
$738,58
$795,07
$854,91
$1 067,48
$1 058,70
$1 115,19
$1 175,03
$1 387,60
$1 378,82
$1 435,31
$1 495,15
$1 707,72
$320,12
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$836,92
$949,90
$1 069,58
$1 494,72
$2 271,38
$1 157,04
$1 270,02
$1 389,70
$1 814,84
$1 477,16
$1 590,14
$1 709,82
$2 134,96
$1 797,28
$1 910,26
$2 029,94
$2 455,08
$320,12
Toc - Plan #25 Cigna Healthcare
Gold

(EPO) Cigna Connect 750

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 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
$513,26
$582,55
$655,94
$916,67
$1 392,98
$905,90
$975,19
$1 048,58
$1 309,31
$1 298,54
$1 367,83
$1 441,22
$1 701,95
$1 691,18
$1 760,47
$1 833,86
$2 094,59
$392,64
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1 026,52
$1 165,10
$1 311,88
$1 833,34
$2 785,96
$1 419,16
$1 557,74
$1 704,52
$2 225,98
$1 811,80
$1 950,38
$2 097,16
$2 618,62
$2 204,44
$2 343,02
$2 489,80
$3 011,26
$392,64
Toc - Plan #26 Cigna Healthcare
Bronze

(EPO) Cigna Connect 8550

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

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
$339,26
$385,06
$433,57
$605,92
$920,75
$598,79
$644,59
$693,10
$865,45
$858,32
$904,12
$952,63
$1 124,98
$1 117,85
$1 163,65
$1 212,16
$1 384,51
$259,53
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$678,52
$770,12
$867,14
$1 211,84
$1 841,50
$938,05
$1 029,65
$1 126,67
$1 471,37
$1 197,58
$1 289,18
$1 386,20
$1 730,90
$1 457,11
$1 548,71
$1 645,73
$1 990,43
$259,53
Toc - Plan #27 Cigna Healthcare
Silver

(EPO) Cigna Connect 3500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 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
$420,76
$477,56
$537,73
$751,48
$1 141,95
$742,64
$799,44
$859,61
$1 073,36
$1 064,52
$1 121,32
$1 181,49
$1 395,24
$1 386,40
$1 443,20
$1 503,37
$1 717,12
$321,88
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$841,52
$955,12
$1 075,46
$1 502,96
$2 283,90
$1 163,40
$1 277,00
$1 397,34
$1 824,84
$1 485,28
$1 598,88
$1 719,22
$2 146,72
$1 807,16
$1 920,76
$2 041,10
$2 468,60
$321,88
Toc - Plan #28 Cigna Healthcare
Silver

(EPO) Cigna Connect 3500 Diabetes Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 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
$421,94
$478,90
$539,24
$753,58
$1 145,14
$744,72
$801,68
$862,02
$1 076,36
$1 067,50
$1 124,46
$1 184,80
$1 399,14
$1 390,28
$1 447,24
$1 507,58
$1 721,92
$322,78
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$843,88
$957,80
$1 078,48
$1 507,16
$2 290,28
$1 166,66
$1 280,58
$1 401,26
$1 829,94
$1 489,44
$1 603,36
$1 724,04
$2 152,72
$1 812,22
$1 926,14
$2 046,82
$2 475,50
$322,78

ADVERTISEMENT

Ambetter from Sunflower Health Plan

Local: 1-844-518-9505 | Toll Free: 

Toc - Plan #29 Ambetter from Sunflower Health Plan
Bronze

(HMO) Ambetter Essential Care 1 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$294,71
$334,48
$376,62
$526,33
$799,81
$520,15
$559,92
$602,06
$751,77
$745,59
$785,36
$827,50
$977,21
$971,03
$1 010,80
$1 052,94
$1 202,65
$225,44
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$589,42
$668,96
$753,24
$1 052,66
$1 599,62
$814,86
$894,40
$978,68
$1 278,10
$1 040,30
$1 119,84
$1 204,12
$1 503,54
$1 265,74
$1 345,28
$1 429,56
$1 728,98
$225,44
Toc - Plan #30 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 11 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$365,28
$414,58
$466,81
$652,37
$991,34
$644,71
$694,01
$746,24
$931,80
$924,14
$973,44
$1 025,67
$1 211,23
$1 203,57
$1 252,87
$1 305,10
$1 490,66
$279,43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$730,56
$829,16
$933,62
$1 304,74
$1 982,68
$1 009,99
$1 108,59
$1 213,05
$1 584,17
$1 289,42
$1 388,02
$1 492,48
$1 863,60
$1 568,85
$1 667,45
$1 771,91
$2 143,03
$279,43
Toc - Plan #31 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 4 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$377,20
$428,11
$482,05
$673,66
$1 023,69
$665,75
$716,66
$770,60
$962,21
$954,30
$1 005,21
$1 059,15
$1 250,76
$1 242,85
$1 293,76
$1 347,70
$1 539,31
$288,55
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$754,40
$856,22
$964,10
$1 347,32
$2 047,38
$1 042,95
$1 144,77
$1 252,65
$1 635,87
$1 331,50
$1 433,32
$1 541,20
$1 924,42
$1 620,05
$1 721,87
$1 829,75
$2 212,97
$288,55
Toc - Plan #32 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 12 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$359,13
$407,60
$458,96
$641,39
$974,65
$633,86
$682,33
$733,69
$916,12
$908,59
$957,06
$1 008,42
$1 190,85
$1 183,32
$1 231,79
$1 283,15
$1 465,58
$274,73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$718,26
$815,20
$917,92
$1 282,78
$1 949,30
$992,99
$1 089,93
$1 192,65
$1 557,51
$1 267,72
$1 364,66
$1 467,38
$1 832,24
$1 542,45
$1 639,39
$1 742,11
$2 106,97
$274,73
Toc - Plan #33 Ambetter from Sunflower Health Plan
Gold

(HMO) Ambetter Secure Care 5 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$405,52
$460,26
$518,25
$724,25
$1 100,56
$715,74
$770,48
$828,47
$1 034,47
$1 025,96
$1 080,70
$1 138,69
$1 344,69
$1 336,18
$1 390,92
$1 448,91
$1 654,91
$310,22
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$811,04
$920,52
$1 036,50
$1 448,50
$2 201,12
$1 121,26
$1 230,74
$1 346,72
$1 758,72
$1 431,48
$1 540,96
$1 656,94
$2 068,94
$1 741,70
$1 851,18
$1 967,16
$2 379,16
$310,22
Toc - Plan #34 Ambetter from Sunflower Health Plan
Expanded Bronze

(HMO) Ambetter Essential Care 2 HSA (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$320,02
$363,21
$408,97
$571,53
$868,50
$564,82
$608,01
$653,77
$816,33
$809,62
$852,81
$898,57
$1 061,13
$1 054,42
$1 097,61
$1 143,37
$1 305,93
$244,80
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$640,04
$726,42
$817,94
$1 143,06
$1 737,00
$884,84
$971,22
$1 062,74
$1 387,86
$1 129,64
$1 216,02
$1 307,54
$1 632,66
$1 374,44
$1 460,82
$1 552,34
$1 877,46
$244,80
Toc - Plan #35 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 24 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

Annual Out of Pocket Expenses:

Individual Family
$7,450 $14,900 Annual Deductible
$7,450 $14,900 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
$371,84
$422,03
$475,20
$664,09
$1 009,15
$656,29
$706,48
$759,65
$948,54
$940,74
$990,93
$1 044,10
$1 232,99
$1 225,19
$1 275,38
$1 328,55
$1 517,44
$284,45
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$743,68
$844,06
$950,40
$1 328,18
$2 018,30
$1 028,13
$1 128,51
$1 234,85
$1 612,63
$1 312,58
$1 412,96
$1 519,30
$1 897,08
$1 597,03
$1 697,41
$1 803,75
$2 181,53
$284,45
Toc - Plan #36 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 27 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$392,17
$445,10
$501,18
$700,40
$1 064,33
$692,17
$745,10
$801,18
$1 000,40
$992,17
$1 045,10
$1 101,18
$1 300,40
$1 292,17
$1 345,10
$1 401,18
$1 600,40
$300,00
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$784,34
$890,20
$1 002,36
$1 400,80
$2 128,66
$1 084,34
$1 190,20
$1 302,36
$1 700,80
$1 384,34
$1 490,20
$1 602,36
$2 000,80
$1 684,34
$1 790,20
$1 902,36
$2 300,80
$300,00
Toc - Plan #37 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 28 (2021)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$389,83
$442,45
$498,19
$696,22
$1 057,98
$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
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$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
$298,21
Toc - Plan #38 Ambetter from Sunflower Health Plan
Bronze

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$308,28
$349,89
$393,97
$550,58
$836,66
$544,11
$585,72
$629,80
$786,41
$779,94
$821,55
$865,63
$1 022,24
$1 015,77
$1 057,38
$1 101,46
$1 258,07
$235,83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$616,56
$699,78
$787,94
$1 101,16
$1 673,32
$852,39
$935,61
$1 023,77
$1 336,99
$1 088,22
$1 171,44
$1 259,60
$1 572,82
$1 324,05
$1 407,27
$1 495,43
$1 808,65
$235,83
Toc - Plan #39 Ambetter from Sunflower Health Plan
Gold

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$424,21
$481,46
$542,12
$757,62
$1 151,27
$748,72
$805,97
$866,63
$1 082,13
$1 073,23
$1 130,48
$1 191,14
$1 406,64
$1 397,74
$1 454,99
$1 515,65
$1 731,15
$324,51
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$848,42
$962,92
$1 084,24
$1 515,24
$2 302,54
$1 172,93
$1 287,43
$1 408,75
$1 839,75
$1 497,44
$1 611,94
$1 733,26
$2 164,26
$1 821,95
$1 936,45
$2 057,77
$2 488,77
$324,51
Toc - Plan #40 Ambetter from Sunflower Health Plan
Silver

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$394,58
$447,83
$504,25
$704,69
$1 070,85
$696,42
$749,67
$806,09
$1 006,53
$998,26
$1 051,51
$1 107,93
$1 308,37
$1 300,10
$1 353,35
$1 409,77
$1 610,21
$301,84
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$789,16
$895,66
$1 008,50
$1 409,38
$2 141,70
$1 091,00
$1 197,50
$1 310,34
$1 711,22
$1 392,84
$1 499,34
$1 612,18
$2 013,06
$1 694,68
$1 801,18
$1 914,02
$2 314,90
$301,84
Toc - Plan #41 Ambetter from Sunflower Health Plan
Silver

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$382,11
$433,68
$488,32
$682,43
$1 037,01
$674,41
$725,98
$780,62
$974,73
$966,71
$1 018,28
$1 072,92
$1 267,03
$1 259,01
$1 310,58
$1 365,22
$1 559,33
$292,30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$764,22
$867,36
$976,64
$1 364,86
$2 074,02
$1 056,52
$1 159,66
$1 268,94
$1 657,16
$1 348,82
$1 451,96
$1 561,24
$1 949,46
$1 641,12
$1 744,26
$1 853,54
$2 241,76
$292,30
Toc - Plan #42 Ambetter from Sunflower Health Plan
Expanded Bronze

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$334,76
$379,94
$427,81
$597,86
$908,51
$590,84
$636,02
$683,89
$853,94
$846,92
$892,10
$939,97
$1 110,02
$1 103,00
$1 148,18
$1 196,05
$1 366,10
$256,08
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$669,52
$759,88
$855,62
$1 195,72
$1 817,02
$925,60
$1 015,96
$1 111,70
$1 451,80
$1 181,68
$1 272,04
$1 367,78
$1 707,88
$1 437,76
$1 528,12
$1 623,86
$1 963,96
$256,08
Toc - Plan #43 Ambetter from Sunflower Health Plan
Silver

(HMO) Ambetter Balanced Care 24 (2021) + Vision + Adult Dental

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

Annual Out of Pocket Expenses:

Individual Family
$7,450 $14,900 Annual Deductible
$7,450 $14,900 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
$388,97
$441,47
$497,09
$694,69
$1 055,65
$686,53
$739,03
$794,65
$992,25
$984,09
$1 036,59
$1 092,21
$1 289,81
$1 281,65
$1 334,15
$1 389,77
$1 587,37
$297,56
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$777,94
$882,94
$994,18
$1 389,38
$2 111,30
$1 075,50
$1 180,50
$1 291,74
$1 686,94
$1 373,06
$1 478,06
$1 589,30
$1 984,50
$1 670,62
$1 775,62
$1 886,86
$2 282,06
$297,56
Toc - Plan #44 Ambetter from Sunflower Health Plan
Silver

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$410,24
$465,61
$524,27
$732,67
$1 113,36
$724,07
$779,44
$838,10
$1 046,50
$1 037,90
$1 093,27
$1 151,93
$1 360,33
$1 351,73
$1 407,10
$1 465,76
$1 674,16
$313,83
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$820,48
$931,22
$1 048,54
$1 465,34
$2 226,72
$1 134,31
$1 245,05
$1 362,37
$1 779,17
$1 448,14
$1 558,88
$1 676,20
$2 093,00
$1 761,97
$1 872,71
$1 990,03
$2 406,83
$313,83
Toc - Plan #45 Ambetter from Sunflower Health Plan
Silver

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

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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
$407,79
$462,83
$521,15
$728,30
$1 106,72
$719,74
$774,78
$833,10
$1 040,25
$1 031,69
$1 086,73
$1 145,05
$1 352,20
$1 343,64
$1 398,68
$1 457,00
$1 664,15
$311,95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$815,58
$925,66
$1 042,30
$1 456,60
$2 213,44
$1 127,53
$1 237,61
$1 354,25
$1 768,55
$1 439,48
$1 549,56
$1 666,20
$2 080,50
$1 751,43
$1 861,51
$1 978,15
$2 392,45
$311,95

ADVERTISEMENT

Blue Cross and Blue Shield of Kansas City

Local: 1-816-395-3558 | Toll Free: 1-888-800-4478

Toc - Plan #46 Blue Cross and Blue Shield of Kansas City
Expanded Bronze

(EPO) Blue KC Spira Care BlueSelectÊPlus 7300Ê(Spira Care Center: $0 Cost Share Office Visits,ÊLabs & X-Rays;ÊTelehealth: $0 Copay Primary Care Office Visit &Behavioral Health Therapy; $0 Preventive Care)Ê

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$7,300 $14,600 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
$338,90
$384,65
$433,12
$605,28
$919,78
$598,16
$643,91
$692,38
$864,54
$857,42
$903,17
$951,64
$1 123,80
$1 116,68
$1 162,43
$1 210,90
$1 383,06
$259,26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$677,80
$769,30
$866,24
$1 210,56
$1 839,56
$937,06
$1 028,56
$1 125,50
$1 469,82
$1 196,32
$1 287,82
$1 384,76
$1 729,08
$1 455,58
$1 547,08
$1 644,02
$1 988,34
$259,26
Toc - Plan #47 Blue Cross and Blue Shield of Kansas City
Silver

(EPO) Blue KC Spira Care BlueSelect Plus 5000Ê(Spira Care Center: $0 Cost Share Office Visits,ÊLabs & X-Rays;ÊTelehealth: $0 Copay Primary Care Office Visit &Behavioral Health Therapy; $0 Preventive Care)Ê

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 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
$477,88
$542,40
$610,73
$853,50
$1 296,97
$843,46
$907,98
$976,31
$1 219,08
$1 209,04
$1 273,56
$1 341,89
$1 584,66
$1 574,62
$1 639,14
$1 707,47
$1 950,24
$365,58
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$955,76
$1 084,80
$1 221,46
$1 707,00
$2 593,94
$1 321,34
$1 450,38
$1 587,04
$2 072,58
$1 686,92
$1 815,96
$1 952,62
$2 438,16
$2 052,50
$2 181,54
$2 318,20
$2 803,74
$365,58
Toc - Plan #48 Blue Cross and Blue Shield of Kansas City
Gold

(EPO) BlueÊKCÊCommunity BlueSelect 1250Ê(Telehealth: $10 Copay for Primary Care Office Visit & Behavioral Health Therapy;Ê$0ÊPreventive Care)Ê

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$1,250 $2,500 Annual Deductible
$6,250 $12,500 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
$455,72
$517,24
$582,41
$813,91
$1 236,82
$804,34
$865,86
$931,03
$1 162,53
$1 152,96
$1 214,48
$1 279,65
$1 511,15
$1 501,58
$1 563,10
$1 628,27
$1 859,77
$348,62
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$911,44
$1 034,48
$1 164,82
$1 627,82
$2 473,64
$1 260,06
$1 383,10
$1 513,44
$1 976,44
$1 608,68
$1 731,72
$1 862,06
$2 325,06
$1 957,30
$2 080,34
$2 210,68
$2 673,68
$348,62
Toc - Plan #49 Blue Cross and Blue Shield of Kansas City
Silver

(EPO) Blue KC Spira Care BlueSelect 5000 ($0 Cost Share Office Visits, Labs & X-Rays at Spira Care Centers; Telehealth: $0 Copay Primary Care Office Visit & Behavioral Health Therapy; $0 Preventive Care)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 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
$415,01
$471,04
$530,39
$741,21
$1 126,34
$732,49
$788,52
$847,87
$1 058,69
$1 049,97
$1 106,00
$1 165,35
$1 376,17
$1 367,45
$1 423,48
$1 482,83
$1 693,65
$317,48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$830,02
$942,08
$1 060,78
$1 482,42
$2 252,68
$1 147,50
$1 259,56
$1 378,26
$1 799,90
$1 464,98
$1 577,04
$1 695,74
$2 117,38
$1 782,46
$1 894,52
$2 013,22
$2 434,86
$317,48
Toc - Plan #50 Blue Cross and Blue Shield of Kansas City
Expanded Bronze

(EPO) Blue KC Spira Care BlueSelect 7300 ($0 Cost Share Office Visits, Labs & X-Rays at Spira Care Centers; Telehealth: $0 Copay Primary Care Office Visit & Behavioral Health Therapy; $0 Preventive Care)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$7,300 $14,600 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
$294,32
$334,05
$376,14
$525,65
$798,78
$519,47
$559,20
$601,29
$750,80
$744,62
$784,35
$826,44
$975,95
$969,77
$1 009,50
$1 051,59
$1 201,10
$225,15
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$588,64
$668,10
$752,28
$1 051,30
$1 597,56
$813,79
$893,25
$977,43
$1 276,45
$1 038,94
$1 118,40
$1 202,58
$1 501,60
$1 264,09
$1 343,55
$1 427,73
$1 726,75
$225,15
Toc - Plan #51 Blue Cross and Blue Shield of Kansas City
Gold

(EPO) BlueÊKCÊCommunity BlueSelectÊPlus 1250 (Telehealth: $10 Copay for Primary Care Office Visit & Behavioral Health Therapy;Ê$0ÊPreventive Care)Ê

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-800-4478

Annual Out of Pocket Expenses:

Individual Family
$1,250 $2,500 Annual Deductible
$6,250 $12,500 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
$524,76
$595,60
$670,64
$937,22
$1 424,20
$926,20
$997,04
$1 072,08
$1 338,66
$1 327,64
$1 398,48
$1 473,52
$1 740,10
$1 729,08
$1 799,92
$1 874,96
$2 141,54
$401,44
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1 049,52
$1 191,20
$1 341,28
$1 874,44
$2 848,40
$1 450,96
$1 592,64
$1 742,72
$2 275,88
$1 852,40
$1 994,08
$2 144,16
$2 677,32
$2 253,84
$2 395,52
$2 545,60
$3 078,76
$401,44

‡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 Johnson County here.

Johnson County is in “Rating Area 1” of Kansas.

Currently, there are 51 plans offered in Rating Area 1.

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2021 Obamacare Plans for Johnson County, KS

Plan Browser: 51 Plans
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